Care.data
As you will be aware, there has been a lot of discussion about this – locally, regionally and nationally. I sent an email to all GPs and practice managers on Friday (20.09.13) outlining our position to date. If you have not received this please get in touch I will resend. The BMA has received a number of concerns from practices and LMCs about the level of patient awareness, and whether an eight week period of activity undertaken by the practice will be sufficient in informing all patients of the extract. Some practice shave suggested applying the objection code to all their patients’ records and removing the code once patients have provided explicit consent.

The BMA strongly advise practices against doing this because the HSCA creates a statutory obligation for GP practices to disclose data to the HSCIC. In addition, it is a patient’s right to object, not that of the practice. As the law creates a legal obligation to disclose data, consent is not required. GP practices must meet their legal obligations under the HSCA, as well as their obligations under the DPA to undertake fair processing. The BMA has been in regular contact with NHS England and have been advised that they will be providing further information about awareness raising activities. Practices should, therefore, be reassured that they will not be solely responsible for making patients aware of care.data and they will be informed before any extractions take place. NHS England has been working with the ICO so that there is clarity about what GPs have to do in order to meet the fair processing component of the DPA. I have suggested something in writing from the ICO for practices to use in recording the sharing would be helpful but we do not know if anything will be produced. It has also bee confirmed that data will not be extracted until the awareness raising activities have taken place.

Collaborative Arrangements/Fees
There has been confusion since April 2013 amongst everyone as to who is responsible for payment to doctors for work that falls under the term collaborative arrangements (including mental health act and child protection work). Sadly this confusion remains. Until a longer term solution is reached, it has been agreed centrally that Area Teams will pick up the payments unless direct arrangements for the LA to pay were already in place or there is evidence that the funding was included in the CCG budgets. We do not believe the latter was the case in Tees so we are trying to get clarity as to whether direct arrangements were in place with the LAs. As soon as we receive a definitive answer on this I will provide the details as to where to send those invoices you have been saving!

Primary Medical Services Assurance Management Framework
Following legal advice, the BMA can confirm the extent to which there is a contractual obligation on practices to provide the information requested as part of the Primary Medical Services Assurance Management Framework is as follows:

• There is a contractual obligation to provide the information requested in the annual practice declaration. There is a section in both the GMS and PMS regulations stating that contractors shall submit an annual return to the Board (NHS England). There is not a specific contractual obligation to submit this information in electronic format, but practices may find it is more convenient to do so.
• The letters sent out by NHS England to practices about the framework state that practices will be required to submit their catchment area electronically. There is no specific contractual requirement to submit this information in electronic format, but practices, again, may find it more convenient to do so. The BMA has written to NHS England and advised hat practices which have problems submitting this information electronically, or choose not to do so, will be able to submit the information in a different format.

The web interface that is being shared with practices also includes data about practices based on NHS England’s high level indicators and outcome standards. The information on the interface relates to every practice in England, with the intention being to allow comparisons with local practices within the CCG or Area Team and also to practices with similar demographics. Even though the process has been improved through discussions, the BMA does still have some concerns about this process and the validity of some of the data, including how this data might be used in the future. Both the BMA (nationally) and CLMC locally (through discussions with the DDT Area Team) are continuing to try and minimise the risk through continued engagement.

Migrant Access to Healthcare
The BMA has responded in full to the government consultation on implementing new rules for migrant access to primary care. Whilst agreeing to the principle of protecting the public purse and preventing the deliberate misuse of scarce resources, the BMA has raised concerns about cost and complications with some of the proposals.

Revalidation
The Revalidation Support Team has published 4 surveys to collect information on the current and expected impact of revalidation from the perspective of doctors, appraisers, responsible officers and designated bodies. We strongly urge you to complete this doctor’s survey which will take around 5 minutes.

BMA GP Contract Survey Results
In September the BMA launched the largest survey of GPs since the latest contract was imposed in April 2013. The survey aimed to find out how the contract had affected their practice and the impact this had on patients. A total of 3,629 GPs, more than 1 in 10 GPs in England, took part. GPC Chairman, Chaand Nagpaul has sent the results to all GPs in England; headlines include:

• 97% of GPs said that bureaucracy and box ticking had increased in the past year while 94% said their workload has increased
• 82% felt that some of the new targets were actually reducing the number of appointments available to the majority of patients
• 76% believed they had reduced the time spent on patients’ other clinical needs as the result of the latest QOF changes
• 86% of GPs reported a reduction in their morale in the past year
• 90% of GPs said their practice’s resources are likely to fall in the next year
• 45% of GPs said they are less engaged with new CCGs because of increased workload.

History of the BMA
The third volume of ’History of the British Medical Association’ brings to life and places into context the tumultuous last 30 years in UK health policy and medical ethics. Bookshop price is £25 or BMA members and staff receive a £5 discount. This flyer provides further detail, including how to order.

Broadening your Horizons – International Guidance for Doctors & Medical Students
The BMA has launched ‘Broadening your Horizons’, updated guidance on international experience for doctor’s and trainee. It supports UK doctors at all stages of their careers who are considering working or training in developing countries, and helps employers and medical educators in the NHS understand how best to assist those who choose to undertake work abroad.