Forthcoming Events
At a time to suit you
Excel – manipulating data from your clinical system Recorded Webinar
Venue: Web Based
At a time to suit you
Changes to QoF 2012/13 Recorded Webinar
Venue: Web Based
At a time to suit you
QoF Back To Basics Recorded Webinar
Venue: Web Based
At a time to suit you
CQC Webinar Recording
Venue: Web Based
Latest news items from Insight Solutions and other sources. If you require further information about any of the items displayed or services we offer please contact us
28/05/2013 V25 - QoF Read Codes Desktop Quick Reference Guide
This Handy Desktop Reference Guide thats Quick and Easy to use and Contains the most common QoF Read codes for every disease area.
This is the perfect tool for every desk where QoF data is entered - a quick reference flip over booklet that includes the most common codes for each QoF disease area. This quick reference guide will aid with consistent data entry by ensuring that you are entering the correct codes to achieve your QoF points, as well as the correct diagnosis codes to maximise prevalence (practice income) and patient care. We have only included the most common codes for each area to keep it simple & easy to use - perfect for everyday use.
Based on the current QoF rule sets & is available for both V2 read codes & CTv3. Price includes VAT and postage.
1-5 Flip Guides £30 each
6 or more £24 each
Go to our 'E Shop' to order http://insightsol.co.uk/shop.php
Further Information: Click link to E Shop
28/05/2013 Changes to QoF 2013/14 powered presentation
Get the whole practice together & listen as a group, stopping for discussions about the changes as you go along.
Different groups can listen to different sections so they just get the bits relevant to their role in the practice.
Use throughout the year as a reference guide.
Costs from only £100 + VAT
Purchase this Changes to QoF 2013/14 powered presentation and have all of the changes available as a powered presentation, with full audio, for use by the whole practice as and when you need it. Even if you have attended one of our recent seminars, this presentation will help you cascade the changes to your practice team. Presentation lasts for approximately one hour and includes all of the main changes to QoF this year as well as applicable read codes & hints & tips to help maximise your practice potential.
And that's not all ...
Insight have teamed up with Dr Simon Clay, GP & QoF expert. Simon Clay's QoF presentation is specifically aimed at the clinicians and how the changes to QoF this year affect your clinical team.
Contact us for an Order form(for payment by BACS or cheque). Orders via our website (for credit card payments) will be available from next week. If you have any queries about the presentation, do not hesitate to contact us on 01527 557407.
(currently only available for England - if practices in Wales, Scotland or NI are interested in purchasing this presentation, please email laura@insightsol.co.uk to register your interest)
26/05/2013 Manipulating Data in Excel Recorded Webinar
Data is provided in a number of ways either from the clinical system or other organisations and being able to analyse it is key to presenting and understanding what it means. Excel provides a number of ways to analyse and manipulate the data easily to make the results more meaningful and usable
This recorded webinar will show you how to:
Analyse the Data in Excel
- Using Excel Functionality to format the Data
- Insert/Delete/Hide Rows and Columns
- AutoFit Data
- Using Filters
- Using Subtotals
- Conditional Formatting
- Using Pivot Tables
Further Information: Insight Solutions Recorded Webinars
09/04/2013 INSIGHT MEMBERSHIP
How often do you use Google to find answers? Do you end up wasting valuable time & often end up feeling more confused? Do you find that the
answers you get are not really reflective of what happens in practice?
Insight Membership means you get direct access to our expert consultants, you can ask any IT or HR related question as & when you need to - either by calling us and getting the answer there & then or you can email us, get on
with something else & just wait for the answer to pop up in your in-box!
Answers to all your IT & HR queries - email your query 24/7, you can then get on with something else until our response pops into your inbox, or call to speak directly to one of our IT/HR experts for the answers you need 24 hour guaranteed response to unlimited training queries logged via our email helpdesk
Full access to our IT document library, which contains IT policies, how do I do clinical system documents, posters, patient leaflets, guidance and much more.
Access to our HR document library, which contains HR policies, HR information sheets, guidance documents and much more.
Regular special discounts only extended to our members throughout the year.
Access to all frequently asked questions(FAQ’s) -this will enhance your knowledge and you can use these questions to run informative in-house
training sessions. Many practices get answers before they even have the question!
Exclusive free invitations to regular Insight events such as regular updates.
ANNUAL MEMBERSHIP ONLY £60 + vat
All the support you need for less than 20p per day.
Call the office on 01527 557407 or email info@insightsol.co.uk
27/03/2013 APPRENTICESHIPS
Insight have full centre approval for finding apprentices & working with them to gain their NVQ qualifications. If you areconsidering an apprentice, work with a company who truly understands how your business works so we can find the best fit for your business.
Benefits to employers are many & varied:
You train them to do the job you want them to do & they gain a recognised qualification (NVQ) in the process
They offer a route for you to harness fresh new talent
It is an effective way of tackling skill shortages within the practice
Apprentices are usually more motivated - they understand this is their way of gaining valuable experience , they can see that you are investing in their training & development
They are extremely cost-effective - as this is a training opportunity you only pay them £2.65 per hour
They do not bring any experience with them but they do not bring bad habits either - you pay a high price for experience & sometimes that high price is not good value for money
Apprentices deliver real returns to your bottom line, helping to improve productivity
Apprentices can bring new ideas to your organisation
Research from the National Apprenticeship Service has shown apprentices are frequently better employees - they make better, more motivated applicants who are more loyal than other employees resulting in them making perfect economic sense in these tough financial times
Statement from a Practice who has taken on an Apprentice
I had been made aware of the apprenticeship programme by another local practice manager. Having used and worked with Insight Solutions over the last few years for training and updates, when they advised they had been accredited to deliver the training and most importantly for me, post the advertisement and screen candidates, the practice decided to proceed. The scheme is an excellent opportunity to offer young people a chance to gain experience in an organisation that they are often lacking when applying for jobs. In return for helping the apprentice to attain the apprentice qualification, the practice benefits from an extra pair of hands. Our advertisement was posted via the apprentice website on our behalf and candidates screened with the result that our apprentice joined us at the start of 2013. This process was extremely straightforward, all I had to do was provide the job description and interview potential candidates.
Our apprentice is already contributing to the practice by undertaking sessions on our reception desk, assisting our practice secretaries and helping me to achieve our QoF points. Insight will come back to assess progress towards the vocational experience, so apart from being available to answer questions and give some assistance, the rest is looked after by the staff from Insight. If you are prepared to give your time and experience to help a young person, I hope like me, you will find it a fulfilling and rewarding experience.
Sandra, Practice Manager, West Midlands
31/05/2013 Quick QOF tips, 2013-4: Hypertension (HYP), blood pressure and the GPPAQ
From Pulse
Dr Simon Clay explains the 2013/14 changes to hypertension, blood pressure and the GPPAQ
The hypertension requirements have changed considerably for QOF 2013-14.
Firstly, the entire ruleset is re-named – now being called ‘hypertension’ rather than ‘blood pressure’. There is, however, a new set of business rules called ‘blood pressure’ dealing with screening for hypertension.
Secondly, a new two-tier target for blood pressure targets has been introduced. So there are two new indicators:
- HYP002 (previously BP5). This requires the patient’s BP to be ≤ 150/90. There are only 10 points available for this now, with target thresholds of 44-84%.
- HYP003 (new). This requires that in those hypertensives aged <80, their last BP should be ≤ 140/90 from July each year. Target thresholds are 40-80% with 50 points available.
Thirdly, a further new indicator is introduced: HYP004.
This requires all hypertensive patients aged 16-74 to have annual assessment of physical activity using GPPAQ (General Practice Physical Activity Questionnaire). Five points are available with thresholds of 40-90%.
This questionnaire of a patient’s activity levels was developed by NICE in 2006. They’ve introduced it into the QOF – requiring GP’s to apply it to all their target patients, despite the fact that of the 7 questions, only the first three have been validated as being of any predictive value so the patient’s answers to the last four questions are ignored in the final calculation.1
GPPAQ posts seven questions:
1 How much work the patient’s job requires
2 How many hours of sport they do per week
3 How many hours of cycling they do per week
4 How many hours of walking,
5 Housework and
6 Gardening is done, and
7 Their usual walking speed
The questionnaire can be used on patient.co.uk.2
Based on the patient’s first three answers, they are categorised into one of the following activity levels:
1 Inactive – e.g. sedentary job and no physical exercise or cycling
2 Moderately inactive – e.g. sedentary job and some but less than one hour of physical exercise and/or cycling per week
3 Moderately active – e.g. a standing job and some but less than one hour of physical exercise and/or cycling per week
4 Active – e.g. a physical job and some but less than one hour of physical exercise and/or cycling per week or heavy manual job
Finally, based on the patient’s GPPAQ score, there is a further new indicator: HYP005.
We’re required to ‘encourage’ any patients who score less than ‘active’ to do more exercise by what’s termed ‘brief intervention’. This is described as ‘opportunistic advice, discussion, negotiation or encouragement’. I’m sure GPs will embrace this opportunity wholeheartedly.
This brief intervention has to occur once each QOF year for those hypertensives scoring anything but active aged 16-74. 6 points are available with thresholds of 40-90%.
The valid code to score HYP005 is: 9Oq3. ‘Brief intervention for physical activity completed’.
If the patient tells you what to do with your well-meaning advice, there is an exception code you can use: 8IAv. ‘Brief intervention for physical activity declined’.
The GPPAQ assessment and the brief intervention can be done on the same day now. The original ruleset suggested that they had to be at least a day apart, but this is corrected in version 25.1 of the Ruleset.
Finally, I should say that all the above refers, I’m afraid, only to England. There are varyingly differing requirements for each of the other three U.K. countries: Some have differences in target thresholds, some countries have not introduced the two-tier BP target requirements and some have eschewed the GPPAQ indicator. (Well done, Wales). All details on the precise requirements for each country (based on present information) are available at the link below.
Dr Simon Clay is a GP in Erdington, Birmingham
For details of Dr Clay’s comprehensive QOF Resource disc go to tinyurl.com/qofdisc
References
1 www.nice.org.uk/nicemedia/live/11927/40195/40195.pdf
2 www.patient.co.uk/doctor/General-Practice-Physical-Activity-Questionnaire-(GPPAQ).htm
Further Information: Clcik link to go to Pulse and other stories
31/05/2013 QMAS closedown
FROm PCC
All updates to QMAS will be suspended at 8pm on 2 July 2013. From this date QMAS will only be available in 'view only' mode for all users until 31 July 2013. QMAS will close on the 31 July 2013.
Where a GP practice has not declared its achievement for QOF 12/13, and the area team has not approved financial payment on QMAS by the 2 July 2013, they will have to do so manually “off system”. Neither QMAS or CQRS, or their project teams, can support this process after 2 July.
Full details on the QMAS closedown can be found on the QMAS pages on the Health and Social Care Information Centre website.
Further Information: Link To PCC Qmas info
30/05/2013 The June edition of the CQC
fROM CQC
CQC strategy for 2013 to 2016
Last week the Department of Health published a joint policy statement to accompany the Care Bill introduced to Parliament on 9 May. The document brings together developments from our strategy for 2013 to 2016 and the Government’s response to the Francis Report to give a broad view of how organisations across health and social care will work together to drive up the quality of care.
click link to go to the website
Further Information: Link To CQC News Update for June
28/05/2013 Six in ten GPs 'could resign' over out-of-hours proposals
Story from Pulse
Six out of ten GPs would consider resigning if the Government forces GPs to take back out-of-hours responsibility, a survey of hundreds of grassroots GPs reveals - and an overwhelming majority believe the GPC should make it clear such proposals are ‘unacceptable’ without waiting for further detail to emerge.
The snapshot poll of almost 450 GPs, seen by Pulse, was commissioned by Bedfordshire and Hertfordshire LMC early last week following press reports trailing health secretary Jeremy Hunt’s speech, in which he suggested that the GP contract would have to be changed to hand back responsibility for patients’ out-of-hours care to general practice.
The survey is the first to examine how GPs could respond to Mr Hunt’s proposed changes, and the strongest indication yet of the depth of feeling among grassroots doctors. It follows a stormy debate at the LMCs conference on Friday, where delegates voted against a motion calling for out-of-hours responsibility to be transferred back to GPs but stopped short of formulating a response on behalf of the profession.
The chief executive of Bedfordshire and Hertfordshire LMC, Dr Peter Graves, told Pulse that the survey’s findings were particularly alarming because 67% of respondents said they were at the start or in the middle of their career.
The survey asked the question: ‘If the Government imposes a change on GP surgeries so that they have to stay open and have responsibility for out of hours, how would you respond?’
Of the 397 respondents who answered that question, 63% said they would resign or retire. A further 36% said they would ‘accept the change unwillingly’, while just seven GPs said they would welcome the change.
There was also an overwhelming majority of GPs - 85% - who said the GPC should make it clear that Mr Hunt’s proposals were ‘unacceptable to GPs’ even before any further detail is revealed.
Dr Jeremy Cox, a member of Bedfordshire and Hertfordshire LMC, said: ‘The survey response was quite remarkable. We have never seen anything like the torrent of responses.’
‘There was a huge amount of emotive stuff about how this made them feel…. Grassroots GPs just don’t want this to happen. They’ll walk.’
‘The young GPs said they would go to other specialties. It’s really upsetting. One young GP said she was at the end of the tether. This would finish her off – she’d leave.’
For full story and links to others click the link below
Further Information: Link to Pulse story
28/05/2013 Part 2 CQRS training now available for GP practices
Taken From PCC
Registration is now open for the second part of CQRS training. Sessions will run for four weeks from 29 May.
The sessions will focus on:
•What is needed to prepare for CQRS go-live
•What GP practices need to do to participate in the DES
•How to input achievement data for any payments eg DES, QOF
•How to run reports
•How to declare an achievement for payment.
Places are limited to one user per practice.
Phase two training booking for CQRS
CQRS will go live early June to support the Learning Disability DES and soon after, practices will be able to access data for QOF 2013/14. It is important that GP practices undertake phase two training to learn how CQRS works and what is required to ensure that practices continue to receive accurate payments throughout the financial year.
Phase two training sessions will run from the 29 May to the 26 June and are bookable via the CQRS Learning Management System (LMS). Following on from phase one training, which took place in February this year, this second phase consists of two webinar training sessions and will also use interactive simulations to mimic the service. These sessions will be hosted by a facilitator and users will be able to interact and ask questions. The sessions will focus on:
What is needed to prepare for CQRS go live
What GP practice need to do to participate in the DES
How to input achievement data for any payments e.g. DES, QOF
How to run reports
How to declare an achievement for payment.
The June go live has been chosen, in
consultation with users, so the service is available to support the calculation of payments for the Learning Disability DES from the end June 2013.
Further Information: Click the link below to go to the PCC site and the link to register
27/05/2013 Welsh Government to prioritise MMR vaccinations for young children
Story from Pulse
The Welsh Government will prioritise MMR vaccinations of children up to four years of age, it has revealed in its programme for the coming year.
This follows the recent measles outbreak in Swansea, which led to more than 1,000 people contracting the disease, with more than 10,000 young people between the ages of 10 and 18 found to be unvaccinated.
The Welsh Government’s NHS Delivery Framework, published last week, said it is aiming for a 95% vaccination of all children up to four years of age.
It has also prioritised improving dignity in care through patient experience surveys and spot checks carried out by the independent health watchdog to assess improvements, it said.
The Welsh Government will also concentrate on improving ambulance response times, patient waiting times in A&E Departments and access to planned care and further reducing emergency hospital admissions through closer working between the NHS and social care agencies.
NHS Wales chief executive David Sissling said: ‘During the course of the next few months we will be looking to further improve our targets.
‘We will be working with our staff, stakeholders and service users to ensure we are monitoring and measuring the things which will really make a difference.’
Further Information: Link to the MMR pulse story
07/05/2013 Primary medical care functions delegated to CCGs
Taken from PCC website
Primary medical care functions delegated to CCGs
NHS England has the power to direct a CCG to exercise any of its functions relating to the provision of primary medical care services. This guidance sets out the arrangements for CCGs to manage, on a transitional basis, local enhanced services for primary medical care and primary ophthalmic services that were commissioned by PCTs, and commission out-of-hours primary medical services for their area.
Link to the Guidance- copy into your address bar
http://www.england.nhs.uk/wp-content/uploads/2013/04/pri-med-care-ccg.pdf
or go to our free download area
http://goo.gl/INZ34
Further Information: Link to the PCC website and to further links
07/05/2013 The FRAX® tool
The FRAX® tool has been developed by WHO to evaluate fracture risk of patients. It is based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck.
The FRAX® models have been developed from studying population-based cohorts from Europe, North America, Asia and Australia. In their most sophisticated form, the FRAX® tool is computer-driven and is available on this site. Several simplified paper versions, based on the number of risk factors are also available, and can be downloaded for office use.
The FRAX® algorithms give the 10-year probability of fracture. The output is a 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture).
Further Information: Link to The FRAX® tool UK
22/04/2013 GP medical defence costs rise to almost £7,000 per year
Story Taken From PULSE
Exclusive GP medical indemnity costs have risen by over four times the rate of inflation in 2013, with an average annual premium of nearly £7,000 for the average GP partner.
Medical defence bodies approached by Pulse provided figures showing current average annual indemnity costs had risen by 13% for partners and 12% for salaried GPs, even though the current rate of inflation is 2.8%.
Medical defence bodies defended the indemnity costs rise, pointing to the rapid rise in the number of legal claims, which according to the Medical Protection Society was up by 40% in 2012.
But they also pointed out that recently enacted legislation clamping down on so-called ‘no win, no fee’ cases should reduce indemnity costs in time.
The rise in indemnity costs is slightly higher than last year when Medical Defence Union fees rose by 11% for salaried GPs and 3% for partners.
The MDU said the average cost of indemnity cover for for an eight-session GP partner in 2013/14 was now £6,975, compared with £6,200 in 2012. For an eight-session salaried GP legal indemnity costs had risen from £6,280 to £5,605.
The Medical Protection Society also said that their rates had risen, but refused to provide historical figures. It currently charges an average of £6,865 for an eight-session GP partner and £6,595 for a salaried GP working eight sessions.
The Medical and Dental Defence Union of Scotland said its current rates were £4,930 for a partner or salaried GP working seven to 10 sessions in England, but it would be reviewing prices in June.
MDU chief executive Dr Christine Tomkins said indemnity costs have continued to rise in order to meet the rising costs of claims.
She said: ‘We opened 15% more medical claims files in 2012 than 2011 and claims inflation is now running at over 10% per year, far exceeding other inflation measures.
‘The MDU is calling for legal change and a national debate in order to address the cost of compensation and its effects on the public interest.
‘Claimants’ legal costs - which in some no-win-no-fee cases are disproportionately high - are another contributing factor to high claims costs.
She added that legal aid reforms - stemming from the official review into civil litigation funding, including conditional fee arrangements -that came into force at the start of April should reduce legal costs in time, but warned: ‘It will take a while to work through to reduced legal costs as there are many cases still in the system under the old procedure rules.’
Further Information: Link to Pulse for story and more links
21/04/2013 Invitation to join NICE Quality and Outcomes Framework Advisory Committee
NICE is seeking new members to join its Quality and Outcomes Framework (QOF) Advisory Committee.
The QOF rewards practices for the provision of quality care and helps standardise improvements in the delivery of clinical care. Practice participation in QOF is voluntary but most practices on General Medical Services (GMS) contracts, as well as many on Personal Medical Services (PMS) contracts, take part in QOF. It was introduced as part of the new GMS contract in 2004
NICE works with the Advisory Committee to develop evidence based clinical and public health indicators for the QOF.
NICE's Public Involvement Programme (PIP) is also currently recruiting separately for additional standing lay members. Please refer to the NICE website for further information.
Committee members are drawn from the NHS, health, public health and social care professionals, patients/service users and academia. They do not represent their organisations but are selected for their expertise, experience of working with multidisciplinary and lay colleagues and understanding of evidence based care.
All QOF Committee members have equal status, which reflects the relevance and importance of their different expertise and experience. All group members need to attend regular meetings and undertake background reading.
Skills and experience
We are looking to appoint a number of standing members for three years (12 months for the trainee)
Please click the link below to go to the NICE website for more information and Skills and Experience required.
Further Information: Link to Nice Website and Full details
10/04/2013 CQC FEES and calculator Information
FROM THE CQC Site
Every registered provider will pay a single annual fee on the same date each year. This fee will cover all registration and compliance requirements for all locations.
When is my fee due?
You will be invoiced on the same date each year. The date will depend on your specific circumstances, but is usually the anniversary of the date of your registration.
Providers that are new to registration will receive their first annual fee invoice once their registration has been completed and they have received their certificate of registration.
You will be sent your invoice in advance of your payment due date.
How much will my fee be?
You can find out how much your fee will be using the calculator above.
How do I pay my fee?
Full details of how to pay will be outlined in your invoice.
Who do I contact if I have any questions about my fee?
You can contact our National Customer Service Centre if you have any questions about registration fees.
Email: enquiries@cqc.org.uk
Telephone: 03000 616161
Or you can write to:
CQC National Customer Service Centre
Citygate
Gallowgate
Newcastle upon Tyne
NE1 4PA
Full details of the scheme for 2013/14, which is applicable from 1 April 2013, are available to download.
Click the link below to go to the CQC website where you will find the Fees, Calculator and various documents to download.
Further Information: Link to the CQC Website
05/04/2013 Practices hit with £850 fee for CQC registration
News Item taken form GPONLINE
GP practices in England will have to pay up to £850 to register with the CQC this year and those with several premises face thousands of pounds of charges, the regulator has revealed.
Practices with multiple premises face thousands of pounds of fees to register with the CQC
Practices operating from a single location will be charged between £550 and £850 depending on list size in 2013/14, the CQC announced on Thursday.
Practices with more than 15,000 patients will pay the maximum £850 fee. Those with fewer than 5,000 patients will pay the minimum of £550, with all other practices paying on a sliding scale.
However, these rates rise quickly for practices with several premises.
A practice working out of two locations will pay a fee of £1,200, while a practice with more than 40 locations will be forced to pay £15,000.
The fees will cover the cost of registration and inspection during 2013/14.
Fees could double next year because the CQC is only seeking to recover half of its costs in the first year of registration.
CQC chief executive David Behan said: ‘We have managed to keep the majority of fees unchanged this year, and introduced fees for GPs who are new to regulation, at 50% of estimated costs on a sliding scale so that small practices pay less than large ones.'
The CQC will run a consultation on next year’s registration fee in September, with next year's fees announced in March 2014.
The GPC has called for NHS England, previously known as the NHS Commissioning Board, to cover the fees.
GPC negotiator Dr Chaand Nagpaul said: ‘It has always been our position that GP practices should not be incurring any additional expense for CQC registration.
‘We have always argued that it should be centrally funded. We believe that it is in iniquitous that practices in England face this extra charge on the back of workload increases and a reduction in contract funding.’
The CQC also revealed that 87% of people responding to its consultation on the fees disagreed with the proposals for charging practices. This included 332 GPs, who made up 81% of respondents.
Responding to the consultation, the CQC said: ‘We recognise the strength of feeling among GPs at the requirement to pay fees.
'We have set fees in line with our approach to other sectors new to regulation, to generate 50% of total expected cost overall, and sought to do so in way that distributes charges fairly.We propose to introduce fees at the levels set out in consultation.
'We will, however, keep options open and seek to work with the sector to consider fees for the future, as well as reviewing and evaluating our costs. In this way, we will demonstrate to the sector that we are taking their concerns into account.’
Link to the CQC web site http://www.cqc.org.uk/organisations-we-regulate/registered-services/fees
Further Information: Click link to go to GPONLINE for story and other links
04/04/2013 QOF Rulesets Released V25 April 2013
Now on PCC website, the new rulesets are available to download.
Join us on one of our seminars to have a complete breakdown and explanation of the changes.
Clicck on our 'whats on ' tab to register
Further Information: Business Ruleset V25 from PCC
26/03/2013 GPs to be given legal 'duty of candour' to highlight bad patient care
story from GPONLINE
GPs face a new statutory ‘duty of candour’ to report treatment or care that they believe has caused death or serious injury, says the Department of Health in its official response to the public inquiry into the failures of care at Mid Staffordshire NHS Foundation Trust.
The duty will apply to all all providers registered with the CQC, but the Department of Health said it would look at how how broadly the duty should apply.
Health secretary Jeremy Hunt also said they would explore whether to introduce a new ‘chief inspector of primary care’ to sit alongside chief inspectors for hospitals and care homes, which would act as ‘whistleblower in chief’ for the NHS.
But it stopped short of recommending an Ofsted-style quality rating for indivividual GPs - with ratings of ’inadequate’ to ‘outstanding’ - but the measure will be intrdoduced for hospitals and care homes. Mr Hunt said the ratings could not be entirely ruled out for GPs in the future.
The DH document said: ‘A spirit of candour will be critical to ensuring that problems are identified quickly and dealt with promptly. Openness is a key element of healthy organisational cultures in health.’
It added that while such a contractual duty already exists, it intends to go further and make this a statutory duty.
The document added: ‘We intend to go further and introduce a statutory duty of candour on health and care providers to inform people if they believe treatment or care has caused death or serious injury, and to provide an explanation. We will need to carefully consider the scope of this duty on all providers.’
It comes as the DH also published its revised version of the NHS Constitution today but it said further changes are likely to be consulted on in light of Francis later in the year.
Other actions that may come to be of relevance to GP practices include making nurses subject to revalidation; the CQC adopting a new peer-review model for assessments that will take into account whether patients are being listened to and are treated with dignity and respect; as well as the DH asking the GMC to tighten and speed up its procedures dealing with breaches of conduct.
Click link for full story
Further Information: link to GPONLINE story and more
25/03/2013 NHS Commissioning Board reveals final specifications for new DESs
Story from PULSE
GPs will have to inform their local area team by the 30 June if they are going to take up the various directed enhanced services for 2013/14, the NHS Commissioning Board said as it released the final details of how practices will be paid for the schemes.
The specifications reveal that the risk-profiling DES will provide the single biggest opportunity for a one-off payment for practices, as it will be worth 74p per registered patient, or £5,175 to an average-sized GP practice.
The board said that GPs will be invited by their Local Area Team to take part in the DESs before then end of June, although practices will also have to agree terms of the remote monitoring DES with their CCG before they can take part.
The biggest changes from the draft specifications released last year are to the remote monitoring DES, that was due to be for patients with one long-term condition chosen by the NHS Commissioning Board.
This has been revised so that practices have to agree an a group of patients with their CCG to introduce remote monitoring and register patients to the scheme this year, in preparation for next year, to gain payments of 21p per patient, representing a payment of £1,478 to an average-sized GP practice.
The most controversial DES - for dementia case-finding - will involve practices opportunistically offering an assessment for dementia to ‘at-risk’ patients during routine consultations. They will then have to refer patients for any specialist help needed, offer a care-planning discussion and identify any carers to gain the 37p per registered patient for the DES, representing a payment of £2,587 to an average-sized GP practice
GP practices will also earn separate payments for the online access DES, which incentivises practices to introduce online booking of appointments and online repeat prescribing.
Further Information: Link to the full pulse story and other stories from PULSE
25/03/2013 More than 100 practices set to miss CQC deadline
Taken form GPonline
More than 100 providers of primary medical services have not applied for registration with the CQC, less than a fortnight before the 1 April deadline.
The CQC said that as of 18 March, 114 potential providers had yet to apply for registration, and 46 had submitted applications but had not received their registration certificates.
Of a possible 7,700 eligible organisations 7,586 (98.5%) had submitted applications to the CQC, and 7,400 had received their registration paperwork.
A spokeswoman for the CQC said some of the outstanding providers may not need to register and they were being ‘followed up’ to establish this.
She said other providers may simply be late with their application, and the CQC was trying to determine why they had yet to submit an application.
These practices or other organisations would be ‘supported in making their applications by the required date’, she said.
As long as GP practices and other providers submit an application by 1 April, no action will be taken against them even if they do not receive their certificate before the deadline. In the short term the CQC is likely to work with any organisation that fails to submit an application by 1 April rather than taking immediate action.
The CQC is due to publish the fee level for GP registration in future years later this week. The annual fee could be as much as £1,600 for an average GP practice.
Further Information: clcik link to go to GPONLINE and more stories
23/03/2013 Northern Ireland GPs to block NHS reform in contract protest
Taken from GPONLINE
Northern Ireland GPs will boycott reforms that aim to move work out of hospitals unless ministers scale back GMS contract changes believed to be the 'harshest in the UK'
Details of GMS contract changes for 2013/14 have been finalised in England, Wales and Scotland, but the Northern Ireland health department has yet to confirm the changes it plans to impose.
Northern Ireland GPC chairman Dr Tom Black said that if the government presses ahead with tough GMS contract changes - believed to be the harshest in the UK - GPs will withdraw support for wider reforms.
NHS reform plans launched this week by Northern Ireland health minister Edwin Poots, dubbed Transforming Your Care (TYC), aim to move more work into the community through 'a focus on prevention, earlier interventions, integrated care and promotion of personalised care'.
Dr Black said GPs had supported the reforms 'from the start'. He said: 'We strongly believe this is what our local health service needs.'
But he added: 'TYC represents a huge shift of work from hospitals to general practice, which must be planned, agreed and resourced. We have yet to see the detail as to how this will proceed.
'In the midst of this, minister Poots plans to impose a new contract on GPs the same day as the start of TYC on 1 April 2013.'
Dr Black said the contract proposals outlined by the Northern Ireland government had not been 'negotiated or agreed by GPs' and were the 'harshest seen in the last 30 years'.
click link to read full story
Further Information: link to full story on GPONLINE
19/03/2013 DH reveals full detail of 2013/14 GP contract deal
Story from GP Online
DH reveals full detail of 2013/14 GP contract deal.
GPs face huge swings in income after the DH confirmed today it will press ahead with sweeping GMS contract reforms that will axe MPIG from 2014 and impose a range of new work.
GMS contract changes that will take effect from April appear largely unchanged from proposals set out in a consultation earlier this year.
MPIG top ups to core pay will be phased out over seven years from 2014, and this funding will be redistributed through practices' global sum payments. Accountants and senior GPs have warned that the move could trigger six-figure swings in GP practice income.
DH confirms detail of QOF changes from April
DH plans for distributing a 1.32% GMS uplift from 2013/14 could also produce significant variations in actual increases practices receive. The DH announced that the 1.32% uplift it plans to impose - despite advice from the independent Doctors and Dentists Review Body that general practice should be awarded a 2.29% rise - will be distributed through increases to global sum and global sum equivalent payments.
In previous years some increases have been awarded through an increase in the value of QOF points, allowing all practices to benefit equally, but plans to distribute it via global sums mean the 35% of GMS practices that do not require MPIG support are likely to benefit far more than others.
The DH will press ahead with plans for the largest overhaul of QOF since its inception, scrapping organisational indicators worth around £20,000 per practice and implementing the vast majority of QOF changes proposed by NICE.
Click the link below to go to the full story and links to other stories.
Further Information: Link to GP Online full story and more
07/03/2013 What kind of a beast are CSUs?
Story taken From Pulse.
Commissioning Support Units are the quiet big beasts in the new commissioning jungle. Alisdair Stirling looks at what CCGs can expect from them - now and in the future
It´s odd to think that an emerging service industry, employing over 9,000 staff, was more-or-less an afterthought in Lansley’s health service reforms.
The 23 commissioning support units (CSUs) are now firmly on the commissioning map - but curiously were not mentioned in either the 2010 White Paper ‘Equity and Excellence’ or the Health and Social Care Bill.
’Commissioning for Patients’ - the detailed consultation paper on the original 2010 proposals - had only this to say about commissioning support: ‘We envisage that over time a more competitive market will develop for supplying some of these services.’
Back then, with the focus on GPs being handed vast budgets and forming exotic-sounding ‘consortia’, the riddle of who would supply commissioning support was very much part of the ‘It´ll be alright on the night’ flavour of the times.
The lacuna allowed critics to warn that the lack of detail hid a Conservative agenda to privatise the NHS, leaving a back door open where commerce could creep in.
But as the Bill´s lengthy progress through parliament focused minds on the details, it became apparent that there would be no immediate ‘gold rush’ for commissioning support. And in 2011 giant US healthcare firm Humana made a dramatic exit from the NHS commissioning support market.
Click link below to read the full story
Further Information: Lick to Pulse and full story and to other stories
05/03/2013 The CQC, partner changes and practice mergers
News Item taken from Medeconomics
The CQC, partner changes and practice mergers
Practices must tell the CQC when a partner joins or leaves and practice mergers may involve re-registering, Lynne Abbess advises.
The deadline of 31 March 2013 for practices in England to be registered with the Care Quality Commission (CQC) is almost upon us and I doubt that many GPs or practices will forget that date in a hurry.
As well as a declaration of compliance with the CQC essential standards, another requirement is that a GP partnership as a whole, and each partner individually, needs to meet the criteria for being ‘fit’ to carry on its regulated activities.
And if this was not enough, if a partner has joined or left in the last few months the practice’s CQC registration may already be invalid.
Surprise for GPs
It may surprise you to learn that, until 3 February 2013, the way the CQC system was set up meant that if the constitution of a GP partnership changed in any way after your initial registration application, you would have needed to submit a completely new application.
Why? Because the CQC system was intended to follow the legal consequences of a change in a partnership’s make up.
Under the Partnership Act 1890, any change – whether it is as a result of a partner retiring, or a new partner being admitted – technically creates a completely new legal entity. Luckily the CQC has simplified its system from 4 February.
Unlike a limited company or a limited liability partnership (LLP), an ‘1890 partnership’ has no legal personality - although a legally binding partnership agreement, signed by all relevant partners can prevent the business from automatically ending if there is a partner change.
On this basis, until 3 February the CQC’s registration of a GP partnership could apply only to the constitution (members) of the partnership at the date of registration.
The CQC states on its website: ‘Partnerships registered before this point [4 February] have to cancel their registration and apply again as a new provider when one or more of their partners changes.’
What has changed
From 4 February 2013 a partnership’s CQC registration is made subject to an agreed condition listing the partners’ names.
Click the link below for full story
Further Information: http://www.medeconomics.co.uk/article/1172942/CQC-partner-changes-practice-
05/03/2013 GPs face fresh QOF overhaul in cardiovascular push
Story from GPONLINE
GPs could be hit by a new raft of QOF targets for cardiovascular diseases and will be asked to 'screen' more patients for the conditions under plans set out by the DH.
The DH has asked NICE to review QOF indicators in a bid to transform how the NHS detects and treats cardiovascular diseases.
GP practices will also be scrutinised on how many patients with cardiovascular disease they can detect, and face regular examination of the quality of care they provide.
The development comes as GPs already face much tougher QOF thresholds under DH plans for the 2013/14 GP contract.
The DH has also published a 'call to action' on reducing avoidable deaths, after a Lancet study found the UK's health outcomes lag behind many other European nations.
Health secretary Jeremy Hunt said improvements in care for cancer, heart, stroke respiratory and liver disease could save 30,000 lives by 2020.
Click the link below to read full story.
Go to our free documents to download the 'CVD outcomes' document.
Paste the link below into your address bar and then click on the QoF Rulesets folder
http://tinyurl.com/cvbvhan
Further Information: Link to full story from GPONLINE
27/02/2013 Cost to practices of locum superannuation change
Ask the experts: Cost to practices of locum superannuation change.
Taken from Medeconomics
Jenny Stone explains how changes to locum superannuation payments, which will be introduced as part of the government's plans for the GMS contract, will affect practices.
QUESTION: As practices' use of locums varies, I do not understand how the cost to practices of paying locums' NHS superannuation can be reimbursed via the global sum. Unless we claim this back per locum session, how can we get the correct amount?
ANSWER: The proposal is that under UK government plans for the 2013/14 GMS contract, practices will be responsible for paying the employers’ superannuation for all locums they use.
Practices will receive some funding towards the cost, and the indications are that this will be via adjusting the global sum.
An average practice is expected to receive about £1,500 a year.
Assuming the average locum charges £250 per session, the cost of employers’ superannuation at 14% would be about £35. Therefore if an average practice receives £1,500 via the global sum, this will only cover the employers’ superannuation for about 42 locum sessions.
If a practice uses locums for more than 42 sessions a year, the employers’ 14% will be an extra cost to it.
The employers’ NHS superannuation will only be payable for those locums that pension their locum income in the NHS pension scheme.
Some locums work through limited companies and do this with income paid to their personal company.
Further Information: Link to Medeconomics
26/02/2013 GPs to pay locum pensions contributions from April 2013
Story from Pulse (Dec 2012)
Practices will have to pay locums’ employer pensions contributions under new plans proposed by the Government, with the cost reimbursed through the global sum.
The plans will mean that practices will pay for the contributions from April 2013, which GP leaders say will add to the mounting paperwork burden faced by practices.
The contributions amount to an 8% increase on locum fees for practices, with the additional expense recouped through the global sum. Currently, PCTs pay and administer the employer contributions for locum doctors.
In a letter to GPC chair Laurence Buckman on the contract changes last week, a Department of Health official said that although the NHS Commissioning Board will take on GP contracts, it will not administer locum pension payments.
Richard Armstrong, DH head of primary care, referred to a consultation begun last month, saying: ‘The consultation document includes a proposal to transfer responsibility for payment of locum superannuation contributions to the employing body, bringing this responsibility into line with all other superannuation payment responsibilities.
‘Although the consultation on the NHS Pension Scheme Regulations is separate to the GMS negotiations, it is worth noting that it includes a proposal that the primary care organisation-administered funding that currently pays for locum superannuation will be transferred into GMS global sum funding.’
It has not yet been decided how the funding will be paid through the Global Sum.
Click the link below to read full story
Further Information: Link to Pulse
25/02/2013 Commissioning Board given green light to routinely extract data from GP practices
Story from Pulse
The NHS Commissioning Board’s bid to routinely extract data from GP practices has been accepted, allowing CCGs to ‘compare data between practices’ and provide individual GP practices with ‘points to where improvements can be made’.
The GPES Independent Advisory Group (IAG), which approves the use of the General Practice Extraction Service (GPES), said the Board will be allowed to extract patient-anonymised data on demographics, diseases, events and referrals from GP systems each month.
However, it ruled this will be dependent on three conditions: that the Board must more clearly define the purpose of the extraction; that the BMA and RCGP should be included in discussions about what data should be extracted; and that any extraction will ensure patients’ rights around objections and opt outs will be in line with the outcomes of the consultation on changes to the NHS Constitution.
As part of the application to make the data extractions, the Board said the data would be used to allow CCGs to track outcomes, compare data (for example on referrals and A&E attendances) between practices and to map obesity, alcohol and lifestyle factors against public health estimates.
It also said that the data would be used to ‘support the GP in managing disease’ and to provide ‘a holistic analysis of the practice itself and points to where improvements can be made’.
However, the IAG ruled: ‘A clearer explanation and justification should be provided for the data required, the frequency of extraction and the specific retention period, and that this clearer explanation is linked explicitly to the purpose for which the data will be used.’
The ruling comes as Dr Paul Cundy, chairman of the GPC’s IT subcommittee, voiced concerns that patients are not aware their data will be used for purposes other than their care, and advocated a publicity campaign to highlight the changes to patients.
Click link below to read full story from Pulse and for other stories
Further Information: Link to Pulse article
25/02/2013 One in three PMS practices hit by contract change since 2011
Story from Pulse
Exclusive Over a third of PMS practices have had their contracts changed by managers within the past two years, in the biggest reappraisal of PMS funding since the alternative contract was introduced, a Pulse investigation reveals.
Some 55% of PMS practices have been subject to a contract review since April 2011, while 37% seeing their terms varied as a result. In total, 4% of contracts have been terminated, resulting in practice closure, merger or – in most cases – reversion to a GMS contract.
The investigation findings are based on data obtained under the Freedom of Information Act from a sample of PCTs, covering 1,278 PMS contracts which were in existence on 1 April 2011.
In some areas practices have lost tens of thousands of pounds in funding, sending GP drawings plummeting and putting staff at risk of redundancy. Many GPs attributed the changes to managers seeking efficiency savings, although a small number of practices did gain from the reviews.
Dr Di Aitken, a GP in Lambeth in South London, said her local PCT had unilaterally reduced her PMS practice’s annual funding by £179,000 since 2011, with the partners taking a 40% pay cut as a result.
‘We [the partners] are now being paid less than our salaried GP, and I know that is not unusual because I am part of a peer support group and it is the same across the board,’ she said.
Further Information: Link to full story
21/02/2013 Third wave of CCGs pass authorisation
Item taken from Pulse
Sixty-two more CCGs have been authorised by the NHS Commissioning Board, although three will require ‘intensive support’.
The third wave of CCGs to undergo authorisation will join the 101 CCGs which have already been approved to take control of NHS budgets and commission NHS services for their communities
Dame Barbara Hakin, the NHS Commissioning Board’s national director for commissioning development, said that 163 CCGs are now in full operation, although five among the new crop will needed ‘intensive support’.
Dame Barbara said: ‘The vast majority of these 62 new organisations have demonstrated excellence and a very high level of achievement and are clearly ready for the challenge of leading their local health communities in partnership with the public and local partner organisations.’
The remaining 48 CCGs will be authorised next month, so that from April 1 a total of 211 CCGs will be responsible for £65 billion of the NHS’s annual £95 billion budget, Dame Barbara added.
Dr Michael Dixon, interim president of NHS Clinical Commissioners, the independent organisation representing CCGs, said: ‘Given the timelines and the fact that the Health and Social Care Act was passed less than a year ago, it is extraordinary that clinicians have been able to step up to the mark and get their organisations to this stage in such a short time.’
Each CCG will need an ‘individual package of support’, said Dr Dixon. He added that the NHS Commissioning Board’s role is to ensure CCGs are fit deliver their responsibilities rather than to ‘micro-manage’ how they deliver patient outcomes.
For story and list of the 3rd wave of CCG's click the link below
Further Information: Link to pulse article and further stories
21/02/2013 GPC calls for publicity campaign over 'fundamental change' in use of patient data
Story taken from Pulse
Exclusive The Government should launch a publicity campaign to ensure patients are aware of the ‘fundamental change’ that is being planned in the use of their personal medical data, the GPC has said.
Dr Paul Cundy, chair of the the GPC’s ICT subcommittee, said that patients needed to understand that identifiable and anonymised data from their GP records was going to be used for purposes other than their care.
Dr Cundy argued that the General Practice Extraction Service (GPES) - which will be used to extract patient data from GP systems routinely to manage the NHS and be available to regulators and private companies - marked a sea-change in the way patient data was used over the past 60 years.
But the NHS Commissioning Board said the use of patient data in GPES was ‘nothing new’ and rebuffed concerns that it would be used for performance management of GPs.
For the full Story please click the link below to be taken to Pulse and other pulse stories
Further Information: Link to Pulse article
19/02/2013 Ten things to do before April
This item is taken from Pulse.
To read the full story you will need to register with Pulse.
Here are some things to do before April-
1 Identify and reduce excessive workload
All providers of care have suffered from rising workload and financial restrictions. To manage this, many have redefined their core work and reduced their workload by returning this work to the GP. Many practices have reached saturation point and are struggling to meet the needs of their registered population. Partners need to look at how they meet key demands, and audit workload to discover sources that they feel might be inappropriate or excessive. Identify the work that you are not funded to undertake and then discuss whether this can be stopped – always remembering your professional responsibilities to your patient.
Dr Nigel Watson is chair of the GPC’s commissioning and service development subcommittee, chief executive of Wessex LMC and a GP in the New Forest
2 Prepare for a tougher QOF
There are radical changes proposed for the QOF in the 2013/4 contract. It will be much more difficult to achieve QOF under the proposed contract compared with before, and achieving the top quartile will be very difficult. At my practice we plan to keep aiming for a broad range of points, but it will be too difficult to achieve the top quartile – it will mean that we will prioritise work.
We did two things at my practice. We looked at the changes and asked how to achieve QOF points if the contract proposals go through. At our practices we are hoping for a broad spread without aiming for the top quartile in most cases. We also bought an auto blood-pressure machine for the waiting room, which has reduced the burden on staff time in terms of blood pressure readings needed for QOF. We expect it to have paid for itself in the next year or two.
Dr Adam Jenkins is the vice-chair of Ealing, Hammersmith and Hounslow LMC and a GP in Greenford, west London
5 Make sure staff understand the CQC process
GPC guidance on CQC compliance, which we have been following at my practice, suggests you review policies, make sure all GPs and staff know the policies and use them. Our practice manager takes the lead but we’ve also appointed people as leads in different areas – for example, the nurses lead on infection control. We have also set up an intranet site so that the policies and procedures are in one place. We explained to staff that CQC inspections are part of an ongoing process. Keep reviewing policies regularly and give staff the confidence they’ll need when the inspector knocks.
Dr Richard Vautrey is deputy chair of the GPC and a GP in Leeds.
Insight Solutions offer Managers packs for CQC staff training- contact us for more information
Further Information: Link to pulse- Requires Registration
16/02/2013 CSUs to spend £670m a year
This news item is taken from E Health Intelligence.
The commissioning support units that will come into being on 1 April will spend around £700m a year on IT and other support services, according to a new report from EHI Intelligence.
The report from eHealth Insider’s research arm indicates that the 22 CSUs, which will provide IT, data collection, warehousing and analysis services, HR and commissioning functions, suggests they will employ 8,700 staff and set a total budget of just under £670m in their first year.
As such, they will be an important new market for suppliers, who are already targeting CSUs in order to sell to the clinical commissioning groups that will come into being alongside the NHS Commissioning Board and the other organisations being set up by the ‘Liberating the NHS’ reforms this spring.
“The great majority of CCGs are set to buy IT and business services from CSUs,” said report author and EHI Intelligence senior analyst SA Mathieson. “Anyone wanting to sell IT to the health service in England will have to work out how to deal with them.”
Commissioning support units were not mentioned in the original ‘Liberating the NHS’ white paper, or in the contested Health and Social Care Bill that enacted the reforms.
However, they have emerged as potentially important players in the reformed NHS, because of their role in providing key support to CCGs; some of which have indicated that they would rather provide services in-house or break with NHS tradition completely and work with the private sector.
The NHS CB, which will host the CSUs, expects them to become free-standing organisations through a process of “externalisation” by April 2016.
click link belwo to be taken to the EHI webiste for full story
Further Information: Link to EHI
22/01/2013 How QOF is evolving
Taken from GPONLINE
As the GP contract dispute rumbles on across most of the UK, perhaps the only consensus between GP leaders and politicians is that, after nine years, the QOF faces its biggest transformation yet.
But, looking beyond April, the signs are that such changes will keep on coming.
Back in April 2004, the virgin framework had just 10 disease areas. Eight years on, this has swollen to 22, along with entirely new and controversial targets, such as paying GPs to lower A&E admissions. In its 10th year, 2013/14, the whole framework stands to change again if, as expected in England, the organisational domain is dropped and the QOF shrinks by 10%.
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Further Information: LINK TO GP ONLINE AND FURTHER LINKS
22/01/2013 Calculating Quality Reporting Service (CQRS)
Item from Connecting for Health
Calculating Quality Reporting Service (CQRS)
The Calculating Quality Reporting Service (CQRS) is replacing the Quality Management and Analysis System (QMAS), the system currently used to calculate payments to GPs under the Quality & Outcomes Framework (QOF).
CQRS is currently in development and will be in place to calculate payments for GP practices across England for the 2013/14 financial year. CQRS will be capable of calculating achievement and payments on quality services delivered by GP practices, including the QOF, nationally-commissioned enhanced services and services commissioned locally from GP practices that go beyond the scope of the GP contract.
It will also be able to calculate achievement by clinical commissioning groups (CCGs) against outcome indicators and quality rewards.
CQRS will use data supplied by the Health and Social Care Information Centre, including data from the General Practice Extraction Service (GPES).
** CQRS TRAINING **
GP practices will need to use CQRS for QOF and other payments for the 2013/2014 financial year. One place will be available per GP practice for CQRS training. It is imperative that an individual from each GP practice participates in the training.
If you work in a PCT or SHA and are transitioning into a CCG or Local Area Team, and you may either be a user of CQRS or involved in commissioning services from GP practices, then training will be available but places will be limited.
** YOU NEED TO TELL CONNECTING FOR HEALTH/CQRS IF YOU ARE LIKELY TO BE A USER OF CQRS AND THEREFORE REQUIRE TRAINING BY SIGNING UP FOR UPDATES HERE
http://www.connectingforhealth.nhs.uk/systemsandservices/cqrs/regforupdates
Further Information: lINK TO CONNECTING FOR HEALTH
21/01/2013 CQC issues closure notices to two GP practices
Taken From pulse
Two GP practices face closure from the 1 April after they were issued notices by the Care Quality Commission stating that the regulator intends to refuse their registration.
The CQC told Pulse said there were concerns, either raised by the GMC or by the practices themselves, about the standards at the two practices, but they had been served the notices because they failed to respond to correspondence from the regulator.
A CQC statement said today: ‘To date two “notices proposing to refuse registration” have been issued; the applicants affected have 28 days within which to challenge and appeal against the CQC’s decision.’
The CQC spokesperson added that the CQC hopes to resolve the issues with the two practices before 1 April and that 95% of practices have registered before the 1 April deadline.
Click link below to read full story and to go to more Pulse Links
Further Information: Link to Pulse and more stories
16/01/2013 BMA asks GPs: will contract changes make you quit NHS?
News Item taken form GPONLINE
The BMA is urging all GPs to complete the survey, launched today to inform its official response to a consultation on GMS contract changes the DH plans to impose from 2013/14.
Questions being emailed to GPs in England from today include asking them if they would quit the NHS if the proposals went through and how the changes would affect practice staffing levels.
Reforms the DH plans to impose would axe MPIG over seven years from 2014, creating six-figure swings in income, and could cut practices’ QOF income by £30,000.
Please click the link below to be taken to the full story and links to the ready reckoners
Further Information: Link to GPonline for full story
15/01/2013 GPs to pick and choose QOF work
Story taken from pulse
Exclusive A third of GPs are planning to re-evaluate the QOF work they undertake as a result of the proposed contract changes being implemented in April 2013, a Pulse investigation has found.
Under the changes, the Government proposes to reinvest funding from the organisational domain of QOF in to four new directed enhanced services, which GPs can implement in order to earn back the money lost by the removal of the old QOF work.
But almost a third of the 229 GPs surveyed said that their practices would not take on any of the four new DESs, thereby sacrificing £19,800 worth of funding to support their practices, according to BMA estimates.
Click the link below to read the full story and survey
Further Information: Link to Pulse
14/12/2012 QOF thresholds to rise to 100% in contract plans
Story from GPONLINE
Planned QOF changes mean GPs face huge pay cuts because 'crude and simplistic' targets mean practices will lose income unless they pursue and treat every single patient on some disease registers, the GPC has warned.
DH proposals for the QOF 2013/14 would set thresholds for achieving maximum points at the level of the best-performing 25% of practices.
A DH model of the proposed changes shows some clinical areas' upper thresholds would rise to 100% - meaning practices would need to treat or refer every single patient with the condition to earn all QOF points in that area. It may force practices to exception report more patients.
In a letter spelling out the proposals, Richard Armstrong, DH deputy head of primary medical care, said the changes would 'benefit more patients in receiving evidence-based care that will save more lives and enhance quality of care for people with long-term conditions'.
GPC negotiator Dr Chaand Nagpaul said the DH had taken a 'hugely crude and simplistic view' of QOF that failed to account for differences in practice populations, local services and infrastructure, all of which can affect achievement.
'There is already a high level of achievement,' he said. 'What will happen is this will simply increase the threshold requirement year on year. This moving, harder target really seems to penalise GPs rather than rewarding them.'
He warned that some practices will simply be unable to achieve these higher targets. 'Practices will lose money because they are not able to achieve the maximum as they would have done in previous years,' he said. 'In some indicators which are low-value, practices will have to consider whether it is worth the effort to work towards lower-funded QOF points.'
Under the proposals, 20 indicators' thresholds would initially be changed to this new approach in 2013/14, followed by the remaining indicators in 2014/15. Only indicators older than three years would be included, as the calculation for quartile performance will be based on data from two years prior.
The proposals would force practices to vaccinate every patient with CHD against flu to earn maximum points. In some areas thresholds would rise by as much as 25 percentage points.
Ensure your disease registers are accurate with an Insight Solutions Data Quality Assessment day-includes a Money Back Guarantee.
Call 01527 557407 or email info@insightsol.co.uk
Further Information: Link to GPonline and further stories
29/11/2012 Practices face £31k gap in QOF funding next year, claims GPC
News item taken from Pulse
GPs face a £31,000 gap in QOF funding next year unless they work much harder under the Government’s proposed contract deal for 2013/14, the GPC has revealed.
In a warning letter to practices, GPC chair Dr Laurence Buckman told GPs they should ‘look hard’ at their accounts and start planning so they can make ends meet next year.
The figures from BMA analysts show the average practice stands to lose £11,000 in QOF income under Government proposals for QOF thresholds to increase in line with the upper quartile of average current achievement, and achievement remains the same.
It also shows the average practice stands to lose £20,000 from the removal of the organisational points in QOF.
GPs will be able to earn back the money from this domain through new indicators introduced in QOF and a raft of new DES agreements.
But the GPC warned practices will not have time for the extra work, given that they are still expected to carry out much of the organisational work under CQC registration.
In a letter to practices sent out on Friday last week, Dr Buckman said that while the GPC is still awaiting confirmation from Government that they do intend to go ahead with imposing these changes on practices, but that they should start planning for the changes now.
He said: ‘The GPC is still waiting for confirmation of these changes but we know that practices need to understand now what is likely to happen to them so they can plan their services for next year and beyond.
‘If the Government’s plans do not change, and practices do not take on significantly more work, general practice could be seriously destabilised.’
The GPC has so far refused to negotiate with the Government on its proposals for the GP contract revealed last month, instead it is waiting for the DH to begin an official consultation with the BMA on the changes that is due to begin later this month and a DDRB assessment of GP pay next year.
Dr Buckman said that the threshold change alone is very likely to wipe out the DH’s proposed uplift in GP pay of 1.5%.
He said: ‘At this point we cannot assume there will be any additional investment in the contract at all…Although the Government’s proposals may yet be subject to change, now is the time to begin to plan for their impact.
‘In the coming months, all practices will need to look hard at their accounts and consider what changes will need to be made to make ends meet next year.’
A Department of Health spokesperson said: ‘Our proposed changes are not designed to remove any funding from primary care. Our aim is to drive up standards so all patients receive care consistent with that at the best performing practices.
‘Improving the quality of care we offer our patients is essential and GPs – like the rest of the NHS – must strive to meet new challenges and work in new ways. All money released from removing the basic organisational standards will still be available to practices who deliver improvements in patient care.’
Message from Insight- Data Quality is now more important than ever- your disease registers need to be accurate to ensure that you are not missing out on practice income.
If you wish to discuss our Data Quality Assessment days, which come with a full money back Guarantee- please call the office on 01527 557407
Further Information: Link to Pulse and further News items
28/11/2012 EPS Release 2 national rollout
Item from NHS Connecting for Health
On 1 November 2012, a further 21 PCTs entered their 3 month notice period.
The notice period allows dispensing contractors time to respond to their local prescribers' change in status.
The notice period for 33 PCTs granted Secretary of State Authorisation Directions in September will end on 1 December and by 1 February a total of 137 PCTs will have Directions enabling their local GPs to apply electronic signatures to Release 2 prescriptions
There are 83 PCTs listed in The Primary Medical Services (Electronic Prescription Service Authorisation) Directions 2008, meaning that they are able to authorise their primary medical services contractors or any practice established by the PCT to use Release 2 of the Electronic Prescription Service.
For full information click the link below
Further Information: Link to connecting for Health EPS Information
25/11/2012 QMAS closure – important information on GP payments
QMAS will make payments for the QOF 2012/13 for GP practices. However, QMAS is going to be replaced by a new service called the Calculating Quality Reporting Service (CQRS).
CQRS will be in place to calculate payments for GP practices across England from the 2013/14 financial year. For further information about the new service, including the training that will be needed by colleagues in GP practices and other organisations, please visit the CQRS web pages.
For further QMAS to CQRS information please click the link below
Further Information: Link to Connecting for Health QMAS/CQRS information
23/11/2012 Practices face 48-hour notice for CQC inspection
The CQC has also revealed that 16% of practices that have completed registration declared themselves non-compliant with the regulator's standards in some way.
These practices must now produce an action plan setting out a date by which they will become compliant.
Speaking at a board meeting on Tuesday, CQC operations director Amanda Sherlock said that around 60% of the 8,123 GP practices in England have now registered with the CQC. Of that 60%, 780 (16%) declared ‘some level of non compliance’, Ms Sherlock said.
Details of how practice inspections will work were revealed in a CQC report on GP inspection pilots on 42 GP practices across England.
Practices will receive 48 hours notice before routine inspections, but no notice will be given before inspections that are the result of concerns being raised. Inspections will cover a minimum of five CQC essential standards but could cover all 16 standards in some cases, the CQC said.
Victoria Howes, design team leader for GP practice registration, said it was possible that one or two standards above the minimum five could be looked at by an inspector during their visit, but she said it would be ‘very rare’ for all 16 standards to be looked at.
GPC chairman Dr Laurence Buckman said he was said he was unconcerned by 16% of registered practices declaring non-compliance. He said: ‘Most of the non-compliance will be on premises – something that practices can do nothing about.'
Dr Buckman said practices that declared non-compliance were likely to be less of a concern to the CQC than practices who declared compliance in all areas. ‘The moment you’ve declared non-compliance you’ve said "I’ve thought about this",’ he said.
Dr Buckman, who took part in CQC pilots, said 48 hours notice and inspection on a minimum of five standards was a fair approach to practice inspections.
Ms Howes said the CQC was now working on guidance to help practice staff prepare for their inspection. She said the CQC was also planning to provide further training for inspectors on primary care and establish a group of GP special advisors.
According to the report, the CQC will also address other issues that arose as part of the pilot including expectations around CRB checks for existing staff, how to inspect branch surgeries and accessing patient records. The CQC said it would also review its current guidance around looking at patient records.
Further Information: Link to GP Online CQC article
22/11/2012 CCGs set to inherit multi-million pound debts from PCTs next year
Exclusive From PULSE:
CCG leaders are likely to be saddled with multi-million pound deficits from April next year, despite previous Government assurances they would not inherit legacy debts.
Managers in at least five areas across England are predicting they will begin the new financial year with a deficit.
It comes as the NHS Commissioning Board revealed it is looking again at the issue of CCG debt. It is due to make an announcement in early December to clarify what will happen to any deficits or surpluses left over by PCTs.
Even earlier this year ministers were continuing to insist debts would not be passed on to CCGs – a key demand of Pulse’s ‘A Clean Slate’ campaign.
Then-health secretary Andrew Lansley told CCG leaders at the Commissioning Show in July: ‘We are still intending for CCGs to start in April 2013 with no legacy debts.’
However, a Pulse investigation reveals that CCG leaders in many areas are likely to have large holes in their finances from April 2013.
A financial report from Croydon CCG forecasts a ‘best case’ scenario of a £5m deficit by the end of the financial year, and a ‘worst case’ of a £12.6m deficit if it does not get financial support.
NHS Hillingdon has had to borrow £15m from a neighbouring PCT to cover its deficit, which will have to be repaid by Hillingdon CCG over a three-year period.
Board papers show NHS Peterborough is predicting £6.4 million of the PCT’s historic debt will remain in 2013/14 and NHS Enfield is forecasting a £5.3 million deficit.
And September board minutes for NHS North of England SHA cluster confirm that, as reported earlier this year, NHS North Yorkshire and York is anticipating a £19m deficit.
Meanwhile Stafford and Surrounds CCG said it is still forecasting a balanced position at the year end but it has overspent by £885k by the fifth month and achieving a balanced position will depend on ‘delivering a series of mitigating actions to offset the current known risks’.
Dr Michael Dixon, interim president of NHS Clinical Commissioners, said it was crucial CCGs were given a ‘fighting chance’ by being free from historic debt in April 2013.
He said: ‘There is no reason for CCGs to pay for the sins of their fathers.’
Dr Huw Charles-Jones, chair of West Cheshire CCG, said CCGs with inherited debt would ‘struggle’, but added that the whole local health economy would have implications on CCGs’ commissioning decisions.
He said: ‘If your major provider has difficulties, it will make it harder.
Clcik Link below for Uk Map and more stories from Pulse
Further Information: Link to Pulse CCG story
22/11/2012 QOF set for 'biggest ever change' in DH overhaul
From GPONLINE
The QOF faces its 'biggest ever change' from April 2013, with practices forced to compete for points, a whole domain axed and new DESs introduced under plans set out by the DH.
The DH wants QOF's organisational targets axed and the money for these paid moved to enhanced services for long-term conditions, dementia and online access to patient records.
Under the offer made to the BMA, the overall size of QOF would fall to around 845 points and upper thresholds would become harder to hit.
The changes form part of the biggest proposed overhaul since the QOF's introduction in 2004. Other changes proposed include:
Accepting all new indicators, wording changes and retirements proposed by NICE in August.
Changing the way the average practice list size is calculated.
Retaining quality and productivity (QP) indicators in 2013/14.
Asking practices to save the NHS money through new DESs.
Changing business rules to avoid 'anomalies' that pays GPs twice for one piece of work.
GPC chairman Dr Laurence Buckman said the proposal was in effect 'the addition of new work into existing remaining points for no new money'.
'Money taken off QOF will be used to support enhanced services, the details of which we do not know,' he said. 'None of these have been negotiated, two we had never heard about at all.'
Dr Buckman said as far as he knew none of these enhanced services were developed by experts at NICE.
DH proposes major rethink of QOF
The proposals are part of the offer to the BMA unveiled on Tuesday after negotiations between the two broke down following five months of negotiations.
Changes to the QOF form the main plank of the government's plan for the GMS contract in 2013/14. The BMA has rejected the overall proposal as a 'threatened imposition', but may be forced to accept the changes if a settlement cannot be agreed within 13 weeks.
A letter sent to PCT and SHA chief executives on Tuesday and seen by GP spells out the DH's intentions.
All changes advised by NICE in August would be accepted, including retirements, new indicators and changes to wording.
Indicators worth 135 points for depression, diabetes, hypertension, epilepsy and dementia would be retired. In their place would come different indicators for cancer, COPD, depression, diabetes, hypertension and RA.
The whole organisational domain minus the quality and productivity (QP) indicators would be scrapped, a total of 154.5 points.
The DH says these indicators 'reflect basic standards of good organisational practice that should not need financial incentives'.
DH 'aware of workload concerns'
The money from these points would pay partly for the NICE-recommended additions to the clinical domain but also for the new enhanced services to 'support quality improvement and promote innovation'.
The DH told PCT chiefs it was 'aware of concerns about practice workload'.
But it said the new enhanced services would be designed to support general practice 'to make most effective and efficient use of resources to improve quality of care'.
Areas could include diagnosis and care for people with dementia, care for frail or seriously ill patients, enabling patients to have on-line access to services, and helping people with long term conditions monitor their health.
It hinted that GPs would be expected to work with nearby practices on these areas to make improvements and 'to help improve overall use of NHS resources'.
Though the letter relates to GMS contracts, the DH expects the NHS Commissioning Board to pursue a similar deal with PMS contracts.
The DH said GPs' current QOF indicator thresholds were below their average achievement levels. 'Independent research' has shown introducing the QOF cut mortality by 11 per 100,000 people, but that raising thresholds could increase this to 56 per 100,000, the DH said.
In response, it wants to raise upper thresholds over the next two years 'so they are in line with the upper quartile of current performance and maintain that link in setting future thresholds'.
This would effectively mean practices would compete against each other to achieve scores within the top quarter of performance from the previous year. For many practices this would make it far more difficult to achieve maximum points than at present.
It also wants to retain the QP indicators in 2013/14.
The wording of some indicators and related business rules will be changed to avoid 'the unintended anomaly of some practices being rewarded for two years for interventions only carried out (or offered) in one'.
IF YOU ARE INTERESTED IN ATTENDING AN ALL DAY 'CHANGES TO QOF 2013-14' SEMINAR NEXT YEAR, PLEASE REGISTER YOUR INTEREST BY EMAILING
Laura@insightsol.co.uk
We will contact you once the seminars have been set up sometime in April /May
Further Information: Link to GPOnline
20/11/2012 BMA wants GP contract plan for Scotland by next month
Taken from GPline
GPC Scotland chairman Dr Alan McDevitt hopes to negotiate a GP contract deal for Scotland by early December, but has admitted negotiations are proving difficult.
GPC Scotland has been in contract talks with the Scottish government for two weeks. Scotland's health secretary Alex Neil invited GP leaders to take part in talks on a 'Scottish agreement' after rejecting contract changes the Westminster government plans to impose as 'a threat to the NHS'.
GPC Scotland has said the deal will not split Scotland away from the UK GP contract, but will allow changes to be agreed rather than imposed as looks likely in England.
Dr McDevitt told GP he wants to get close to an agreement by 5 December, so that he can take the offer to a special meeting of the Scottish GPC on that date to ask for a mandate to keep negotiating or to accept the deal.
The GPC Scotland chairman warned that contract changes the UK government plans to impose, including overhauling the QOF and axing MPIG over seven years could leave some Scottish practices unable to survive.
Asked how the talks were progressing, Dr McDevitt said: 'I think "difficult" is as much as I can say at this time. You can’t underestimate the complexity of what we are trying to take on in a very short space of time.
‘Obviously the UK negotiations went so far and what we are now saying is can the Scottish government finish off that negotiation. It is more difficult and complicated than I had hoped for.
‘The Scottish government effectively wasn’t negotiating to the level of detail we did with NHS Employers. They had a different role then and now they have taken on this role of negotiating. Their team has just recently increased to try to deal with this so it is a logistical challenge and an intellectual challenge as well.’
Dr McDevitt added that GPC Scotland and the Scottish government has agreed to try to conclude a deal by early December. 'We didn’t want this to go on interminably. We are not saying we are going to do a vast renegotiation of the contract, we are just trying to get an agreement this year.'
Further Information: Link to full story and others from GPONLINE
15/11/2012 Online GP consultations 'to become widespread'
GPs will be forced to offer online consultations under DH plans to 'significantly increase' the use of technology in the NHS.
The government expects the NHS to provide more internet and technology-based services to help people manage their health and care.
Under plans from the DH, the option of e-consultations will become 'much more widely available' for patients.
By March 2015, patients must also be allowed to view medical records, book appointments and order repeat prescriptions over the internet. They should also be able to talk with their GP practice via email.
The NHS must also ensure GP patient records are transferable between different NHS providers. Greater use of telehealth and telecare will be prompted to three million people, as set out last year.
The move is one of a raft of technology-based changes to NHS and GP services under a new set of standards for the NHS called the 'NHS Mandate', launched by health secretary Jeremy Hunt on Tuesday.
The mandate sets out how the NHS Commissioning Board (NHSCB) should prioritise care and the outcomes it should pursue, such as improving dementia care and early diagnosis of cancer.
The NHSCB will use the 'ambitions' set out in the NHS Mandate and the NHS Outcomes Framework to performance manage clinical commissioning groups (CCGs).
The mandate states: 'In a digital age, it is crucial that the NHS not only operates at the limits of medical science, but also increasingly at the forefront of new technologies.
'In particular, the government expects that by March 2015 ... everyone will be able to have secure electronic communication with their GP practice, with the option of e-consultations becoming much more widely available.'
NHS performance will also be exposed to far greater scrutiny in what the DH calls a 'revolution in transparency'. The health service will be required to publish outcomes data online for all major services by 2015 'to drive standards of care', according to the DH.
Health secretary Jeremy Hunt, who unveiled the NHS Mandate on Tuesday, revealed the NHSCB will be handed a budget of £95bn for 2013/14.
Further Information: link to gponline and further stories
15/11/2012 CCG constitutions legally binding whether signed or not
story taken from PULSE
GPs will be tied to legally binding agreements drawn up by their CCG whether they sign them or not, after the NHS Commissioning Board revealed they were not necessary to pass authorisation.
The board told Pulse that CCGs could be authorised without providing a single signature to prove that local practices have approved the constitution, as long as they can provide other evidence that they have engaged GPs.
Less than a month before the first wave of CCGs are authorised, official GPC advice that GPs should only sign constitutions they are comfortable with has been plunged into doubt.
Negotiators are urgently seeking clarification from the board after it emerged that there is no fixed threshold for the proportion of practices signed up to constitutions as part of the authorisation process.
The GPC warned in September that CCGs were pushing GPs to sign constitutions holding practices to performance management targets and incentive schemes.
Their advice was to refuse to sign, but it has since emerged that this provides no protection because, after authorisation, the constitution is legally binding on all practices in the CCG – whether they have signed or not.
The GPC admits that GPs who refuse to join a CCG face being forcibly allocated one from April 2013 and signed up to its constitution, after the GPC agreed as part of the 2012/13 contract negotiations that all GP practices in England would be contractually required to be a member of a CCG.
GPC negotiator Dr Chaand Nagpaul said: ‘We are seeking clarification ourselves and it is hard to give a definitive answer.
‘What we do know is that every practice will need to belong to a CCG. If a practice has not signed it will still be allocated to a CCG – and that CCG will have a constitution.’
Dr Nagpaul said the GPC did not want any further obligations on GP practices, but said it was currently in negotiations with the DH over GPs’ contractual duties to support their CCG when it is authorised.
Copy the link into your address bar to read the editorial: GPs must approve constitutions.
http://www.pulsetoday.co.uk/commissioning/commissioning-topics/ccgs/gps-must-approve-constitutions/20000872.article
Dr Nigel Watson, chief executive of Wessex LMCs and chair of the GPC commissioning subcommittee, said: ‘There is nothing in the rules that says 100% of practices need to sign up.
‘We’ve asked whether, if 100% of practices aren’t signed up, does it mean the CCG doesn’t get authorised and the answer is “no it doesn’t”. But if they had fewer than 50% sign up, that would indicate that they didn’t have the support of practices.’
A spokesperson from the NHS Commissioning Board said the 50% figure was not correct and it was up to individual CCGs how they signed off their constitution. She said: ‘CCG constitutions are legal documents and member practices will need to abide by their terms once CCGs take up commissioning.’
She said GP engagement was an integral part of the authorisation process – but this could be demonstrated by letters of support, 360-degree feedback or other evidence of involving practices in commissioning decisions.
‘There will be all sorts of ways to measure GP engagement with CCGs and [signatures] are just one of them. There could be CCGs without any signatures.’
BMA lawyer Alex Fox, partner at Manches LLP, said: ‘Signing is not a legal test – when the constitution is approved by the board, it is authorised.’
Dr Tony Grewal, medical director of Londonwide LMCs, said the move was designed to make it more difficult for practices that were not co-operating with terms put forward by their CCG.
‘The intimidation starts from the top. It started with the DH and is trickling its way down to practice level,’ he said.
A GP in south-east England, who preferred to remain anonymous, said he was concerned as he was refusing to sign his local CCG constitution due to clauses that made it hard to hold CCG board members to account.
He told Pulse: ‘If the NHS board goes ahead and authorises CCGs anyway, it cannot claim they are GP-led.’
Further Information: click to be taken to PULSe and further stories
14/11/2012 One in 25 practices yet to register with the CQC
Story from GPonline
Almost 4% of GP practices in England are yet to begin registration with the Care Quality Commission (CQC) and risk losing their contracts if they fail to do so by April 2013.
The CQC is consulting on registration fees and revealed earlier this year that practices could pay as much as £1,600 a year.
All practices in England were asked to set up online accounts with the CQC over the summer. The vast majority of practices did so, and over half have now applied for registration with the CQC by submitting their details. The rest of those who have come forward will submit their registration details by early December.
Around 4% of practices - more than 300 in total - have not responded to the CQC's letters asking them to activate their online account. However, according to the CQC the figure may not be an accurate representation of the actual number of practices yet to start their registration.
A CQC spokesman said: ‘One GP may have multiple PCT contracts. They might be on the border of three PCT areas, and hold contracts with each of those PCTs. On the system that would say there are three practices requiring registration, when in reality there is only one practice.’
The CQC spokesman said any practices that failed to register with the CQC by April 2013 would face legal prosecution for running an unlicensed practice.
GPC negotiator Dr Peter Holden said: 'One would be worried if these are genuine missed registrations.' Dr Holden said he thought it was possible that many were duplicated.
The CQC is currently holding a consultation on the annual fee it will charge GPs for registration. Under the CQC’s preferred model, practices with between 5,000 and 10,000 patients would pay £650 in 2013/14. This figure could increase, or even double, in subsequent years as the CQC aims to reclaim all of its costs through registration fees.
GPC negotiator Dr Chaand Nagpaul warned that GPs could be hit twice by CQC costs. After the government revealed plans to retire organisational indicators from the QOF as part of wider changes to the GMS contract, Dr Nagpaul said that much of the work practices were required to do for CQC registration would no longer be funded.
‘It’s effectively a double whammy of CQC,’ Dr Nagpaul said.
Further Information: Link to GPonline for story and more links
08/11/2012 High QOF scores 'linked to happy patients'
Story from GPONLINE
King's Fund study, Improving GP services in England, compared QOF and GP Patient Survey (GPPS) data for 2010/11 for all practices in England.
It found practices that scored highly in patient satisfaction surveys also achieved high clinical outcomes and QOF scores. Practices with more GPs were found to fare better on patient experience and QOF outcomes.
The study found a strong link between a practice’s QOF scores and patient experiences of using its services. ‘In particular, patients’ feedback on ease of access to their general practice consistently showed a strong link with the process and outcome indicators for all clinical conditions,' the report said.
'Patients’ responses to questions about the information they received also consistently showed a clear positive link with all process and outcome measures of quality of clinical care.’
The study suggested that patients' ease of access to their practice and preferred GP could affect quality of care and outcomes ‘through its impact on attendance rates, continuity of care, communication and engagement with clinical staff, compliance and adherence with treatment, and out-of-hours access’.
Co-author of the study and senior fellow at the King’s Fund, Veena Raleigh PhD, said the study had not established a causal link between QOF scores and patient satisfaction. But she said: ‘It is realistic to expect that enabling easier access, meeting patients’ preferences, involving them in decisions will improve compliance with treatment and better engagement in self-care in general.’
Practices that performed poorly both on patient experience and clinical quality tended to be in London or deprived areas. London practices fared worse than practices in other parts of England both on QOF and patient experience scores.
London practices scored particularly badly in the ‘dignity and respect’ domain of the patient survey. Londonwide LMCs chief executive Dr Michelle Drage said the results were not a reflection of the standard of GPs in London. ‘We know London is not typical of the rest of the country,’ she said.
Dr Drage said London GPs were campaigning for longer consultation times to help them cope with hugely diverse patient populations, and called for investment in premises and services.
Dr Raleigh said: ‘London practices face particular challenges, but we can see variation in performance even within London, and there are examples of innovative practices that are performing better despite these obstacles.
'This can be done, for example, by tailoring services to the specific needs of local populations. The challenge for those providing and commissioning services in London is to learn from these innovations so that they can transfer elsewhere.’
Further Information: Link to GPonline and further stories
31/10/2012 'Bloodbath' predicted for GP practices due to MPIG phase out
Taken From Pulse
Exclusive: Smaller and multi-site practices will be hit hardest by the Government’s plans to phase out MPIG, leading to closures and increased privatisation of GP services, predict accountants.
Accountants predict the withdrawal of MPIG from the 63% of GP practices who remain on the payment scheme will lead to a ‘bloodbath’, with practices with a list size of less than 4,000 patients closing for good.
The stark warning comes after the Government revealed it intends to remove MPIG completely over seven years from 2014 in order to make practice funding more ‘equitable’.
The move comes after years of rises in global sum payments designed to shift more practices from their reliance on MPIG, but accountants warn it will disproportionately affect certain practices who are already struggling to make ends meet.
The Government says that 50% of practices will gain income and 50% will lose income from the withdrawal of MPIG, although the extent of the losses ranges from ‘a few pounds to hundreds of thousands’ per practice.
But leading medical accountant Bob Senior, of RSM Tenon accountants, said the proposals will change the landscape of general practice in England, with a gradual disappearance of small and single-hander practices and a shift towards larger practices as practices could stand to lose over £100,000 in correction payments.
He said the practices that stand to lose the most are those who don’t have ‘economies of scale’ and those with split sites who may opt to run just one site going forward to reduce their overheads.
He told Pulse: ‘A lot of small practices who are going to wake up and think “Crikey, if I am going to survive here, I am not going to do it in my current, small surgery.’ So we’re going to see federations, practices running joint services, and those who will go a step further and merge into larger units.
He added: ‘I wouldn’t be astonished if you had a number of single-handers who give up, make their staff redundant and hand their list back and say “I’m done”. Because if you look at the practicalities of running existing practices, if the funding gets cut, it is going to be a bloodbath.’
Dr Mark McCartney, a GPC member and a GP in Pensilva, Cornwall, said his practice had a below average list size and would be hit hard by the changes.
He said: ‘We see that as core income. This will slice another significant percentage off funding on top of all the other cuts being imposed on us.’
He added: ‘The danger in this policy is that we will see corporates moving in who are happy to run larger practices, practices moving from GP ownership to corporate ownership. This Government has an ideological belief that corporates will run services better, but they are wrong. Corporates do not have local interests or long term commitment. They are more interested in profits than patients care and the way they are organised they move profits overseas without paying too much tax.’
But Dr Peter Swinyard, chairman of the Family Doctors Association, said the move towards more ‘equitable’ funding would be welcomed by some practices.
He said: ‘There is no justice in the same town for one practice being on about £55 per head and another on £120 per head and expected to offer the same service to patients.’
A DH spokesperson said: ‘NHS Employers and GPC have been discussing these matters and looking at the analysis on a range of options for a number of months. At this time the discussions remain unresolved.
‘Where changes proposed by the Government would take place after 2013/14 they remain subject to discussions offered to GPC on how they might best be taken forward.’
Further Information: Click here to go to PULSE and further stories
29/10/2012 Flu vaccines recalled
Taken from gponline
Two batches of flu vaccine are recalled by manufacturer Novartis, following a request by the UK's medicines watchdog.
The MHRA asked the company to undertake a 'precautionary recall' of two batches of Agrippal vaccine, but stressed there was no evidence of safety concerns.
The recall came after visible 'protein aggregates' were detected in one batch for the Italian market during a routine inspection by Novartis. The company said it had availability to replace all recalled doses.
An MHRA statement said: 'At the request of MHRA, Novartis Vaccines and Diagnostics is executing a precautionary recall of the above batches.
'Based on the information available, there is no evidence of any new safety concerns or of any impact on efficacy. No adverse reactions which may be associated with this issue have been reported to Novartis in connection with these batches.'
The MHRA said there was no need to revaccinate people who have received flu vaccine from these batches. Remaining stocks should be quarantined and returned to the original supplier, it said.
A spokeswoman for Novartis said: 'During a routine pre-release quality analysis of one batch of Agrippal for the Italian market, Novartis identified visible protein aggregates in one batch of vaccines which was not released to the market.
'The protein aggregates are not uncommon in vaccines and have no impact on their safety or efficacy. Individuals already vaccinated with Agrippal in the UK should not be concerned and there is no need for revaccination.'
The affected batch numbers are 126201A and 126102. Both contain pack sizes of 10 pre-filled syringes with the expiry date of 31 May 2013, and were first distributed on 9 and 17 October 2012 respectively.
The recall comes after manufacturer Crucell voluntarily halted deliveries of two batches of flu vaccine to the UK in October on patient safety grounds.
Further Information: Link to GPONLINE and further stories
26/10/2012 2012/13 Seasonal Influenza Vaccination Uptake Survey
Taken From Primis
2012/13 Seasonal Influenza Vaccination Uptake Survey
PRIMIS will be releasing a query library for the 2012/13 Seasonal Influenza Vaccination Uptake Survey. The library will be available to download from Friday 26 October. As part of our ongoing commitment to make our services more accessible to users, you will now be able to download the query library by using the ‘Check for updates’ link within the CHART tool. There is no requirement to login to the PRIMIS Hub to download the query library: simply open CHART, click the 'Check for updates' link and install.
We will begin monthly collections of cumulative data from the start of November 2012.
Please email influenza@hpa.org.uk if you have any questions about the survey.
A helpdesk telephone service will be available to all users during the collection windows, regardless of PRIMIS Hub membership status. An email helpdesk service will also be available throughout the 'flu season:
t: (0115) 846 6320
e: flu.helpdesk@primis.nottingham.ac.uk
Disclaimer: This query library should not be used for recall, nor for payment or target purposes. The query library is not designed to support any of these activities.
Further information relating to this issue will shortly be made available From the Primis Website.
Further Information: Link to Primis Website
26/10/2012 Ministers invite GPC for talks on separate Scottish GP contract deal
Story From PULSE
Exclusive: GP leaders have been invited to negotiate a separate contract deal in Scotland for next year as the impact of events south of the border threatens to speed the break-up of the UK GP contract.
The Scottish Government said it was committed to working with the BMA in Scotland to come up with a contract that ‘works for both parties’ and that it would be ‘taking a different approach’ to the UK Government.
The Scottish Government usually bases its negotiations over the GP contract on the UK-wide deal, but said this year the ‘impasse’ in talks over the UK-wide contract had prompted a move toward separate talks.
As Pulse revealed earlier this year, the Scottish Government has consulted on what a Scottish version of the GMS contract should contain and was looking at developing a series of Scottish-only QOF indicators by April 2014.
But ministers in Scotland look to be going further after than this after the Department of Health threatened to impose a UK-wide deal that would give GP practices a 1.5% gross uplift in practice funding in return for a raft of new work under QOF and new enhanced services.
Health secretary Jeremy Hunt said talks with the BMA over the UK-wide deal had broken down and that it would impose the deal unilaterally if the union did not accept the changes it had offered.
Scottish health secretary Alex Neil said: ‘Given the impasse in the UK negotiations on the GP contract, we have invited the BMA for talks on arrangements in Scotland which would better suit both patients and GPs.
‘We agree with the BMA that the market driven model being put in place in England represents a real threat to the NHS and to GPs ability to treat patients effectively – but Scottish patients shouldn’t suffer because of this.
‘That’s why we want to take a different approach in Scotland and want to work closely with the BMA to agree a Scottish arrangement that takes account of workloads and meet the needs of Scottish patients.’
‘Both the BMA and the Scottish Government want the same thing – a well-functioning health service that meets the needs of Scottish patients. We will be working to achieve that over the next month.’
When asked if this means that Scotland will move to an entirely separate GP contract, a Scottish Government spokesperson said: ‘They are still ongoing discussions – nothing has been confirmed.’
In an email sent out to members this week, GPC chair Dr Laurence Buckman said: ‘Health secretary Jeremy Hunt today issued a statement which made clear he intends to impose a programme of new changes to the GP contract despite the fact the BMA and NHS Employers had almost concluded their detailed annual negotiations which had been underway for the past five months.’
‘In the devolved nations: We do not yet know how what contract changes will be made in Wales and Northern Ireland. In Scotland, the Cabinet Secretary has indicated willingness, within the context of the UK contract, to enter into further detailed discussions with an aim of reaching a negotiated agreement for this year that meets the needs of both the Scottish Government and general practice.’
‘The BMA’s Scottish GP committee will keep members updated on the progress of these discussions.’
Dr Alan McDevitt, Scottish GPC chair, said the move was ‘helpful’.
‘The Scottish Government recognises the workload pressures facing general practice and acknowledges that GPs need a more stable financial environment from which to continue delivering high quality care to patients now and in the future.’
‘This willingness to enter into discussions is a positive first step by the Scottish Government and I hope that we can reach a negotiated settlement in Scotland.’
The move to develop a separate deal in Scotland also comes as the Scottish Government was in the process of setting up a ‘programme board’ to look at how to implement a more Scottish-focussed contract.
Further Information: Link To PULSE for more stories and links
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