Fit Note Data Extraction & Publication
Practices have received a communication from the Health and Social Care Information Centre (HSCIC) on the extraction and publication of fit note data. The extraction is intended to allow the Department for Work and Pensions (DWP) to collect data on fit note usage to inform policy development and evaluate the Fit for Work service.

The data being collected will be fully anonymised and will include:
• The number of computer-generated fit notes issued;
• The number of patients recorded as ‘unfit’ or ‘maybe fit’ for work;
• Fit note duration;
• Gender;
• Health condition type aggregated to high-level diagnosis code;
• Location, including CCG area;
• Whether workplace adaptations were recommended.

The Joint GP IT Committee of the BMA and RCGP (JGPITC) was consulted on this data collection and has taken steps to reduce the burden on practices and clarify the legal position. The legal basis for the collection of this data is the issuing of Directions under section 259 of the Health and Social Care Act, and as such it is recommended that practices comply with this legal requirement.

There is also a legal requirement under the Data Protection Act (DPA) for practices to inform patients of the extract through fair processing. The DWP has recommended practices provide a brief overarching statement for patients, for example, on the practice website or notice board. The statement should include links to further information for patients seeking more detail. The template statement, plus links, is available within the briefing pack sent out to all practices. Practices may also wish to inform patients in person when attending the practice for a fit note. Please note that data will not be extracted for those patients with a Type 1 objection recorded i.e. those who have objected to their identifiable data from leaving the practice for purposes beyond their direct care. These objections will be respected, even though the extract does not include any patient identifiable data. Data will be collected in February 2016 (to include fit notes issued from December 2014) and published from spring 2016. Aggregated data will be published on the HSCIC website at CCG level and above.

Further information for practices is available online.

Maternity Locum Reimbursements
NHS England has now sent a clear communication out to local teams that the maximum period of non-discretionary locum reimbursement for GPs on maternity leave is 26 weeks. It is hoped that this will stop local teams’ attempts to limit reimbursement to 20 weeks – if practices find they are still encountering a 20 week conversation please email the LMC office – janice.foster@nhs.net

Avoiding Unplanned Admissions & Core Plan Reviews
The Avoiding Unplanned Admissions (AUA) enhanced service specification states that patients who remain on the case management register from the previous year will need to have at least one care plan review during 2015/16. Elsewhere in the guidance the timeframe for reviews is stated as within the last 12 months. GPC understand a number of practices have been penalised due to this ambiguity, having planned to complete care plan reviews during the course of 2015/16. GPC formally raised this issue with NHS England on the basis that it is unacceptable for practices to be denied payment due to a discrepancy within the guidance. Practices have incurred significant work in implementing this enhanced service, acting in good faith in their interpretation of the specification. We are awaiting a response from NHS E.

Expiry Date of FluMist Nasal Vaccine
This year the FluMist® Quadrivalent vaccine is available as well as Fluenz Tetra® vaccine, due to a shortage of Fluenz Tetra. However, practices need to be aware that the expiry date of the FluMist vaccine is 24 February 2016, and should not be used thereafter. The following information was included in the PHE vaccine update (no. 237):

When does the FluMist nasal vaccine expire?

To ensure timely supply, changes in the supply schedule were required. This has resulted in a mismatch between the actual expiry date and that printed on the packaging and labelling. The two batches of FluMist quadrivalent being supplied (FL2113 & FL2118) must not be used after the 24 February 2016. This does not affect the safety, quality or efficacy of the batches. In agreement with the MHRA, a pre-planned withdrawal of any unused stock of FluMist quadrivalent will begin on the 25 January 2016. This will help ensure that no time-expired vaccine remains in circulation. AstraZeneca’s logistics provider, Movianto, will contact you to arrange collection. Please quarantine any unused FluMist quadrivalent ahead of 24 February 2016. This should avoid accidental administration prior to collection.

Batches of UK labelled Fluenz Tetra will not be subject to the withdrawal and may be used up to the expiry date stated on the carton and nasal applicator.

Cessation of National Supply of Paracetamol Sachets for the MenB Immunisation Programme
Public Health England (PHE) informed that as the temporary supplies of paracetamol sachets, to be given after the doses of the Men B vaccinations for infants have been given, have been fully distributed, the central supply of paracetamol sachets is being phased out. The updated patient leaflets make it clear that parents will need to make arrangements to have infant paracetamol at home in time for their baby’s first immunisation appointment, and practices will be able to order these leaflets in paper copy, to be handed out at the time of the vaccination, from late December through the DH Orderline.

MDU Medico Legal Advice
The MDU has advised GPC that it wishes to dispel the myth that MDU members could be disadvantaged if they contact their 24 hour medico-legal advice service. One of the MDU’s core services is to provide expert medico-legal advice to members and they positively encourage members to call for advice at any time; whether pre-emptively when they need guidance on how to approach a potential matter, or when something has gone wrong. The MDU receive over 30,000 calls from members to its advice-line every year helping members to avoid potential problems and to mitigate the position if a problem has arisen. The MDU very positively encourages members to contact it whenever they need it’s input.

Contact details are:
UK 0800 716 646
Ireland – 1800 535 935
Fax (UK) 020 7202 1662
Email: advistory@themdu.com
Website: http://www.themdu.com/about-mdu/contact-us

NHS England Funded OOH Indemnity Cover
Following intense lobbying by GPC, NHS England has announced plans to make £2m available, to help with GP indemnity costs to GPs providing OOH (out-of-hours) care this winter – December through to March 2016. In partnership with medical defence organisations, NHS England has developed a time-limited scheme to offset the additional indemnity premium GPs would incur when working additional OOH sessions. GPC has long argued that the significant extra costs to GPs doing OOH work is disproportionate, often deterring many from providing this extremely valuable aspect of general practice care. While GPC welcomes NHS England’s announcement this is a temporary short-term solution to what is a much wider problem, with indemnity costs having rocketed across all aspects of general practice provision, which is in need of a considered longer-term response. It is also unclear whether those doctors who have already paid additional fees to cover extra OOH shifts this winter, will have their costs reimbursed. GPC is seeking clarity on this.

GPC Primary Care Infrastructure Fund Survey Results
The GPC survey of practices’ experience of the primary care infrastructure fund (now called the primary care transformation fund), was launched in response to a growing number of concerns about difficulties with practices receiving support and funding to progress schemes. The four-year £1bn infrastructure fund is intended to provide practices with much needed financial support to improve their premises, and on the back of four in 10 practices stating that they do not have the space to provide adequate core services. The responses the GPC received sadly reveal a picture fraught with delays, lack of clarity in processes and threats to the funding of approved schemes.

The key findings show:
• Of those with supported bids, 54 per cent experienced delays of more than six months
• ‘Lack of leadership or clear process’ and ‘lack of expertise within the local NHS England team’ were the main reasons cited for these delays
• Of those with approved bids, 83 per cent believe that the project will need to be extended beyond the March 2016 deadline to receive funding
• Around one in five (22 per cent) of those facing delays have been advised by their local NHS area teams that they could lose their funding altogether
• For all those that received initial approval, ‘refusal to meet recurrent costs by NHS England or the local CCG (clinical commissioning group)’ is cited as a major obstacle by a quarter (22 per cent) of respondents.

GPC maintain it was always unrealistic to expect such building projects not to suffer unexpected delays, and this has been fuelled by lack of clarity and delayed processes on NHS England’s own part, in particular via its area teams. It is therefore unacceptable that any area team should rescind funds on approved projects which have experienced delays. GPC have taken this up with national director for commissioning development at NHS England Ros Roughton, who has provided written assurance that there will be reasonable allowance for slippage into next year. Some area teams are clearly diverging from this assurance, creating further uncertainty and delays, and it is vital NHS England ensures consistency in implementation nationally. It is important to restate that these funds are vital for GPs and practices to deliver core and expanded services, and patient care will suffer if resources are not deployed to improve the impoverished infrastructure of the GP estate. GPC will continue to press for the funds to remain in general practice and for a more robust framework to be put in place for the future years of the fund.

Elections to BMA Council
Nominations open on 7 January 2016 for the election of 18 voting members of the UK council of the British Medical Association to serve for a two year term of office for the sessions 2016-17 and 2017-18. The sessions normally run from June to June. Further details on the activities of council will be available from the website and the details of the election will be advertised in the December editions of the BMJ. Candidates must be current members of the BMA and nominations must be made via the following weblink: www.votebyinternet.com/bmanoms2016. The link will be open from 7 January 2016. The deadline for completed nominations is 4pm Friday 5 February 2016.

GPC Sessional GP Newsletter
This edition focuses on the Special LMC Conference in addition to features, news and information aimed at supporting sessional GPs as well as blogs from sessional GPs; including one from newly quailed Pooja Arora on her experience of getting ill whilst working as a locum and another from Paula Wright on how to use clinical IT systems effectively whilst working as a locum GP. The e-newsletter also highlights useful appraisal tips for sessional GPs.

Royal Benevolent Fund Support
The Royal Medical Benevolent Fund, the charity for doctors, medical students and their families, has recently released its Annual Review. In 2014-15 the RMBF helped 212 beneficiaries with financial support, nearly 50% of whom were GPs or GP trainees. The charity has been helping doctors and their families for nearly 180 years, giving support through times of adversity and hardship which may have been caused, for example, by personal tragedy, financial problems, ill health or an accident. Reaching the doctors who are most in need continues to be both a top priority and a challenge for the charity. You can contact the RMBF if you are in need of financial support or if you know of a colleague who may need help – please visit the RMBF website.

Cameron Fund & BMA Law Partnership Clinics
The Cameron Fund, in association, with BMA Law is offering a series of partnership clinics early in 2016.Further information on how to access these is available here.