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Topics: DVLA Questionnaires & CNSGP indemnity; Suffolk LMC Survey; Flu Vaccs for frontline practice staff; BMA Update
Information, Guidance and News
DVLA Medical Questionnaires and CNSGP Indemnity Cover
Completing DVLA’s medical questionnaires is not part of the NHS contract so DVLA pays NHS healthcare professionals for completing each questionnaire. As completion of these questionnaires is a private service, it is not compulsory for GPs or healthcare professionals to complete them.
As the work is non-NHS it is not covered by the CNSGP indemnity cover, until now GPs have protected themselves by seeking Private Work cover from their MDO. Some MDOs charge for this additional cover and others automatically include this cover. However, LMCs have now become aware of a GP being sued by a patient as a result of a submitted DVLA questionnaire that caused the removal of the patient’s HGV licence. In this case the MDO stated that such work was not covered even under Private Work cover. GPC are in urgent discussions with the MDOs to clarify why this work has been deemed non-clinical and therefore decline. We will update practices as soon as possible.
Last chance to complete the Suffolk LMC survey!
We would love to hear from as many GPs as possible about what is important to you and how we can shape our future plans to meet your needs.
“Dear Suffolk GP colleagues
My name is Dr Sarah Caston and I qualified as a GP here in Suffolk through the Ipswich VTS scheme. I first joined the Suffolk LMC as a trainee and I am now a Board Member representing Mid Suffolk.
I am writing to ask for your help with a development project I am undertaking as part of the New to Practice Fellowship. We know from your feedback that many of you would like a higher level of engagement with Suffolk LMC and that, in these challenging times, a strong, coherent voice is needed, more than ever. There is work to be done to better represent different groups of GPs across the county. We would like to talk to you more, to have more opportunities to listen and to strengthen our collective voice.
Our first step is to ask you, the constituent GPs of Suffolk, what your thoughts are about where we are now and where we want to be. We are a small county with small numbers of backroom staff, but we are committed to building up a strong relationship with the GPs working in our beautiful county. I would be very grateful if you could take a moment to fill in a short survey. Even if you don’t know anything about the LMC, this is useful for us to know! If you have any thoughts that are not addressed by the survey, you are very welcome to contact me directly – sarah.caston@nhs.net “
Please do click on the link: https://forms.office.com/r/ZsMs0EcZ8S
The administration of the 2023/24 flu vaccine by practice staff to frontline patient-facing staff working in general practice.
It has now been confirmed that this will be eligible for cover under CNSGP.
The Enhanced Service (ES) Specification – Seasonal influenza vaccination programme 2023/24 has been updated to enable practices to offer their frontline patient-facing staff working in general practice a flu vaccination, effective from 1 September 2023. This covers frontline patient-facing staff who are either registered with the GP practice or not registered with the GP practice (therefore including peer to peer vaccinations), and who elect to receive their vaccination from the GP practice.
As the service is offered and provided under the terms of the seasonal influenza vaccination enhanced service specification and therefore under a primary medical services contract (GMS, PMS, APMS or Schedule 2L provisions under an NHS Standard Contract) the activity falls within the scope of the Clinical Negligence Scheme for General Practice (CNSGP).
BMA GPC Update
COVID vaccination programme update
NHS England has announced new changes to the previously published winter covid vaccination guidance, as part of an ‘accelerated programme’. Following the earlier notification of a reduction to covid fee payments, there will now be time limited ‘accelerated payments’ offered to bring forward the covid vaccination programme to 11 September for completion by the end of October (this relates to the enhanced fees and vaccination can continue after 31 October, but at the reduced IoS fee of £7.54). NHSE guidance states:
‘Vaccine providers will receive an additional payment of £10 (in addition to the Item of Service (IoS) fee) for each COVID-19 vaccination administered to care home residents between Monday 11 September and Sunday 22 October 2023 inclusive; and a separate one-off additional payment of £200 for each Completed Care Home by the end of the day on Sunday 22 October.
For other eligible groups, vaccine providers will receive an additional £5 acceleration payment (in addition to the IoS fee) will be made available for each COVID-19 vaccination administered to eligible people between 11 September and 31 October 2023’.
In line with previous BMA guidance, we continue to advise practices to consider and assure themselves of the financial viability of participating in the COVID vaccination programme under these shortened time frames.
Accelerated Access to Records Programme update
GPC England continues to support patients taking a proactive role in the management of their own health. This could be facilitated through access to a patient’s own electronic health records. Following the imposition of the 2023/24 GMS contract, the Accelerated Access to Records Programme is currently scheduled to go live for all patients on 1 November 2023. From that date, patients in England will be given prospective access to information entered into their GP record.
However, GPC England believe there are patient safety and information governance concerns that remain outstanding, and which need to be addressed. For this programme to be successful and fulfil its potential we believe it should not be rolled out in a ‘big bang’ style on 1 November. Practices need to be given the appropriate time and resources to safely plan this in each practice across England, and we continue to press for this as well as further modifications.
Rollout dates
We are aware that EMIS have shared training dates to facilitate their ‘bulk upload’ and they are encouraging EMIS practices to use the new functionality which has been paid for by NHS England. Earlier this year, many practices wrote to system suppliers to turn this functionality off.
We will publish comprehensive advice and guidance for all practices and will continue to set out concerns and solutions to Government ministers. We will also be engaging with EMIS and TPP to ascertain how they can best support GPs with respect to bulk uploads in the lead up to and after the proposed switch on date.
We would therefore reassure practices that they have time to consider matters, and contractors do not need to make any quick decisions before our guidance has been published.
GP pressures
GP practices in England are experiencing significant and growing strain with declining GP numbers, rising demand, struggles to recruit and retain staff and knock-on effects for patients.
The latest GP workforce data showed that the number of fully qualified GPs has dropped since September 2015. In July 2023, the NHS in England had the equivalent of 27,177 fully qualified full-time GPs, which is 2,187 fewer than in September 2015.
The longer-term trend shows that the NHS is losing GPs at an alarming rate: over the past year (between July 2022 and July 2023) it lost the equivalent of 330 fully qualified full-time GPs and the equivalent of 358 full-time partners. This means that, on average, the NHS lost 28 fully qualified FTE GPs per month over the past year.
The number of GP practices in England has decreased by 102 over the past year – reflecting a long-term trend of closures as well as mergers primarily due to a lack of workforce. This coincides with a rise in patients. As of July 2023, there was another average of 9,834 patients registered per practice, and as a result, the average number of patients each full-time equivalent GP is responsible for continues to rise, and now stands at 2,305. This is an increase of 367 patients per GP, or 19%, since 2015, demonstrating the ever-mounting workload in general practice.
Wes Streeting proposal to pay GPs more to allow patients to see the doctor of their choice
Responding to shadow health secretary Wes Streeting’s proposal to pay GPs more to allow patients to see the doctor of their choice, Dr Katie Bramall-Stainer, chair of GPC England, said:
“Mr Streeting was correct to say fewer patients were now able to see a doctor of their choice, but argued it was vital to see this in the context of 2,200 full-time GP posts being lost since 2015.
Combine this workforce exodus where GPs at breaking point are retraining, taking on other roles or leaving entirely with millions of patients on NHS waiting lists and we have the perfect storm.
Every GP strives to deliver the best care to our patients in the most appropriate way we can based on patient choice, but the reality of the chronic workforce shortage makes this an impossible ask against the backdrop of increasing demand from a growing – and ageing – population.
” Every day over a million appointments are delivered across England, way more than even before the Pandemic – with less staff. GPs regularly see more patients than our safe working guidance recommends. And yet, we still cannot keep pace with demand.
Junior doctor re-ballot results
The results of the junior doctor re-ballot are now in and we are pleased to confirm that their mandate for strike action has been extended for a further six months. Junior doctors are not prepared to let 15 years of real-terms pay cuts stand. Now with this renewed mandate, junior doctors, including GP trainees, and consultants will take joint action for the first time. The key dates are 19 – 22 September and 2 – 4 October and you can find full details on the BMA website.
Best Practice Show, 11-12 October 2023, NEC Birmingham
This year the BMA and GPC England will be at Best Practice Show, UK’s number one event for the primary care and general practice community, at the NEC Birmingham on 11-12 October 2023. GPC England will have a dedicated theatre at the conference, with a programme focussed on the most pressing issues facing sessional GPs and GP partners including safe working and workload management, patient access to records, the future of general practice, GP contracts and more. Free for healthcare professionals, the conference programme will provide up to 12 hours of CPD certified training, expertly tailored to meet the training requirements of healthcare professionals. If you are interested in attending, you can register here.
