LMC update - 4 November, 2022

Accelerated citizen access to records

There has been a lot of work undertaken over our concerns about this roll out and we previously advised colleagues they had options before them including asking your system supplier to delay the roll out by using a template letter we had provided. You can find this template letter in our guidance to practices which urges for a delay to the rollout of the programme, as many practices are not currently in a position to activate it safely.  We also offer guidance on codes you can add to the records.

The Rt. Hon Steve Barclay MP, Secretary of State for Health and Social Care, announced earlier this week that the Citizens' Access to Records programme would be going live. NHS Digital are now suggesting the switch on will occur for all by November 30th and we are challenging this as our major concerns have not yet been addressed. As a reminder you can inform your supplier to pause the roll out by using our template letter in this guidance and email it to your supplier.

In response to the announcement, the BMA issued a statement calling for clarity over the deployment of the programme and assurances that practices who do not yet feel ready, have ample time as they deem necessary to make preparations in order to ensure patients are protected.

We continue to have significant concerns over your role as a data controller being ignored, the redaction software not being fit for purpose, the risk to patients (especially ones in coercive relationships) and not to forget of course the workload involved at a time when we are already seeing intolerable demands on us day to day.

We are very keen to ensure you are aware of this current guidance from NHS Digital:

• For those practices that ask EMIS and TPP by 5pm on 4 November 2022 to not enable the change we (NHS Digital) have instructed both suppliers to pause. 
• For all other practices that will not have informed EMIS and TPP to pause by 5pm on 4 November we (NHS Digital) will continue to work with EMIS and TPP to implement the change as planned, with prospective data entered into patient records from 1 November 2022 automatically becoming visible in a phased way.  

You may still wish to send in the template letter even if you missed the deadline above. We believe additional support is needed for practices to implement this change and we recommend that practices follow the guidance and steps as set out.  If you have any questions, please get in touch with info.lmcqueries@bma.org.uk

We will be in touch again next week with more information as this issue develops.

GPC England meeting update

GPC England met yesterday, 3 November, where we discussed accelerated citizens access to data, and how we have been in regular contact with NHS Digital, continuing to raise our concerns. The Committee received an update on the forthcoming negations for the 2023-24 contract, the final year of the five-year contract deal, and discussed strategy going forward.

Snapshot Survey

What are your views on the Health and Social Care Select Committee report on the future of general practice? 

• Support all the recommendations
• Support most of the recommendations
• Support about half of the recommendations
• Support less than half of the recommendations
• Do not support any of the recommendations
• I haven't read the report

Answer our brief survey here

Wellbeing

As we continue to face overwhelming pressures in general practice, we encourage practices to focus on their own team’s wellbeing.

Dr Vongai Shuro, a GP at Spilsby surgery, Lincolnshire, has written a blog considering the value of taking time out to reflect on wellbeing. Read the blog here

A range of wellbeing and support services are available to doctors, from our 24/7 confidential counselling and peer support services to networking groups and wellbeing hubs with peers, as well as the NHS practitioner health service and non-medical support services such as Samaritans. The organisation Doctors in Distress also provides mental health support for health workers in the UK, providing confidential peer support group sessions.

See our poster with 10 tips to help maintain and support the wellbeing of you and your colleagues.

Visit the BMA’s dedicated wellbeing support services page for further information and resources.

We encourage you to access any, or all, of the forms of support mentioned above, and encourage colleagues to do so too if you are ever struggling.

It is due to this crisis, that we are recommending that practices take action to preserve patient care and their own wellbeing, and our guidance on Safe working in general practice is designed to enable practices to make decisions as to how to prioritise care, and deprioritise certain aspects of their day to day activity, within the confines of the GMS contract.

Network Contract DES guidance – pay codes updated for 1^st November

When NHS England published the October variation to the Network Contract DES (directed enhanced service), and associated guidance, there were a number of placeholders in the payments section of the guidance while they waited for new pay codes to be produced.

This reflected the transition from Calculating Quality Reporting Service (CQRS) and manual payments to automated payments via Primary Care Support England (PCSE) Online, as well as the short notice introduction of the new primary care network Capacity and Access Payment. The new automated pay codes are now in place and ready for use, in the updated guidance.

NHS Property Services settlement letters

We know that many NHS Property Services (NHSPS) practices across England have recently received ‘invitation to settle’ letters, ostensibly from credit controllers, seeking to encourage NHSPS practices to settle disputed historical debt with respect to non-reimbursable service charges. Understandably, some partners may read these letters with alarm, especially as they involve a common pressure tactic of requiring a response within a tight timeframe.

Practices that engage with NHSPS on this issue should do their own due diligence. We wanted to take this opportunity to reiterate our guidance for NHSPS practices in dispute with NHSPS; in short, practices should:

• seek independent advice about their occupancy arrangements and what they believe is recoverable by way of service charges
• seek to engage with NHSPS on a good faith basis, and make clear where amounts are in dispute
• allow NHSPS an opportunity to provide evidence to support its claims with respect to the disputed amount, and
• make payments or agree to settle where they agree with the legal basis on which NHSPS have charged them, and where they believe these charges are accurate.

Punitive pensions tax rules

You should have all received the recent newsletter from the BMA Pensions Committee providing an update on their continued lobbying of Government to fix punitive pension tax rules. If you haven’t already done so, we encourage you to take a look at the newsletter which is available to view here.

Trust Registration Requirements

The GPDF has published a guidance note on primary care related trust registration requirements, which have come about as a result of the Fifth Anti-Money Laundering Directive. The guidance outlines a process by which practitioners can determine whether their trust may benefit from one of the exemptions, or whether they are required to register as a trust. The deadline for registering non-exempt trusts created before 3 June 2022 passed on 1 September 2022; trusts created after 3 June 2022 must be registered within 90 days. Read the guidance note

LMC England conference 2022

The Agenda for the 2022 LMC England Conference in London which takes place on 24 November, and the Agenda for a special conference on 25 November, have now been published.

For more information see here: Local medical committees.

Please send any queries to info.lmcconference@bma.org.uk