ࡱ> Y[X @ 5bjbj 8R؝؝-  L^$ %D^Z%\%\%\%\%\%\%$(Rq*% rrr% %rF  Z%rZ%:#, "$  "# %D%0%#R++++"$ ++ "$r\Z%% $ D Appendix 1 NEGOTIATORS REPORT July GPC GP Trainee contracts SGPC have received confirmation that, following their recent opposition to proposed employment contracts for ST1 and ST2 trainees in general practice, the Scottish Government Health Departments (SGHD) will issue instruction to all Scottish health boards not to issue hospital terms and conditions of employment to these trainees. SGPC will now take work forward with NHS Education for Scotland and SGHD to implement the GPC-COGPED national framework contract in Scotland for all trainees in general practice. We were very concerned that the South West and North West SHAs were proposing to employ GP trainees at ST1 and ST2 level in general practice on hospital terms and conditions and in the case of the South West, without full payment of the GPR supplement. The GPC Chairman raised the issue with NHS Employers and both SHAs. We have now received confirmation from the South West SHA that they will ensure that these trainees are employed on terms and conditions appropriate to their general practice placement, and with full payment of the supplement. This is a very good result. The full GPR supplement is worth approximately 7,000 to each six month placement. The procurement process for new primary care services a new guide for GPs A guidance note to help GPs navigate the bidding process for new primary care services is now available. It pulls together all the publicly available information on the procurement process and is a factual guide to help GPs and LMCs understand the changes taking place in primary healthcare. The guidance sets out the timescale, principles and process of procurement and advises GPs and LMCs to engage with local consultation processes. It also suggests that LMCs and GPs closely involve their local authoritys health Overview and Scrutiny Committee wherever new services are being proposed as these can be very influential. The guidance can be accessed from the following link:  HYPERLINK "http://www.bma.org.uk/ap.nsf/Content/PrimCareProcure08" www.bma.org.uk/ap.nsf/Content/PrimCareProcure08 Kings Fund report on Polyclincs The Kings Fund released a critical report on the Governments plans to introduce polyclinics. The analysis examines the impact polyclinics would have on quality of care, the accessibility of services, costs, and, whether or not the NHS has the medical workforce in place to deliver them. It warns there will be significant risks to patient care if polyclinics are poorly introduced into the health service. The BMA responded stating that we share many of the concerns about polyclinics highlighted by the Kings Fund and noting that the consultants rejected an imposed model of privately-owned polyclinics across England at their annual conference. The full report can be accessed here -  HYPERLINK "http://www.kingsfund.org.uk/publications/kings_fund_publications/index.html" www.kingsfund.org.uk/publications/kings_fund_publications/index.html Kings Fund reports on NHS Reform The King's Fund has published two linked reports on the future of the NHS reform agenda. The first report is based on the findings from an expert working group made up of leaders from the NHS and private sector. It makes strong calls for the Darzi review to hand much greater freedom and control over how local health services are run to professionals, with ministers and the DH starting to take a back seat but being responsible for overall standard setting and funding allocations etc. Specifically, it calls for greater competition in primary care; MPIG to be phased out; and Ministers to set a clear timetable for PCTs to stop providing services themselves and instead focus on strengthening commissioning. The second report is all about the barriers that are preventing more care being taken out of hospitals and delivered in the community - it makes strong recommendations for how local commissioners can deliver this. This was commissioned by the DH and was specifically intended to inform the Darzi review.  HYPERLINK "http://www.kingsfund.org.uk/publications/kings_fund_publications/shifting_the_balance.html" www.kingsfund.org.uk/publications/kings_fund_publications/shifting_the_balance.html  HYPERLINK "http://www.kingsfund.org.uk/publications/kings_fund_publications/making_it_happen.html" www.kingsfund.org.uk/publications/kings_fund_publications/making_it_happen.html Extended Hours statement from the GPCs Trainees Subcommittee The GP Trainees' Subcommittee notes that with regard to the current impositions by HMG over the offering of extended hours for routine general practice appointments, that: (i) A GP trainee's contract provides for seven clinical sessions and three educational sessions per week, with an additional benchmark amount of OOH sessions per annum. (ii) The role of the GP trainee within primary care is supernumerary in terms of service provision, for the purpose of high quality education and training experience. (iii) The extension of routine hours excludes ancillary and supportive primary and secondary care structures questioning the equivalent educational value of GP trainees replacing experience within core service hours with service in extended hours. And calls for: (i) GP trainees' clinical sessions to take place, wherever possible, within core hours to offer the highest standard of education and training for the trainee. (ii) A GP trainee who wishes to undertake a clinical session within extended hours should be supervised and supported at all times on site by their trainer, or equivalent. (iii) GP trainees who wish to replace a core clinical session with a session in extended hours should do so only through individual choice and should face no coercion to do so. Focus on the Dynamising Factor This guidance note has been updated in light of the result of the Judicial Review and is available on the BMA website at the following link  HYPERLINK "http://www.bma.org.uk/ap.nsf/Content/focusdynamfactor0305" www.bma.org.uk/ap.nsf/Content/focusdynamfactor0305 The rates for the dynamising factor for the years 2004-05 and 2005-06 are now being calculated by the Technical Steering Committee and GPs will be advised as soon as they have been determined. Additionally, under the judgement, the Secretary of State is free to re-determine the calculation of dynamising factors for the two years 2006/08. It is understood that the Secretary of State intends to replace the previous determination made for 2006/07 and 2007/08, which will be likely to result in a DF for both years of 1. It is expected that confirmation of the details of this method and its implications will be clarified during any consultation process. GPs will be informed as soon as further information is available. Directory Services Scams The GPC secretariat is receiving an increasing number of queries from practices who have received large invoices from companies offering directory services. The companies generally contact small businesses offering to list them in their paper or web-based directory. The way that the offer is worded usually makes it seem as though the listing is free of charge. However, buried somewhere in the small print is often a clause allowing the company to charge a hefty fee (often of 1,000 or more) for the listing. Practices should always exercise due caution when sending their details for inclusion in such directories. If they do receive a large, unexpected invoice, they should contact their local trading standards office for further advice. We would be grateful if you would cascade this warning to any practices in your area. British Dental Association Case The GPC has recently become aware of a case relating to a local Personal Dental Services contract whereby the judge in question has ruled that a clause in the contract allowing the PCT to terminate the contract on notice without cause was not within the spirit of the agreement nor within the intention of the parties and therefore was not operative. The judge concluded that the insertion of this clause negated the effect of the other termination clauses which were based on default. The Secretary of State is now appealing the decision of the court. This clause and the content of the agreement relating to termination, almost exactly mirrors the termination clauses mirrored in GPs PMS agreements and therefore we would advise any PMS practice that is worried about the threat of termination from a PCT to argue that a precedent has been recently set in law by the above case and argue that by virtue of this current decision the clause may well be invalid. The PCT will probably take the decision to wait until the outcome of the appeal decision. Pensions Ill Health Retirement Update from the BMA Pensions Department: You may be aware that there have been significant problems with regard to the implementation of the ill health retirement section of the NHS pension scheme regulations. The implications will affect the NHS pension schemes of the devolved nations. The regulations themselves were agreed and signed off by DoH/NHS Employers/TUs in February on the very strict understanding that DoH would provide TUs with a memorandum of understanding which explained the agreed policy intentions and also an agreement to incorporate these policy intentions into the scheme's medical advisors guidance. We were given assurances at the time (both verbally and in writing) that with regard to meeting the criteria for tier 2 ill health retirement, members "could not reasonably be expected to work across a general field of employment" and that they would only be judged against "work of a broadly equivalent standard". These assurances were clearly very important in ensuring that our members would not have their application for tier 2 benefits rejected on the basis that they could do work requiring much lower skills, qualification and experience that bore no relation to the posts they had previously held. These principles formed part of the consultation document and the heads of agreement paper. We expected the memorandum of understanding to be sent shortly after the meeting on 27 February. Despite several reminders it did not arrive until 11 June. Staff side were disappointed to note that the memo did not include the guarantees we were previously promised. During subsequent correspondence it became apparent that the use of the word "equivalence" was unacceptable to DoH solicitors, despite them having advised DoH officials throughout the meeting on 27 February. DoH then prepared a policy intention document (known as a provision definition) which again failed to provide the assurances we were seeking. A meeting was held where, in an attempt to make progress we submitted a revised version of the provision definition, containing two amended paragraphs. This amended version was rejected by NHS Employers/DoH on the grounds that they were standing by their previous written statement to the effect that with regard to meeting the criteria for tier 2 (the higher tier) ill health retirement members could not reasonably be expected to work across a general field of employment and that they would only be judged against work of a broadly equivalent standard. The DoH and NHS Employers appear to have reneged on the agreement that we made with them. It would seem inevitable that this matter will now be referred to Ministers by senior staff side representatives.   "&+,@A? B ? @ |jXFX3X%h{5B*CJOJQJ\^Jph"h[aB*CJOJQJ\^Jph"h{B*CJOJQJ\^Jph"hnjB*CJOJQJ\^Jph+hnjhnj>*B*CJOJQJ\^Jph(hnjhnjB*CJOJQJ\^Jphhohnj5CJOJQJhnj5CJOJQJh?5CJOJQJhE5CJOJQJhoh~ 5CJOJQJh{5CJOJQJh[ah{5CJOJQJaJ  +,A? @ & MNMNOp  gdH 7$8$H$gdH 7$8$H$gdnj$a$gd$a$gd{5 & KLMNO¯wcTG<1hTb 5CJOJQJhS5CJOJQJhxhHCJOJQJh]ah{0JCJOJQJ'jh]ah{CJOJQJUh{h{CJOJQJh{CJOJQJjh{CJOJQJU%hxhHB*CJOJQJ^Jph%hxhHB*CJOJQJ^Jph+hxhH5B*CJOJQJ\^Jph%hTb 5B*CJOJQJ\^Jph(h{h{B*CJOJQJ\^JphOp89?@  3y%&9}ùùù䨚sfRs'jCh]ah{CJOJQJUh{h{CJOJQJjh{CJOJQJUhH5CJOJQJh{B*CJOJQJphhHB*CJOJQJph!h^hHB*CJOJQJphh{CJOJQJhhHCJOJQJhHCJOJQJhCCJOJQJh^hHCJOJQJh3zhH5CJOJQJCFRTthhtXhIhh{h{CJOJQJ^Jjh{CJOJQJU^Jh{CJOJQJ^JhUhHCJOJQJ^JhTb CJOJQJ^JhUhHCJOJQJ^JhCCJOJQJ^J+hUhH5B*CJOJQJ\^JphhTb 5CJOJQJhH5CJOJQJhhHCJOJQJjh{CJOJQJUh]ah{0JCJOJQJDGcdeQRJ 0^`0gd{gd 7$8$H$gdHgdHTUVabcdetٹ٭ٹxeO<%h 5B*CJOJQJ\^Jph+hp>h 5B*CJOJQJ\^Jph%hTb 5B*CJOJQJ\^Jphh B*CJOJQJ^Jph+jh]ah{CJOJQJU^Jh{h{CJOJQJ^Jh{CJOJQJ^JhUhHCJOJQJ^J h]ah{0JCJOJQJ^Jjh{CJOJQJU^J+jh]ah{CJOJQJU^JPQVWXٴw^B^0^#h)hH0JCJOJQJ\^J7jph)hHB*CJOJQJU\^Jph1jh)hHB*CJOJQJU\^Jph"hHB*CJOJQJ\^Jph(h)hHB*CJOJQJ\^Jph+h)hH5B*CJOJQJ\^Jph%hH5B*CJOJQJ\^Jph"h{B*CJOJQJ\^Jph"h B*CJOJQJ\^Jph(hp>h B*CJOJQJ\^JphVW i"j"""""$$%%&&&1&N*O*P*q***+gd gdH ) | h"i""""""""""%%&&&o]oRh(25CJOJQJ"h(2B*CJOJQJ\^Jph(hhHB*CJOJQJ\^Jph"h{B*CJOJQJ\^Jph"hTb B*CJOJQJ\^JphhhH5CJOJQJhH5CJOJQJhTb CJOJQJ^JhHCJOJQJ^J"hHB*CJOJQJ\^Jph(h)hHB*CJOJQJ\^Jph&1&&&N*O*P*p*q*******R/U/ 222222ԯt___M_M_;"hHB*CJOJQJ\^Jph"h[aB*CJOJQJ\^Jph(hRCh B*CJOJQJ\^Jph%h{5B*CJOJQJ\^Jph+hRCh 5B*CJOJQJ\^Jph"h B*CJOJQJ\^Jph%h 5B*CJOJQJ\^Jph"h{B*CJOJQJ\^Jph(hskh B*CJOJQJ\^Jph+hskh 5B*CJOJQJ\^Jph++,,// 2 294:45gd(2gd 223T4^44455(h(2h?B*CJOJQJ\^Jph"hHB*CJOJQJ\^Jph(hRCh B*CJOJQJ\^Jph6&P 1h:phq. A!"#$% CDyK 0www.bma.org.uk/ap.nsf/Content/PrimCareProcure08yK nhttp://www.bma.org.uk/ap.nsf/Content/PrimCareProcure08DyK Ewww.kingsfund.org.uk/publications/kings_fund_publications/index.htmlyK http://www.kingsfund.org.uk/publications/kings_fund_publications/index.htmlDyK Twww.kingsfund.org.uk/publications/kings_fund_publications/shifting_the_balance.htmlyK http://www.kingsfund.org.uk/publications/kings_fund_publications/shifting_the_balance.htmlDyK Pwww.kingsfund.org.uk/publications/kings_fund_publications/making_it_happen.htmlyK http://www.kingsfund.org.uk/publications/kings_fund_publications/making_it_happen.html]DyK :http://www.bma.org.uk/ap.nsf/Content/focusdynamfactor0305yK thttp://www.bma.org.uk/ap.nsf/Content/focusdynamfactor0305<@< R@?NormalCJ_HmH sH tH fA@f 'Default Paragraph Font, Char Char1 CharRiR  Table Normal4 l4a (k(No List^O^ R@? Char Char1dx1$9DH$CJOJQJmH sH tH NON R@? Char Char1 Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Chardx1$9DH$CJOJQJmH sH tH 6U@6 R@? Hyperlink >*B*phlO"l R@? Char Char1 Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Chardx1$9DH$CJOJQJmH sH tH O2 ~ V Char Char1 Char Char Char Char Char Char Char Char Char Char Char Char Char Char Chardx1$9DH$CJOJQJmH sH tH HBH  Balloon TextCJOJQJ^JaJFV@QF -gFollowedHyperlink >*B* phRObR vd Char Char dCJOJQJmH sH tH J^@rJ vd Normal (Web)dd[$\$CJaJB'B vComment ReferenceCJaJ88 v Comment TextCJ@j@ vComment Subject5\O ? Char Char1 Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Char Chardx1$9DH$CJOJQJmH sH tH zOz H Char Char Char Char Chardx1$9DH$CJOJQJmH sH tH -R +,A?@&MNMNOp D G cdeQRJVWij1N"O"P"q"""##$$'' * *9,:, -00x0x000000 000 000000 0 0000000000 000000000x000 0000000000000000 00000000x00`0000 0 0x000000 00 0000 0000(00x+AM cJij1N"O":, -@00Z@00Z@00 dZ@00Z@000Z@0 0 gZ@0 0Z@0 0Z@0 0 YYX@0 0X@0 0@00Z@0,0 gZ@0,0Z@0,0@00@000Z@0#0 &YZ@0#0Z@0#0@00Z@0'0 &YZ@0'0Z@0'0@0000Z@0C000Z@0F0 h*@00< OT&25 "#%&(+5!$'5K% UaW-XXXXX r s  t T<u v <w x ܜy  z { `|  5 -   8 - 9 *urn:schemas-microsoft-com:office:smarttagsplaceB *urn:schemas-microsoft-com:office:smarttagscountry-region? *urn:schemas-microsoft-com:office:smarttags stockticker  eoST##'$*$ -*%* -33@@L% bq""""""R'U' *********+T,^,,,-- - - 06+RV[h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHRV[ 076<rTb  ;[o G$" [&s%.;X:yw: K<R@?zBK)N S|[[asn vfhqc4nj}adE\g* 8Lw?(2H'{FSH#=C~ ?-gv.vd*+AK- -BBB@D -P@Unknown Gz Times New Roman5Symbol3& z ArialK"Frutiger 45 LightWTms RmnTimes New Roman7&  Verdana5& zaTahoma?5 z Courier New;Wingdings"qhȒǦ5ǦO&QO&Q!924d,,3qHP)?hq.QOF changes for 2008-09 and Focus On guidance Christopher Scott Karen Day  Oh+'0  4@ \ h t0QOF changes for 2008-09 and Focus On guidance Christopher ScottNormal Karen Day3Microsoft Word 10.0@ @@q(@O&՜.+,D՜.+,\ hp|  BMAQ, /QOF changes for 2008-09 and Focus On guidance Title4 8@ _PID_HLINKSAD :http://www.bma.org.uk/ap.nsf/Content/focusdynamfactor0305,7 Whttp://www.kingsfund.org.uk/publications/kings_fund_publications/making_it_happen.html[http://www.kingsfund.org.uk/publications/kings_fund_publications/shifting_the_balance.html^OLhttp://www.kingsfund.org.uk/publications/kings_fund_publications/index.html%!7http://www.bma.org.uk/ap.nsf/Content/PrimCareProcure08  !"#$%&'()+,-./013456789:;<=>?@ABCDEFGIJKLMNOQRSTUVWZRoot Entry F]\Data *1Table2?+WordDocument8RSummaryInformation(HDocumentSummaryInformation8PCompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q