EMail Alerts - Archive
Jul 09 - Dec 09
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. Â
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. Â 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 PCTsÂ
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
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
Â
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?Â
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:
- Individuals aged six months and up to 65 years in the current seasonal flu vaccine clinical at risk groups
- Pregnant women
- Household contacts of immunocompromised individuals
- 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
- Confidence Interval of >7
- Confidence Interval greater than previous years survey results for the same practice
- 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.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 0GQÂ
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.Â
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.Â
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
- 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.
- 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.
- 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.
- 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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