Bulletin 15.04.2014

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Bulletin 15.04.2014

Unplanned Admissions DES, Updated Guidance
Revised guidance on the unplanned admissions enhanced service clarifies that:

  • Care plans for patients initially added to the case management register have to be in place by the end of September 2014, not June 2014 as was originally specified. This recognises the difficulty with producing care plans for these patients for the end of June and ensures consistency with the payment structure in place for the enhanced service.

  • Patients initially added to the case management register have to be informed of their named accountable GP and care co-ordinator by the end of July 2014, not June 2014 as was originally specified. The July deadline for the named accountable GP applies only to patients added to the register who are under the age of 75, as patients aged 75 and over will have been informed of their named GP by the end of June (existing patients) or within 21 days of registration (new patients), as per the requirements of the GMS and PMS regulations for a named GP aged 75 and over.

The changes are made on pages 7 and 15 of the guidance. Practices signing up to this voluntary service should read the guidance and ensure that any requirements from their CCGs beyond the enhanced service are met with additional resources. The GPC have made it clear to government that reducing unplanned admissions is not in the direct control of GPs and requires the whole system to play its part, from community services to urgent and social care. This enhanced service is part of a wider programme of care for vulnerable older people, and NHS England expects CCGs to give practices an additional £5 per head to support them in managing such patients, as specified in the Everyone Counts planning guidance (paragraphs 36 and 37).

QOF Recalculation of Achievement
This newsletter from HSCIC has been sent out to practices in relation to the re-calculation of their QOF achievement.

QOF Business Rules v28
Version 28 of the QOF Business Rules have now been published on the HSCIC website.

Vaccinations & Immunisations Guidance 14/15
Guidance on a number of changes to the vaccination and immunisation programmes has now been published along with a summary table. Note that guidance or service specifications are still outstanding for some of the vaccinations; these will be added as soon as they are finalised. In short – the changes refer to:

New vaccination programmes commencing 1 April 2014
Hepatitis B for new born babies at risk (SFE) – guidance published.
MenC vaccination booster for freshers (ES) – guidance and service specification published.

Existing vaccination programmes continuing from 1 April 2014
MMR (SFE)
 – for patients over 16 who self present at practices (this was an enhanced service in 2013, but has now moved to the SFE, so no new service specification will be published).
Pertussis for pregnant women (Temporary ES) – service specification 2014 has been published.
Rotavirus (SFE) – guidance published.

Existing vaccination programmes continuing after August 2014
Seasonal influenza for at-risk patients (DES/ES) – widened so that it mirrors the at-risk groups set out in the Green Book to include pregnant women, but excluding 2-4 year olds – guidance and service specification to be published in June 2014.
Childhood seasonal influenza (ES) – this has been extended to include children aged 4, so that the new cohort is children aged 2-4 – guidance and service specification to be published June 2014.
Pneumococcal (DES) – There is an addition to programme to include the cohort as indicated within the Green Book – i.e. those aged under 65 in the at-risk groups – guidance and service specification to be published June 2014.
Shingles (routine cohort patients aged 70, SFE; Catch up programme (patients aged 78-79, ES) – Guidance and service spec to be published soon.
Men C for freshers (England)
Full details were included in the CLMC bulletin dated 010414

Increase in Prescription Charges April 14
The Department of Health (England) has announced that prescription charges in England will increase from £7.85 to £8.05 for each medicine or appliance dispensed as from 1 April 2014. The charge is also intended to increase by 20p to £8.25 in the following year.

Controlled Drugs and Repeat Prescriptions
Though we have not heard any reports locally, some CCGs in the country are telling GPs they cannot put Controlled Drugs on repeat prescriptions, which is incorrect. There appears to be some confusion generated by only reading the first sentence of a paragraph in the NPC’s Guide to the management of controlled drugs in primary care (12/09) on page 53 it says:
It is clear under the current legislation that repeat prescribing of CDs in Schedule 2 and 3 is not permitted. However, management systems which allow the patient to receive a prescription (hand signed by a practitioner) without a consultation is not subject to legislation, but is a clinical decision made on a case by case basis. It is good practice that patients should be reviewed before prescribing Schedule 2 and 3 CDs.

The repeat prescribing systems within practices are not the definition to which the regulations refer – the CCGs are confusing repeat prescribing within a clinical context (i.e. as every GP would understand it) with a “repeatable prescription” which is defined in the Pharmaceutical Services Regulations. They are correct in so far as Schedule 2 or 3 drugs cannot be prescribed on such a form but there is no restriction whatsoever on what may or may not be contained within the patient’s practice based medication repeat list.

Amendment to Generic Medicine Reimbursement Prices: April 2014
NHS England has reduced generic medicine reimbursement prices (Category M) from April 2014 by £10 million per month, equivalent to £120 million in a full year – view NHS E letter here. The Drug Tariff will be amended from April 2014 to reflect this change.

MRCGP Exam Costs
You may have been contacted by the RCGP regarding tax relief on AKT and CSA examination fees paid since 2009. This will translate into a significant tax saving. Please see the dedicated RCGP web page for more information about this issue.

GP Retainer Scheme North East
Health Education North East (previously the Northern Deanery) would like to raise awareness locally about the GP Retainer Scheme  they run. This is an opportunity for practices (funded) as well as for GPs wishing to retain a part-time clinical commitment.

CCGs 1 Year On, GPC Surveys
April marked the first anniversary of the Health and Social Care Act and CCGs. The GPC are carrying out a short survey  to assess GPs’ views and experiences of CCGs, and are interested in the perspectives of all GPs, from sessional doctors to partners, CCG clinical leads and board members. It should only take a couple of minutes to fill out and the results will help inform GPC policy. The BMA has also marked this anniversary by launching a campaign to repeal the act, highlighting the damaging effects of imposed competition and tendering, and pressing the need for policymakers to prioritise integration over competition. You can read about the launch event in Westminster and provide your views/experiences of working under the Act via email to info.gpc@bma.org.uk  or by posting on the BMA forum.

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