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Weekly Update Friday 20th March 2015

Date sent: Friday 20 March 2015

GMS Contract 2015 -16: Enhanced Services Specification

Over the next few weeks the GMS contract documentation for 2015-16, including enhanced services specifications and QOF guidance, will be published by NHS England.

The clinical enhanced services specifications (for Childhood flu, Seasonal flu and Pneumococcal, Men C, Pertussis for pregnant women, Shingles catch up, and Dementia) are already available on the NHS England website and the BMA website will be updated shortly to reflect these changes and provide links to these guidance documents.

Information Governance (IG) Toolkit Survey
Personalised Health and Care 2020: a framework for action  published by the National Information Board, proposed that HSCIC should, by October 2015, ‘relaunch the Information Governance Toolkit to reflect enhanced information governance and data security requirements’.

To support development of the new toolkit, HSCIC has launched a survey  asking GP practices, amongst others,   what they think about the current toolkit, what they like about it, and how it might be improved.

You can access the survey at Link to Survey. The closing date for responses is Wednesday 25 March. Any  comments and feedback will help shape the development of the new look toolkit. 

Flu Vaccine Programme  for 2015-16
As the number of flu immunisations purchased and administered has continued to rise ( now some 100, 000 in Somerset)  the difference in acquisition cost between the various brands  is having an increasing  effect on the CCG’s prescribing budget.

Whilst practices remain free to choose whichever of the available products they feel is most suitable ( a number are available through the LMCs Buying Group for members) the CCG is understandably keen to encourage practices to select lower cost products.

Enzira and Influvac   - both available through the Buying Group -  remain the CCG’s preferred choices, and  the LMC and the CCG both  also suggest that practices consider ordering from more than one supplier  so as to minimise the risk of serious disruption to this year’s immunisation programme if any particular manufacturer has a supply problem.

Somerset Domestic Abuse Newsletter
The latest edition of Somerset Domestic Abuse Newsletter.   It contains  a lot of useful information and guidance here on all areas of interpersonal violence, including  how to access  some local and national  specialist services, and where to obtain advice.

Bank Holiday Additional Opening Proposal - New use for CCG Primary Care Resilience Funding
Most practices have been taking part in the data collection ES offered  by the CCG over the winter, and this has already yielded useful  information about the quantity, range and variability of urgent demand in general practice.

For 2015-16 the CCG plans to use some of the “resilience fund” that it has allocated to primary care to explore whether asking practices to offer additional opening  hours for urgent  primary care problems over Bank Holiday weekends reduces demand on A&E and secondary care, and relieves pressure on the whole unscheduled care system.

By now practices will have had a letter from the CCG asking for expressions of interest in the first pilots, and the scheme is refreshingly simple and flexible -  just how you provide the service is open to negotiation.

The key elements are that additional opening should be for “urgent”  problems, that is, the sort of thing for which  111 triage would  advise the caller to see a GP the same day. You need to be prepared to see patients from other practices  (in the longer run, this would be something that federations could explore) and you need to have a way of recording consultations and passing information on to the “home” practice.  An obvious solution would be for the receptionist  to put the patient on to EMIS with an “Immediately Necessary” registration code and for the receptionist  to print out the record and give it to the patient as he or she  leaves.

The service is specifically not intended to provide second opinions,  chronic disease  management or repeat prescriptions, and  home visiting is at the discretion of the practice. You could, for example,  choose to visit  your own patients but refer those for whom you had no records to the OOH service.

The LMC agrees  with the CCG that practices are likely to need at least three people on duty during additional opening, but the number of  days (there are four available in total) , your  hours of availability,  and  the details of staffing are all open to negotiation.

Because of the short notice for this first trial run,  several things like the treatment of prescribing costs and the  reporting format (we are promised this will be simple) have not been  finalised,  and the volume of work is still unpredictable, but we do hope that some practices will be prepared to give this a go so we can start to get a feeling for how useful  additional opening could be. It is important to emphasise that this is not part of your GMS/PMS contract, and it is funded by the CCG not NHS England.  Participation is entirely voluntary, and it is not the thin end of a wedge  of expectation that  practices will  open 8-8 every day of the year.  The CCG knows as well as the LMC that GPs are already working over their capacity, but this trial should give us a little more information to help plan a sustainable future.