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Somerset LMC Weekly Update Friday 16 August 2019

Date sent: Friday 16 August 2019

Sent to all Somerset GPs and Practice Managers          This and previous updates are available here

Network News:

Safeguarding Reports and CNSGP: GPC rep Mark Sanford-Wood writes, “Following further discussions on some of the finer definitions of the scope of CNSGP, we are pleased to announce that it has been agreed with DHSC and NHS Resolution that the compiling of safeguarding reports for NHS patients will now be included within scope. It was initially thought that as these reports can be chargeable under collaborative fees arrangements they should be deemed to be private work and therefore out of scope. However, lobbying from the BMA extended an alternative view of these statutory reports as being reimbursed by the system rather than a private service to patients. This perspective has been accepted by DHSC and NHSR and therefore actions originating from the completion of safeguarding reports after 1stApril 2019 will be covered by CNSGP.”

NHSE is consulting on out of area (OOA) registrations given the expansion of digital first primary care: with a deadline of 23rd August. A “digital first provider” (DFP) is one that uses video or other remote consultation and so registers patients away from the CCG where they reside. NHSE is concerned over a funding lag following the new registrations to DFPs worrying that there is potential for double payment after a rapid migration of patients away from conventional primary care creates many “ghosts.” More positively they acknowledge our concerns that DFPs cherry pick younger, fitter, low demand patients, that they do not offer a full range of service and also create barriers to integrated community services and screening. NHSE is proposing to change funding of CCGs so that they allow a threshold of 1000-2000 patients to register OOA; beyond this an APMS contract would be awarded to the DFP. LMC IT Lead Stuart Baker points this would seem to presume there being only one DFP with whom all the 1000-2000 would register, namely Babylon /GP at hand? NHSE accepts difficulties measuring OOA patient registrations but proposes to change IT systems to help. NHSE wants to keep global sum payment the same for OOA registrations rather than reducing them by anything from £0.72-£2.93. Shockingly this is what NHSE has calculated the added value that practices deliver for being able to actually see examine visits patients! NHSE do not think it worth the bother to deprive DFPs of this paltry sum. More equitably there is talk about altering the new registration premium currently paid to DFPs as there a large drift back to conventional GPs, 25% in a year in one study. Perhaps if a new patient stays for over six months they could get the premium? Stuart reports NHSE’s hopes DFPs will solve to poor provision in deprived areas but could only detect wishful thinking that PCNs will sort it all out. He concludes Babylon will come and steal “easy patients” if we don’t come up with a local remote consultation response. As this would destabilise primary care it should be a priority for PCNs. Dr Baker is attending a conference to see how to embed remote consulting into EMIS. He concludes there a very clear steer that video consultation will eventually become contractual and so we may as well get on with it!
BMA response to consultation.

Somerset Integrated Digital e-Record (SIDeR): The LMC fully supports SidER which will enable practices to view other clinical and social care systems using a single log in. The Tier 2 Information Sharing Agreement and first use cases will be released by the CCG for DocuSign signature next week. Designated signatories and practice managers have been contacted with details of how the new e-sign system will operate so identified signatories should look out for a DocuSign email from Susan Fisher. You may have spotted a rogue message that was circulated through DocuSign last week – an unintended part of the ‘dress rehearsal’ – for which the CCG apologised.. Signatories may be assured a due diligence process will have been completed which includes engagement with the LMC.

Blue Badge Scheme Changes: Somerset County Council Customer Contact Service took over the Blue Badge Service in April 2018. A spokesman told us, “before this time Blue Badge Applicants completed the forms stating they had medical conditions and, unless they were seen in a clinic, we only had their word they had these conditions. Obviously this was open for abuse. Department for Transport does not make medical evidence a compulsory requirement, it is a suggestion for all local authorities. We were in the minority in Somerset from other councils I consulted in not asking for medical evidence from applicants. As we introduced a new system for SCC for Blue badges in February we made a number of changes, that included the need for applicants to produce evidence of medical for conditions that they had. We have asked for one of the following:

As you can see, these options do not require time from the surgery or a GP. During a recent regional training session I attended, I was told that the GP Print out was available from all surgeries, free of charge... [but] we agreed not to proceed as above documents we require are satisfactory.”
However, from the end of August those with Hidden Disabilities will be entitled to apply for a Blue Badge. These are “people who cannot travel without risk of serious harm to their health and safety or someone else's (such as young children with autism), people who cannot travel without "very considerable psychological distress" (BBC News) and “… drivers or passengers with dementia, anxiety disorders or reduced mobility, the anticipation of travel difficulties such as finding a parking space can build on top of the stress of the journey itself” (Gov.uk website).The evidence criteria remain the same for all applicants but some are bound to approach practices for evidence. As you can see from the above there is no need to provide a letter or medical report but all patients can be directed to the three evidential criteria above.

Windows 10 Enterprise (Win10) Upgrade for general practices – Compatibility check: Most computers provided the CCG use Microsoft Windows 7 but support will end this year. The NHS will not sanction unsupported software so CCG funded and SCWCSU supported computers will be upgraded to Win10 Enterprise with Advanced Threat Protection (ATP). Work to replace older computers has been delayed as Win10 licences were not made available NHSE but Somerset will receive a full licence allocation imminently. In the meantime Somerset has used a few Win10 licences to help find any incompatible hardware or software. IMPORTANT: For any hardware and software not provided through SCWCSU each Practice must contact their supplier to confirm if it is compatible with Win10 and, if not, is there is an upgrade available? If you are considering new hardware or software please ensure it is Win10 compatible or can be upgraded. Also please make sure you have licences and information to reinstall third party software/hardware.Any questions please liaise with GP IT on TopDesk.

Flu vaccine ordering: If you’re short of QIVc or QIVe you can still place orders. The LMC buying group can help (link) you will need to be logged in to view, there is also a link to the list of manufacturers is here. We know GSK is only accepting in-season ordering from the Autumn. More information is available from england.swscreeningandimms@nhs.net.

LMCs Buying Group: Have you had a look at the suppliers recently? a lot of new companies offering good discounts for our practices including Royalty Free Music https://www.lmcbuyinggroups.co.uk/suppliers/royalty-free-music all Somerset practices are members of this group, if for any reason you have forgotten your log in please contact info@lmcbuyinggroups.co.uk.

And finally, the Greta Thunberg memorial item: A single HFA- propelled MDI has the same carbon footprint as driving a car for 180 miles. Dry powder inhalers are not suitable for everyone, of course, but predictably Scandinavian countries use MDIs at a rate less than half the MDIs of the UK.

 

Kind Regards

 

Jill

Jill Hellens

Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY

Tel: (01823) 331 428            
Fax: (01823) 338 561     

www.somersetlmc.co.uk
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