Bulletin 23.12.2014

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Bulletin 23.12.2014

Co-Commissioning, GPC Guidance
You have received information from your CCG with regard to co-commissioning – it is vital that you read this information and take this opportunity to inform their intentions. This is your opportunity to have your say – every practice should make their voice heard.
 GPC Chair, Chaand Nagpaul sent this message to all GPs and the GPC recently published this guidance designed to inform GP practices about co-commissioning, including the commissioning and performance management of general practice contracts. It is important that all practices understand these changes and their implications. This guidance follows the release of NHS England’s plans for primary care co-commissioning, outlined in the ‘Next steps towards primary care co-commissioning’ report, and the request from NHS England for all CCGs to express their intentions for co-commissioning in January. The Next Steps report provides information on the scope of co-commissioning arrangements that CCGs can apply to take on board from April 2015. This includes the option for CCGs to maintain their current arrangements and not apply for any of the co-commissioning models proposed.

The three models described in the report are:

(1) greater involvement in primary care commissioning,
(2) joint commissioning with area team (application deadline is 30 January), and
(3) delegated commissioning (application deadline is 9 January).

Amongst the many changes outlined in the report, a number are of great concern to the GPC. These include the proposal to extend the following powers to CCGs who take on board delegated commissioning:

  • newly designed enhanced services;
  • design of local incentive schemes as an alternative to the Quality and Outcomes Framework (QOF);
  • the ability to establish new GP practices in an area;
  • approving practice mergers; and
  • making decisions on ‘discretionary’ payments (e.g. returner/retainer schemes).

The GPC will be issuing further specific guidance covering conflicts of interest in early 2015. NHS England has released this Conflicts of Interest Guidance for CCGs.

CQC Intelligent Monitoring Update
The GPC is considering whether any further action might be possible on behalf of practices who were banded inaccurately. They would like to hear from any practices that were subsequently informed by the CQC that had been placed into the wrong band. Please contact Greg Lewis, glewis@bma.org.uk, in the GPC secretariat with details. Following the CQC’s introduction of intelligent monitoring, based on a narrow range of indicators, the GPC wrote to Professor Steve Field to express concern about the process and the way GP practices had been publicly banded ahead of inspection – arguing that the data used to band practices had been published without proper context and was misleading patients. The information did not take into account the differing circumstances in which GP practices operate, including levels of deprivation in the practice population, the level of support the practice receives from community services or the state of its facilities. These and other factors outside the practice’s control had a major impact on how well it performed against these indicators. It was predictable that the publication of the indicators and in particular the bandings for all GP practices in England would result in hostile press coverage that did not reflect the reality of good health care being delivered by the vast majority of them. While the CQC stated on its website that “intelligent monitoring” was not a judgement on GPs that is exactly what it became, with some uninformed and inaccurate stories at both a local and national level. The negative reporting in local media was particularly damaging as GPs and their practice staff, rooted as they are in local communities, had their reputation undermined with practices being subject to unfair criticism. Subsequently, on 5 December, the CQC announced that it was revising the intelligent monitoring indicators, as a result of which a number of practices were placed in different bandings. The GPC reacted strongly to this announcement, urging for the banding system to be withdrawn.

CQRS December QOF Reporting
There’s been an issue with the QOF reporting collection in December that has prevented QOF data from coming into CQRS. You won’t receive data back from this collection and you don’t need to take any further action.  The December collection is part of the normal reporting collections cycle for QOF. HSCIC will be running the next scheduled collection in early January. In line with previous years, payments for QOF 2014/15 will be based on final year-end achievement which can be made from April 2015 onwards. No payments are based on the data in the monthly reporting collections – other than the final year-end collection in April.

Managing Injuries to immobile Children, CCG Guidance
The CCGs have requested we forward this guidance and protocol/flowchart on managing injuries to immobile children following publication of several SCR’s in neighbouring areas in relation to significant injuries/death of immobile children. It does not replace procedures however, the CCGs hope it will support appropriate decision making and communication to parents.

Sessional GP Newsletter
The second monthly e-newsletter for sessional GPs focuses on the recent BMA Conference for sessional GPs, initial findings from our survey on sessional GP experiences of appraisal and revalidation and working as a GP appraiser.

MEDFASH Educational Tools on HIV Testing in Primary Care
MEDFASH has developed HIV Testing in Practice (HIV TIPs), an online educational tool, to help increase rates of HIV diagnosis in primary care. Launched in National HIV Testing Week, the interactive web tool will enable GPs, practice nurses and their teams to raise their knowledge of HIV and enhance their confidence in offering HIV testing. This in turn will reduce the avoidable illness and deaths that still occur because of late diagnosis. It provides updates about HIV testing in primary care; includes patient stories, quizzes, group exercises, downloadable teaching materials and an HIV testing audit tool and will help GPs and practice nurses to:

  • find out more about the importance of HIV testing in general practice
  • reflect on obstacles (barriers & challenges) to HIV testing
  • improve their own ability to diagnose HIV
  • improve their team’s ability to diagnose HIV
  • change HIV testing practice in their team.

Developing Patient Leaders
Practices may find this programme designed to develop patient leaders of interest to their PPG members. This is a free course and closing date for expressions of interest is 9 January 2015. Please find information attached regarding our Developing Patient Leaders programme. You can find further details and how to register in these supporting documents.

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