Change in Average List Size for 14/15 QOF Calculations
Following some queries on the change in the average list size figure used in the CPI for QOF purposes, the Health and Social Care Information Centre (HSCIC) has provided the following explanation:
“There have been a number of questions raised concerning the recent change to the average list size figure used in Contractor Population Index (CPI) that is used as part of the year end QOF achievement.

NHS England would like to assure users that the figure of 7,087 is the correct figure for use and is the average list size figure as at 1 January 2014 as required under the Statement of Financial Entitlements.

There has been no change in the calculation of CPI other than to ensure an incorrect figure is replaced with the correct figure in time for calculation of 2014/15 QOF Achievement.

It was identified that the previous figure (7,052) was incorrect and communicated in error having been calculated based on the data available at the time rather than using the information calculated and reported directly from Exeter Registration System (which is the correct and routine procedure for confirming average list size for use in CPI). The error was spotted and amended immediately and before the calculation was used, this ensured that all practices will be paid the correct amount due and we would not be in a situation where funds had to be reclaimed.

NHS England apologises for the misunderstanding and confusion caused by calculating and publishing the incorrect figure.”

Legislative Changes to Electronic Prescribing of Schedules 2 & 3 Controlled Drugs
As a result of the public consultation and advice from the Advisory Committee on Misuse of Drugs (ACMD), legislative amendments have been made to enable the electronic prescribing of Schedules 2 and 3 controlled drugs for NHS and private prescribers. Prescriptions will be signed with an advanced electronic signature and sent via the electronic prescription service (EPS), with its additional security features. The amendments require the total quantity of Schedules 2 and 3 CDs dispensed to be recorded in words and figures within the electronic prescription, as is the case for paper prescriptions for these drugs. This public consultation response document and letter containing advice from the ACMD have both been published on GOV.UK. Three statutory instruments underpin this change:

NHS – comes into effect from 1 July 2015 and enables:

• those providing GMS and PMS to issue electronic prescriptions (including instalment prescriptions) for Schedules 2 and 3 CDs via EPS

• those providing GMS and PMS to issue electronic prescriptions via the EPS for prescriptions written as part of a private arrangement but within an NHS consultation, when the medicine required cannot be prescribed at NHS expense. Where the electronic prescription contains Schedules 2 or 3 CDs, the EPS is the only electronic system which can be used.

• providers of pharmaceutical services and local pharmaceutical services to dispense electronic prescriptions for drugs listed in Schedule 2 or 3 of the Misuse of Drugs 2001Regulations (MDR) when they are sent via the EPS.

Human Medicines – comes into effect from 1 July 2015 and:

• enables prescriptions for Schedules 2 and 3 CDs to be signed with an Advanced Electronic Signature (AES) – this will be limited to the EPS

•  corrects a transposition error which arose during the consolidation of the Medicines Act into the Human Medicines Regulations 2012 (HMR) – see below for background.

Home Office – comes into effect from 1 June 2015 and contains provisions which enable:

• electronic prescription forms to be sent via the EPS for Schedules 2 and 3 CDs.

Prescription Pad Security Policy
The LMC has been made aware of a performance issue with regard to Rx pads. Practices are reminded that they require a robust policy for the security management of their Rx pads.

Gender Dysphoria
The GPC was invited to comment on a draft version of the NHS England guidance ‘Primary Care responsibilities in relation to the prescribing and monitoring of hormone therapy for patients undergoing or having undergone gender dysphoria treatments‘. Although some changes were agreed, NHS England refused to specify that these services should be commissioned outside the GMS contract through shared care arrangements. The key phrase in the document is this:

“Once a patient has completed the care pathway and has been discharged by the GIC [Gender Identity Clinic], GPs should offer them the usual range of primary healthcare services that are available to other patients.”

This is absolutely correct as these are defined in the GMS contract (Part 8.1.2, Essential Services). However, GPC believes that as treatment for gender dysphoria requires specialist input, therefore, should sit outside GMS and needs separate commissioning and funding to ensure patients with gender dysphoria receive the specialist service they require.

GP Networks, amended GPC guidance
The GPC has recently added to its guidance on forming GP networks. The BMA has also launched a database of GP networks and is inviting GP networks to register for inclusion. If any newly emerging GP networks are interested in joining, please contact Janice.foster@nhs.net with a few contact details (name, area, email address, number of practices) and we will arrange your inclusion in the database.

Sessional GP Newsletter
The April edition of the sessional GP newsletter includes major features on the new national GP Induction and Refreshers Scheme and the sessional GP specific findings from the recent GP survey. It also features news and information aimed at supporting sessional GPs as well as blogs from sessional GPs.