Newcastle and North Tyneside s2

Newcastle and North Tyneside Local Medical Committee

http://www.nntlmc.co.uk

LMC Newsletter November 2015

LMC Open Meeting & Proposed Model of Care in N. Tyneside. The LMC held an open meeting for North Tyneside GPs and practice managers on the 2nd November. This was to discuss and raise awareness of the proposed Accountable Care Organisation (ACO) that the CCG was proposing for North Tyneside. The meeting was very well attended and it was clear that many were not happy with the proposals and the following themes were evident:  That the timescale proposed was not acceptable as time was needed to assimilate and discuss any proposal;  That other models of care have to be explored alongside an ACO model - as the GPs present wanted choice in the future model of care;  Any new model of care must be bottom up and GP led;  The Federation must be supported, strengthened and more robust;  Special measures of the CCG was discussed. What does this mean? GPs present did not want this to be used as a threat against general practice;  Will an ACO reduce the CCG financial £17m deficit? If so how quickly? Where will the savings come from?;  That practices cannot decide on the way forward at the present time;  The proposed ACO model was not discounted but much more information was needed.

1 Newcastle and North Tyneside Local Medical Committee

Another meeting arranged by the LMC has been requested at the start of 2016 in February or March and we will continue to keep you informed as the new model of care debate continues.

A copy of the presentation is now available on the website at http://www.nntlmc.co.uk/styled-3/downloads-28/index.html

In addition we have received some observations from the Chair of the Regional LMC who was present and these can be seen at http://www.nntlmc.co.uk/styled-3/downloads-28/index.html

Primary Care Strategies. As mentioned previously general practice is at the centre of the biggest transformational change of all time. Simon Steven’s Five Year Forward View and its proposed new models of care is something that all GPs should read, digest and discuss. The CCGs are looking at this but frontline GPs and their managers must get involved to shape the future of general practice – if you don’t then models, that you may not want, will be imposed upon you. Around our area CCGs are taking slightly different approaches e.g.  Newcastle Gateshead CCG – have prepared a primary care strategy document that all practices have been sent to comment upon. From this certain work streams are developing i.e. workforce, premises, IT, finance etc.  Gateshead have invested in a small active team to take things forward over the next 3 years and involve all practices  South Tyneside CCG have funded some GP time to take the agenda forward and again involve front line GPs  Northumberland CCG is part of a vanguard looking at an Accountable Care Organisation (ACO)  Sunderland CCG is also part of a vanguard but looking at a Multispeciality Community Provider (MCP) model  North Tyneside CCG is pushing forward an ACO model but in a more top-down approach that is not acceptable to GPs –see above

Shared Care Agreements. These agreements between secondary and primary care are important as it makes it clear what is expected from either party. The number and scope of them is expected to increase in the future and hopefully they can be exchanged electronically also. It is important that practices that take on shared care arrangements return the signed agreement as soon as possible so that patients are not inconvenienced.

Data Protection Act. The cost of postage, especially if recorded, is becoming expensive for practices to return copies of notes to patients or third parties. Advice has been sought as below: “The GPC is aware that the fees chargeable under the DPA for Subject Access Requests (SARs) are often inadequate in covering practices’ costs in supplying this information, but unfortunately the fee is set by legislation. Practices can charge up to £10 for a SAR relating to health records held only electronically and up to £50 where health records are held wholly or partly in non-electronic form. These charges can be made where the patient is supplied with a permanent copy and postage costs are included in this fee. Under the DPA provisions, it is expected that the data controller will post the record to the patient where necessary, since postage is specifically covered by the fee. However, there is no reason why the practice couldn’t suggest to the patient that they may wish to pick up the record themselves – but the practice couldn’t insist on this. One thing to note is that if the requester has made the SAR electronically, they may be content to receive the response electronically too, which may save time and cost for the practice. It would be good practice to check the patient’s preference in these circumstances.”

LMC Administrator Appointment. As the LMC plans for the future it was thought very important that adequate admin. support is available to practices and the executive team of the LMC. The LMC has appointed Ms. Joanna Lumley to take on this role and she can be contacted by email at [email protected] Practices that wish to raise any query can contact Jo and she will ensure that the query is passed to the most appropriate person. 3 Newcastle and North Tyneside Local Medical Committee

Medical Interoperability Gateway (MIG). North Tyneside CCG has secured resources to implement the Medical Interoperability Gateway (MIG). This allows providers to share patient information across different platforms in real time. This means that data is accessed and not extracted as in the care.data programme. Patients’ consent has to be given at the time and the MIG has been used in nearby areas to great success and the LMC fully supports this development.

Junior Doctors’ Dispute. As everyone knows the junior doctors are in dispute with the Secretary of State for health, Jeremy Hunt, over their proposed terms and conditions and the threat of an imposition of a contract next August. A rally was held recently in Newcastle and many GPs, consultants and other doctors marched alongside them to show their support. Your LMC was there to demonstrate that the GPs of Newcastle and North Tyneside supported the junior doctors.

Patient Registration. GPC has published updated guidance on patient registration, which is available here: http://bma.org.uk/support-at-work/gp-practices/service- provision/patient-registration-for-gp-practices

The key message to practices is that any patient in England, regardless of their residency status, regardless of where in the world they are from, and regardless of how long they will be in England, must be treated in exactly the same way as a UK resident . This applies in respect of emergency and immediately necessary treatment, application for temporary resident registration and application for permanent registration

Intelligent General Practice Reporting Tool (iGPR). The iGPR provides an electronic process for practices to provide patient information to requesting third parties, such as insurers and solicitors. Requests can include Subject Access Requests (SARs) and GP Reports (GPRs). There are other systems that provide similar functionality.

Firstly, with regard to any SAR from an insurer, practices should read the BMA guidance on how to manage SARs for insurance purposes. A template letter is included in the guidance, which asks the patient to choose between receiving the medical record themselves), or to ask their insurer to seek a GP Report from the practice.

It should also be noted that when a SAR is produced, the Data Protection Act (DPA) requires certain types of data to be redacted. Any additional redaction offered by any reporting tool over and above the legally required redaction would, in the JGPITC’s view, mean that the resulting report no longer constitutes a SAR. Where practices wish to use these tools for purposes other than an insurance company SAR, this is a matter for individual practices to decide. Separately, practices have asked for advice on electronic patient consent, and the legal position is that electronic patient consent is acceptable. However, where there is any doubt that the patient has consented to the report, practices should check with the patient. There is no requirement for practices to use these reporting tools, and it is for practices to decide whether they receive requests through them or whether to deactivate the tool.

Primary Care Infrastructure Fund . There are increasing concerns about the use of the Primary Care Infrastructure Fund, which was the £1 Billion capital investment spread over four years announced at the beginning of the year. Primary care premises investment has been neglected for 10 years, but the emphasis on capital rather than recurrent funding was questioned. It is becoming clear that NHS England is struggling to release funds to approved practice schemes across England, and that there is a significant

5 Newcastle and North Tyneside Local Medical Committee shortage of the relevant expertise in this field. In recent weeks GPC has received a number of queries and complaints from practices about a lack of decision making at local or regional level, and even of the withdrawal of previously given approval for developments. NHS England has recently sent new instructions to CCGs about the use of this fund, now renamed the Primary Care Transformation Fund. It is always a concern when there are changes in the criteria around new funds, and the risk that name changes can frequently move funds away from their proper planned destination. This has happened before. GPC is therefore sending a survey to all practices in order to gather information on what is happening across England.

The survey can be accessed via: https://www.surveymonkey.com/r/PCIF

Emmanuel College – Request for Information. This college has approached the LMC with a form they wish to use to ask for medical information on a few students who are raising cause for concern in their attendance due to medical problems. The form informs the parents that a fee is payable and that it is reimbursed by the college if cause of absence is genuine. This is not for the “run of the mill” absences but at last a college understands that this is a service outwith a GPs terms of service!

GPC News, GP News from the Chair and local issues. This months GPC News contains some important information on:  CCG Outcomes Indicator Set – England  GP workforce 10 point plan – Research study into GPs joining and leaving the profession  GPC guidance notes – update  Health Foundation report on indicators of quality of care in general practice – England.  Men ACWY for University freshers – missed cohort – England  Meningococcal B for infants – FAQs – England  NHS England Commissioning Standards – Integrating Urgent Care (England)  Pertussis data collections - England  Prime Minister’s announcement on a new contract from 2017 and 7 day working – England  Tamiflu for the prophylaxis of influenza in nursing and care homes 6 Newcastle and North Tyneside Local Medical Committee

 The State of Health Care and Adult Social Care in England

For national issues from the GPC with relevant links etc. please see the LMC website: http://www.nntlmc.co.uk/styled-3/downloads-2/index.html and http://www.nntlmc.co.uk/page55/index.html

Also please watch your LMC Blog http://www.nntlmc.co.uk/blog/index.html

Use of the LMC RSS feed on the Blog page will automate your updates.

Website The LMC now has a Facebook page: http://www.facebook.com/pages/Newcastle-North-Tyneside-LMC/252898648158228 We hope that most of the LMC’s communication will be by way of our website and that practices will use the LMC RSS Feed for automatic notification of new information.

See http://www.nntlmc.co.uk and try it out

George Rae Chief Executive Officer David Black Executive Officer Ken Megson Executive Officer