Bulletin 24.03.2010

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Bulletin 24.03.2010

Extended Hours DES 2010 and DES Directions 2010/11

As previously reported, the GPC and NHS Employers have agreed that the extended hours access scheme will continue for a further year from 1 April 2010. The main change from the existing arrangements will be that practices will be required to indicate by 30 June 2010 whether they are proposing to participate in the new extended hours access scheme (or equivalent local arrangements) in 2010/11, so that PCTs are clear early in the financial year which practices will be involved. PCTs must, before 30 April 2010, offer all existing GMS and PMS contractors in their areas the opportunity to enter into arrangements for extended hours access under the DES Directions. Contractors that wish to participate in these arrangements must submit a written proposal to the PCT within 28 days of the PCT’s offer to enter into arrangements under the DES Directions. Where possible, PCTs must enter into these arrangements with practices before 1 July 2010. PCTs will not normally be obligated to enter into extended hours access arrangements after 30 June 2010 (exceptions are set out in the Directions). However, PCTs retain the discretion to do this if they wish. Any agreement made under these DES Directions will last until 31 March 2011.

Extended access to GP services remains a priority of the English government. The DH has made it clear that PCTs should try to maximise the number of practices offering extended hours access and is keen that PCTs commission additional appointment times in line with patient preferences as expressed through the GP patient survey. Once PCTs have established which practices will be involved in the scheme, they are expected to commission alternative arrangements for patients whose practices are not involved in the DES or equivalent local arrangements. PCTs will be advised to use the balance of the funding available for extended opening to commission these services from other GP practices already participating in this initiative, GP health centres or out-of-hours providers.

There is obviously a risk in this policy of further fragmentation of routine patient care, especially as information sharing between practices is far from straightforward. The reality is that consultations taking place outside a patient’s normal practice may be limited for practical reasons to treatment of minor illness.

The new Directed Enhanced Services Directions for 2010/11 are available here along with the associated SFE amendment; coming into effect 1 April 2010.

Practice Boundaries Survey

The Department of Health has released a public consultation on its proposal to remove boundaries from general practice. We would encourage practices and individuals to submit a response, online here. The GPC set out its views on practice boundaries in this position paper in January and will submit a response based on the ideas it contains.

H1N1 Vaccination for travel use

Practices should have received this letter informing of provision of the H1N1 swine flu vaccine for protection of travelers to Southern Hemisphere countries from Professor Salisbury, Director of Immunisation at DH. Practices can use their existing stocks of H1N1vaccine as a travel vaccine for members of the public intending to travel to the Southern Hemisphere during their influenza season. GPs are able to charge patients for administration of the vaccine and GPs can set their own rates for this service.

Note the paragraphs in the appendix which state that:
Whilst GPs can generally charge patients for administering an H1N1 vaccine in connection with travel abroad, if the contractor is participating in the Swine Flu directed enhanced service or any local enhanced service that provides for a payment in relation to an H1N1 vaccination, no charge can be made to:

  • patients in the priority groups defined in the Swine Flu directed enhanced service; or
  • patients who are in a group covered by any local scheme under which the contractor is paid for administering the H1N1 vaccine.

Patients in these groups should receive the vaccination free of charge in accordance with the directed enhanced service or in accordance with the local agreement even if their request is related to travel abroad.

Revalidation, GMC consultation document

The committee discussed the GMC Consultation Revalidation: The Way Ahead, which was published on 1 March. The consultation sets out the GMC’s view on how revalidation will work in practice. The BMA will be responding to this consultation in due course.

Locum GP Pension Contributions

This is a reminder of the importance of practices paying locum GPs for their work as quickly as possible, thus enabling them to pension their income. The GMC are aware of anecdotal evidence of PCTs increasingly enforcing the rule whereby locum GPs engaged by GP practices have a ‘10-week window’ in which to pension their income. Practices not paying locum GPs within this timeframe can lead to locum GPs missing this contribution deadline.

Consolidated GMS Regulations

This consolidated version of the NHS (GMS Contracts) Regulations 2004 as amended incorporates the changes that will be coming into force on 1 April 2010.

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