CCG Outcomes Indicator Set

A number of LMCs have sought IT Subcommittee advice on the CCG Outcomes Indicator Set (CCG OIS) for 2013/14 and 2014/15. Practices have been asked to sign up to this collection within CQRS to allow data to be extracted through GPES. The intention of the extract is to provide information for CCGs about the quality of health services. Further information from the HSCIC on the CCG OIS, including the data to be extracted, can be found here.

The GPC IT Subcommittee has discussed this extract and contacted the HSCIC on behalf of practices. We can confirm that participation in the extract is voluntary, and it is matter for practices to decide whether to take part.

There is no CQRS payment attached to this service. The data to be extracted is aggregated at practice level, with no record level or sensitive data included. We have been informed that 73% of practices offered the extract have signed up (not all have practices have received this request - only those where the HSCIC has the facility to extract this data automatically).

Please note that the GPC has highlighted the limitations of this dataset to the HSCIC. These indicators are unlikely to be coded consistently and any interpretations of the data are likely to be inappropriate. Some of these indicators are those no longer in QOF and GPC has previously noted that the coding of retired QOF indicators will become increasingly variable over time.

Contract finder

In this brave new world of procurement and competition, many opportunities are advertised nationally, even those that used to be automatically offered to practices. We strongly advise all practice managers to sign up to the Contracts Finder to keep up to date with developments in your area.

All future opportunities will be listed here.  You have to register – provide the details of your organisation and your email address.  Once your registration is activated you can search opportunities-

Tips

Type ‘GP’ in the keyword box

Location of contracts – select East Midlands

Industry CPV code – select ‘Other’ and then tick ‘Health and social work services’. 

You can then save this search and request updates on a frequency that works for you, depending on whether you are merely curious about what is being procured in your local area (e.g. out of hours or 111 services your patients may use), or whether you are part of a larger group actively seeking to bid for contracts.

Please note APMS contracts are advertised via this route.

Our AGM makes front page news

After a well attended AGM, our key messages are making the headlines.

On Monday LMC Medical Secretary Dr Saqib Anwar appeared in the Leicester Mercury, as he was approached to provide a view on the BMA Junior Doctors’ ballot on industrial action.

Last Wednesday evening we held our AGM, and there were some lively discussions about the future of general practice, sparked off by our guest speaker Dr Zoe Norris, a GP in Yorkshire who writes for PULSE and the Huffington Post, and is media spokesperson for the pressure group set up by and for GPs, GP Survival.  Her theme was ‘GPs are awesome’ – and she urged all GPs to inform their patients about the impending crisis in general practice.  She drew our attention to the existence another group, NHS Survival, which is campaigning for a Royal Commission on the NHS.

The next day our chief executive Dr Chris Hewitt received a call from Daily Express journalist Lucy Johnston.  We were initially cautious about this, as the Daily Express is not generally noted for its support of GPs.  However, they ran a story about the impending crisis in General Practice on the front page of their Sunday edition on 4th October:

There had been a debate at PULSE Live in Liverpool the previous day about mass resignations from the contract.

We were pleased that the Express checked in with us as to what had been discussed at our AGM, and were able to correct an impression our LMC was about to lobby for the immediate resignation of GMS contracts. We held a wide ranging discussion about the pressures on general practice, and what our LMC can do to support our practices with the many problems.

The themes discussed and the valuable feedback from those who came to the AGM will be incorporated into our updated three year business plan, which will be published on our brand new website towards the end of 2015.  This informs the LMC’s programme of activities throughout the year.

Hardly had the LMC’s committee members digested their Sunday breakfast after reading this, when the Prime Minister appeared on the Andrew Marr show announcing a new voluntary GP contract.

As ever, the PM was very light on the detail of this, but he remains obsessed with the idea of a 7 day, 8 am to 8pm GP service.  He conveniently ignores the fact such a service already exists and that many of his Challenge Fund pilots have slashed their weekend opening hours, due to lack of patient demand.

Neither the BMA or the GPC had been consulted on this issue.  We note this contract will be available to practices (or groups of practices) covering populations of 30,000 patients or more.  The government continue to push forward the new models of care outlined in the Five Year Forward View, without allowing time for the Challenge Fund pilots to be evaluated.

CQC - What to expect from an inspection

For those GP practices that might be about to face an inspection by the CQC, a ‘what to expect from an inspection’ video has been created which is a mixture of interviews with a CQC inspector, a GP and a practice manager explaining their experience of an inspection. It is supported by a more detailed publication giving practical advice as to what to expect from an inspection and another ‘hard copy’ case study.

We understand that these materials have been shared with all GP practices, but for anyone who may not have seen them the links are here:

• Salford Health Matters: What to expect when we inspect
• What to expect when we inspect PDF | 499.43 KB
• Edenbridge Medical Practice: Experience of new approach
• Guidance to providers on meeting the regulations

Remember, the LMC can support practices before, during and after an inspection. We are here to help, just get in touch.

Medical interoperability gateway information sharing agreement

The LMC continues to receive queries from practices about whether or not they should sign this Information Sharing Agreement. The LMC has studied in full and discussed it in June with reps from CCG and GEM. 

The project team should be providing practices with posters, and summary details, as it is a long and detailed document, however the Caldicott Guardians within practice will need to read it in full.

The LMC can see the benefits to patients of secondary care clinicians having access to coded information, and we noted that explicit consent must be sought by the treating clinician each time the record is viewed.  The ISA is thorough and detailed, and we understand the MIG system has been piloted in Nottingham.

Some issues we highlighted to the project team were regarding potential workload for practices- particularly the practice manager and/or privacy officer, as practices are notified when the record is accessed in secondary care as part of the audit trail.  The project team said they could support practices with how these notifications are received.  We also noted there is some work up front in updating practice websites with fair processing/privacy notices and posters and leaflets, as well as dealing with any patient queries arising.  Also Systm One practices may need to review their protocol on marking read coded sensitive data as 'private' for some patients.

We suggested to the project team they produce posters, leaflets and website copy, as well as some success stories, FAQ and an implementation guide for practices to support them with the rollout.

In terms of the decision as to whether or not to sign up, each practice will need to weigh up the benefits to patients and assess whether or not they have the capacity to do this.  

Use of SARS

We have been made aware that there is an ongoing issue with insurance companies requesting access for full patient records rather than full GP reports. We have now received a response from the GPC.

"The GPC has received a reply from the ICO regarding the use of Subject Access Reports (SARS) under the Data Protection Act rather than requesting GP reports.

"The ICO has ruled that this use is inappropriate. In particular note the first paragraph of the Summary:

'The right of subject access is a key element of the fundamental right to the protection of personal data provided for under Article 8 of the EU Charter of Fundamental Rights which is conferred upon individuals. It is not designed to underpin the commercial processes of the life insurance industry. The Commissioner takes the view that the use of subject access rights to access medical records in this way is an abuse of those rights.'"

To see the ruling letter in full, click here.

In light of this, we would recommend that practices do not respond to these SARS requests. We will update you very soon with further information

Out of area patient registration

Practcies are reminded that although the implementation date of the scheme was 5th January, the advice of the GPC is that a practice should only register out of area patients after they have sought and obtained assurances from area teams that arrangements for urgent GP services including home

visits are in place for individual patients at their place of residence.

Without that assurance practices are strongly advised that they should not currently register any patients under the new regulation.

Further guidance is available here on the BMA website.