Christmas & New Year Opening Hours
We understand NHS England have now issued a letter to all practices confirming our original thoughts hared in eth mid November bulletin – practices who usually provide Saturday opening as part of their extended hours will be expected to do so on Boxing Day as the Bank Holiday is Monday 28^th December NOT Saturday 26 December. System Resilience Groups (SRGs) will be required to provide assurance for this period. This GPC guidance from previous years should be read in conjunction with the NHS England letter. The CQC has also issued this myth-buster on opening hours that is worth reading.

Patient Registration
GPC has published this updated guidance on patient registration which aims to clarify the conditions surrounding patient registration in GP practices. The key point to remember is that anyone, regardless of nationality and residential status may register and consult with a GP without charge.

NHS England has worked with patient groups and advocacy organisations to produce this guidance on registering with a GP. It clarifies that patients do not legally need to provide documentary evidence of identity, immigration status or proof of address, to register with a GP. Practices should not refuse registration on such grounds and there is no contractual duty to seek such evidence. This approach is supported by the BMA General Practitioners Committee. The Department of Health will shortly be consulting on extending charging of overseas visitors. However, the consultation does not propose introducing charges for anyone attending an NHS appointment with a nurse or GP in primary medical care.

CQC Registration Requirements for GP Federations
The Care Quality Commission (CQC) guidance on CQC registration requirements for GP practices working together as part of federations has recently been updated with more information. The guidance will help groups of registered providers who wish to form a federation to understand their duties in regard to CQC registration. The guidance summarises the issues that federations should consider and provides case studies to illustrate different registration scenarios. CQC National GP advisor Nigel Sparrow has also discussed what the guidance means in a new myth-buster.

1995 NHS Pension Scheme, Final Pay Controls
Practices may be aware that final pay controls were introduced this year for those in the 1995 NHS Pension Scheme. As a result of these controls, a penalty may be applied to an NHS Employing Authority, including GP practices, where a scheme member is awarded an increase to pensionable pay which exceeds CPI plus 4.5% and where this increase will be included in the calculation of the best of the last three years pensionable earnings increase. Guidance and working examples can be found on the BMA website.

Men ACWY Vaccination for Freshers
As you may recall we sent a message out in October about the missed cohort of Men ACWY vaccination for freshers. NHS Employers’ FAQ in relation to this has now been updated to accommodate those who left school but may be older than 17 or 18 but don’t fall in to the freshers programme. This is to ensure practices are remunerated for vaccinating these patients. The updated FAQ reads as follows:

Q: What about teenagers and young adults who left school in the last term of the 2015/16 school year and may be going to university in autumn 2015 but do not meet the age criteria for the two MenACWY programmes?

A: Children who finished school year 13 in August 2015, but are either younger or older than the normal age and are therefore outside the cohorts defined in the specification are expected to be at similar risk to their peers. As these patients fall outside of the eligible cohorts defined by the NHS England service specifications, they would not covered by the automated data collections. Where these children self-present for vaccination, practices should discuss the vaccination of these patients with their commissioner on a case-by-case basis. In line with established procedures, where the practice and commissioner agree to the amendment the commissioner will adjust the practice achievement.
In the spirit of the agreement, GPC would expect these practices to be remunerated for vaccinating these patients. All of NHS Employers’ FAQs on vaccinations and immunisations are available here.

Antimicrobial Resistance, e-learning Package
As part of the 5 year antimicrobial resistance strategy, Health Education England has produced an e-learning package to help healthcare staff understand the threats posed by antimicrobial resistance  (select the open access session on the link).

The updated Health & Social Care Act Code of Practice now contains ‘Antimicrobial stewardship’ (AMS), defined as ‘an organisational or healthcare‑system‑wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness’ and recommends:

“3.6 Providers should ensure that all prescribers receive induction and training in prudent antimicrobial use and are familiar with the antimicrobial resistance and stewardship competencies.”

The NICE AMS systems and processes guideline also recommends:

1.1.10 Consider using the following antimicrobial stewardship interventions:

• education‑based programmes for health and social care practitioners, (for example, academic detailing, clinical education or educational outreach).

Request for GPs to Help with Audit of Research Requests
The BMA’s Ethics department is seeking GP practices who are willing to provide examples of requests for patient information that they receive from researcher to help them work with the Health Research Authority (HRA) to develop a set of standards for researchers. The aim is to hopefully reduce the work required for GP practices to comply with requests for research.

Researchers regularly approach GP practices to provide patient information or support with recruitment for research projects; often there can be gaps in the information provided in these requests, which can leave doctors unsure if they would meet their legal and professional obligations if they complied with the request. GPs would often like to support research, but are unable to because they do not have time to find out the additional information they need.

The standards the BMA are developing with the HRA will inform researchers about when it is appropriate to contact GPs with requests for information, and what information to include. To do this, they need to know more about the nature of the requests that practices currently receive. For example, they would like to know what kinds of people or organisations are making these requests, what type of research they are doing, and what kind of information and/or support they are requesting from the practice. The BMA are seeking the help of any GP practice that is willing to send photocopies of all requests for information that they receive from researchers between now and 29 Jan 2016.  If you are interested in helping, or would like more information, please contact Hannah Quigan – hquigan@bma.org.uk or 020 3058 7463.

Bulletin 287