District Valuer Visits

Some practices will have had a recent visit from the District Valuer. The approach taken at these visits was to identify practice accommodation which was used by services other than the practice delivering GMC services. This included such things as midwives, health visitors, district nurses, phlebotomy, speech and language, audiology, retinopathy screening, community/secondary care physiotherapy, drug and alcohol services/counsellors, mental health services/counsellors, CCG pharmacy technicians, CAB, Age UK, Sightsavers, Scope and Sense.

The Valuer proposed reducing the reimbursements to practices by a proportion equal to the area and time used. Practices were told that they had to pursue those service providers to make up the differenc e in reimbursement. This left practices in an invidious position as services may not have had budgeted for this sudden charge. NHS England has since revised this practice. They now say that they will not lower reimbursement for services commissioned by CCGs. These include physiotherapist, chiropody, optician, pharmacy, beautician, sports massage and laser treatment.

Practices are required to submit claims in August. All claims should be submitted in keeping with previous practices. If any practice has submitted claims already on the basis of the District Valuer changed reimbursement they should resubmit or contact admin@sandwelllmc.com


Secondary Care DNA’s

https://www.england.nhs.uk/wp-content/uploads/2017/07/interface-between-primary-secondary-care.pdf

Managing DNAs and Re-referrals
Where providers automatically discharge all patients who do not attend a clinic appointment back to their GP, this can create inconvenience and delays for patients and cause significant additional work for practices in simply re-referring many of the patients. Provider procedures for managing DNAs are set out in local access policies, which are published on their websites. The contract requires that a provider’s local access policy must not involve blanket administrative policies under which all DNAs are automatically discharged; rather, any decisions to discharge are to be made by providers on the basis of clinical advice about the individual patient’s circumstances.


Feedback from Sandwell LMC AGM / Open Meeting (12.6.17)

Sandwell LMC recently held an open meeting where the main topics were IR35, work place pensions, and the PCCF.

The guest speaker was Justin Quinton (Senior Solicitor, BMA Law). Justin provided a useful overview of IR35 and workplace pensions.

The key messages included;

– Be aware of the employment status of individuals you engage.
– Make sure your practice has a written contract in place.
– Seek advice on workplace pensions.

The presentation delivered at the meeting is available upon request.


New GPC Guidance on the MCP alliance agreement for “virtual “ MCPs

Guidance is now available at this link. There will be further guidance on the other two proposed MCP models.


LMC Conference – May 2017

The BMA local medical committees’ annual conference took place on 18 and 19 May in Edinburgh, bringing together representatives from across the UK to debate a range of issues that affect general practice. Sandwell LMC sent two representatives to this conference; Dr Raymond Sullivan and Dr Binod Choudhary.

The crisis in general practice continued to be the main concern of delegates. Drs Sullivan and Choudhary both spoke on this subject and on the over complicating regulation complaints procedures.

Please click the link to read the BMA Chair’s latest newsletter which in this edition, amongst other issues, focuses on the LMC Conference.


Police requests for medical notes from general practice

The BMA has received new legal advice regarding medical note requests received from the police, which are detailed below. There is clear guidance regarding the obligations that GPs have with respect to copying and/or release of the GP record. For your reference, these circumstances are:

  • If the police do not have a court order or warrant they may request voluntary disclosure of a patient’s health records under section 29 of the Data Protection Act 1998.
  • However, while health professionals have the power to disclose the records to the police where section 29 applies, there is no obligation to do so.
  • In such cases health professionals remain bound by the long-established common law duty of confidentiality and may only disclose information where the patient has given consent, or there is an overriding public interest. They may also be required to defend their decision to disclose before the GMC which is a statutory tribunal.
  • Disclosures in the public interest based on common law are made where disclosure is essential to prevent a serious threat to public health, national security, the life of the individual or a third party, or to prevent or detect serious crime. This includes crimes such as murder, manslaughter, rape, treason, kidnapping and abuse of children or other vulnerable people. Serious harm to the security of the state or to public order and serious fraud will also fall into this category.

Your practice is entitled to a fee for producing the notes. There is no set fee for produc ing these notes, as they are not considered a subject access request that you may receive from a patient. Therefore the practice is able to set its own fee. It is vital that the police agree in writing to pay the fee, otherwise you will not be able to claim for the service. If the police authority does not agree to pay the GP can decide whether they would like to provide the service free of charge, or not at all.

In order for you to proceed with the police request, it is recommended that a pro forma is complete and sent to the police authority.

Please note that if the police authorities have a court order or warrant for disclosure of the records, you may be required to comply with the request even where a fee has not been paid or agreed. This will depend on a number of factors, including the terms of the court order or warrant.

GPs should, in all cases where there is no patient consent, consider whether the benefits to an individual or to society of disclosing the records outweigh both the public and the patient’s interest in keeping the information confidential before agreeing to disclose the records.

For any queries please email info.professionalfees@bma.org.uk


2016 Junior Doctor Contract: Guidance for GP Practices

Please find attached guidance for GP practices on the 2016 junior doctor contract. The BMA remains in dispute with the government about the imposition of the contract and is providing practical advice and support for those affected.

https://www.bma.org.uk/advice/employment/gp-practices/gps-and-staff/guidance-for-gp-practices-on-the-2016-junior-doctors-contract