Back Pain Pathway App
We have been made aware of an app (provided by Inhealthcare) for the evaluation of the Regional Back Pain Pathway for new acute low back and radicular pain which can be downloaded onto PCs. To run the evaluation via the app, GPs are advised they only need to click once for those patients who provide consent and this will pull through patient contact details (name and contact number). Inhealthcare will then provide the patient with a link to an outcomes based questionnaire. Practices are not obliged to use this app. LMC worries sit around:

• Who gets the consent
• How is it recorded
• Is this only for those referred or all patients coded with back pain – if it is follow up of the referred cases to conduct an audit of the service it may be acceptable under the contract requirement to engage with audits/provide information as reasonably requested. Even if the provision of information is reasonable, the use of the app to do so cannot be enforced. It could be deemed under DPA that this is passing on patient details for something other than patient care so the patient would need to be clear that a third party will be contacting them for audit purposes. It goes without saying that CLMC do not believe the responsibility for the bullets above should sit with the practice without the resource to be able to do so. Without resource and governance assurance, the providing of patient identifiable data for a third party to contact a patient may not be deemed as reasonable.

TPP/QRISK2 Issue
SystmOne practices should have received a number of emails and letters with regard to code mapping issues with the QRISK2 Calculator in SystmOne.If you have not received these and require further details places contact janice.foster@nhs.net. We understand that the expectation is that the average SystmOne practice will have approximately 100 patients affected by errors in the QRISK2 scores. NHS England have been made aware of the workload implications for practices as a result of this incident, which will vary (potentially significantly) from practice to practice. GPC are clear this must be recognised. NHS England will be carrying out an audit, using a number of practices, to assess the workload impact. The issue of how practices will be compensated for this additional work has not yet been resolved but this is something which GPC are insisting NHS England addresses to ensure that practices are resourced appropriately.

Prescribing with Confidence
GPC has raised concerns about GPs being pressurised to prescribe specialist medication outside their competences, with particular reference to gender dysphoria. The GMC has proposed that GPs should consider prescribing ‘bridging medication’, where the local NHS has insufficient access to provide specialist treatment. GPC believe that GPs prescribing in this way would be breaching the principles of good medical practice, and it should be a responsibility for NHS commissioners to ensure patients have access to appropriate specialist services. GPC also object to GPs coming under pressure to prescribe under shared care arrangements. This should always be voluntary, and based upon the GP having the requisite competence and ability to provide ongoing monitoring.  GPC believe that this should be under a formal locally commissioned arrangement, and have highlighted that the GMC guidance places a worrying expectation on any GP, regardless of their knowledge and competence, to continue prescribing specialist medication in this instance.

CQC Ratings Related to Practice Funding
An analysis from the BMA has revealed that there is a relationship between CQC (Care Quality Commission) ratings and the level of funding of a GP practice; the more funding the practice has, the higher their CQC rating is likely to be. The research also demonstrated wide disparities in funding for practices. This all comes as no surprise, in that we know that CQC inspections incur considerable time for GP managers and staff in preparation for inspection as well as on the day – not to mention the significant expense. It is grossly unfair that practices with lower resources are disadvantaged and put in a situation where they have to focus more on box-ticking preparation for inspections, rather than being supported to prioritise patient care. GP practices must not be unfairly judged when they are not being given the tools they need to run their practices effectively. This further highlights fundamental flaws in the CQC inspection process, and which is why GPC is calling for it to be replaced with a fit for purpose system.

ICAS Small Companies Guidance
The Institute of Chartered Accountants of Scotland have kindly shared this article which may be of interest to you.

Sessional GP Bulletin
The latest Sessional GP newsletter can be viewed here.

LMC Annual Conference Resolutions 2016
The 2016 Annual Conference Resolutions have now been published.