Health & Social Care Bill 2011 & Lobbying MPs

You are strongly recommended to keep up to date with the BMA Health Bill webpage, where detail on the Bill can be found. The BMA has produced a useful toolkit to inform the profession about the draft Health Bill, and also to enable members to lobby their MPs on issues that concern them. In particular, please take the opportunity to write to your MP and express your concerns using the template letters. At the GPC meeting, the following motions relating to the Health and Social Care Bill were passed:

• That the GPC recognises there is ample international evidence to show that competition over price for health care results in a poorer quality of health care provided but that competition in quality of health care provided improves the quality of health care provided. The GPC therefore resolves to promote and support amendments to the Health and Social Care Bill that will preclude price competition within the National Health Service.
• That the GPC resolves to promote and support amendments to the Health and Social Care Bill that permit commissioning consortia to choose which licensed providers are entered on their local lists from which GPs can help patients decide which provider to choose. GPs should also have access to the national list of licensed providers for patients who wish to make an ‘out of area’ choice.

Transfer of NHS staff into Shadow Consortia

On 31 January, the Department of Health published a guidance document on the implementation of PCT clusters. This discusses a number of HR issues related to the reform of PCTs, raising serious implications for the transfer of NHS staff into shadow consortia arrangements. The GPC strongly advises GPs in making any agreements with PCTs regarding the transfer of staff into roles that are in any way related to clinically-led commissioning consortia to consult current employment legislation and seek further advice from the BMA if needed. The Department of Health will be producing guidance on the assignment of PCT staff to the new organisations shortly.

Royal Wedding 29 April

The 29 April 2011 has been declared a bank holiday in the United Kingdom by the Queen. All practices should put in place their normal arrangements for bank/public holidays on that date. Bank holidays are out-of-hours periods in the NHS (General Medical Services Contracts) (England and Wales) Regulations 2004 and NHS (Personal Medical Services Agreements) Regulations 2004. The PCT will be discussing the out of hours arrangements with NDUC but this Bank Holiday, in conjunction with the preceding Easter Bank Holidays will result in practices, possibly, only being open 3 days out of 11. We expect that this will put great pressure on all elements of health provision within Tees. The LMC is working with practices, the PCT, secondary and community care and NDUC as to how this period can be best managed and we will issue further information shortly. In the meantime we urge practices to review their business continuity plans and consider possible implications for repeat prescription requests, appointment capacity etc in advance of this period.

Medical Indemnity Cover

Having adequate insurance against liability arising from negligent performance of clinical services is a contractual obligation for most GPs. Ensure your GMC/MDO subscriptions are up to date and that the organisations know your current address. Inadvertent slippages are often avoided by having Direct Debits rather than waiting for a reminder. GPs may wish to review subscriptions periodically and ascertain from their MDO, the services available to them in case of need to ensure it still provides appropriate and satisfactory services to meet their requirements. This is particularly important if you are looking to carry out private work – if the private activity is GP/redirected NHS work then it is most probably covered by your MDU but we would always recommend checking to ensure you are protected.

Blue Badge (disabled parking) Scheme

The government has announced a programme of reforms to the Blue Badge scheme. As part of the reform programme the Department of Health and Department for Transport will be reforming the eligibility assessments for the Blue Badge (disabled parking) scheme. The reform will mean a transfer of the assessment of applicants’ eligibility by GPs to assessment by independent mobility assessors and change the budget holder for these assessments from PCTs to local authorities. The GP assessments are non-contractual. The summary of the estimated timescale of delivery of the forms can be viewed here.

SCR – joint statement

The GPC, RCGP and BMA has released this joint statement with regard to the DoH review of SCR and the subsequent outcomes. The statement also includes some useful links to supporting materials for practices.

GP Practice websites

Many GP practices opt to use third party suppliers to build and host their practice websites. Some practice websites include functionality which allows patients to order prescriptions, download forms, manage their appointments or apply to register with the practice. As these websites are often hosted by companies outside the NHS, this may result in a third party processing information about patients, which could include name, address, date of birth and NHS number. Patients may be unaware that the website is not directly part of the GP practice. It is important that websites make it clear to patients that any data they submit are being handled by a third party, if this is the case. It is recommended that GPs check that any company offering services that work with patient identifiable data (PID) has appropriate information governance safeguards in place. Where data is held on servers, for example when patients complete web forms, there should be an agreement, in the form of a signed contract, with the web hosting service which states that they will not retain copies of any data.

Marmot Report – Health Inequalities

Sir Michael Marmot (the current BMA President), gave a presentation to the GPC about health inequalities and the involvement and engagement of the medical profession. This follows on from his review and the subsequent report ‘Fair Society, Healthy Lives’, published in February 2010. At the meeting, Sir Michael covered the key messages covered in the report, including:

1. reducing health inequalities is a matter of fairness and social justice
2. the lower a person’s social position, the worse his or her health
3. health inequalities result from social inequalities. Action on health inequalities requires action across all the social determinants of health
4. focusing solely on the most disadvantaged will not reduce health inequalities sufficiently
5. action taken to reduce health inequalities will benefit society in many way
6. reducing health inequalities will require action on six policy objectives:
   • give every child the best start in life
   • enable all people to maximise their capabilities and have control over their lives
   • create fair employment and good work for all
   • ensure healthy standard of living for all
   • create and develop healthy and sustainable places and communities
   • strengthen the role and impact of ill-health prevention.

To celebrate the anniversary of the launch of the report, the BMA also hosted a conference on ‘Health inequalities – the role of the medical profession’. The main purpose of the conference was to explore ways in which the social determinants of health can be addressed through local action, in particular how the medical profession can support this. The BMA (in particular, the Board of Science) continue to be involved in work in this area. Further information about the Marmot review and how to get involved.

Bowel Cancer Screening – Electronic GP Test Results

Following consultation with GPC and RCGP, the Bowel Cancer Screening System (BCSS) has announced that Faecal Occult Blood test (FOBt) result messages can now be sent electronically to GP practice systems. Practices may choose to receive electronic result messages in place of, or as well as, hard copy results letters. Abnormal results sent electronically will always be accompanied by a hard copy letter in confirmation. The FOBt “results” that are sent in this way are correctly READ coded by the NHS CFH central server before they are sent to the GP Practices. GP practices do not need to re-code them when importing into the patient’s records. For more details on how to implement this service at your practice, and to find out which practice systems are compatible or plan to be compatible, please see this announcement.

Breast Cancer Resource Pack

The charity Breast Cancer Care has developed a new information pack for patients to use after they have finished hospital treatment for cancer. It has been developed with extensive background research and is designed so that patients can dip in and out and use the parts that are pertinent to them.

National Association for Patient Participation – PPGs and GPCCs

This leaflet from the National Association of Patient Participation explains further information about its work in helping establish effective PPGs and working with commissioning consortia.