What is New & Interesting on the Devon LMC Site
Information
is normally on here for a couple of months after which it is moved to the Info&Guidance
Page
If you are looking for something specific please use
the search facility above
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Hot Topics Colour Coding |
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December 06 - LMC Newsletter |
Trouble with PDFs |
DOH Link or DH Link |
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Yellow = Local issue |
Blue = National Issue |
White = General Info |
Green – High Priority |
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Updated Areas- Salaried GPs Page - PBC - Practice Based Commissioning - GPC & BMA |
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List
of LMC Meeting Dates - SEE |
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The
web site has been getting bigger. Therefore, to simplify the site and to
speed up load times, I have moved some nGMS - Data Protection Act (DPA)
- Sessional
& Freelance GPs - GP
Appraisal - Hep B
- SI 2004 No. 291 “The NHS (GMS Contracts) Regs 2004” - Quality and Outcomes Framework - Criminal Record Bureau (CRB) checks on GPs |
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Looking for Work in Why not visit the Adverts Page for a wide range of posts and opportunities. We have vacancies for GPs, Practice Nurses, Practice Managers and General Admin Staff - If you are interested in Sessional or Freelance work, then have a look at the Locum Page |
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Please
note all GPC guidance’s have a BMA copyright. The content, layout, design, data and
graphics contained in this document are protected by |
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Please note a new
web site is currently being developed this site will continue to be supported. If you experience
any problem with content please contact admin@devonlmc.org
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Information for GPs about the
decision by the Secretary of State for Health to cap pension dynamising factors - Jan 2007 Most
GPs will now be aware that the Secretary of State has announced her intention
to limit the dynamising factor (DF), used to uprate GPs’ pensionable
earnings for the period 2003-2006. She has declared that the figure will be
set at 48% and, additionally, that this increase will be spread over a
five-year period (2003-2008) instead of the 3 years (2003-2006) that GPs have
earned the income and paid the equivalent contributions for their pensions. Local Copy 5 Feb 07 |
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Guidance for medical practitioners
undertaking work under the collaborative arrangements (including family
planning and sessional work) The rates for work under the collaborative
arrangements have until 2006/07 been set by the Doctors’ and
Dentists’ Review Body (DDRB) and issued via an NHS circular. In its 2006 Report, however the DDRB did
not recommend collaborative arrangement fees for 2006/07 and it seems
unlikely that it will do so in the future; the Government has accepted the
DDRB report in its entirety, although there was a staging of pay awards for
consultants. The DDRB has recommended
doctors set their own fees for work done under the collaborative arrangements
and this position has not been opposed by the Government. The Professional Fees Committee has drafted
this guidance as a result of the DDRBs
recommendation and seeks to clarify doctors’ fee arrangements, superannuation
and obligations under the collaborative arrangements, as well as the
situation on family planning and sessional
work. This guidance provides a more
detailed update to the interim guidance produced for the profession in June
2006. Local
Copy 5 Feb 07 |
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GPC
Guidance – Charges to NHS Patients – Jan 2007 Private practice is still significantly restricted under the GMS
contract. GMS regulation 24,
subsection 2, as set out at appendix 1, prevents contractors from charging
their patients for most services. There
are however instances, as set out in this guidance, where charges may be
made. Schedule 5 of the National Health Service (General Medical Services
Contracts) Regulations 2004 lists the strictly limited circumstances in which
GPs may charge fees for providing treatment to their NHS patients. These
provisions are listed in appendix 2.
In addition to the circumstances which apply to all doctors, Schedule
5, regulation 24 sets out that dispensing doctors
may charge a fee for the supply of drugs which are either restricted or
prohibited from being ordered on an NHS prescription, to NHS patients. In the current climate, there is an
increasing tendency for private companies to provide services to NHS patients
and the BMA as a consequence is receiving a growing number of queries in
relation to the topic. This guidance seeks to address those and to outline
the circumstances when it is allowed for charges to be made to NHS patients. Local
Copy
5
Feb 07 |
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BMA Professional Fees Committee -
Guidance for negotiating fees for Locum services in General Practice In
the past the BMA published a range of ‘suggested fees’ for
locums, but in 1999 the Office of Fair Trading (OFT) advised that publication
of these fees was anti-competitive in the context of the Competition Act 1998.
As a result the fee guidance, which had been published as Fee Guidance Schedule (FGS) 12, Fees for
GP Non-principals, was withdrawn and guidance issued to BMA staff that no
advice could be given to members on suggested fees for sessional
GPs.
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QOF
Implementation: Business Rules The business rules on this site are for use with the
revised QOF which came into operation on 1 April 2006. This is the
officially published version and should be used for all matters relating to the
technical requirements for correctly recording QOF information on the new,
revised and unchanged indicators. Version 9 of the QOF business rules/read
codes is now available at the following address: http://tinyurl.com/n9yto
or www.primarycarecontracting.nhs.uk/145.php 5 Feb 07 |
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Implementation
of VAT on medical services – 30 Jan 2007 Please see below from the Professional Fees Committee of the
BMA. HM Revenue and
Customs formally announced that implementation of the VAT ruling on medical
services (Dr D’Ambrumenil judgment) will take
effect from 1 May 2007, subject to House of Commons approval.
http://www.bma.org.uk/ap.nsf/Content/VATonmedicalservices or http://tinyurl.com/2ggdlc
HMRC
have given the medical profession three months notice to prepare for
implementation on 1 May 2007. See - http://tinyurl.com/hyfwa LMC advice
– if you think you are going to be or might be liable be please discuss
with your accountant ASAP 5 Feb 07 |
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Revised GPC
Guidance - Focus on… the Patient Experience Survey (PES) - posted 8 Dec October 2006 (updated December 2006) This guidance
note has been produced by the BMA’s General Practitioners Committee
(GPC) to help GPs and Local Medical Committees (LMCs)
understand the development of the Patient Experience Survey (PES) that was
introduced as part of the 2006/07 GMS contract review in England only to
measure achievement of the Access DES. This guidance note should be read in
conjunction with the contract guidance ‘Revisions to the GMS contract
2006/7 – delivering investment in general practice’ available on
the BMA website and the ‘Focus on access’ guidance note PDF
Copy |
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New “Physiotherapy
Clinical Policy for Sickness Certification of Patients with Musculoskeletal
Problems” The lead physiotherapists
from Devon PCT, Northern Devon Healthcare Trust, South Devon Healthcare Trust
and Torbay Care Trust have been working together to produce a definitive
guidance on the above process. The
main aim was to ensure that patients who are having their simple
musculoskeletal problems managed by the Physiotherapy service are:
Training
for the physiotherapists began on the 1st December 2006 and should be rolled
out to all areas shortly. Please note
Plymouth Teaching Primary Care Trust was involved in the process but opted to
conduct a small pilot, hopefully the policy will come on stream for the whole
county early next year. PDF
Copy |
The General Practice Physical Activity
Questionnaire (GPPAQ)
- posted 8 Dec
DH - The General Practice Physical Activity Questionnaire is
intended for use in adults (16 - 74) years in routine general practice to
provide a simple, 4-level Physical Activity Index (PAI) reflecting an
individual's current physical activity. The index can be cross-referred to
Read codes for physical activity and can be used to help inform the decision
as to when interventions to increase physical activity might be
appropriate. http://tinyurl.com/ydwa7p
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New
PBC Guidance from the Department of Health for 2007-08 - posted 8 Dec The DH has produced 2 useful updates on PBC, the
GPC is currently reviewing the publications and they will be commenting on
the guidance shortly. |
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DH Briefing Paper -
Access to Health Care - posted 8 Dec Can choice for all
improve health for all? The evidence on whether NHS patients can and should
become consumers of health care This
briefing paper outlines the main findings of a review to assess the extent
and nature of the evidence available on patient choice and its impact on
equity, efficiency and quality within the NHS. It was commissioned in 2004 by
the NHS Service Delivery and Organisation (SDO) Research and Development
Programme and carried out by researchers at Devon LMC was interested to see that one
of the main findings was "There is no evidence that giving patients
greater choice will, in itself, improve the quality of health care. Some studies suggest that increasing choice
may result in deterioration in the quality and cost-effectiveness of
services. |
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Fit to Lead - a review of the Primary Care Trust -
posted 8 Dec The DH has launched a
consultation document called 'Fit to Lead' which is a review of the Primary
Care Trust Professional Executive Committee. PDF Copy |
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BMA Professional Fees Committee guidance on the completion of health
reference forms for prospective registrants with the General Dental Council -
November 2006 - posted 8 Dec The General Dental Council (GDC) has
introduced a requirement that states all prospective registrants for clinical
practice must have a health reference form completed by a doctor, or in some
circumstances a supervising dentist. All dental professionals applying for registration
or restoration with the GDC must provide certain information about their
health. This applies to dentists as well as dental care professionals (DCPs) including dental hygienists, dental therapists,
dental nurses, dental technicians, clinical dental technicians and
orthodontic therapists. PDF
Copy |
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GPC Focus on….
Excessive Prescribing Annex
8 of the Revisions to the GMS Contract 2006-07 ‘Excessive or
inappropriate prescribing: guidance for health professionals on prescribing
NHS medicines’ is a document aimed at helping LMCs
and PCOs encourage appropriate and cost-effective
prescribing. The
GPC is aware of cases where PCOs and LMCs seem to be taking a different view on what is
excessive prescribing, and in some cases PCOs are
making financial threats to practices.
The GPC have suggestions on how best to understand issues around
excessive prescribing in practice, and what is or is not possible within the
regulations – PDF |
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URGENT Focus on….the Patient Experience Survey
(PES) - October 2006 To help GPs and Local Medical Committees (LMCs) understand the development of the Patient
Experience Survey (PES) that was introduced as part of the 2006/07 GMS
contract review in England only to measure achievement of the Access DES - PDF This
is a very hot topic and is being discussed on Devon Voice |
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GPC Guidance - On Exception Reporting Exception reporting was introduced into the Quality and Outcomes
Framework (QOF) in order to allow practices to pursue the quality improvement
agenda and not be penalised, where, for example, patients do not attend for
review, or where a medication cannot be prescribed due to a contraindication
or side-effect. It has become clear that a variety of
interpretations and applications of the nationally defined exception
reporting criteria are possible. NHS Employers and the BMA agreed to issue
further guidance regarding what constitutes good practice in exception
reporting (see Revisions to the GMS Contract 2006/07, paragraph 1.23). This
guidance is designed to provide additional clarity in order to help maintain
a consistent approach to exception reporting by practices, PCOs and QOF assessors. - PDF |
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GP Registrars
e-bulletin, October 2006 Welcome
to the third issue of the GP registrars e-bulletin, in which we aim to bring you
news of some of the major issues facing registrars today, as well as an
update of the ongoing activities of the GP registrars subcommittee. - PDF |
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A CAUTIONARY TALE FROM CORNWALL Dr |
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GPC Guidance - GP Returners - October 2006 - posted 4 Oct Intro - In order to work as NHS GP
in the UK, a doctor needs to be on the GMC’s new GP register, and be on
a PCO’s Performers List in the country where
they are working or intend to work. Up until earlier this year funding was available in England for the GP returners’ scheme. This was an excellent mechanism for encouraging qualified GPs (particularly those who had taken a career break for family reasons) back to work. It provided a funded placement for the returning doctor normally for six months on a full-time basis or 12 months part-time in a practice experienced in offering support and training. It also represented very good value for money to the NHS. Unfortunately, the funding for the GP returners’ scheme has been withdrawn by the English Department of Health, although some deaneries have retained local sources of funding for returners’ schemes. The BMA has made numerous representations about the withdrawal of the funding to the Health Department, including a meeting with Lord Warner, Health Minister. We are also seeking to publicise the advantages of the scheme. – Full PDF copy of Guidance |
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GPC Guidance for GPs - Primary
Medical Services Contracts: Advertising and Appeal -
posted 26 Sept Dear LMC There is considerable
variation in practice regarding the advertisement of primary medical services
contracts. This paper discusses requirements for advertising and outlines
appeal mechanisms for parties that feel the tendering process has been unfair
or obscure. GPC would like to be kept informed both of any problems that
cannot be resolved locally and of examples of successful resolution of issues
that could be used as examples of good practice. Regards - Karen Day - GPC
secretariat – PDF
Copy |
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GMS
dispensing quality payment scheme SFE Amendment -
posted 26 Sept Dear LMC,
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Rural
Proofing the new GMS Contract
- posted 26
Sept This
report examines the new GMS contract from the rural perspective. Primary care
is an essential part of health service delivery and in rural and remote parts
of the |
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(GPC) Issues regarding sending attachments to GP records in electronic form - posted 5 Sept This
is advice from the Joint GP IT Committee (JGPITC) of the General Practitioners
Committee (GPC) of the BMA and the Royal College of General Practitioners (RCGP). This
document is not designed to be a definitive guide regarding the electronic
transfer of documents relating to the GP held patient record, but merely to
list the areas that need to be considered. It
is limited to the transfer of electronic documents (not the core record)
between practices, or from practice to PCT, where the documents are not also
being sent in hard copy. - Link |
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(GPC & DOH) ‘Health reform in This
commissioning framework is split into two parts; the main document and an
annex, which contains the bulk of information relevant to LMCs
and GP practices. This GPC analysis
seeks to highlight the new and/or important developments in policy that will
be relevant to GPs/LMCs. |
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NHS Pensions Newsletter – NHS Pension Benefits
& Retirement (TN 14/2006) This
letter contains important clarification about NHS Pension benefits and the
rules regarding qualifying for retirement benefits. Following a number of
recent enquiries, discussions have been held with the Department of Health
who have confirmed that the underlying requirement of the NHS Pension Scheme
Regulations is that all Scheme members must demonstrate a clear intention to
retire from the NHS before NHS pension benefits are awarded. - Link - External |
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(GPC) Identifying services that should not be
provided by GPs under primary medical services GPs
should not be asked to accept overall clinical responsibility for patients in
secondary care institutions or for those in any setting where the clinical
needs of the patient fall outside the normal skills of GPs. On
several occasions in the past, the GPC has been made aware of GPs being asked
to provide services to patients residing in institutions or homes where the
type of services expected do not fall under the responsibility of primary
care. At the margins between secondary
and primary care, most typically in various types of long-stay psychiatric
institutions, it is sometimes difficult to define in any absolute sense where
responsibility for patient care lies.
This is not in patients’ best interests. Care
for patients in intermediate care can also present problems of poorly-defined
professional remits. This problem is
salient in the light of the trend to discharge relatively high-dependency
patients from hospitals to other institutions. Although GPs often provide vitally
important care for patients in intermediate settings, the care these patients
need will sometimes go beyond that which most GPs are trained, or contracted,
to provide. With
this in mind, this short guidance document has been put together to help
doctors decide whether or not the patients they are treating in institutions
and residential homes fall under standard primary medical services contracts. - Link |
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(GPC) Guidance on the implications of the new age
discrimination legislation - posted 5
Sept The
Employment Equality (Age) Regulations are due to come into force from October
2006. The regulations are complex,
cover all areas of employment and apply to both ‘workers’ and
partners. They will make it unlawful
to discriminate against any person on the grounds of their actual or
perceived age. Employers need to
ensure that they make themselves fully aware of all the relevant provisions. - Link |
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As part of the changes to the
arrangements for dispensing doctors for April 2006, agreed as part of the GM ·
Appendix A – ·
Specification of Requirements for Receiving |
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GPC backs new GP Practice Workload Survey - posted 9
August Family
doctors and health teams at around 4,000 GP Practices across the |
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Professional
Education and Training PEAT at |
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Update of LMC Secretariat
Database The LMC is
updating their database at present and although we receive details from the PCTs this is not always up-to-date. Enclosed
with this newsletter is a “Practice Contact Details” form which
it would be appreciated if the practice manager could complete and return to
this office by the end of June. The form
is also posted on the LMC website - this can be faxed, emailed or posted to Electronic Copy of Document – Doc updated
12 July |
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Good Doctors, Safer Patients: Proposals to strengthen the
system to assure and improve the performance of doctors and to protect the
safety of patients A report by the
Chief Medical Officer This report aims to create a new approach to promoting and assuring
good medical practice and protecting patients from bad practice. The Chief Medical Officer was asked to
undertake this broad review of medical regulation, following Dame Janet
Smith’s inquiry into the circumstances surrounding the murders
committed by Hyde GP, Dr Harold Shipman. The CMO’s
report, Good doctors, safer patients, advises Ministers on measures to
strengthen the arrangements in place for the protection of patients. The
report contains 44 detailed recommendations. Proposed changes include
devolving some of the powers of the GMC to a local level, changing its
structure and function, and creating a new framework for revalidation. The
Secretary of State for Health has welcomed the publication of Good doctors,
safer patients and has launched a period of consultation. |