Somerset LMC Weekly Update Friday 18th March 2022
Date sent: Friday 18 March 2022
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
Barry: Following the very sad passing of Dr Barry Moyse last Friday, Dr Nick Bray previous LMC chair and close friend of Barry has written a tribute to Barry which we felt summarised what a truly amazing person he was. Brace yourself.
Dr Karen Sylvester LMC chairman
- Access to Records Important Update
- Pneumococcal Vaccine Claims
- Trauma Informed Chaperone Policy
- Correction to last week’s article 11.03.22 - QOF Payments Linked to the Childhood Vaccination and Immunisation Program
- Imminent Changes to the Completion of the Medical Certificate of Cause of Death (MCCD)
- Oximetry@Home and Covid-19 Antivirals (CMDU) Services
- All Things Bright and Beautiful LMC Calendar
- Job Vacancies
- Top Tips...
Access to Records Important Update: The "Access to Records" program will NOT be launched in April. As anticipated the program has now been delayed until July the GPC continue to meet weekly with the NHSE teams to look at all aspects of the program and raise concerns.
Pneumococcal Vaccine Claims: As practices may be aware, from April 2022 it will no longer be possible to submit claims to the NHS BSA for reimbursement of locally procured PPV23 vaccines administered, and practices should only be using centrally procured PPV23 vaccine for immunising their eligible population. From 1 April 2022, the pneumococcal vaccines (both the PPV23 and Pneumococcal polysaccharide conjugated vaccine) will be removed from the bulk vaccine list, for which claims are made via the FP34PD/D appendix form, and practices will need to submit pneumococcal vaccine reimbursement claims via a prescription form (FP10) for each administration instead.
Trauma Informed Chaperone Policy: As promised in a recent LMC bulletin, the CCG safeguarding team and LMC have worked together to develop a new “Trauma Informed Chaperone Policy” that incorporates some of the learning from survivors of sexual abuse. You may like to consider replacing your old chaperone policy with this new one. But if not then please do incorporate some of its principles in your practice. Dr Jo Nicholl, the Designated Doctor for safeguarding children and Barry Moyse worked together on this policy and Jo would like to thank Barry for his wise and sensible contributions. We are very sad that he is not here to see this final version being shared with practices.
Correction to last week’s article 11.03.22 - QOF Payments Linked to the Childhood Vaccination and Immunisation Program: The GPC have confirmed that NHSEI have refused to re-negotiate the QOF payments linked to the childhood vaccination and immunisation program. The QOF payment is triggered by achievement thresholds, there is a lower points threshold for which you will receive a payment, please follow this link (pages 90-93) for details where you will see the total points, lower threshold points and percentage achievement thresholds. The percentage thresholds are high and there is no ability to exempt patients, except for contraindications. As before the LMC therefore advises practices to look in detail at their projected achievement under this QOF domain for 2021-22, as some practices may find that they have provided the service optimally in the past year, but may not receive any of the QOF income associated with the domain. Practices in this situation will need to consider the viability of providing this service in future years.
Imminent Changes to the Completion of the Medical Certificate of Cause of Death (MCCD): The Coronavirus Act 2020, which introduced easements to death certification processes and cremation forms, expires at midnight on 24 March 2022. Some changes have been retained on a permanent basis and other processes revert to previous practice.
The following provisions are continuing after 24 March 2022:
- The period before death within which a doctor completing a MCCD must have seen a deceased patient will remain 28 days.
- It is still recommended that medical practitioners send MCCDs to registrars electronically.
- The government’s intention is that the form Cremation 5 will not be reintroduced after the Coronavirus Act expires. A medical practitioner will be able to complete the form Cremation 4, if they attended the deceased (including visual/video consultation) within 28 days before death, or viewed the body in person after death (including for verification). Electronic signature includes being sent from the secure email account of the person completing the form Cremation 4. Question 8 on form 4 can cause confusion: "Please state the date and time that you saw the body of the deceased and the examination that you made..." However there is no legal requirement to examine the body, "not examined" would suffice.
The following emergency provisions are changing with the expiry of the Coronavirus Act after 24 March 2022:
- The provision temporarily allowing ANY medical practitioner to complete the MCCD will be discontinued. Only a medical practitioner who has ‘attended’ the deceased for their last illness (i.e. in person or video but NOT telephone consultation) will be allowed to complete a MCCD. A medical practitioner with GMC registration will be able to sign the MCCD if they attended the deceased during their final illness up to 28 days before death, or viewed the body in person after death, and can state the cause of death to the best of their knowledge and belief.
- The key change to MCCD completion is the mention of viewing the body. In essence, this is not an expectation but an option if verifying a death. If the above cannot be met, which is entirely acceptable, then an MCCD can still be issued once the coroner has authorised it by means of completion of Form 100A. In Somerset, though ‘attended’ is ambiguous in the Somerset County Council documentation attached, the Coroner’s team have stated that unless a patient has been ‘seen’ as described in the above paragraph, the coroner would need to be informed.
- Informants will have to register deaths in person, not remotely.
The full summary C1566_-coronavirus-act-expiry-death-certification-and-registration-easements-from-25-march.pdf (england.nhs.uk) Somerset’s guidance is attached here. Further information on verification of death GP mythbuster 13: Verification and certification of death | Care Quality Commission (cqc.org.uk). We will update with further guidance as it develops.
Oximetry@Home and Covid-19 Antivirals (CMDU) Services: Report that they are seeing very high rates of Covid-19 infection in Somerset. Fortunately, the progression to severe (respiratory) Covid pneumonitis is increasingly rare. In the past month the Oximetry@Home team have supported nearly 1000 patients with pulse oximeters in their own homes and only 5 patients have required admission; none of whom developed severe Covid. Currently there are no patients with Covid in either intensive care units and very few requiring supplemental oxygen.
The antivirals are currently restricted by national policy to a very small group of those with heavy immunosuppression either through high dose medications (eg solid organ transplant or complex immune-mediated disease) or cancer and associated therapies. Risk factors for Covid such as obesity, underlying respiratory, cardiovascular disease or diabetes does not make patients eligible for antivirals.
Both Oximetry@Home and CMDU teams are at or exceeding their capacity and ask that only those considered at highest risk of complications are referred so they can respond to GP referrals in a timely manner.
All Things Bright and Beautiful LMC Calendar: During Lockdown the LMC team decided to have a competition of the photos they took while out on their daily walks. We decided to have these made into calendars for practices, and from March each month there is a top tip or reminder, we do hope you enjoy them when they land in a practice in tray near you soon.
Can be found here. New item this week is:
Crown Medical Centre, Venture Way, Taunton, TA2 8QY
Tel: (01823) 331 428
Fax: (01823) 338 561
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