Newsletter September 2007 |
Health Visitor Review Every GP practice was recently sent the Health Visitor Review consultation document. If you have not yet seen it a copy can be found on our web page www.glasgow-lmc.co.uk. The LMC is undertaking a very robust response to this document however, given the importance of this review and its impact on primary care and especially the general practice team, we would ask as many individuals as possible to also respond. Please, please send your comments to George Hunter, c/o Ann Law, East CHCP, Building 1, Templeton Business Centre, 62 Templeton Street, Glasgow, G40 1DA. You might want to look at the following website www.phru.net/phnhealthvisitingreview/default.aspx and post your comments there as well GP Sub/LMC Committee Our thanks to Dr Douglas Colville whose tenure as chairman of the GP Sub/LMC came to an end in April. Douglas has been a very able, fair and diplomatic chairman who, for his sins, is now chairman of the Area Medical Committee. More recently he has been elected as chairman of the Area Clinical Forum, which brings with it membership of the GG&C NHS Board. Douglas does, of course, remain a very active member of the GP Sub/LMC Committee. Our new chairman is Dr Paul Ryan. Paul, like his predecessor, is a very active member of the Committee representing GPs at every level. Dr Maureen Smith has been elected as Vice-Chairman. Maureen practices in Port Glasgow and brings a wealth of experience having served as GP Subcommittee Medical Secretary in Clyde. Dr Ian Thompson representative for sessional GPs, has also resigned from the GP Sub/LMC (relocated to Aberdeen). We thank Ian for his input and wish him well in the future. Ian is actively campaigning amongst his sessional colleagues for a replacement representative and we look forward to welcoming his replacement. Scottish National LMC Conference The Scottish LMC Conference held on 26th April was attended by 20 members from Glasgow. Dean Marshall delivered his report as chairman of SGPC, commending GPs on their hard work and levels of achievement over the year, but criticising the continuing negativity towards General Practice both from the government re 0% pay award and in the media with anti-GP stories being the norm. Glasgow and Clyde proposed motions on the following topics which were passed; 1. Deploring DDRB ruling on pay award 2. Requiring QoF changes to be negotiated in advance of year end 3. Requiring that lifestyle issues such as obesity should not be part of QoF 4. Welcoming increase to 18 months training in practice for GP registrars 5. Increasing flexibility in MMC to allow more choice for young doctors, and to make more info available about schemes in the MTAS system (subsequently overtaken by events). 6. Supporting the delivery of health care being as local as possible, with full funding 7. Calling for roll-out of local laws banning alcohol consumption in public streets, and increased funding of services to treat alcohol problems 8. Calling for more funding of Dosette boxes/ medication delivery devices 9. Recognising the continuing input of GPs in provision of OOH care 10. Calling for a halt to the implementation of SCCRS, and for a fundamental review, and opposing the proposal that all smear requests must be submitted electronically (well, we all know what happened after that!) 11. Insisting that GP reception staff must not be expected to check passports etc for new patients registering with the NHS for the first time 12. Deploring the cap on the pensions dynamising factor 13. Supporting legal action by the GPC to support recently retired GPs who have been penalised by the cap on the dynamising factor A number of our other motions, whilst not proposed at conference by us, were included in bracketed motions, proposed by other LMCs and passed by conference. These included motions on; supporting negotiators in saying no to inadequately resourced new work and unilateral changes to the contract; calling for an increase in Global Sum funding due to population increases; raising concern over how the Global Sum is calculated; welcoming the recommendations of the Deloitte report but demanding that system choice to practices should remain; calling for anti-doctor spin to cease. There appeared to be general disappointment and anger about the 0% pay award from DDRB, however there seemed to be little appetite for taking industrial action in response this year. If there is a similar situation next year, this view may change. UK National LMC Conference 14th & 15th June Dr Jim O’Neil found himself unexpectedly opening the event with his motion on guidance for registering overseas visitors (which was overwhelmingly supported by conference). Delegates also heard that this was an area that the Department of Health might finally be looking into. Drs Douglas Colville, John Ip, Murray Macpherson, AndrewTownsley and Barbara West also had the chance to speak on our behalf to various motions and were all very well received. There was also a very lively closing debate about GPs opening OOHs and charging patients (as you can imagine). GPC News You will have read in the medical press that Hamish Meldrum has now taken over as Chairman of the BMA. We wish him well in his new position and most certainly the BMA could not have a better chairman. This left a vacancy for Chairman of GPC and, after a hard fought election with six candidates, Laurence Buckman was elected as chairman. This left a vacancy in the negotiating team which has been filled by Chaand Nagpaul from London. These changes happened at the July GPC. At that time we were also formally told that the BMA had been given leave to present evidence to a judicial review of GP pension arrangements. Essentially the agreement for the first three years of the new contract was that the dynamisation factor would rise in line with the rise in income. Although a dynamisation factor of 12.9% has been agreed for the first year of the new contract, subsequently the government has reneged on the deal for the next two years when the dynamisation would have been considerably higher. The review will probably not report until next year and we await progress with interest. This is especially important for doctors who retired at the end of the three year period in expectation of a good pension and have now had the rules retrospectively changed. LMC Elections Elections for half of the Committee will take place in the new year, and further information will be sent to you nearer the time. If you are interested in becoming involved in the work of the Committee please contact the LMC office for an informal chat. Please do consider standing for election; we meet once a month, and the meetings cover a huge range of topics of interest to Glasgow and Clyde GPs. Health Centre Charges Well there is good news and there is bad news. For GPs in health centres in Glasgow, the service charge will actually go down this year as the cost of fuel has reduced considerably, more than cancelling out rises in cleaning and maintenance. Clyde practices will find that their health centre charges go up considerably but this is because they didn’t go up last year and they will, in effect, be feeling the effects of both the increase of last year and the slight decrease of this year. There will however be no retrospective charges, thank goodness! It’s worth noting that service charges per square metre in Clyde are still lower than Glasgow charges due to some fairly technical reasons which could be explained maybe on request. PSD Newsletter You will have seen the recommendation in the June PSD newsletter stating that we had to get two pieces of supporting documentation before registering a new patient. This was clearly a mistake and in the subsequent newsletter PSD have explained this. We should make it clear that it is no part of a GP’s job to ask for this proof from the indigenous population however much they would like us to do it. Royal Medical Benevolent Fund The Royal Medical Benevolent Fund provide financial help, information and advice for doctors and their families in times of crises. Recent cases include doctors who have suffered strokes, cancer, multiple sclerosis, paralysis after serious road accidents, blindness, schizophrenia, manic depression, dependency and the suicide of a partner. The Royal Medical Benevolent Fund currently have vacancies for Area Visitors in the Glasgow area. They are looking for doctors to join their team of dedicated and committed Area Visitors who go to see applicants in their own homes, assess individual circumstances and report back to their Casework Department to help determine how their financial help and advice can be effectively provided. For more information please contact Kate Sheppard, Volunteer Support and Development Co-ordinator on 02032 553 003 or by email to ksheppard@rmbf.org. Further information about the Royal Medical Benevolent Fund can be found on their website www.rmbf.org. MMR Vaccine and Adult Foreign Travel A practice nurse has highlighted the high cost of obtaining MMR vaccine from Leverndale for adult foreign travel, as it is now recommended in the schedules and the practice wondered whether this cost could be passed to the patient. Any vaccine for foreign travel that wasn’t paid for by the NHS prior to the new contract is de facto a private provision of service (same as rabies and Japanese encephalitis). You are therefore entitled to pass on the cost of the vaccine to the patient plus any administration fee that you charge. The very fact that Leverndale is charging for MMR for travel purposes proves it is not an NHS service. Wart Clinic We recently received a query from a practice who wished to withdraw from providing a service for the removal of warts as they were finding this work to be increasingly resource intense and reward light. The practice wondered whether they were obliged to provide this service under their terms of contract and what would be the financial implication of stopping the service. Cryo of warts is an additional service; therefore the practice could opt out of doing it and the Health Board would be obliged to provide the service by some other means. The practice must write to them to formally to request to opt out and the Health Board can refuse, in which case the practice could appeal. By opting out the practice would lose 0.6% of its global sum funding, and would risk (although we don’t think this has actually ever happened) losing enhanced service money as well. This is covered in part 10 of the contract document. Practices should remember that there is no obligation to freeze every wart you see, immediately, on request. It’s not an urgent procedure or a life threatening condition. In a secondary care setting they would operate a waiting list and treat only the number of patients that they can realistically manage, without impinging on more important services. Partnership Agreements We have been asked a couple of queries relating to partnership agreements:- Q/ “Is there reimbursement for locums if a partner is suspended?” A/ Yes, provision is made for this under part 4, subpara 11 of the Statement of Financial Entitlement. Q/ “Is there a qualifying period before which maternity locum expenses can be paid to a partner.” A/ A doctor is eligible to claim Locum reimbursement in respect of Maternity leave after the 24th week of pregnancy up to the birth of the baby for a maximum period of up to 26 weeks. The SFE/Protocol indicates that the practice is entitled to claim locum reimbursement provided that:- “the locum is not a partner or shareholder in the contractor, or already an employee of the contractor, unless the performer on leave is a job sharer; and “the contractor is not also claiming another payment for locum cover in respect of the performer on leave” A practice seeking to claim reimbursement to engage a partner as a locum would have to outline the circumstances for such an engagement and submit this to the Head of Primary care Support (Nic Zappia) for consideration of the application before a decision would be taken on whether locum reimbursement in the circumstances would be approved. Kate McGloan, Family Health Services Officer (Medical), will be able to advise. Q? “Can a partnership become a limited company under nGMS?” A/ Yes, practices are allowed to become limited companies under nGMS. However, we would suggest that any practice thinking of going down this route seeks appropriate legal and accounting advice before doing so. In particular, the situation regarding membership of the NHS Superannuation Scheme is still not clear. Certificates/Reports/Certificates Education (Additional Support for Learning) (Scotland) Act 2004 & GPs The responsibility and duties under this Act are for the education authority to obtain medical reports, where necessary, but not for the Doctor to have to provide them. As such they would constitute a private report which is optional for the doctor, would require consent and would have to be paid for. We would encourage a GP to be willing, where consent by the child or guardian is provided and the fee is agreed, to provide a report which would be helpful in the care of the child. However, if the person requesting such a report disagrees please ask them to contact the LMC quoting the Act which applies. Below is the list of prescribed certificates which are required by law from a GP under various acts and for which you cannot charge. List of Prescribed Medical Certificates 1. To support a claim or to obtain payment either personally or by proxy; to prove inability to work or incapacity for self-support for the purposes of an award by the Secretary of State; or to enable proxy to draw pensions etc. (Naval and Marine Pay and Pensions Act 1865 Air Force (Constitution) Act 1917 Pensions (Navy, Army, Air Force and Mercantile Marine) Act 1939 Personal Injuries (Emergency Provisions) Act 1939 Pensions (Mercantile Marine) Act 1942 Polish Resettlement Act 1947 Social Security Administration Act 1992 Social Security Contributions and Benefits Act 1992 Social Security Act 1998) 2. To establish pregnancy for the purpose of obtaining welfare foods Section 13 of the Social Security Act 1988 (schemes for distribution etc of welfare foods 3. To secure registration of still-birth (Section 21 of the Registration of Births, Deaths and Marriages (Scotland) Act 1965 (special provision as to registration of still-birth) 4. To enable payment to be made to an institution or other person in case of mental disorder of persons entitled to payment from public funds. (Section 142 of the Mental Health Act 1983 (pay, pensions etc. of mentally disordered persons) 5. To establish unfitness for jury service (Criminal Procedure (Scotland) Act 1995 Court of Session Act 1988) 6. To support late application for reinstatement in civil employment or notification of non-availability to take up employment owing to sickness. (Reserve Forces (Safeguarding of Employment) Act 1985.) 7. To enable a person to be registered as an absent voter on grounds of physical incapacity (Representation of the People Act 1983 8. To support applications for certificates conferring exemption from charges in respect of drugs, medicines and appliances. (National Health Service (Scotland) Act 1978) 9. To support a claim by or on behalf of a severely mentally impaired person for exemption from liability to pay the Council Tax or eligibility for a discount in respect of the amount of Council Tax payable. (Local Government Finance Act 1992. Schedule 1, paragraph 2(1)(b)) Strathclyde Police and Hep B Strathclyde Police introduced a new Hep B immunisation service in October 2006 and as a result no GP practice should be contacted by a serving or probationer police officer for Hep B. All Hep B immunisation will be carried out by the force’s own occupational service. Strathclyde Police and Vests Evidently some officers have also been approaching GPs to obtain a certificate to replace their police belts which carry handcuffs, equipment etc. for a new style vest which also allows equipment to be carried. We have been asked by the force to advise GPs not to give out such certificates and ask the officer to discuss the issue with their line managers. Evidently it makes no impact on the officer’s health whether equipment is carried on the police belt or vest and a medical certificate requesting a change is therefore not required. Good Morning Project This project offers a telephone befriending and alert service. We have been made aware that they are contacting practices and asking practices to advise the project when their clients have either a hospital or GP appointment arranged. There has been no discussion with GPs about this matter. Apart from the obvious increase in workload this would entail for GP staff, there are major data protection issues and we would therefore ask that you think carefully before you agree to such a request. Hep B for Students Just a reminder that Hep B immunisation for students should be organised and carried out by their educational institution. Please refer to the GPC guidance on Hep B for Occupational Purposes (copy can be found on the information page of our website). Referrals for Complementary Therapists We had a query recently about referring to complementary therapists. We would suggest that if you do not have any understanding of what the complementary therapy entails, nor have any knowledge of its alleged efficacy or contra indications, then you could not safely make a referral or a recommendation. You could, however, supply the patient with a list of diagnoses and medication from which the complementary therapist can make up his or her own mind as to the patient‘s suitability for treatment. On a similar vein Clydebank College’s Beauty Department was disappointed when a GP refused to certify that a patient was fit to undergo a new facial treatment that involved the use of electrodes. The LMC was contacted by both the College’s Health and Safety Department and Beauty Department regarding this decision and the implications it had on the services offered by its department to the public. However after a lengthy chat, the college now understands (and agrees with) the reasoning behind GPs’ refusal to provide such certificates. The College suggested that they will now incorporate a disclaimer in the Beauty Department’s forms removing the need to contact practices for a ‘fitness to undertake‘ certificate. Requests for Patient Information from External Agencies We heard from a practice who was concerned about the increasing number of requests to supply practice information to external agencies - their most recent requests being a child protection/welfare audit of IT systems in practice by the Trust IT Dept and a questionnaire on deprivation/epilepsy link in children by Yorkhill Hospital/Epilepsy Managed Clinical Network. The practice was concerned that this work was unresourced and unfunded. It wondered whether or not it should undertake this work 'for the greater good of the community', or whether, in view of falling practice profits, the practice should be minimising costs and not complying with the request. Our response is that as far as we were aware the LMC had not been informed of these projects and they are treated in the same way as the many other requests you might receive from a large number of organisations. From the description of the requests there is no contractual requirement to participate and practices would have to judge each request on its own merits and consider whether you have the time and resources (and inclination) to participate. We expect many practices will find it increasingly unattractive to participate in unfunded activity as GP budgets are being eroded. Whilst we would absolutely encourage participation in activity to protect individual children, audit activity has to be judged on its merits (may come under the freedom of information act) and your capacity to participate. We would also suggest that such requests for audit information by Board departments could be funded via an enhanced service. This would, hopefully, allow appropriate resources to fund this increasing non clinical workload in GP surgeries. Practices might therefore like to respectfully decline such requests and suggest that the department concerned approach Dr John Nugent, Chairman Enhanced Services and QoF Workgroup to discuss setting up an enhanced service for adequately resourcing the provision of this information. Mental Health Services Integrated Care Pathway – Physical Health Check A practice received an invitation from the homeless mental health team to attend an integrated care pathway meeting for a patient. The were also asked to complete an annual physical health check form (two pages complete with diagram of the human body). The practice wondered whether it was obliged to complete the form. Our advice was that under nGMS the practice have their own requirements for health checks and this was sufficient. It was therefore not necessary to complete the form which, incidentally, had not been seen or approved by the LMC. Less than Seven Days Sick Certificates for Glasgow City Council (G.C.C.) Staff Please note that Glasgow City Council no longer requires employees to supply self certificates for short episodes of illness of less than seven days (evidently covered in their staff employment contracts). However, during the current industrial action by social work employees we are aware that some employees have approached practices for a sick line, evidently on the advice of their line managers. This advice is incorrect. G.C.C. informed their employees prior to the start of their industrial action on 24th July, that no sick lines (self certified or from a GP) would be accepted by them throughout the period of the dispute. The LMC has also discovered that during strike action, employers can state their refusal to accept sick lines in times of industrial action. However, they may be challenged on such a policy by employees and/or union representatives and might therefore have to judge each case on its own merit. Such a policy might also impact on the payment of any statutory sick pay due and employers would be expected to put in writing the reasoning behind non payment of S.S.P. In these circumstances the employee would forward the information to Customs and Revenue who would take up the case, contacting the employer direct and authorising payment if satisfied that it was indeed due. Child Benefit Payments Office A practice received a letter from Claimant Compliance at the Child Benefit office asking for confirmation that a child and his father were registered at the practice. It also asked for the date the child was last seen by a health visitor or doctor. This request raised several issues. Who had parental responsibility? Was the father estranged from the family? Was the child of an age to determine for themselves whether information about them could be accessed by a third party, in which case they would need to be contacted. Did the mother also need to be contacted (joint responsibility)? Advice received was that the practice should not give out information without checking that appropriate and valid consent had been received. Consent and Insurance Reports An English practice received a request from Nat West for a standard PMA report for life insurance purposes on the basis that telephone oral consent had been obtained from their customer. The practice were not happy (rightly so) with third party oral consent and wrote to their patient seeking written consent. They also sought advice from GPC on this as it had been implied that this was now acceptable practice. Can we remind practices that the ABI agreement for all insurance reports covered by the agreement is for written consent to accompany the request. However, it may be that this report was a ‘targeted’ report which companies are trying to introduce and on which no agreement has been reached. In either case oral consent from a third party is not acceptable. Below is an extract from GPC guidance on insurance reports and the full document can be found on the info page on our website www.glasgow-lmc.co.uk. “Targeted reports A number of insurance companies have introduced targeted reports for life assurance and income protection. These reports are shorter than GP factual reports and require information on a single condition. The BMA’s Professional Fees Committee has not supported the introduction of these targeted reports, and therefore there is no fee agreement with the ABI. We would therefore suggest that doctors’ charge at their own rate for undertaking targeted reports. It should also be noted however, that there is no obligation on the doctor to undertake this work, but where the work is declined the effect on the doctor-patient relationship should be considered”. Soul and Conscience Letters Please be aware that a standard soul and conscience letter only removes a patient from a court list for up to 30 days at which point they are returned to the list and will receive another citation. If a GP thinks the patient’s condition will last for longer than 30 days you should state this in the letter. Can we also remind you that you may be summoned to court to justify a soul and conscience letter (and we do know some GPs this has happened to). Fitness for Jury Service Certificates These should be passed directly to the patient and the patient (not the GP) should forward to the courts. VAT on Electric Recliner Chairs A practice was approached for a letter to state that a patient’s mobility would be greatly improved by this chair (or could be a bed). Evidently this would make the item VAT exempt and save the patient money. Our advice is that this is not covered under nGMS, is therefore entirely at the discretion of GP whether they wish to provide and chargeable. Silly Season Letters No, we do not have to provide a letter to state that a patient needs a bath at least every second day as was requested by a local authority department on being asked to put in a new central heating and hot water system in an elderly person’s home. No, we do not have to provide a letter for patients who request kitchen, bathroom and rewiring works (or any planned works) to be halted on health grounds especially as the patient was more than able to refuse the works and give reasons why the works should be stopped. Westmark Referrals and Ambulance Required If you are referring a patient to Westmark for a wheelchair can we please ask that you attach an ambulance required form if the patient needs transport. Westmark will then organise the transport. We are still receiving a few queries about ordering ambulances and would remind practices that at the moment, if a patient finds they need transport after the initial referral has been made, the hospital will advise the patient to contact the practice to request that an ambulance required form is sent from the practice. Unfortunately this measure is needed to verify the patient does require transport hopefully avoiding abuse of the service. Slimming Referral A Slimming World consultant contacted a practice to promote slimming world’s “Slimming with Support” whereby practices can purchase (at a reduced cost) slimming world vouchers for overweight patients whom they may wish to refer to slimming world classes. As GG&C Health Board organise and run their own weight management clinics, NHS funding for the purchase of such vouchers is not available in Glasgow and Clyde. We think this programme was designed for English practices involved in practice based commissioning and is therefore not relevant in Glasgow. Pregnant Patients in Contact with Chickenpox We have been advised that should a pregnant patient come into contact with chickenpox (or suspected chickenpox), the quickest and simplest way to determine whether they will require treatment is to contact the laboratory holding the patients’ booking bloods and request a check for chickenpox. UK Biobank Research Project Throughout the UK patients are being contacted to participate in a UK wide Biobank study of a wide range of diseases in people aged 40 to 69. Biobank have stated that all participants in the project are informed that their medical data and genetic variants will be used in the future to study a wide range of health outcomes. Specific consent is sought by Biobank to access a wide range of medical and other health-related records during long-term follow-up. Biobank have stated that on seeking consent it explicitly informs the participants that their specific consent would not be sought thereafter for each individual use of their data or samples. We would advise that if you have a patient wishing to take part in this study you ascertain that they fully understand that their electronic medical records can be accessed by Biobank until the day they die. Unsurprisingly some patients had not understood this! Healthy Start Healthy Start replaced the Welfare Food Scheme on 27th November 2006. Included is a range of “healthy start” vitamins that will be free to those on benefits. The dispensing of these will normally be carried out by Health Visitors. Following recent diagnoses of a number of rickets cases amongst Glasgow children, it had been recommended that children in the age bracket 0 to 5 years (unless their professional adviser is confident that they are receiving sufficient vitamins from their diet and adequate sun exposure) would be given these vitamins. However, there is currently a shortage of the healthy start vitamins and until this shortage is resolved GPs are being asked to prescribe (but only if requested) abidec vitamins for this group of children. This is a short term issue and it may well be that supplies have been restored by the time this newsletter hits your desks. If not we believe the numbers involved will be quite small and would ask you to prescribe if asked. Some pregnant and lactating mums will also be eligible for the vitamin supplements. Witness for the Destruction of Controlled Drugs Unfortunately Strathclyde Police withdrew from monitoring the destruction of controlled drugs at the end of March. Under the new regulations for the management of controlled drugs GG&C NHS Board have appointed Dr Kate McKean as the ‘accountable officer’ to guarantee compliance with controlled drug legislation in the GG&C Health Board area. As part of her duties from September 2007 Kate will become responsible for overseeing the destruction of out of date controlled drugs. In the meantime, we have been asked to advise practices that, until the relevant systems are in place, they should store out of date controlled drugs in a secure environment within the practice. If any practice is experiencing difficulty can they please contact the Prescribing Advisor’s office, Queens Park House at the Victoria Infirmary tel no: 0141 201 5214. Can we also remind practices that every GP within the practice should have his or her own separate controlled drug register and the practice should also have a separate one. If you require any registers please contact the LMC office. Ear Syringing by Health Care Assistants (HCAs) A practice, which was considering sending their health care assistant on an ear syringing course designed for HCAs, has drawn to our attention current MDDUS advice which is that HCAs ought not to undertake any clinical duties which require the exercise of clinical judgement. MDDUS’s current position is that ear syringing would require a degree of such judgement. Evidently MDDUS is involved in discussions with interested parties at the Scottish Executive and it is hoped that clear and consistent guidance on suitable duties for a HCA will be available to Scottish practitioners in the near future. Adults with Incapacity Act There have been a couple of changes made to the Act which will be of interest to you. Requirements for Signing Medical Treatment Certificates The Act has now been amended to allow (in addition to general medical practitioners) dental practitioners, ophthalmic opticians, registered nurses and any other class of individual as may be prescribed in regulations by the Scottish Ministers and who have received the appropriate training, to sign certificates. The objective of this change is to increase the number of practitioners who are able to sign certificates and reduce the workload of general medical practitioners in connection with Section 47 (1). The requirements prescribed for the purposes of section 47(1A)(b) of the Adults with Incapacity (Scotland) Act 2000 are that the person concerned must have completed and passed the course entitled "Adults with Incapacity: Part 5 Amendment – Assessment of Incapacity for Health Professionals" administered by Napier University, Craiglockhart Campus, Edinburgh. We have also heard from practices who have been asked by nursing home management to assess all the practices’ nursing home patients. The Care Commission do not require the assessment of every nursing home resident as this is not in the spirit of the act. We would suggest that any practice receiving such a request only assess a patient requiring treatment. We would also advise asking the nursing home to nominate an appropriate clinical member of staff to undertake the training to enable these assessments to be carried out by the home‘s own staff. BUPA is already aware of the new legislation and is currently looking into organising AWIA training for its staff. Please also note that there is no ‘urgency’ about doing AWIA assessments and they should be undertaken at a time convenient to the GP. Changes to the Certificate From March 2007 AWIA certificates are valid for three years from date of assessment. Practice nurse training for Chronic Disease Management LES Tom Clackson has arranged for a further training day on 3rd October for nurses who have not attended previous training about the CDM LES screens. The LMC supports this training which is essential to help keep up to date with changes in the screens, and would encourage all practices who have nurses who have missed previous training to attend on these dates. Please contact Marion Watson, Practice Development Admin on 211 3632 for details and to reserve a place. Training for practice managers and nurses in practices in Clyde who will be taking on the Keep Well CHD LES later this year will be arranged later in October and November. IT Training for Sessional GPs IT training is now available to all sessional GPs on the Greater Glasgow and Clyde performers’ list. The LMC facilitates GPASS and Microsoft training and a booklet detailing the modules and their prerequisites is being sent to all doctors on the GG&C supplementary medical list. Ian Mackie, General Practice, O.D. Manager will also provide Vision training. Please contact Ian at the LMC office for details. IT Training for Primary Care Staff A full listing of the courses and their delivery dates for the new quarter starting September to December 2007 have been sent to practices (and the bookings have been quite brisk!). The training dates are also available in the training page on the LMC website. Please either fax a booking form or contact Elaine elaine1@glasgow-lmc.co.uk and she will reserve a place for you (or your staff). If you cannot get your preferred date a back-up list is maintained and if there is sufficient demand for a particular course an additional date will be arranged otherwise delegates will be contacted should a place become available through a cancellation . Euro Business Guide We have highlighted this company’s business methods before. Practices may receive an email asking them to please print and fill the enclosed document and send it back to: Euro Business Guide, P.O. Box 2021, 3500GA UTRECHT, The Netherlands, with the claim that “updating is free of charge!” However within the document itself is the following statement; “I hereby order a subscription with service provider EU Business Services Ltd “Euro Business Guide”. I will have an insertion to its data base for three years. The price per year is Euro 965. The subscription will be automatically extended every year for another year, unless specific written notice is received by the service provider or the subscriber two months before the expiration of the subscription.” Signer beware!!!! Private and NHS Care There is now explicit guidance from the Chief Medical Officer Dr Harry Burns about patients receiving both private and NHS service for the same episode of care. In the CMO letter SEHD/CMO(2007)3 it states that ‘A patient cannot be both a private and an NHS patient for the treatment of one episode of care’. Therefore it is clear that in cases where the care is started in the private sector, all the follow up should be in the private sector. For example, if a patient has an operation done privately, the post op care including suture removal and analgesia should all be provided by the private sector. GP practices and NHS staff are not obliged to provide the routine post op care to such patients. If practices have had instances were the private sector is passing work to the NHS, please contact the LMC about this. Please note that this will also apply to requests for blood tests etc from private IVF clinics and you can find a sample letter to give to patients explaining about such tests in the information page on the LMC website. Service Level Agreements and Third Party Software Can we please remind practices that before installing third party software, you must contact the IT Support Team. This also applies to software and/or hardware supplied by CH(C)Ps as there has to be clear support agreements in place for any additional software or hardware installed. There have been some instances recently where hardware and software installed without being cleared by the IT support team, failed on the installation of a new server. It was then discovered that there was no technical or maintenance support organised for the equipment, which caused some difficulty for the IT support team. GP Attendance at Child Protection Case Conference We have been advised that there is funding available to allow GPs to attend Child Protection Case Conferences. This funding is accessed via Terry Findlay, Director West CHCP. Glasgow Locum Group As suggested in previous articles for the LMC newsletter the Glasgow Locum Group has been updating it's website, these changes are now mostly complete and the group are pleased to be able to tell you about them. Visually you won't notice much difference as many of the changes have been to the administrative side of the site. The registration process for locums has now been simplified, new members need only register on-line on the Glasgow Locum Group website http://www.glasgowlocumgroup.org with their GMC number and send in their fee. The group perform a check of the on-line Performers list [http://www.sml.show.scot.nhs.uk/search.cfm] to check that they are valid locums for the area and then their accounts are activated once fees are received. The locum group no-longer make direct checks of PMETB/JCPTGP and defence union status, as to be listed on a Performers lists a locum GP must have presented these to the host board. The registration process for practices remains unchanged. Please note there may be a delay in activating any user until the group’s administrator is able to check the relevant details and activate the account. Other parts of the site such as the links section have received an update of content and the documents section has also been updated (now only available to locum members). The group now have a list of the monthly educational meetings for locum members.
Counselling Services for GPs and their Families Can we remind Glasgow colleagues that the Dovedale Counselling service is a free and confidential service available to GPs and their immediate families. Dovedale can be contacted on 0800 214 307 twenty-four hours a day, seven days a week. Our Clyde colleagues will be pleased to note that this service will also be available to them (and their families) from 1st October 2007. More information on the service will be sent to you.
“Much of the social history of the Western world over the past three decades has involved replacing what worked with what sounded good.” - Thomas Sowell
Medical Secretaries LMC Office Barbara West Mary Fingland Alan McDevitt Ian Mackie John Ip Elaine McLaren Murray Macpherson
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