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Somerset LMC Weekly Update Friday 5th June 2015

Date sent: Friday 5 June 2015

Sent to all Somerset GPs and Practice Managers previous editions of the update can be found here

Insurance Company  Requests for  Patient Records The BMA has published a helpful template letter that you may find useful when  asked for medical records to be disclosed using  the “Subject Access Request” route.

It  can be found at

We have also had more information from Niche Health about their electronic  PMAR reporting system, iGPR.  Practices will have heard from Legal and General about this system, which they propose to start using. 

The LMC has been  reassured  about the information governance and data security  aspects of iGPR,  particularly as their server is hosted within an N3 data centre.

We are also reasonably  happy about the  selection process for data uploading given that  the GP has to check the report before it is sent – as he or she would for the paper equivalent- and can remove material if necessary.    There is the  opposite risk that relevant material will not be included  in the upload, but if the insurer is making an application using this system we presume that is their problem, not ours, unless there is an explicit request for additional or non-coded data.

However, the LMC  remains  concerned  about  practices accepting  indirect consent from the patient.  Whilst we appreciate that there is a legal basis and precedent for accepting digital signatures, we think there are three problems with them  in this context.

First, without a “wet ink” signature there is no certainty that the person filling in the electronic on-line application form was in fact the patient.

Secondly we cannot be sure that consent has not been withdrawn after the request  has been sent, and finally we need to know that the patient has been fully informed as to  what information is being requested before the practice,  as the  data controller, can send anything to a third party.

We understand  that this matter is still under discussion between the BMA and the Association of British Insurers, and an informal GPC opinion suggests  that LMCs  “ advise constituents to decline digital signatures at present, citing that there is no agreement with GPC yet. After there is agreement it will be up to constituents whether to accept these or not.”

The LMC  position remains therefore that practices should obtain written consent  from patients  in all cases.

Outcome Based Commissioning Sometimes the most important things have the most unassuming names…

There is a growing realisation amongst health service planners that the system needs  fundamental change  if it is to survive.  The NHS is - and always has been - an “illness” service, reacting to crises that should have been prevented long before. But there is an emerging consensus that we have to change that mindset, and stop paying providers for “doing stuff” to people  and switch to a system that actively supports them to maintain their own health 

However, this simple and self-evidently sensible proposition  is going to start a of events that will dramatically change the way in which the different parts of the NHS relate to one another and work together.  It is the Big Idea behind many of the changes already underway and it is now being discussed in the   the form of Outcome Based Commissioning. In essence this takes a whole system view of health, which , might, for example  mean providers are no longer paid for he number of hip operations they do or for the number of physiotherapy attendances a patient has, but for the  percentage of the population who are still independently mobile at the age of 85.

The  consequences of such a change could be spectacular, and a lot of the things about the current NHS we find frustrating like political constructs over “choice” , marketisation, the commissioner/provider split and distinctions between primary, community, and secondary care become simply irrelevant.

Such a change cannot happen overnight and the path to a more rational and humane health service will not always be smooth and no change can happen without clear information on the consequences for General Practice and without agreement from them.   In common with most health commissioners, Somerset CCG is starting to look at the broad principles about how such a system could start to be assembled in our county. The LMC is closely involved with these discussions and we will, of course, continue to ensure that the voice of general practice is clearly heard and the current and future best interests of Somerset practices are protected.

Processing of Genital Tract Specimens for bacterial Vaginosis Practices will have received correspondence from Dr Mike Smith Clinical Lead at South West Pathology services advising practices of a change in process and the purchasing of PH strips to carry out these tests.  We have written to Dr Smith are regarding this correspondence and the fact this is not a commissioned service and will be speaking to the CCG at our meeting with them next week.  We would advise practices not to implement any change at the current time and we will advise on the outcome of our talks as soon as we can.

Cold Calling to sell medication (scam) We have been advised by practices that a number of their patients in the Burnham Highbridge and Cheddar area have been contacted by phone by a caller purporting to represent their medical centre, they then ask what medication the patient is taking and try to sell them other medications, this has been reported to counter fraud and NHS England to establish if widespread. There appears to be no breach of confidentiality, and the calls are ad hoc.

Remedial action in response to the Dridex malware attack important action for affected practices The detail has been removed from this article, please contact the LMC office or Where practices require further advice, they can contact the HSCIC via quoting ‘cyber incident’ in the subject line or by calling 0300 303 5678, selecting option 2.

LMC Training 11th June spaces available

Places available on the following training next week - Thursday 11th June at Taunton Rugby Club

Information Governance/Data Protection training – 9.30-12.30
FP34’s, Vaccine Claims & Personally Administered Items training – 13.30-16.30

Please book by Tuesday 9th June


Kind Regards



Jill Hellens

Executive Director

Somerset LMC

TEL: 01823 331428

Fax:01823 338561

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