EMail Alerts - All 3 Counties

New GPC guidance on Summary Care Record (SCR)   (09/03/10)  

Please see: http://www.bma.org.uk/ethics/health_records/connecting_for_health/scrguidance.jsp

Paul Roblin
CEO of BBOLMC

The future of GP practice premises                                     (09/03/10)  

Dear All
For your and your GPs’ information, please see the attached GPC Guidance re the Future of Practices Premises. 

The updated guidance examines the current state and future of the various primary care premises development options available and describes the premises provisions of the GMS  contract. It incorporates guidance on the premises costs directions and on the  impact of the Disability Discrimination Act.

Please accept my apologies for any inconvenience caused - the Guidance is now attached.

The Guidance is also available on our website at:
http://www.bbolmc.co.uk/ftrpractprem0310.pdf  

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

Dr Roblin's 2009 Annual Report                                             (03/03/10)  

Dear All
Please find attached, for your and your GPs’ information, Dr Roblin’s latest (2009) Annual Report. 

The Annual Report is also available  via our website at: www.bbolmc.co.uk  

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

GPC Guidance on SCR Feb 2010                                         (02/03/10)  

Please see the attached GPC guidance on the Summary Care record (SCR) and Public  Information Programmes (PIPs)

Berks and MK PCTs have been “fast followers” (see paragraph 3) and opted to use the DOH money  by the end of March 2010. 

Other PCTs will eventually have to do the same. 

The second half of the document is probably the most relevant to you.

I don’t think you need to know out of date information about which SHAs are early  adopters.

Paul Roblin
BBOLMC

GP Trainees Conference 2010                                               (26/02/10)  

Dear All
For your and your GPs’ information please see the email below, and attached flyer, re the BMA’s 2010 GP  Trainees Conference.

This information is also available on our website www.bbolmc.co.uk .

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk    

Dear all,
I would be grateful if you could circulate the attached flyer and below info to anyone who  you think might be interested in attending the BMA's 2010 GP Trainees Conference

The BMA’s 2010 GP Trainees Conference, “Get Ahead: The Essential GP Trainee Skills Day” will take place on  Friday 16^th April at BMA House. If you want to make the most of your training, prepare for life as a qualified GP, and network with colleagues from across the country, this is the event for you.

Members of our General Practitioners Committee (GPC) will share their experiences and advice on  subjects such as finding a partnership and options for sessional and locum  working. Dr Laurence Buckman, the current Chairman of GPC will introduce the day, and a representative from The Careers Group will give advice on how to best  present your CV and succeed at interviews.

You can find out more on the BMA website at: http://www.bma.org.uk/whats_on/gpreg2010.jsp  


Best wishes,
Faye
Faye Bunch
Executive Officer
NHS GPs Division
British Medical Association

Summary Care Record (SCR) and GP practices               (26/02/10)  

PCTs in Berks and Milton Keynes are taking advantage of a time limited government offer to fund their Public Information Programme costs for the Summary Care Record. I am sending this to all ThamesValley practices because it is likely that other PCTs will soon follow 

Because of the rushed  implementation, issues are cropping up regularly.

Workload for practices seems to have been underestimated. Please let me know the impact the initiative  is having on you. 

I am personally in favour of the SCR but feel ashamed of a national system that makes it difficult for patients to  opt out and to exercise free choice. 

Discovering “how to opt out” on the  SCR website is difficult: the mechanism is somewhat hidden.

In the end I found a hyperlink entitled 'What  happens if I choose not to have a summary care record (SCR)?' (PDF,  50Kb). The form is hidden at the end of  this document. 

LMC has discovered that any parent that calls the SCR line is told that they cannot opt out their children without first seeing their GP for assessment of child competence followed by Read coding  of opt out intentions. This requirement does not appear in any of the SCR  literature. Several Thames Valley GPs have already been on the receiving end of this both as GPs and parents 

Some PCT letters are explicit that practices are responsible for coding new patients yet there seems to be a lack of information about how an Opt Out Form should be handled by practices.  

My understanding of the electronic system is that at some time in the future a national computer will talk to each practice computer and only upload those records which do not contain an opt out code. Free text recording of patient opt out would by definition not be recognized. I don’t believe any PCT has supplied such a code (which is a bit of an omission) so I have made enquiries and been told the appropriate one is 93C3.

Please note the poster and patient leaflet devised by London wide LMCs at
http://www.lmc.org.uk/news/news-detail.aspx?dsid=7118  

I have obtained their permission for ThamesValley practices to use their documents.

Paul Roblin
CEO of BBOLMC
07799116597

DWP guide to GPs on fit notes                                               (24/02/10)  

Dear All
For your and your GPs’ information, please see attached the Department for Work and  Pensions - guide on the new fit notes.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

Consolidated SFE                                                                       (23/02/10)  

Dear All
For your and your GPs’ information, please see attached the BMA’s Consolidated Statement of Financial Entitlements (SFE).

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

GP trainees subcommittee e-bulletin, February 2010       (19/02/10)  

Dear All
For your and your GPs  information, please see the BMA’s email below and the attached GP Trainees  E-Bulletin Feb 10. 

The Bulletin will also be available on our website after the weekend at www.bbolmc.co.uk

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

Dear colleague
Please see the attached GP trainees subcommittee newsletter.

This is also available on the BMA website.

We hope that you have found  this edition of the GP Trainees subcommittee e-bulletin interesting and helpful. Please do pass it on to anyone interested in GP trainee issues, and if you would like to be added to our mailing list please email fbunch@bma.org.uk.

Regards
Karen Day
Division Secretarial Assistant
NHS GPs  Division

BMA Half-day Seminars: Making the Most of being a Salaried GP
                                                                                                         (12/02/10)   

Please find attached details of the BMA’s half day Seminars re “Making the Most of being a Salaried GP”, to be held by between March and November this year, for circulation to your Salaried GPs. Many thanks.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

NHS Appraisal Toolkit - An Update                                       (12/02/10)  

Dear LMC secretrary / office
Following Laurence's update below, this is to update you on the situation regarding the shutting down of the NHS appraisal toolkit. We are happy for you to pass this on to GPs in your area (in fact we would encourage this).

Following the telephone conversation between Laurence and Mike O' Brien, we have now written formally to the  Department to ask them to write to all PCTs, advising them to be flexible in  their use of appraisal deadlines for any GPs affected by the problem. We have also asked for any costs incurred by appraisers and appraisees to be met, as well as re-affirming the importance of the security of information uploaded on to the toolkit. We have not asked them to revise the three week shut down period, due to the importance of the security problem being resolved properly.

In case you missed it, the Department of Health released the attached  statement regarding this situation. There is advice for GPs from the people who  run the toolkit at its website at http://www.appraisals.nhs.uk, and in the attached document.

Other than that, the situation outlined in Laurence's  e-mail remains. We will provide further updates as and when we get them.

Best Wishes
Joe Read
Senior Policy  Executive
General Practitioners Committee

CRB checks & ISA                                                                     (10/02/10)  

A query over the ISA vetting and barring scheme and CRB checks has arisen in the ThamesValley and I thought my reply might be useful to all practices 

Paul Roblin
CEO BBOLMC

Answer:

See ISA and BMA  websites and the attached GPC guidance
http://www.isa-gov.org.uk/ and http://www.bma.org.uk/employmentandcontracts/employmentcontracts/salaried_gps/vettba rringscheme.jsp  

Query:

I have been asked to contact you on behalf of local PMs, although everyone is likely to be  affected.
We would all like to have clear, succinct guidelines as to which members of the team need which checks done by  what date and by whom.
Over the last few months practices have been given different advice from different members of the PCT and TVPCA and it is quite clear there is no common understanding of what is required, some practices have requested CRB checks and some not for new employees, and some have employed agencies to CRB check all their current team including GPs!
The PCT feels it has exhausted all avenues and accepts we are generally none the  wiser.
Has something been produced by either Oxfordshire or Berkshire, that we could adopt?
Or does a small team need to meet, agree a process and validate it.

NHS appraisal toolkit unusable for the next three weeks
                                                                                                        (10/02/10) 

Dear All
I was phoned about this at lunchtime today by the  minister, Mike O'Brien. 

The government today announced that they have identified a security problem with the NHS appraisal toolkit. As a result of this, the  toolkit is to be shut down for three weeks, so that the suppliers can modify it to ensure security. Mike O'Brien, the health minister, was meant to make an announcement so we could alert all GPs but I am not certain he has announced it formally yet. This PDF has turned up however. 

There are two clear aspects to this problem - data security and the appraisal itself. Taking these in turn:

Data Security
We have been unable to ascertain exactly how long the security problem existed for before it was  identified yesterday. However, we have no reason to believe that an actual  security breach occurred - i.e. that anyone accessed data that they were not authorised to see on any doctor(s) using the toolkit. The government have  assured us that steps will be taken to ensure the full security of doctors' data before the toolkit is re-launched.

It is expected that this will take about three weeks.  

Appraisal
The shutting down of the toolkit will affect the appraisal of any GP who uses the NHS appraisal toolkit, and whose appraisal is  due to take place during the three week period (and possibly after). GPs who are  unable to participate in their arranged appraisal due the toolkit being shut down should organise an alternative date for their appraisal. PCOs are being told about this tonight and are being told to be reasonable.
I know...
This situation may lead to some GPs being unable to meet the normal deadline for the completion of their appraisal. We have urged the government to advise PCOs not to put unfair pressure on GPs who have not  completed their appraisal before the deadline, through no fault of their  own.

Additionally, we have stated to the government that any  extra costs to appraisers and appraisees caused by this problem should be met in full.

We will provide further details on this issue as soon as we have them.

Laurence

Maximising your points for patient survey part of QOF     (02/02/10) 

I wrote to you some  while ago about the failure of appeals against the patient survey part of QOF across the Thames Valley.

I talked then of it  being a patient perception survey, and how practices needed to advertise clearly  what they offered to patients.

The GPC has now  developed leaflets and posters which may help you do  this.

Copies of the poster and leaflet were sent to all GP practices on 14.1.10.

These can also be found  at:
http://www.bma.org.uk/employmentandcontracts/independent_contractors/general_medical _services_contract/yoursurgyoursay.jsp

The poster and leaflet explain what the practice is doing to offer patients the best possible access,  and also explains how patients can give their views directly to the practice.

The  poster also reminds patients of the importance of completing the Government's patient survey, and explains directly what many might not understand - that their practice's funding depends on their  responses.

Paul Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Dec 09 - Jan 10 Information Roundup                                 (29/01/10)   

Please find attached BBOLMC’s latest  bi-monthly Information Roundup - I would be grateful if you could please circulate it within your practice and hope you, and your GPs, find it of interest and value.

Comments and suggestions for improvements and/or items for inclusion in future editions to pauline.green@bbolmc.co.uk are very  welcome.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

Latest BBOLMC Website Updates                                         (28/01/10)  

For your and your GPs’ information,  please note that the following are all available on our website:

• Latest Secretariat Hot Topic and Information Alert emails to practices*
• Draft Minutes of the January 2010  East and West Berkshire LRC/PCT Liaison meetings
• Latest job vacancies across the 3  counties
• Flu Vaccine Discount 2010 – LMC  Discount Buying Group
• GP practices coping with the freezing weather – LMC Press Release
• Calculator allowing practices to calculate their costs for each under 5s Swine Flu  vaccination
• Updated joint GPC/RCGP/DH Pandemic Flu Guidance for GP Practices – Dec 09
• GPC “Your Surgery, Your Say” Poster and Leaflet Information and links
• GPC Guidance: Use of 084 numbers in  the NHS
• GPC Guidance: The Disability Discrimination Act - GP Premises
• GPC Guidance re Vetting &  Barring Scheme
• GPC News - Dec 09.

All of the above, and more, can be accessed at: www.bbolmc.co.uk  

*NB: Our most recent Hot Topic and Information Alert emails can be accessed via the red ‘Click for Latest  Email Alert’ link on our Home Page - www.bbolmc.co.uk

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

Sibutramine licence suspended                                             (22/01/10)   

Please note the information on the following URL
http://www.pulsetoday.co.uk/story.asp?sectioncode=35&storycode=4124812&cid=sibutra mine_210110#  

The obesity drug sibutramine has had its licence suspended by the European authorities due to concerns over an increased risk of cardiovascular events with the treatment.

'Prescribers are advised not to  issue any new prescriptions for Reductil and to review the treatment of patients taking the drug.

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Updated GPC Disability Discrimination Act for GP premises Guidance
                                                                                                        (08/01/10)   

Dear All
For your and your GPs’ information, please find attached the GPC’s updated Guidance :
Disability Discrimination Act: Physical adjustments to GP premises required under the Act  

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk    

2010 Wyeth Flu Vaccine Deal                                                   (08/01/10)   

Dear All
For your and your GPs’ information, please note that full details of the LMC’s 2010 Wyeth Flu Vaccine  deal are now available on our website via the following link:

http://www.bbolmc.co.uk/discgrp/discgrp.html#index01      

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

What I have sent to the media about GP practices coping with the freezing weather                                                                         (07/01/10)   

Please see below (and attached) what I have sent to the local and national media about GP practices coping with the freezing weather

I think general  practice and its staff can be justifiably proud of how it has responded

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

GP practices coping with the freezing weather

To:  Local Radio/TV/Newspapers

Many of you have asked for examples  of what GP practices have done to deliver patient services during the  freeze
I attach some responses to my survey of how practices are coping.
There are many examples  of staff going the extra mile to help patients  (literally!!)

GPs and staff battle to keep general practice open during adverse weather conditions  

GP leaders in Berkshire, Buckinghamshire and Oxfordshire have praised the effort of doctors and practice staff in the region for continuing to operate normal, or near normal, services for their patients, despite the extreme weather conditions. With parts of the region experiencing temperatures of -18C almost all practices have stayed open for their normal contracted hours, with staff and doctors making special effort to get in to work.  

Dr Paul Roblin, from the Berkshire, Buckinghamshire and Oxfordshire Local Medical Committee, which represents GPs locally, said:
“We’ve heard of doctors bringing sleeping bags to their practices and staying overnight, of GPs and nurses walking miles through snow and ice, of staff staying locally instead of going home and of some bringing their children in with them so they could make sure their surgeries remained open.
“There are probably many more examples of GPs and staff going the extra mile that we’re unaware of and we want to say we are extremely proud of the efforts that have been made by those working in general practice to ensure patients are not let down.”
“To be on the safe side we would advise patients who have routine appointments to check with their practices before setting out, just in case their surgery has had to amend their timetable.”

Extended hours cover during extreme weather conditions
                                                                                                         (07/01/10) 

I have been asked the  following question and my reply may help others who feel disinclined to operate extended hours during the freezing weather

Q         Do you know where we  stand with extended hours cover during extreme weather conditions - we have a clinic booked for this Saturday and sure half the patients won’t turn up.  Have not asked the PCT as sure thy will say we have to stay open. 

A         I would ask  the PCT as their permission to cancel extended hours is part of the agreement you signed. If they do not use common sense in their response then please let  LMC know.

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

LMC would like to advertise how GPs stayed open when many closed on 6.1.10                                                                         (07/01/10)  

I support the request  from one of our Thames Valley GPC reps below 

As a counter to many critical media stories about GPs, LMC would like to advertise how GPs stayed open when many closed on 6.1.10  
(eg walk in centres, pharmacies, local social services) 

Can  you let me know if you provided a normal or near normal service on Wednesday  6.1.10?

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Paul 

There has been a discussion on the GPC listserver about the bad press GPs always receive.  Could  you ask your office to conduct a quick straw poll of how many practices provided a full or near-full service today despite the snow? 

The only thing we were unable to do was take blood, because there was no transport to take the samples to the hospital.  Four out of five pharmacies in town are closed, but all GP practices are functioning.

Prit

Vetting & Barring Guidance & GPC News                           (22/12/09)  

Dear All
For your and your GPs’ information,  please note:

1    GPC Vetting & Barring Guidance

The GPC’s Updated Guidance re the  Vetting & Barring Scheme is now available on our website  at:
http://www.bbolmc.co.uk/vetbar1209.pdf  

2    GPC New 5 December 2009

The latest GPC News is available via our website at:
http://www.bma.org.uk/images/gpcnews5dec09_tcm41-193223.pdf  

Best wishes for the Festive Season and 2010. 

Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

BBOLMC Summary of PCT LESs for swine flu vaccination of under 5s: Please read  this even though it seems long             (22/12/09)  

Oxfordshire PCT (lead  TV pandemic PCT) and I have tried to deliver a single LES across the ThamesValley, but unfortunately  failed

It is disappointing  that despite practices rising to the challenge of swine flu over the past 6 months, (both for the initial swabbing, subsequesnt illness management and then  phase 1 of the vaccination campaign), some PCTs seem not to understand the capacity constraints and financial realities experienced by their practices, and  have offered a very unattractive LES (particularly in MK and Bucks)

Given the right  extended hours concessions from PCTs and finances to cover their costs, practices could have improvised to expand capacity and delivered flu vaccination to the whole under 5 population. Some PCTs now face the real possibility of patchy covergae of the under 5s, and a need to find alternative provision for some.

The effort and money involved in this could have been better spent on reaching a reasonable LES with  its main GP providers.

PCT  unwillingness to  spend appropriately ia about to produce such complicated arrangements that it is  inevitavble that the public will be confused and the media  critical.

I will ensure that the latter understand that the inevitable mess has originated within PCTs

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Evolution  of the problem

I met with Oxfordshire PCT (lead TV PCT on pandemic issues) on 17.12.09 

I agreed to recommend the text below to practices, and they agreed to do the same to the other 4 TV PCTs

• £5.25 per  vaccination
• No call and reminder responsibilities for practices
• Vaccination can take place in extended hours clinics
• Those not currently  doing extended hours can negotiate (pro-rata to clinic hours taken up) a time limited Extended Hours fee solely for delivering the vaccination

I do not believe any call system is necessary for the under 5s

The availability of a  comprehensive service could have been made known by the PCT advertising through  local media, and via practice notices and website

Parents wanting the  vaccination could phone the practice, and book into clinic  slots.

For practices to deliver this efficiently and economically, this would require PCTs to accept that both phase 1 and phase 2 immunisations were given equal priority and  delivered in mixed clinics. 

On Monday 21.12.09,  representatives from the 5 Thames Valley PCTs failed to agree on a common LES and all now plan to produce their own proposals

I began to receive these from PCTs late that day

Each PCT offer is below  (East Berks and Bucks PCT proposals are still awaited)

Also attached is my calculator allowing practices to assess whether the arrangements offered by their own PCT covers their costs.

This may allow you to  decide whether to take up the particular LES in your  area

Oxfordshire  PCT

• £5.25 per  vaccination
• No call and reminder responsibilities for practices
• Vaccination can take place in extended hours clinics
• Those not currently  doing extended hours will receive an additional payment of £115 per hour for  vaccination clinics during extended hours.

West Berks PCT

• £5.25
• PCT will do the call and recall of thechildren via  Synertec via TVPCA
• If a Practice chooses  to do their own call and recall we will reimburse at the same rate that we are being charged by Synertec.
• Those Practices already  doing extended hours can be flexible andswap GP time for nurse  time

The PCT has further  considered your concerns around extended hoursfor those practices not  already signed up to the LES/DES. The PCT is keen to ensure that all eligible children can access this service from their registered practice so we  are preparedexceptionallytooffer a limited extended hours LES to the 10 practices not currently signed up to provide extended hours. This will pay £30 per hour for nursing timeto provide the vaccinations in extended hours.  This is in line with our extended hours LESwhich offers £19.33 per hourand we have  added £10.77 towards the cost of a receptionist. The  expectation is that 8 children per hour can be vaccinated and payment will bemade on this basis.
We propose to write to all practices on 22.12.09.

PHR  comment
How some WB PCT will advertise the patchy administration arrangements clearly to the public is beyond me.

Milton Keynes PCT  

A summary of the LES which will be offered to MK GP practices is as follows: 

• £5.25 per child  vaccinated
• No call and recall required by the practice
• Where vaccination of children occurs within extended hours surgeries, this will be provided in addition to the GP routine appointments that are required by the extended hours enhanced service.
• An alternative provision has been agreed for patients of GP practices who are not happy with these arrangements.  Their patients will be offered a vaccination service  through the new Broughton Gate practice (their recently opened Darzi  practice). 

East Berks PCT  

Still awaited but will be forwarded to EB practices as soon as it becomes available

Bucks  PCT  

• £5.25 per vaccination including the first call for your under 5s cohort.
  LMC comment: This  requirement makes the LES particularly unattractive as a response rate of 25% consumes about £2.50 of the vaccine fee
• Those already providing  extended hours may use these clinics and include nurses time for vaccinations.
• Non-participating  practices in the Extended Hours DES may sign up to the full DES for the  remainder of 09/10. 
  The intention is to allow practices to smooth their work over an extended timeframe.
  (In order not to disadvantage the 50 practices already providing Extended Hours there will not be a temporary sign up package  solely for swine flu vaccinations) 

LES for under 5s Swine Flu Vaccine                                   (15/12/09)  

I know many practices  are under pressure from patients to vaccinate young children after the premature  ministerial announcement of phase two and failure of national negotiations.

Local negotiations on  an under 5s Swine Flu vaccination LES are almost complete and I hope for a response from all 5 Thames Valley PCTs by tonight 

This email is therefore  being sent to keep you up to date with developments.

The text below is essentially what I have sent to all LMC reps and details what I have agreed to  recommend to practices 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

I met with Oxfordshire PCT (lead TV  PCT on pandemic issues) early on Thursday. I have agreed to recommend the  following to practices and they have agreed to do the same to the other 4 TV PCTs
(The 5 Thames Valley PCTs think they can get me a decision by Friday night)

• £5.25 per  vaccination
• No call and reminder responsibilities for practices
• Vaccination can take place in  extended hours clinics
• Those not currently doing extended hours can negotiate (pro-rata to clinic hours taken up) a time limited Extended  Hours fee solely for delivering the vaccination 

Attached is my calculator allowing  practices to assess whether the £5.25 fee covers their costs without the patient  computer listing, letter or phone call workload

Please note the current figures in the calculator are 8 per hour and no overtime rates being paid. You can alter  any data in the pink cells to suit your own circumstances, and your predicted  costs are then given in the orange cells 

I do not believe any call system is  necessary for the under 5s (practice or PCT controlled)

The availability of the service can  be made known by the PCT advertising through local media, and via practice  notices and website

Parents wanting the vaccination can  phone the practice, and book into clinic slots whose frequency is determined by vaccine availability.

I would give all first and second  wave highrisk groups  the same priority, and just book them into clinics when they phone in. Anything else would be impractical 

I have also asked PCTs to describe how they will vaccinate patients of practices that do not take up the  LES

Swine Flu vaccination for pregnant women: joint statement by RCGP, RCOG and Royal College of Midwives                               (15/12/09) 

Could practices please note that the RCGP, Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) have now issued a joint statement to nurses and  midwives highlighting the importance of vaccinating pregnant women :

See www.rcgp.org.uk/pdf/pregnancy_letter_to_nurses_and_midwives.pdf

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Over reaction of Registrars of Births and Deaths to introduction of GMC Licenses (NOW SORTED OUT)                                 (15/12/09) 

Please note the following from the GPC 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Requirements to sign a death certificate

In October 2009 we were  notified that some local Registrars of Death were requesting unnecessary  information from GP practices because of a misunderstanding about the implications of the new GMC license to practice - for example, practices were  asked to supply the names of GPs who were licensed to sign death certificates,  together with their GMC registration, their GMC licensing number and details of  their qualifications allowing them to sign the forms.

We took this up with the GMC licensing team.  As a result the GMC has clarified the situation with the General Registrar Office as well as updating its FAQ website advice. 

We can confirm that to sign a  death certificate, GPs will not have to supply their GMC license  number.  With the introduction of the license to practise in November 2009, Registrars just need to check that the doctor signing a death certificate is licensed with the GMC at the time of signing the form.  There should not be a need to supply information to the Registrar prior to completing the form (particularly  as the information could be out of date if supplied in advance).  However, it would be helpful to Registrars if GPs could include their GMC number on death  certificates so that it is easier for the Registrars to do the necessary checks.

Updated Flu Guidance & Xmas Arrangements               (11/12/09) 

1    Updated Joint GPC/RCGP/DH Pandemic Flu Guidance for GP Practices - December 2009

The latest joint GPC/RCGP/DH Pandemic Flu Guidance for GP Practices is now available on our website at:
http://www.bbolmc.co.uk/panfluguid1209.pdf  

2  Secretariat  Office’s Christmas & New Year Arrangements 

For your information, please note  the Secretariat’s Christmas and New Year  arrangements:

24 December 2009 - closed from 12 noon
29 December 2009 - 31  December 2009 closed
04 January 2010 onwards - normal office hours (8.00 am - 4.30 pm)

NB:  When the Office is closed Dr Roblin will be available in an emergency on
07799  116597.

Seasons  Greetings
from all the Secretariat Team

Best wishes
Pauline
auline Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

Dispensing Doctors in ENGLAND Prescriptions Services Communication                                                                         (09/12/09) 

Dear All,
NHS Prescription Services (NHS RxS)  will be writing to all Dispensing Practices in England in week commencing 21st  December to remind practice's that this month’s payment, for prescriptions dispensed in October, will be the first payment where they may be financially affected if a patient or their representative hasn’t correctly filled in the sections on a prescription form to declare that they are exempt from charge.  

This is because the transitional arrangements that NHS RxS had in place for the first few months’ of processing  dispensing doctor accounts on its new system came to an end from October.  We previously notified you that NHS Prescription Services started processing dispensing doctor accounts on its new system in July this year.  The new system is much more effective at identifying if a patient or their representative hasn’t correctly filled in the sections on a prescription form to declare that  they are exempt from charge.  Transitional arrangements were in place between the dispensing months June to September to give dispensing doctors and their practices time to make sure that their procedures for checking patient  declarations were robust. The arrangement came to an end from October dispensed prescriptions, and dispensing doctors should receive payment for these  prescriptions in December / January from their PCT.

Senior partners will receive separate notification from NHS RxS from 21 December about  how many items they have identified and how many charges they have collected.

NHS Prescription Services’ helpdesk  can give practices guidance on how to sort and submit their accounts, 0845 610  1171. Practices can also test their knowledge with an online quiz
www.nhsbsa.nhs.uk/prescriptions/quizzes  

Phase two vaccination programme: Letter from Ian Dalton  
                                                                                                       (09/12/09) 

Attached are the instructions Ian Dalton has sent to PCTs 

I would like to draw your attention to three paragraphs (bulleted below)

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

1.  Please note page 3

We recommend a price of £5.25 per vaccination is made available to GP practices or other providers  contracted with to deliver this service, in line with the fees paid for the high-risk groups.

PCTs should ensure that all practices who are ready to transition to vaccinating children over six months and under five years are able to do so, without incurring delays while  the administrative arrangements are confirmed. This might include a reassurance  of payment for any vaccination undertaken during this time.

PCTs will be reimbursed for each vaccination given to children in this age group not in the high-risk groups at a level of £5.25. 

2.   Please note page 3

Dosage change for children over six months

The JCVI has reviewed  data on the immune responses to Pandemrix in children aged over six months, as well as reactogenicity data and HPA studies. They have advised that healthy  children aged over six months should have just one dose of Pandemrix (half an adult dose)  unless the child is immunosuppressed or has an immune deficiency (as specified  in the Green Book). We expect the licence for Pandemrix to change shortly to  permit one or two doses according to national advice.

Children over six  months who are being vaccinated because they are in the priority groups for  phase one, should also have one dose unless they have a similar immune  condition.

3. Please  note page 9 (para 9)

The  Department of Health recommends a payment per vaccination actually administered by the contractor or by staff directly employed by the contractor at £5.25 per dose. Where the contractor is a GP practice, the PCT cannot agree to any easement that would have the effect of overriding any provisions in the SFE (Statement of Financial Entitlements).

(LMC comment on  bullet 3) The SFE is attached to the Swine Flu DES and relates solely to QOF concessions and not the price of £5.25

See :http://www.dh.gov.uk/en/Publicationsandstatistics/Legislation/Directionsfromthesecretaryo fstate/DH_107716

Failure of national negotiations over GPs vaccinating the under  5s
                                                                                                       (09/12/09) 

Please see the attached letter

After the recent ministerial announcement, the GPC and DOH have failed to agree on how to vaccinate the under fives

LMCs are now asked to  negotiate locally with PCTs (BBOLMC will initiate this)

Nationally the GPC felt  the £5.25 (agreed for the first 4 risk groups and frontline staff) was not  enough to cover the workload of this new group.

This logic is explained  in the attached letter

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

 

LMC local negotiating position over vaccinating the under  fives
                                                                                                       (09/12/09) 

I wrote to you yesterday about the failure of national negotiations on under 5 Swine flu  vaccination
I now need your help to devise a local LMC negotiating position 

Many factors have influenced my own  personal view and these are summarized below: 

• We are in a recession, with rumours  of public sector pay reduction in today’s pre budget report
• We need to protect our image in  society, yet ensure that any payment at least covers the cost of delivering the  vaccine campaign 
• This is a busy time of year, where practices have very little spare capacity, especially with phase 1 of the campaign already running
• The time needed to vaccinate children is predicted to be longer than for adults
• Practices could expand capacity by vaccinating the under 5s at weekends, but the cost of paying staff would be  higher 
• I think we have to be aware that many in society are unemployed or facing an uncertain financial future and not push for too much

The £5.25 fee for first wave vaccination was constructed assuming district nurses would vaccinate the  housebound and with QOF concessions

We receive £7.52 for seasonal flu and I would be inclined to push for this rather than a higher  fee which could provoke accusations of  greed

Early feedback to me has been very varied. What are your individual views? 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Oct-Nov 09 Information Roundup                                       (01/12/09)   

Please find attached BBOLMC’s latest  bi-monthly Information Roundup - I would be grateful if you could please circulate it within your practice and hope you, and your GPs, find it of interest and value.

Comments and suggestions for improvements and/or items for inclusion in future editions to pauline.green@bbolmc.co.uk are very  welcome.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

Swine flu vaccination for the under fives                           (01/12/09)   

Could practices please note Laurence Buckman’s advice in red text below? 

PANDEMIC FLU UPDATE
Second phase of H1N1 vaccinations

Following last week’s  announcement regarding the second phase of H1N1 vaccinations, the NHSE and GPC have begun discussions for the vaccination  arrangements for the under 5s, although formal negotiations are yet to commence. 

Information about the  second phase of H1N1 negotiations is available on the DH website: http://www.dh.gov.uk/en/Publichealth/Flu/Swineflu/InformationandGuidance/Vaccinationpro gramme/DH_108850  

DO NOT START TO VACCINATE UNDER 5s NOT AT-RISK UNTIL NEGOTIATIONS ARE CONCLUDED.
DOING  THIS PREMATURELY UNDERMINES NEGOTIATION.

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Answering Patients' Questions About Their  Anaesthetic 
                                                                                                         (01/12/09)  

I thought you all might be interested in this email from West Berks
I didn’t know these  resources existed

See www.rcoa.ac.uk

Leaflets available on the RCoA website include:

• Anaesthesia explained  (a detailed general booklet)
• You and your anaesthetic (a shorter version)
• Your anaesthetic for aortic surgery
• Your spinal  anaesthetic
• Epidurals for pain relief after surgery
• Local anaesthesia for  your eye operation
• Your tonsillectomy as  day surgery
• Headache after an  epidural or spinal anaesthetic
• Anaesthetic choices  for hip or knee replacement
• Your child’s general anaesthetic
• Your child’s general anaesthetic for dental treatment

Dr Paul Roblin
CEO  BBOLMC
07799116597  or 01628 475727

Latest BBOLMC Website Updates                                         (26/11/09)   

Please note, for your and your GPs’  information, that the following are all available on our  website:

• Latest Secretariat Hot Topic and Information Alert emails to practices*
• Draft Minutes of the recent Berkshire, Buckinghamshire and Oxfordshire County LMCs and LRC/PCT Liaison meetings.
• Latest job vacancies across the 3  counties
• BBOLMC’s latest Information Round  Up
• Child Protection: maintaining your skills - joint letter from Dr Laurence Buckman & Prof Steve Field
• GPC News - Nov 09
• The Cameron Fund - information re  their services available to GPs and their dependants
• 02/11/09 letter from Prof David  Salisbury re the vaccination of pregnant women against H1N1 flu
• GMC’s updated guidance - Good  Medical Practice Responsibilities of doctors in a national pandemic
• DES for H1N1 Vaccination Programme
• Swine Flu (H1N1) Vaccination Agreement Q&As
• DES for H1N1 - Directions.

All ofthe above, and more, can be accessed at:www.bbolmc.co.uk  

*NB: Our most recent Hot Topic and Information Alert emails can be accessed via the red ˜Click for Latest  Email Alert” link on our Home Page - www.bbolmc.co.uk

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

Child protection: maintaining your skills                           (24/11/09)   

For your and your GPs’ information, please see the GPC’s email below and the attached joint letter from  Dr Laurence Buckman and Prof Steve Field re maintaining child protection skills.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

Dear LMCs,
I attach a joint GPC/RCGP letter to the profession on the issue of child protection. Please note that we are sending this out via LMCs (i.e this email), to GPC members, and in the BMA's weekly electronic newsletter to BMA  members. It will also be available on the BMA website. The RCGP may also distribute it to its members.

I'd therefore be grateful if you could draw  this to the attention of your GPs. Please also note that the English DH is  writing to PCTs with a copy of the attached letter. When the final DH letter is available, I will distribute it to you (although please note that I am on leave  from tomorrow to Monday).

With kind regards,
Julie  Goodway
GPC secretariat for contracts and performance  subcommittee

Read code for H1N1 refusers                                                 (24/11/09)  

Since BBOLMC sent out  the email below on 20.11.09, many practices have suggested that the better code to use  is:
     "No consent for  influenza A (H1N1) 2009 vaccination"            68Ns.

Some have also suggested:     8IAG.

BBOLMC not having  access to Practices Systems and Read Codes, I am not in a position to verify these, but thought you would want to know what other colleagues are  doing

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727  

Letter from PanFlu Czar re Under 5 vaccinantions           (20/11/09)  

For your and your GPs’ information, please see the attached letter from Ian Dalton re phase 2 of Swine Flu vaccination. 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Swine flu news fom GPC                                                         (20/11/09)  

For your and your GPs’ information, please see the email below from Prit Buttar, Bucks and Oxon GPC rep, re H1Ni vaccination for children.

Dr Paul  Roblin
CEO  BBOLMC

Dear Paul
Please feel free to pass this on to both Bucks and Oxon practices.

The government made an announcement  yesterday about starting a vaccination programme against H1N1 for children. The timing of this is curious, as negotiations with the GPC about how this will be financed and organised are at a very early stage, and there is a widespread view in the DoH that the current campaign of vaccinating “high-risk” adults is likely  to take until mid-January before it is complete.  Those of us who are of a  cynical inclination might wonder whether yesterday’s announcement was designed to ensure that the government’s record borrowing figures were pushed further  down the news agenda, but others would have a more charitable view.  Whatever  the reason, please note that there is currently no agreement for vaccinating children who are not in at-risk groups, and practices are advised to decline any requests from parents to have their children vaccinated until a DES is in place. 

Part of the current DES is a reduction in thresholds for PE7/PE8 if sufficient vaccination coverage is  achieved. It is important, therefore, to record patients who decline the vaccination, to ensure that these do not count against you.  At present, I am not aware of any “agreed” Read code for recording dissenters, but I would  suggest that until such a code is announced, practices might wish to use 68NE.

Prit Buttar

The Cameron Fund                                                                     (10/11/09)   

For your and your GPs’ information, please see the attached information from The Cameron  Fund.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

SHA immunisations project has LMC support                   (10/11/09)

Could practices please note the attached letter and the fact that the project has LMC support?

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727 

Priorities for early H1N1 vaccination amongst the DOH priority groups                                                                                           (04/11/09)

The DOH clinical risk groups, (in order of priority) are:

1. Individuals aged six months and up to 65 years in the current seasonal flu vaccine clinical at risk groups
2. Pregnant women
3. Household contacts of immunocompromised individuals
4. People aged 65 and over in the current seasonal flu vaccine clinical at risk groups

The DH guidance on immunisation against pandemic H1N1 influenza identifies groups for immunisation based on the risk of poor outcome.

These comprise a large proportion of the population.

However, there is no national UK guidance on immunisation within  these groups.

The  following groups are particularly vulnerable and appropriate to  immunise early in the setting of limited initial vaccine availability.

• Patients with  steroid dependent asthma or asthma related hospital admission
• Pregnant women at 20 or more weeks of gestation
• Children with  neurocognitive or neuromuscular disorders
• Children with other  severe lung disease (cystic fibrosis etc.)
• Immunosuppressed individuals 

(Thames Valley HPU recommendations 26.10.09)

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Mixing H!N1 vaccine bottles: ALL of the emulsion is added to ALL of the suspension                                                                           (04/11/09)

Mixing Pandemrix Vaccine

It has been brought to our attention that the summary of product characteristics (SPC) for  Pandemrix^® has the potential to cause confusion.  We have clarified  the specific instructions for making up the vaccine.  
The  literature states that one vial of adjuvant (emulsion - 2.5ml) and one vial of  antigen (suspension - 2.5ml) should be mixed to produce 5mls of vaccine. However when carrying out this process it becomes apparent that there is a greater volume of adjuvant in the vial. Clarification with GSK has been sought and they  have stated clearly that the ENTIRE contents of the adjuvant vial should be  added to the antigen. This excess volume is to allow for losses and there is a  similar excess in the antigen vial (however nursing staff would not be aware of  this as it is never drawn up).

Please ensure that when making up  the vaccine, ALL of the emulsion is added to  ALL of the suspension.  Be aware that this may be considerably more than the 2.5ml stated in each vial and this is acceptable.

TO ACCESS SLIDES ON HOW TO PREPARE THE VACCINE, see:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/@sta/@pe rf/documents/digitalasset/dh_107653.pdf

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Practice Vetting and Barring check obligations from 12.10.09
                                                                                                         (30/10/09)

I have looked into this  issue over the last few days

Practice managers may  find my conclusions (see below) helpful. 

It seems to me that  from 12.10.09, for both regulated activity (doctors, nurses and HCAs) and  controlled activity (receptionists and admin staff) it is an offence for a  practice to knowingly employ someone who is barred

This does not go as far  as saying that the employer has to check with the ISA.

In fact the only check that could be done currently would be a CRB check and via the TVPCA this would cost about £60 for each non doctor employee.

Just asking the  potential employee about barred status seems to be allowed at the moment.

This view has been checked with the GPC lawyers

ISA-registration does  not become mandatory for both types of activity until November  2010.

From then a practice would ask a potential employee for their ISA registration number and then double  check their barred status online

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Latest BBOLMC Website Updates                                         (30/10/09)

Please note for your and your GPs’ information, that the following are all available on our website:

• Latest Secretariat Hot Topic and Information Alert emails to practices*
• Latest job vacancies across the 3  counties
• BBOLMC’s latest Information Round  Up
• DH Guidance on Sickness  Certification in Response to the Swine Flu Pandemic
• DH Guidance on the use of  prophylaxis with antiviral medicines during the H1N1 (swine flu)  pandemic
• Ian Dalton’s 15/10/09 letter to the  profession - A(H1N1) Swine Influenza: Vaccination Programme  Update
• Successful Appeal Against Abatement  of Seniority
• Latest Swine Flu Patient Information Leaflet
• DH Swine Flu Information Materials
• DH H1N1 Guidance for Pregnant Health Care Workers
• GPC News - Oct 09.

All ofthe above, and more, can be accessed at:www.bbolmc.co.uk  

*NB: Our most recent Hot Topic and Information Alert emails can be accessed via the red ˜Click for Latest  Email Alert” link on our Home Page - www.bbolmc.co.uk

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

How does a GP practice check if a potential employee is barred from regulated  activity by the ISA?                                                 (27/10/09)

Please note recent exchange between LMC and the ISA

PHR    From 12.10.09, it will be a criminal offence for a practice knowingly to appoint a  barred person to a 'regulated activity' post.
Other than asking the employee,  how does a GP practice check if a potential employee is barred from regulated  activity? 

ISA      A GP practice can check if a potential employee is barred from regulated activity by carrying out an enhanced CRB check.

PHR      I don't understand the point of being ISA registered if the CRB assessment has to be gone through again?
Shouldn't ISA records on whether someone is barred be  open to all potential employers? 

ISA      Once individuals become ISA registered they will each have their own unique registration number, this number is given to the employer and can be checked for free online, the employer can be updated with information and if an employee is barred the employer will be notified by the ISA.
Unfortunately individuals  are unable to register with the ISA until July 26th 2010 so at present the only means to check the Barred Lists is to carry out an Enhanced CRB  check. 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Vetting and barring scheme                                                     (23/10/09)

The  GPC will shortly be issuing guidance for all GPs (including what a GP employer  should do) on the new vetting and barring scheme.

This scheme  comes into play today (12 October 2009), and is being introduced in stages. From today, the following applies:

1. It will be a  criminal offence for a person who is on a barred list (e.g. the PoCA, POVA  and/or List 99) to seek or undertake 'regulated activity'.  Regulated activity includes working as a GP, as a practice nurse and may also include working as a healthcare assistant.  It applies to those who are already in post or are seeking a new post.

2. It will be a criminal offence for a practice knowingly to appoint a barred person to a 'regulated activity' post. Also practices should require an enhanced CRB check of all new recruits and of  those changing jobs who will be undertaking 'regulated activity'.  
Please note that the PoCA, PoVA and  List 99 are being replaced by two new barred lists managed by the Independent Safeguarding Authority (ISA) - one for barred from working with children, and one for barred from working with vulnerable adults. The enhanced CRB check will now provide information held on these two ISA barred lists.

3. Employers have a duty to inform the ISA if they have believe that an individual has caused harm, or posed a risk of harm, to children or patients that they work with.

Please be aware that no central  funding available to practices for CRB checks.  Therefore the question of who  pays for the check will be one for the employer and the applicant.

As noted above, GPC guidance on the  new scheme will be issued in the very near future.

The ISA's  website is: www.isa-gov.org  

Julie Goodway
General  Practitioners Committee

Getting better results for PE7 and PE8 of QoF in this year's patient surveys                                                                                         (23/10/09)

All Thames Valley PCTs have now heard appeals from their practices over patient survey results for 2008/09 (PE7 and PE8 of  QoF).

None has been successful, because of PCT adherence to government guidance.

The criteria for a successful appeal have  usually been

1. Confidence Interval of >7
2. Confidence Interval greater than previous years survey results for the same  practice
3. Results of an alternative patient access survey (performed at the same time as the national survey) giving a different %  satisfaction 

Unsurprisingly many practices passed 1 and 2 but failed  3. 

Government and PCTs regard the patient survey as assessing patient perception of access (48 hour and advance booking beyond 2 weeks). In their appeals, many practices gave impressive descriptions of their  access systems but the survey does not measure this.  

Similar Patient Surveys are now planned quarterly for  2009/10 so this problem will not go away.

LMC would advise all practices to look at how they advertise access arrangements to their patient  list. 

Practices need to stress that it is possible to see a  doctor (not necessarily their usual one) within 48hours and also book ahead for  long term conditions.

The hope would be that patient perception and survey satisfaction percentages would improve. 

I know many feel patient perception is not what we should measuring, but we have politicians that are unlikely to accept this. The  GPC is striving to alter the survey nationally, but until they are successful, practices need to find practical solutions to improve patient perception or lose QoF income recurrently. 

Any examples of literature designed to raise access awareness (or web pages) would be appreciated. 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727 

H1N1 Guidance for pregnant health care workers           (23/10/09)

Please see attached the DH's H1N1 guidance for pregnant health care workers, which will be published on the DH website and a link will be added from the BMA website shortly

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

DH Swine Flu info materials & latest Patient Info Leaflet (22/10/09)

Dear All
For your and your GPs’ information, please find below links to the DH’s latest Swine Flu information materials - including  template consent forms and invitation letters - and to the latest Patient Information Leaflet:

http://www.dh.gov.uk/en/Publichealth/Flu/Swineflu/InformationandGuidance/Vaccinationpro gramme/DH_107355

http://www.nhs.uk/Conditions/pandemic-flu/Documents/SF%20vaccination%20leaflet_web. pdf

Please note that DH and BMA Swine Flu information and  guidance - and our email alerts to practices - can also be accessed via our  website at: www.bbolmc.co.uk

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

GPC alert about Swine flu patient leaflet and other flu guidance
                                                                                                         (21/10/09)

The DH has published a swine flu patient leaflet available here:

http://www.nhs.uk/Conditions/pandemic-flu/Documents/SF%20vaccination%20leaflet_web. pdf

There is also advice for pregnant  patients: http://www.nhs.uk/Conditions/Pandemic-flu/Pages/Adviceforpregnantwomen.aspx

Note that our FAQs on the  vaccination deal will be published shortly as well as an update of the flu Q&A already available on the GP flu pages of the website:

http://www.bma.org.uk/health_promotion_ethics/influenza/panflugp/index.jsp

Best wishes
Catharina  Ohman-Smith
Senior Policy Executive
BMA General Practitioners Committee

National Statement of Support for Staff  Vaccination       (21/10/09)

Please note the text below (supported by the BMA and RCGP) which contains similar views to the email BBOLMC sent you yesterday

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Swine Flu Vaccination

A coalition of key stakeholders and staffside organisations have today issued a joint statement of support for the start of the swine flu vaccination programme. NHS Hospitals  will begin vaccinating frontline healthcare workers and their patients who fall  into at risk categories against swine flu from today. Around two million  frontline health and social care workers will be offered the  vaccine.
The following  organisations have unanimously supported the  programme:
British  Medical Association (BMA)
Royal College of General Practitioners (RCGP)
Royal College of Midwives (RCM)
Royal College of Nursing (RCN)
RoyalCollege of  Psychiatrists
RoyalCollege of  Obstetricians and Gynaecologists (RCOG)
Royal  Pharmaceutical Society of Great Britain
UNISON
NHS  Employers
Department of Health

The NHS depends on the people  treating and caring for patients, day in day out - they are our most important asset and we are committed to protecting them and their families during the current swine flu pandemic. 

We fully support the swine flu vaccination programme - it will reduce the risk to staff, protect  patients and help sustain services during the pandemic. By the nature of their  work, many NHS staff come into close contact with patients and the public and  have a higher risk of exposure to the virus.  

The vaccine has been thoroughly tested. All NHS organisations will be working hard to ensure that  eligible staff are given access to the vaccination to protect themselves, their families and their patients from swine flu.

We encourage staff to  protect themselves with the swine flu vaccine, in addition to the seasonal flu immunisation. It is your best defence against flu this winter. We also support your right not to be vaccinated, and recognise that the decision to be vaccinated is a personal matter.

Consequences of not having an annual Appraisal           (21/10/09)

As BBOLMC CEO, I attend all five PCT concerns groups in the ThamesValley. These have recently tightened up on checking that all GPs on their medical performers list (MPL) have had an annual  appraisal.

I am now writing to point out that any GP (partner or sessional) who is not documented as having an appraisal in a financial year will be considered for removal from the MPL, and such action  would prevent a doctor from working as a GP.

Having witnessed the distress the  PCT warning letter causes, I would like to minimise this in future.

Please take annual appraisal seriously.

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

LMC view on Swine Flu vaccination                                     (20/10/09)

This BBOLMC email to practices has been composed after extensive discussion amongst all LMC representatives for the Thames Valley. 

Swine Flu vaccine will begin to  arrive in practices on 26.10.09 and GPs and primary care nurses are prioritized to receive it in the first wave.  However, professional and media opinion varies on both benefit and risk. 

Some have speculated about possible  rushed vaccine development and safety assessment.

The LMC view is that new seasonal  flu vaccines are produced each year without such wariness and we are reassured  that no unsafe production short cuts have been taken. The vaccine has already  been licensed in Australia and is being used, apparently without a surge of untoward events. 

The illness so far has been largely  mild, but there have been fatalities.

There are recent reports of higher hospitalization and ITU rates with the autumn  illness

Mutation to a more virulent strain remains a possibility, especially if co-infection with seasonal and swine flu occurs.  

Immunization of clinicians is more about protection of patients than our own personal health.

Swine flu can be relatively  asymptomatic and clinicians can quietly spread it to ill patients without being  aware.

Vaccinating frontline clinicians has the added benefit that it will maintain workforce numbers at a time of pressure  and help with business continuity. 

Whilst recognizing that ultimately it is a personal decision, LMC hopes that primary care frontline staff will take  up swine flu vaccination. 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Notification of Reading event - 21 October                         (14/10/09)

Commissioners and PBC enthusiasts may  be interested in the attached

Ideas for Primary Care Development

21 October 2009 :  18.30 - 20.00
Hilton Reading
Drake Way, Reading, Berkshire, RG2 0GQ 

Kaiser Permanente is an integrated healthcare system serving 8.7  million members. In addition to serving acute care needs, KP provides proactive  population-based care. Proactive population care includes prevention activities,  addressing care gaps, and reinforcing the member's relationship with their primary care physician.  

In this presentation Clinicians from KP will be talking, via video  link, about their evolving experience with what they call "panel management" - an intervention on a group of members that a physician provides  care for. 

We will hear about the tools that facilitate care, the processes put in place around patient or member management, and the staff roles.

KP believe they can demonstrate how this approach has  improved health outcomes and service efficiency.

Although places are limited we will try and ensure there are representatives from all PCTs.
Please contact julia.wilczek@southcentral.nhs.uk to book your place

Aug/Sept Information Roundup                                             (30/09/09)

Dear All
Please find attached BBOLMC’s latest bi-monthly Information Roundup - I would be grateful if you could please circulate it within your practice and hope you, and your GPs, find it of interest and value.  

Comments and suggestions for improvements and/or items for inclusion in future editions to pauline.green@bbolmc.co.uk are very  welcome. 

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

Letter from Swine Flu Czar re: delivery of H1N1 vaccination
                                                                                                         (29/09/09)

Please see the attached  letter from Ian Dalton about DNs vaccinating the housebound without charging the GP, and GPs vaccinating their own staff. 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Poster encouraging inpatients and staff to ask for/give sickness certificates                                                                                   (29/09/09)  

The Oxford Radcliffe has finally put the LMC poster up on each ward.

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Dispensing Doctors' Fee Scale from 1 October to next April
                                                                                                         (24/09/09)

Please see the BMA email below:
The reduced figures  affect the amount of reimbursement (and therefore profit) all practices get for  personally administered items from the PPA

An adjusted calculator is available here: BBOLMC PPA Profit calculator 240909

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

From:GPC Local Medical Committees discussion list
Subject: Dispensing Doctors' Fee Scale 1 October 09- April 10 England and Wales  

Dear All,
Please find attached a focus on the  Dispensing Doctors' Fee Scale from 1 October to next April. This applies to England and Wales only.

It is not good news and a press  release is being issued by our press office today expressing our disappointment; NHS Employers are also issuing a press release but, not surprisingly, their spin is somewhat different. 

You will undoubtedly receive enquiries from your constituents about this, particularly asking how GPC could have agreed to it.  I am afraid that the only answer is that, had we not done so, the Department of Health would have imposed a much tougher set of financial  arrangements which we did not believe was in the best interests of practices.  This represents the best agreement that could have been reached at this time, especially in the light of the success of our campaign to preserve the existing  arrangements for dispensing doctors in England last year.

Matthew Isom
Senior Policy  Executive
NHS GPs Division
British Medical Association 

H1N1 Vaccinations, LINks, Complementary Therapists  
                                                                                                         (18/09/09)

1  Dr  Laurence Buckman’s Letter to all GPs re H1N1 Vaccination  Arrangements
Dr Buckman’ 15 September 2009  letter to all GPs is also available on our website  at:
http://www.bbolmc.co.uk/h1n1lett0909.pdf

2 GPC  Guidance on Local Involvement Networks (LINks)
The GPC’s Guidance on Local  Involvement Networks (LINks) can be accessed on our website  via:
http://www.bbolmc.co.uk/lnkfaq.pdf  

3 Referrals to Complementary Therapists
The GPC has updated its September  2006 guidance in response to evidence of continuing interest amongst patients in the use of treatment modalities which are currently outside NHS healthcare provision but which are delivered by professionals who have statutory regulation in place.
The updated guidance is available on our website via the following link:
http://www.bbolmc.co.uk/refcompl0509.pdf  

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

GPC Letter to all GPs regarding the H1N1 vaccination campaign
                                                                                                         (15/09/09)

Please find attached a letter from Laurence detailing the agreement with NHS Employers  for the H1N1 vaccination campaign in the UK.

The DH have  brought forward the press-release at the last minute, and we are not able to  email the profession this evening. Therefore please cascade this down to colleagues and your LMC lists. We will send the letter to the full profession tomorrow morning.

Kind regards,

Richard  Stebbings
Senior Policy Executive
General Practitioners Committee
 

BMA Conference for Sessional GPs 13/11/09                     (04/09/09)

Dear All
Please let your Salaried and Locum GPs know that the British Medical Association is holding a one day conference for Sessional GPs entitled 'Recognise your Talents, Realise Opportunities: Key steps for Sessional GPs' on Friday 13 November 2009 at the British Medical Association, BMA House,  Tavistock Square, London, WC1H 9JP.

The aim of the conference is to  provide Salaried and Locum GPs with the tools that they need to succeed, including how to develop the skills they already possess, and it will be divided  into three key areas:

• Step 1 - Marketing yourself
• Step 2 - Effective planning and career development: making the job work for you
• Step 3- How to meet  the challenges of revalidation.

This event will be of interest to all current  Salaried GPs (including Retainer Scheme GPs) and GP Locums. It will also be relevant to those considering becoming a Salaried or Locum  GP. 

Full details are available at:
http://www.bma.org.uk/whats_on/SESSGP09.jsp?page=1

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs

BBOLMC Medical Director Opportunity                               (26/08/09)

Dear All
Did you know that BBOLMC is still  looking for a Medical Director to join the team in Marlow?

Full details can be accessed at:
  http://www.bbolmc.co.uk/classifieds/bbomd/bbomd.html  

Please help us by circulating this email to all the Doctors in your practice - partners, salaried and locum GPs - in case they might be interested. Thank you.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

Swine Flu vaccination                                                               (24/08/09)

I hear from my contacts that it may  not be possible to get a national agreement on Swine Flu administration by  GPs

The government through its media connections (eg The Daily Mail) has already begun a softening up campaign 

I now see many TV PCTs calling meetings to discuss Swine flu vaccination, so it looks as though they are  preparing for local negotiation

PCTs may be tempted to bypass GP contract holders and communicate with practice nurses direct.

I imagine many of you will have seen this tactic before and had to put a break on the magnanimity of your treatment  room staff 

Please be aware of PCT behaviour and ensure approaches to your nurses are always fed back for partners to make  business decisions 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

BBO LMC Information Roundup - Aug 2009                       (06/08/09)

Dear All,
Please find attached our second  bi-monthly Information Roundup - we would be grateful if you could please circulate it within your practice. Thank you. 

We hope you and your GPs find it of  interest and value. Comments and suggestions for improvements and/or items for  inclusion in future editions to pauline.green@bbolmc.co.uk are  welcome.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk  

Updated GPC Pandemic Flu Q&A                                         (24/07/09)

Please see latest GPC Guidance on Pandemic Flu at http://www.bma.org.uk/health_promotion_ethics/influenza/panflugp/panfluqa.jsp  

I have extracted (and  edited) the following text on Tamiflu Vouchers to draw it to the attention of practices  

Tamiflu  Vouchers

As from the 15 July, in England, antiviral vouchers have been  distributed to SHAs to be cascaded to practices. This voucher can only be used to prescribe Tamiflu and Relenza to patients with suspected swine flu (H1N1) who can collect these antivirals from Antiviral Collection Points (ACPs) free of charge. The GPC is urging the DH to allow FP10 prescription forms to be used in place of antiviral vouchers, for those GPs who prefer it.

Scotland, Wales and Northern Ireland continue to use prescriptions for the  supply of Tamiflu. 

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Liam Donaldson letter re Swine Flu Line 23/07/09           (24/07/09)

I attach Liam Donaldson’s letter of 23.7.09 about:
1. The new Swine Flu  assessment line
2. Patient groups that  still need to consult a GP
3. Recent Swine Flu figures and epidemiology

See also:
  http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/DH_103226

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Guidance on Sealing Electronic Patient Records             (21/07/09) 

Please see below guidance issued by the Joint GPC/RCGP IT Committee. We would be  grateful if you would ensure that your constituents are made aware of  this.

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs


Some GP clinical systems include functionality that allows a GP to restrict access to elements of  patients’ electronic health records to different levels of user within the  practice. This functionality is not consistent across systems and any data that  is hidden is likely to be revealed when the patient record is transferred to another GP clinical system. This can happen when a patient’s record is transferred to another practice via traditional paper record transfer or GP2GP or following a data migration to another GP clinical system in the practice.

GPs are therefore advised to inform patients, who want elements of their electronic health record to be kept confidential, that the information is not likely to remain hidden when the record is transferred to another system, either electronically or via paper transfer.

Matthew  Isom
Senior Policy Executive
NHS GPs Division
British Medical  Association

Oseltamivir Solution MUST ONLY be for the under 1s     (21/07/09) 

The GPC is getting reports from all across the country that GPs are authorising the use of oseltamivir solution for adults and children who are not able to swallow capsules.

The advice is that GPs should be advising the emptying of the appropriate strength capsules onto something palatable and NOT  prescribing the solution.

Oseltamivir Solution must be limited for use in children under 1.

This is causing an unprecedented demand for the solution and if we continue to use this strategy,  we will run out of solution for babies under  1.

Can we please get the message accross to everyone urgently that the solution should ONLY be used for kids under 1 

Children or adults who are  not able to swallow capsules are asked to empty the contents of the capsules.  

PCTs have been provided with templates for labels and  these clearly state that the contents of the capsules can be emptied into a sweet, sugary solution.

Peter Holden
BMA GPC Pandemic Flu lead

Paul Roblin
Tel: 01628 475727
Mobile: 07799  116597

Dr Buckman's letter to All GPs re Pandemic flu - issues for GPs
                                                                                                         (07/07/09) 

Dear All
For your and your GPs’ information, please find attached Dr Laurence Buckman’s letter of today to all GPs re Pandemic Flu. 

Best wishes
Pauline
Pauline  Green
Administration & Information Manager
Berks, Bucks & Oxon  LMCs
Tel: 01628 475727
www.bbolmc.co.uk

BBOLMC Flu update 060709                                                   (06/07/09)

Please see the attached update for your information.

Kind regards
Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727

Antiviral medication for children                                           (06/07/09)

I thought you might appreciate a copy (see below) of an email from:
Helen Chadwick (Deputy Chief Pharmacist & Professional Member of MKPCT PEC).  

Dr Paul  Roblin
CEO  BBOLMC
07799116597 or 01628 475727 

1. Oseltamivir  solution and suspension is ONLY for use in babies under 1 year of age. All other  children and adults must have capsules. This is due to a very limited availability of the solution so it must be kept for the sole use of  babies. 
2. If adults, adolescents or children are unable to swallow capsules they may receive appropriate doses of Tamiflu by  opening capsules and pouring the contents of capsules into a  suitable, small amount (1 teaspoon maximum) of sweetened food product such as  regular or sugar-free chocolate syrup, honey (only for children two years or older), light brown or table sugar dissolved in water, dessert toppings, sweetened condensed milk, apple sauce or yogurt to mask the bitter taste. The  mixture should be stirred and the entire contents given to the patient. The  mixture must be given immediately after its preparation. It is not necessary to  administer any undissolved white powder as this is inert  material. 
3. When prescribing for babies under 1 year of age - please prescribe oseltamivir solution 15mg/ml. This is not  on your clinical systems as it has been made up specially but is what our  pharmacies have in stock.
4. Here is a  link to the most up to date prescribing guidance from the HPA http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1243581475043

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