Pandemic Flu – North East SHA; vaccination of independent domiciliary and residential care sector staff.

There has been some discussion between the North East SHA and the LMCs with regards to vaccinating independent social care staff. It was agreed that this would be best carried out by GP practices. A letter from the SHA outlining the proposal can be viewed here.

Pandemic Flu – vaccination programme update

We are awaiting details of the Swine flu DES agreed between the DH and BMA but in the meantime please find a summary of the current situation below:

Practices will be paid only for the vaccination of patients in at risk groups.
Payment will be made for every dose of vaccination given at a rate of £5.25 per dose.
All housebound patients will be vaccinated by the District Nursing service. (DNs) This means all patients identified by the practice as housebound. Details of any criteria that can be used in defining the housebound will be within the DES
Practices will be paid £5.25 per dose for all vaccinations given by DNs. There will be no charge to practices for the work undertaken by DNs. This is the responsibility of the PCT
Practices are advised to offer vaccination to all of their own front line staff. It is for practices to define who comes within this definition. Medical defence organisations have confirmed cover for vaccinating those staff members who are not patients of the practice
Proper records of staff vaccinations, and refusals, must be kept and the GP of the staff member must be informed. Information to be recorded and sent to the GP should include: Name, DOB, reason for vaccination, date of vaccination, manufacturer and batch number. If the staff member is in an at risk group then their GP will receive payment
Any locum GP requesting vaccination from a practice in which they are working should be offered vaccination at the earliest mutually convenient time. This should be within the vaccination programme of front line staff and so there is no payment to the practice, nor should the locum GP be asked for any payment
Vaccination is voluntary and any citizen has the right to make an informed decision to refuse this treatment
It is our current understanding that Hajj pilgrims will not be asked for a certificate of vaccination against swine flu (H1N1) to acquire a Visa as it is not yet ‘universally available’ due to only the at-risk groups being vaccinated
Further detail on the vaccination programme outlines above are contained in the latest edition of the GPC news which can be viewed here.

Pandemic Flu – sick certificates

The DH has published guidance on sick certification in a swine flu pandemic which can be viewed here.

Pandemic Flu – guidance on prophylaxis

DH guidance is available here.

Replacement for QMAS (Quality Management Analysis System)

The Department of Health and NHS Connecting for Health are currently considering replacing the Quality Management Analysis System (QMAS) with a more flexible calculating and reporting system. DH and CfH are looking to extend the payments supported beyond QOF to the following:

the Quality and Outcomes Framework (the national QOF)

• quality indicators recommended by NICE that are not negotiated into the national QOF

• most directed enhanced services (DES)

• local enhanced services (LES) that work in the same way as the other payments that are supported by the new system.

DH and CfH are asking for the views of frontline staff, such as practising GPs, practice managers and PCT staff. The results of the consultation will be reviewed by representative groups such as the GPC and the RCGP. To participate in the survey, which is running during October, go to the Connecting for Health website.

Vetting and Barring Scheme

The GPC will shortly be issuing guidance for all GPs (including what a GP employer should do) on the new vetting and barring scheme. This scheme comes into play 12 October 2009, and is being introduced in stages. From the 12 October, the following applies:

1. It will be a criminal offence for a person who is on a barred list (e.g. the PoCA, POVA and/or List 99) to seek or undertake ‘regulated activity’. Regulated activity includes working as a GP, as a practice nurse and may also include working as a healthcare assistant. It applies to those who are already in post or are seeking a new post
2. It will be a criminal offence for a practice knowingly to appoint a barred person to a ‘regulated activity’ post. Also practices should require an enhanced CRB check of all new recruits and of those changing jobs who will be undertaking ‘regulated activity’. Please note that the PoCA, PoVA and List 99 are being replaced by two new barred lists managed by the Independent Safeguarding Authority (ISA – www.isa-gov.org ) – one for barred from working with children, and one for barred from working with vulnerable adults. The enhanced CRB check will now provide information held on these two ISA barred lists
3. Employers have a duty to inform the ISA if they have reason to believe that an individual has caused harm, or posed a risk of harm, to children or patients that they work with.
Please be aware that no central funding available to practices for CRB checks. Therefore the question of who pays for the check will be one for the employer and the applicant.

Sickness Certification on discharge from Secondary Care

The LMC have received examples of a number of instances when secondary care (inc. community services and hospitals) are not certifying when appropriate. Whilst you may feel it is in your patients interests to provide a sick note please be aware that this simply perpetuates the problem and it may be more appropriate to refer the patient back to the doctor responsible – GPs not treating the patient should NOT issue a sick note.