Bulletin 134

21.02.2012

Revalidation
It is currently expected that, subject to an assessment in the Summer, the revalidation legislation will be enabled in December and doctors will start to undergo the revalidation process from early 2013. PCTs should, therefore, not be implementing new appraisal frameworks on this basis.  We will notify you once we are aware when new appraisal processes may commence but, until this time, please notify the LMC if you experience any changes to your appraisal under the guise of the planned introduction of revalidation.

Guidance on Commissioning Support
The GPC have produced this Commissioning Support Guidance that you may find helpful.

Bulletin 133

14.02.12

084 Telephone Numbers
The GPC understands that a nationally coordinated initiative has recently begun by PCTs to remind practices that they must take 'reasonable steps' when reviewing arrangements for the use of 084 telephone numbers, as defined by the Directions to NHS bodies concerning the cost of telephone calls 2009 in paragraph 2(3b), to ensure that the cost of calls made by patients is kept to a minimum.

There are now very few practices in Tees who have an 084 number and, we understand, all those who do have reviewed their arrangements and are operating within the Directions. However, we would like to remind you that GPC's legal advice on this matter is that practices should take 'reasonable steps', but this does not mean practices should break existing agreements with telephony service providers that will incur financial penalties. When the time comes for new agreements to be made with telephony service providers, all practices will be expected to adhere to the regulations in full. For those practices who remain in existing agreements, they should still take all 'reasonable steps' as far as is possible, but they are not expected to incur financial penalties as a consequence.

Practice Lease Arrangements
Following the implementation of the Department of health's Stocktake and Stabilise Project, an auditing initiative designed to ensure PCT documentation is in order prior to handing over responsibilities to the NCB and CCGs, it has come to the GPC's attention that, in many cases, practices do not have premises leases but licences to occupy. These licences carry fewer liabilities, but are weaker to defend legally and some PCTs will be asking practices to sign formal leases. Cleveland LMC has discussed this with Tees PCTs who are working through the process but do not currently envisage any problems for Tees practices as it seems that Tees leases have succession arrangements already so we only anticipate a change in landlord details. We will maintain dialogue with the PCT on this and if the picture changes we will keep you informed but if, in the meantime, you are approached with a new formal lease you are advised to contact the LMC in the first instance and not to sign leases until you have sought legal advice as they may make you responsible for any unnecessary liabilities.

Updated Medicines Section Patient Liaison Group Patient Resource
The BMA's Patient Liaison Group (PLG) has updated its ‘Working together for better health' patient resource to provide more detailed information on medicine waste. The resource features practical tips for patients on how to avoid wasting medicine, together with details of how to dispose of unwanted medicine safely.

Bulletin 132

31.01.12

Commissioning News
This week the Government published more information about the development of CCGs, including final guidance relating to the authorisation of CCGs and proposals for commissioning support. Although timescales are tight, it is important that GPs and CCGs do not make decisions about their structure or support until they are ready - these decisions need to be well thought through and have the support of local practices, GPs and LMCs. This BMA Guidance highlights key issues to consider as CCGs enter into the authorisation process, such as the role of LMCs and appointment and elections to CCGs.

Medicine Reconciliation
NHS Employers have produced a film about medicines reconciliation which may be of some interest to GP practices. This film aims to highlight the role each sector plays in medicines reconciliation, particularly hospital pharmacy and goes through the medicines pathway from a patient's point of view, demonstrating that both hospital and community pharmacists can work together to improve patients' understanding of their medicines. The film builds upon this guidance published by NHS Employers and the Pharmaceutical Services Negotiating Committee (PSNC) for hospital colleagues and community pharmacists to help the transfer of care between settings.

BMA Research Grant
The BMA was among the first of the professional bodies to award grants and prizes to encourage and further medical research. Today, around ten research grants are administered under the auspices of the Board of Science, all funded by legacies left to the BMA. Grants totalling approximately £500,000 are awarded annually. Applications are invited from medical practitioners and/or research scientists and are for either research in progress or prospective research. Information and application details for the 2012 research grants are now available here. The application deadline is 16 March 2012 at 5pm. Subject specifications for each grant vary. For example, in 2012, research areas range from rheumatism and arthritis, cardiovascular disease and cancer to the uptake of preventative measures and the use of information and communication technologies in medicine. If you have any questions about the BMA research grants, or would like to receive alerts about them, please contact Chris Wood at info.sciencegrants@bma.org.uk  or telephone 020 7383 6755.

Bulletin 131

24.01.12

Commissioning News
The GPC discussed recent developments affecting Clinical Commissioning Groups (CCGs), in particular the need to CCGs to develop clear and comprehensive constitutions. It was strongly reiterated that local medical committee (LMC) involvement and engagement would be imperative to the success of successful clinical commissioning. The authorisation process will require CCGs to demonstrate that they have good relationships and engagement with member practices and local GPs (principal and sessional). CCGs will be accountable to member practices for the decisions that the CCG takes on their behalf. LMCs, as statutory representatives of the profession, should work with their CCGs to ensure that the local profession is consulted in the development of their CCG. The GPC has published this guidance which highlights essential elements that should be included in a CCG constitution.  Further to the recent messages, the GPC have been pleased to hear examples of GPs feeling empowered to resist pressure locally for their CCG to reach rapid and unacceptable agreement on commissioning support or CCGs ‘clustering’. They hope other GPs will take heart from this and feel similarly empowered to resist such pressure.

Remediation/Revalidation
The DH steering group on remediation has published this report which sets out the following recommendations:  

• performance problems, including clinical competence and capability issues, should normally be managed locally wherever possible;
• local processes need to be strengthened to avoid performance problems whenever possible, and to reduce their severity at the point of identification;
• the capacity of staff within organisations to deal with performance concerns needs to be increased with access to necessary external expertise as required;
• a single organisation is required to advise and, when necessary, to co-ordinate the remediation process and case management so as to improve consistency across the service;
• the medical royal colleges should produce guidance and also provide assessment and specialist input into remediation programmes;
• postgraduate deaneries and all those involved in training and assessment need to assure their assessment processes so that any problems arising during training are fully addressed.

Although the issue of funding fell outwith the remit of the group, a range of options were developed on the assumption that there was unlikely to be any additional money in the system. The BMA’s view is that remediation must be fully funded to ensure equality across the different branches of practice, and they will continue to lobby the Department of Health for this to occur.

Extending GP Training
GP trainees and trainers may recently have seen a document produced by the Committee of General Practice Education Directors (COGPED) outlining proposals for extending GP training to four years. The GPC is urgently seeking to discuss this with the relevant parties to establish a suitable way forward as the GPC does not believe that these proposals are sufficiently focused on educational benefit for GP trainees, nor do they outline a suitable implementation process, particularly sufficient funding.

NHS 111
The GPC has concerns that the new NHS 111 service has not been properly piloted or evaluated and shadow CCGs are already being asked to make procurement decisions, despite the fact they have not been properly established themselves. Procurement decisions are also being driven at excessive speed and influenced by the Stocktake, Stabilise and Shift project that PCTs have been asked to undertake in preparation for the handover to CCGs. It appears that the exercise may be being used to bring forward reviews of or renegotiate existing out of hours provider contracts. There is a serious risk of a potentially costly, ill-conceived and unalterable urgent, emergency and unscheduled care solution being imposed upon / inherited by CCGs, with consequent detriment to GPs and their practices. GPC representatives are taking forward these concerns with those responsible for the project.

Sessional GPs Newsletter 
The Sessional GPs newsletter draws together information about new and ongoing issues affecting sessional GPs and this issue covers pensions reform, NHS reforms update, guidance on setting up and developing sessional GP groups, locum agreement guidance, devolved administration updates, information cascades, revalidation, retainer and returned schemes and sessional GP conferences. We encourage members to forward this newsletter to any locum and salaried GP colleagues.

Bulletin 130

17.01.12

Dealing with Complaints or Investigations Advice
Cleveland LMC represents and assists all GPs in Tees - irrespective of employment status and contract type. We always recommend that you contact us as soon as possible if you have any questions or find yourself in circumstances where support could be beneficial. The LMC can particularly provide assistance with regard to any performance issues if you are contacted by NEPCSA/PCT. This letter was drafted to assist you at, what could be a difficult time, and remind you of the support that is available when you need it most. Please remember to contact us as soon as possible for confidential support however trivial the issue may appear.

Commissioning News
It is important that ALL GPs are aware of key developments in GP Commissioning. GPC would like to highlight that the NHS reforms in England are moving at breakneck speed and in different directions depending on where you live. The decisions being made now (about democratic processes in CCGs, constitutions of CCGs, appointments and plenty besides) are crucial for many reasons, not least in determining whether in future, the local profession will be able to hold their CCG to account. If you feel concerned about any commissioning developments in your area or need advice, then you should get in touch with the LMC. The BMA have also published this commissioning update which includes the latest on the Health and Social Care Bill and how the reforms are impacting on the ground. This issue focuses on the Authorisation Process for Clinical Commissioning Groups.

Eric Gambrill Travelling Fellowships
The Eric Gambrill Memorial Fund is seeking applications for up to two Travelling Fellowships, to be awarded in Spring 2012. The value of each Award is £3,000.Those eligible for the Award will be fully trained and practising UK general medical practitioners. In recognition of Dr. Eric Gambrill’s interest in general practice, education and travel, the successful applicants will be expected to undertake a study or project as part of his/her professional career development.

For more information, see the Fund’s website