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Somerset LMC Weekly Update Friday 13th May 2016

Date sent: Friday 13 May 2016

All Somerset GPs and Practice Managers                        This and Previous updates can be found in full here

Somerset GP Provider Confederation Meeting A meeting was held on the 3rd May at Taunton racecourse with two representatives from each federation to share innovations across the patch amongst other items, this was found to be very useful for both the LMC and federation leads, please see the notes from the meeting, we plan to hold a further meeting in July.

PMS Contract PMS Practices in Somerset will have received their contracts at the end of last week. This contract was nationally negotiated with no scope for local negotiations. The intention of NHSE is to improve equality among practices and remove contractual differences between PMS and GMS practices.

We have not received any concerns from our South West colleagues,  but it is always worthwhile for practices to read and compare with their current PMS contract.

Having advice from your accountants will help in deciding whether financially it still makes sense for you. You may also find it useful to have your payment schedule from NHSE and the contact remains

The LMC is still in negotiations with the CCG regarding PMS reviews and how the premium which has been removed from PMS practices will be reinvested into general practice so there will be more details to follow in this regard.

Responsibility for Checking Contents of GPs Emergency Bags & Acting on MHRA Drug Safety Alerts A  GP who does a lot of CQC visits  has told us that if an inspection reveals something wrong with  the contents of a GP’s bag – for example, an injection is out of date, then the CQC response will depend on  the specific arrangements  within the practice

“the key to this issue is who is responsible for checking the GPs bags. If it is the practice and there’s something wrong e.g. expired medicines then it is a regulatory breach.  If it is the GP’s  (personal) responsibility then it is their individual failing and this should be reported to the GMC.”

You may like to reflect on these   words from  a CQC Press Release in 2014:

Professor Sparrow says practices should not feel threatened by inspections as the vast majority of them will be fine. “We want to make sure it is seen as a helpful visit as well as regulatory.”

The GP also commented that  many practices are still not picking up MHRA drug safety alerts and so are  not running the relevant searches.  Don’t forget that you can register on the MHRA website to receive automatic alerts which will mean that this important action is not missed

Firearms Correspondence Templates Devon LMC and Surrey and Sussex LMC have kindly shared template letters that practices are free to use, these are now posted into the website here

GPC Advice

Not to Issue Both an FP10 and a Private Prescription The GPC has taken legal advice to whether GPs can issue private prescription forms at the same time as FP10s, in circumstances where paying for the latter  is a cheaper option for the patient than paying the NHS prescription charge. The question was  whether this might either  be a breach of the Regulations or collusion to defraud the NHS of the  prescription charge.  

The advice they  have received is clear that in cases of treatment under the primary care contract, GPs may not issue private prescriptions alongside and as an alternative to FP10s. In any case where a GP is obliged to issue an FP10 the concurrent issue of a private prescription will be a breach of obligation. In any case where a GP is obliged or entitled to issue an FP10 the concurrent issue of a private prescription will be conduct calculated to deprive the NHS of a small amount of money and will on that account also be wrongful.

The advice is therefore that GPs do not issue private prescriptions under these circumstances.

Some of you may be aware of a recent article written in the Financial Times in connection with the NHS Property Service Limited’s desire to move towards full cost recovery when it comes to service charge recovery from their tenants (including GP practice tenants) and the attempts to recover backdated demands.

Service Charge recovery We are writing to re-circulate a short form note that was first disseminated in 2015 on the recovery of service charges. This provides guidance on the costs that can and cannot be recovered by any landlord, including NHSPS, through service charge demands. The ultimate position is that any landlord attempting to charge service charges (whether those charges are backdated or current) must have regard to the specific circumstances relating to the tenant from whom they are seeking recovery. In particular they must have regard to the lease agreement that is in place (if any).  

If you or any colleagues are being issued demands for service charges which bear no resemblance to what you have agreed (whether in writing or otherwise) then please do not hesitate to query the basis upon which that is being claimed. Indeed, if a blanket approach towards recovery of service charges is being taken it is highly probable that practice/tenant specific arrangements are being overlooked. If you have ongoing concerns about the treatment you are receiving when it comes to service charge demands please take professional advice to ascertain your legal position in connection with paying the same.

In order to seek to avoid the ongoing concerns over transparency when it comes to issuing service charge demands and the impact that full service charge recovery may have on practices we have, as part of our discussions and negotiations with NHSPS and NHS England in connection with a template lease with NHSPS which are now drawing to a close, sought provisions, commitments and reassurances which should go some way to address these issues. This includes transitional funding that has been offered by NHSE to support practices in the payment of service charges to allow efficiency measures that NHSPS are committed to deliver to filter through.

The above aside, and turning back to the article in the FT, if you or your colleagues are being issued service charge demands (whether backdated or otherwise) where there has been no agreement towards their payment (whether that agreement is in a lease or elsewhere) please do send us details to so we can collate the information and seek reassurances from NHSPS, as part of a committee that is being established between representatives of NHSPS, the Department of Health and the BMA, that consideration will be given towards practice/tenant specific circumstances.   




Kind Regards



Jill Hellens

Executive Director

Somerset LMC

TEL: 01823 331428

Fax:01823 338561


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