Newsletter June 2005 |
Welcome to our spring/summer newsletter. It has been a very busy past few months, not least of all for Glasgow GPs and their practice staff who have worked so magnificently to attain their quality and outcomes points. Congratulations to our practices for achieving a Glasgow QOF average of 994.2 points. For those of you who may be interested the average point score for Scotland as a whole was 971.3. The LMC have also thanked on your behalf Louise McTaggart and her IT Mentoring Team, Stephen Harris and his IT Technical Support Team, Kate McGloan, Janine Glen and Tom Clackson and his team for their hard work, which also helped ensure that Glasgow practices met the QMAS deadline. QMAS data extraction failed in only three practices however, the IT Support Teams addressed the problems immediately allowing QMAS to successfully extract the data in the wee small hours (2am and yes they did come in that early!) of Saturday 2nd April. The next twelve months will also see some significant change in the Greater Glasgow Health Board area, especially with the advent of CHPs, the new single structure working in the Health Board and the inclusion of parts of the old Argyll and Clyde Health Board within GGHB. We shall keep you abreast of any major developments as and when they arise and will continue to lobby strongly on behalf of Glasgow Practices. To this end can we remind GPs and practice managers to inform the LMC of their new e-mail addresses if and when they join the nhs net. Changes to the GP Subcommittee/LMC Committee Dr Alan McDevitt’s term of office as GP Sub/LMC committee chairman has now ended. Dr Douglas Colville, Rutherglen Health Centre, has been elected as our new chairman. Alan remains as assistant medical secretary and a key member of our negotiating team alongside Barbara West and Douglas Colville. Dr Paul Ryan, Glenmill Medical Practice has been elected as vice-chair. A vacancy for a representative from the East of the City has also arisen. As our next election will not be held until 2006, the committee agreed that a co-opted member should be sought for this vacancy. If you practice in the East of the City and are interested in the work of the committee or medico politics in general, and feel you would like to participate, please contact Barbara on 0141 332 8081. Your Questions, Our Answers Q/ “We are about to employ a new practice nurse do we require a ‘Disclosure Scotland’ statement?” A/ Although this is mentioned in the new framework for practice nurses we understand that the matter is still under discussion with nursing leaders and no decision has yet been reached on the need to obtain such a disclosure at present. Q/ “CPR training for employed staff – should GPs be included for this?” A/ Under the new guidance it is still technically only employed staff who need to undertake this therefore GPs would be exempt. However we think it might be wise for GPs to consider refreshing their CPR skills on a regular basis. We have also been asked about providing CPR training at the LMC and Ian will be looking into the feasibility of providing such a course. Q/ “Implanon removal – can it be treated as a minor surgery procedure and therefore we could technically claim payment for it?” A/ The practice would have to be signed up for the Implanon LES to receive payment for minor surgery procedures. If your practice has not signed up we would advise that you contact the PCD to register your interest. Q/ “We have received a request to prescribe Midazolam as a rescue medicine for epilepsy in children – can you advise?” A/ This issue, like many shared care requests, comes down to clinical responsibility. If a GP prescribes Midazolam he or she will have to take full prescribing responsibility for its use. Our advice is that it would be absolutely for the GP to decide whether they wish to take clinical responsibility for this and if the GP is unhappy about taking such responsibility they should not prescribe the medication. You should note, however, that buccal midazolam is now recommended as a rescue medication in the new SIGN guidelines. This request also comes into the area of unlicensed medication in children and there are some major national initiatives being undertaken in this area at the moment, including producing a BNF for children. It should also be possible for a patient to have this medication prescribed by the hospital as, hopefully, it would not be used very often. The LMC is currently working on whether we can have a hospital repeat prescribing system set-up for drugs like this where GPs are unhappy to take clinical responsibility. However, as you can imagine this is going to take some time to get in place. We have had similar queries for shared care for patients with motor neurone disease and the prescribing of Riluzole another highly specialised drug. Our advice would be not to participate as this is a drug that GPs are unlikely to come across more than once in their careers and it is inappropriate for GPs to be involved in the prescribing and monitoring of such specialised drugs. We would remind colleagues that participation in any shared care is voluntary and not mandatory, unless the practice has signed up to the Near Patient Testing LES and the drug is listed in the NPT LES specification. We are also very aware of the issue of patients being told to attend their GP (or practice nurse) for repeat prescriptions/monitoring/blood tests without the GP being contacted in the first instance to confirm that they are able or willing to undertake the request. We are writing to consultant colleagues to point out that such requests are inappropriate, an unresourced transfer of work from secondary/private care to general practice and could potentially damage the patient/doctor relationship if a refusal is made. Q/ “We have had a request from a consultant to prescribe a Mirena coil for his private patient. We will not be fitting it, only prescribing” A/ Again the prescriber takes full responsibility and as it is unclear who would actually be fitting the coil we would recommend that you do not do this. Q/ “We have patients attending our travel clinic for vaccinations and advice because their own practice cannot see them in time. Can patients not registered with the practice but attending for travel vaccinations be charged a consultation fee as a private patient?” A/ As far as we understand any patient who is not registered with your practice is not receiving NHS care from your practice and you are not funded for providing them with travel information. In such circumstances we consider that you would be acting as a private clinic and would be absolutely entitled to charge them as you see fit. Q/ “We have had a few patients complain about charging private prescription fees and also for the item costs for travel vaccines, it seems that some practices are not charging for any travel vaccines which makes our charging seem unfair. Are we correct in charging for non NHS items like rabies for example?” A/ You are quite correct. Rabies immunisation for patients travelling abroad is a private service and both the vaccine and the administration should be charged for. Vaccines that were available for travellers under the old red book scheme (which should not be thrown away!) should still be given on the NHS either from stock order or by an FP10. These vaccinations are Smallpox! Typhoid, Cholera (including the new oral vaccine), Poliomyelitis, and Infectious Hepatitis i.e. Hepatitis A and B (see below). On our webpage (www.glasgow-lmc.co.uk) in the information page under the section “Requests for Medical Certificates/Reports/NHS Treatment you will find our guide to NHS Travel Immunisation, which details those vaccines available to patients under NHS. Q/ “A student attended looking for hepatitis B vaccination. Do we have to do Hep B vaccinations for occupational health reasons?” A/ Unfortunately the failure to re-negotiate vaccination under the new GMS contract leaves us with the same anomalies that were present in the past which are both inconvenient and confusing to both practitioners and to patients. The new GMS contract does not fund provision of hepatitis B vaccinations and indeed only appears to fund hepatitis B vaccinations for those patients who require it for travel (which are fairly rare). Bizarrely if someone was travelling abroad to undertake occupations which may be hazardous they can receive hepatitis B vaccination under the contract but they cannot do so for this country. In this situation the only sensible answer appears to be to come to an arrangement with another practice that they will vaccinate your patients and you will vaccinate their patients. Each practice is able to charge patients so long as they are not on their practice list. We appreciate that this is unwieldy but it appears to be the only pragmatic solution for those patients who are unable to obtain hepatitis B vaccination through their occupational health services. Certainly it is an occupational health issue and should be provided by occupational health services where they exist. We have raised this issue at a Scottish national level with the universities and they are aware of this problem and are meant to be coming up with a solution to it. Certainly there is no obligation to provide students with vaccination for hepatitis B but, as it is probably difficult for them to obtain it in other ways, we suggest the practice arrangement as detailed above is the most pragmatic solution. Q/ “We have been asked to authorise the district nurse to administer G-CSF by subcutaneous injection to a patient as an outpatient” A/ You would need to point out to the consultant concerned that we cannot tell district nurses what to do – they are not our employees. It would need the approval of the lead nurse!
Q/ “If a patient is sent for respite/recuperation care to a care home outwith our practice area do we have to do a home visit if required?” A/ No, if the patient is not at their registered address and is residing outwith your practice area you do not have to visit. The patient can be registered as a TR with a local practice and would be entitled to a home visit from that practice. It should also be suggested to the care home that they have an agreement with a local practice to automatically register their TR patients regardless of whether they might or might not need a home visit. Q/ “Can you give any advice on what staff increases should be for this year as there is no uplift in the global sum for 05/06 and the Whitley Council has now ceased” A/ It is entirely up to the practice to decide its own pay awards. However, if your staff contracts were based on the old Whitley Council rates we would advise a pay increase of 3.225% for this year . Although the health service is moving to Agenda for Change, Whitley Council rates have been published in the transitional period as not all posts have crossed over. Practices have been in contact regarding moving to Agenda for Change and our advice so far has been to hold back as the mapping across of jobs can be time consuming and costly. Also, contrary to some reports, there is no funding for AfC in the global sum/global sum equivalent and no-one knows how much AfC would impact on staff costs. The majority of practices in Scotland (if not all) are on MPIG which maintains the level of funding (including staff) the practice received in the base year 02/03. GP Expenses are currently being looked at by the Technical Steering Group and we hope that the situation will be redressed following their review. A joint document from SGPC and SEHD on the merits or otherwise, of changing to AfC will shortly be available and we shall be sending it to practices. Q/ “Superannuation and the upgrading of staff from level 2 to level 3, how can we be reimbursed?” A/ The upgrading of staff was done in the period following the relevant global sum/global sum equivalent assessment period, therefore the increased staff pay and its consequent superannuation was not included at that time. The only way to deal with this is to invoke a formal dispute procedure with the division to say they should have used their discretion to increase the global sum equivalent by the relevant amount. Q/ “What about the 14% employer’s contribution for GPs on new money? A/ SGPC has been in intense negotiation with the Scottish Executive about this and there is now an agreement that extra funding will be put into the quality and outcomes framework, and possibly also into the correction factor as a retrospective payment for this year. We don’t know when this will happen but there is an agreement in principle if not in the detail. However, this may not cover the total new money profit and this is a source of much anger and frustration. Nevertheless, it is quite difficult to assess the amount of extra profit earned by practices until they deliver all their accounts and we should be fair to the division in that this aspect of remuneration is not really under their control. GPs can be assured that we are indeed fighting very strongly to get the extra funding but this is a battle that has to be fought at a national level probably more than at a local one. LESs, NESs and DESs All the documentation (except for the influenza and pneumococcal DES) has now gone out to practices, and we are sure you are all working away providing good services to your patients. Even at this late stage there is still uncertainty about the funding that the health board is going to get to support these services this year; the SEHD simply haven’t agreed the budgets. This puts the Board in a potentially difficult position if the funding, when it is finally confirmed, is not adequate. They would be obliged to give three months notice if a LES were to be terminated, but we would hope that they would find the resource within their general budget. Certificates, Reports, Certificates Passport Office An employee of the passport office told a patient to obtain a letter from their GP to confirm that they had lived at their address for the last five years. We advised that there was no requirement for the GP to do this and, as the home address in the practice records cannot be guaranteed to be accurate, would suggest that the GP might not be comfortable providing such information. GPs have previously landed in serious trouble by unwittingly giving the passport office inaccurate information. Beware! Alzheimer Scotland – Action on Dementia Drug Administration Permission Form Our advice is not to complete this form but to forward a copy of the patient’s summary sheet. Data Protection As part of your annual registration renewal you will be asked to complete an additional form to indicate whether or not you will be ‘considered a public authority’ under for the Freedom of Information Act. You are, please tick and return. Work Related Forms – Occupational Health A practice had been asked to complete a form to state that a patient was/was not able to carry out ‘waking night’ duties. The patient had recently secured a new job where shift/night work was involved and, not surprisingly, wanted the doctor to state that they could not undertake these duties. There were a number of issues here. Firstly, completing this is not part of nGMS and would be a private service. As a private service, it would be entirely up to the GP to decide whether or not they wished to complete the form in the first place. A charge should also be levied. Secondly, if the GP agreed to complete, the answers provided would need to be factually correct according to the patient’s record. Thirdly, this should be seen as an occupational health issue and the patient should really be seen by the company’s own occupational health consultant. Also, the GP might not have enough experience of occupational health to say whether or not a patient is suitable for certain duties, for example they would not know what those duties entailed. Glasgow City Council – Garden Maintenance Application It is that time of year again! On our webpage (www.glasgow-lmc.co.uk) in the information page under the section Requests for Medical Certificates/Reports/NHS Treatment you will find “Gardening Certificates – Leaflet for Patients” which explains to patients why GPs have been advised not to do this. Compensation Scheme for Ex-Miners The Department of Trade and Industry runs a compensation scheme for ex-miners with chronic obstructive pulmonary disease. As part of this COPD scheme (which is the largest compensation scheme anywhere in the world) the department has authorised a company called Elision to access patient records on their behalf. The BMA have agreed rates for this. For retrieving and making available medical records Per day £111 Per half day £67 Interim compensation payment form £25 The fees described above are for making the records available, either by allowing Elision to securely remove the record from the practice or by allowing them to make copies. More information on the compensation scheme can be found on www.dti.gov.uk/coalhealth/index.htm and about Elision on www.elision.com/index.php Shared Care Assessments – East Dumbartonshire As agreed, this now appears to have developed into a single “Request for Medical Information” form which is much more user friendly and easily completed by the GP. However, we would remind GPs that the patient’s consent is still required before the form can be completed. Solicitors and Patient Records The BMA and the Scottish Law Society have agreed a consent form (for accessing patient health records) in response to concerns that solicitors were routinely requesting full copies of clinical records without their clients being fully briefed. The new form is intended to ensure that health care professionals can rely on the consent obtained in the knowledge that patients are aware of the extent of disclosure they are authorising. It is not obligatory for solicitors to use this form but it is good practice for them to do so and there are clear advantages for both solicitors and doctors having an agreed form. Although solicitors will be encouraged to use the form you may continue to receive some requests for information with the consent in a different format. The situation regarding such requests has not changed. Provided the consent is valid, information must be provided under the terms of the Data Protection Act. However, we have had a couple of queries about the new form. Firstly, a solicitor had requested patient records using the new BMA form and the practice wondered whether the new forms negated the need to write to the patient as per their practice protocol which allowed patients 21 days to change their minds. We advise that the practice could continue to follow its protocol if it wished but, as the new forms were pretty clear about what was being requested, the practice should not need to. Our second query related to sending solicitors the new BMA form when a request was made without it. We did not see any problem in doing this as it would hopefully promote more use of the forms but remember provided the consent is valid, information must be provided under the terms of the Data Protection Act. Copies of the form can be found on our webpage (www.glasgow-lmc.co.uk) in the information page under the section Requests for Medical Certificates/Reports/NHS Treatment you will find “Access to Patient Records – BMA/Law Society for Scotland Consent Form”. Council Tax Exemption /Discount for Severe Mental Impairment – Glasgow City Council We have heard from a practice who was asked to confirm that two patients suffering from Down’s Syndrome had had the condition since birth. We have written to the finance department advising them that Glasgow GPs do not require to provide additional information once they have certified that a patient qualifies for an exemption or discount due to severe mental impairment. As far as we are aware Glasgow City Council are the only local authority to do so. Please do not supply any additional information if asked, it is not necessary. Criminal Justice Team Glasgow social work’s criminal justice team had been asked to compile a social enquiry report on a patient. They wrote to the practice asking if it was possible for a member of the team to contact them as the patient had mentioned attending the practice for a number of related medical needs. A patient consent form had been provided. Normally the team would approach a number of people connected to the patient seeking approval to contact them when compiling such a report. We would advise that, should the GP be contacted, they verify who the caller was (by contacting the social work services criminal justice team themselves). We see no reason why the GP could not have an informal chat about the patient with the team member as appropriate. In these cases it is sometimes easier and quicker for the criminal justice team to contact the GP directly in this way and saves the need for a more detailed written report. We would not expect a payment for this. Examination Related – Student Certificates We have received a few enquiries about the need to provide a sickness certificate for students who fail to sit an exam or wished to be excused from sitting an exam on medical grounds. A GP does not have to provide any such certificate in relation to exam and education whatsoever. If patients are asking GPs to do a private certificate then they need to realise that this is an optional issue for the GP and may result in a refusal. Exam related certificates are not the same as short-term illness certificates. It is probably true that the system would not work well without some medical statement of illness around the time of the exam. However it is entirely appropriate, and indeed we think essential, that you charge for these certificates so that people do not take them as an easy way out. Students need to realise that they are asking for a professional opinion in order to have exceptional circumstances taken into account. We would generally suggest that a fee around the fee level of a private sickness certificate would be adequate although this may increase if it is a detailed letter of response. It might also be useful to highlight your policy on the provision of private certification in your practice leaflets. You can also find a list of medical certificates and reports provided under the NHS on our on our webpage (www.glasgow-lmc.co.uk) in the information page under the section Requests for Medical Certificates/Reports/NHS Treatment you will find “NHS Certificates Provided by the GP – Information for Patients”. Housing Associations The following housing associations have been contacted (outcomes detailed). Easthall Housing Association – Easthall H.A. operate a self-assessment system for clients and only if they (not the patient) need further detailed information do they contact a GP and that happens very rarely. East Kilbride and District Housing Association Ltd – no reply to date. Hanover Housing Association – no reply to date. Hillhead Housing Association – also operates a self assessment medical form. Any patients asking for their GP’s input are doing so on their own initiative. The association does not require or insist on a GP letter. Milnbank Housing Association – no reply to date. Southside Housing Association – do want a GP’s opinion before allocating a house on medical grounds. However, they did suggest they would be open to advise on a ‘self assessment’ form and they have been written to again. Given that two of the housing associations who replied indicated that they do have a self assessment policy in place, it might be worthwhile to ask the patient if the housing association actually requested a GP’s letter in the first instance. Again, on our website in the information page under the section Requests for Medical Certificates/Reports/NHS Treatment you will find “Requests for Personal Medical Information by Housing Associations” this handy leaflet can be downloaded and given to both patients and housing associations alike. We are more than happy to continue to write to housing associations on your behalf. Please let the office know the details (including a contact person if possible). Insurance Companies and Medical Records A practice recently received a request from an insurance company for a copy of a patient’s medical record. The insurance company told the practice it would only make payment for the actual pages copied based on the sliding scale detailed in “The Data Protection (Subject Access) (Fees and Miscellaneous Provisions) Regulations 2000 – Statutory Instrument 2000 No 191” - last time we looked this scale was for educational records only! Remember that the maximum a practice can charge is £50 and this also includes staff time and postage costs. Immunisation and Vaccination Green book chapters are being updated and are available on the Department of Health website (www.dh.gov.uk) by typing in ‘Green Book’ into the ‘Search this site’ facility. New updated chapters available include:-
Fridge Maintenance Vaccines are sensitive to temperature variations and whilst this different for each vaccine, as a rule of thumb, they should be stored and transported between 2°C and 8°C. Good practice necessitates regular monitoring of fridge performance by recording the temperature range inside the fridge daily using a maximum/minimum thermometer. It is also part of your GMS contract that you do this. An electronic version is recommended, as this is easier to read and reset. A temperature log should be kept, ideally by one individual who is tasked with the responsibility of monitoring the fridge. Areas that should be part of the monitoring process include: Fridge content – foodstuffs should never be stored in vaccine fridges. Defrosting – should be done monthly, unless it does so automatically. Vaccines should be stored in an alternative fridge or cool box whilst the fridge defrosts. Use thermometer to monitor temperature of vaccines during the duration of the process. Stock Rotation – should be in order of shortest expiry date first. Newest stock should be stored to the back of the fridge. Servicing – this should be part of a planned preventative maintenance programme and a service record maintained. Thanks to Dr Martin Donaghy, Health Protection for Scotland and his team, for producing the new Immunisation newsletter, from which this information was taken. Waiting Lists and GGHB Database Information can be found on Glasgow’s consultant and speciality waiting times on the www.nhsgg.org.uk website. In the section Publications/Board Papers go to publications, then click “Green Book – GP Waiting Times” this is an information services spreadsheet and is more accurate than the national waiting times database. GP-CARE This is the confidential support service in place for all Glasgow GPs and their families. It is fully funded by the PCD and is provided independently by Dovedale Counselling Ltd. GP-CARE is a completely confidential service so no one knows whether or not a GP (or their families) has used the service unless the GP chooses to tell them. GP-CARE has now added a new website service which includes pages on lifestyle and wellbeing. The new GP-CARE user pages contain guidance on how to achieve the balance that's right for you and how to keep it that way. To find out more, visit on Dovedale's website: www.dovedale.co.uk/GP-CARE/work-life-balance. There GPs will also find information on improving the way they manage their time and on a variety of other wellbeing issues that can affect their personal and professional life. GPs can also make a secure online request for face to face counselling. Alternatively, the freephone number is 0800 214 307. Help is available 24 hours a day, 365 days a year. The LMC does receive anonymised statistics showing how many people have used this service. Last year 2.1% of GPs in Glasgow accessed it – the highest ever figure. Is this anything to do with the new contract? Locum Insurance Some practices may have received a letter recently from the Medical Insurance Advisory Bureau (M.I.A.B.) suggesting that as of 1st April it is now the responsibility for practices to pay Locum’s 14% superannuation contribution. This is not correct. Last year employer contributions for sessional GPs was paid directly by the host health board. The system has not changed this year. The government would like to make sessional GPs responsible for their own employer contributions, but this would still not be paid to SPPA by practices; the locum fees would presumably go up to reflect it. However this has not yet happened. 0870 Telephone Numbers Just to remind colleagues that GP practices have now been prohibited from using 0870 or premium rate numbers for access to their services. Pity the same cannot be said for the Scottish Ambulance Service! New NHS Education for Scotland Website The revised NHS Education website for GP appraisal information and online resources is www.nes.scot.nhs.uk/gp_appraisal. Methylphenidate Prescribing Dr Alastair Taylor GP Subcommittee/LMC member had been asked to prescribe Methylphenidate for a young adult patient who had previously been under the supervision of Yorkhill NHS Division. Dr Taylor had written to the Medicines Management Team detailing his concerns about this request and the lack of an appropriate supervision and prescribing strategy once such patients reached adulthood. The GP Subcommittee/LMC had been copied into the correspondence.
We are pleased to report that apparently on reaching adulthood, such patients will now be cared for by adult psychiatric services. They will also take over the provision of prescriptions to the patient. We thank Dr Taylor for his persistence in pursuing and resolving this prescribing issue, which had been a source of GP concern over the past few years. Research Projects Two research projects will be carried out in Glasgow over the next few months. One is a joint collaboration supported by Dr Harry Burns which will look at health inequalities and the other is by Professor Watt’s department who wish to collate and analyse CHD Data in Glasgow. Both will involve the participation of practices and we hope our colleagues will be able to assist where they can. The results of both pieces of work will be used to obtain evidential material to support the need for additional funding for Glasgow’s deprived patient populations. Disability Discrimination Act (D.D.A.) Loop Induction System. These have been distributed to all practices to assist in communication with the deaf. Be aware however that the siting of the device can be critical; you do not want your conversation with the deaf person broadcast to everyone in the waiting room wearing a hearing aid. In March this year Derek Rae, Premises Liaison Officer, sent out a letter to primary care practitioners detailing some training that was available on the D.D.A. We would recommend:- Disability Etiquette Briefing Sessions. This is a half day course ideal for ‘front line’ staff and aims to equip staff with an overview of good practice in relation to disability etiquette, enabling them to work more confidently and effectively with disabled people. Disability Diversity Trainin. A full day session aimed at staff who exercise a degree of autonomy in their work practice and service provision to address the unique issues of exclusion, discrimination and stereotyping experienced by disabled people. The courses are run by members of the Glasgow Centre for Inclusive Living and are most informative and thought provoking. Originally there were three courses listed. The Access and Audit Toolkit Training (which was particularly useful for practice managers) has now finished but the Disability Etiquette and Diversity training will continue until the end of the year and dates beyond June will be issued in due course. To book places please contact Christine Carleton at the Primary Care Division OD & Training Department on 211 3563. Scottish LMC Conference The conference this year was overshadowed by the election and as a result did not receive the media coverage that it has in the past. However, the main topic of the day was the discussion on NHS 24. Dr Brian Robson, Medical Director NHS 24 was an invited guest. Dr Douglas Colville made an admirable speech on the current state of the system and delegates made plain their feelings on NHS 24 with the passing of a motion that included a call for a return to local triage and call handling where possible. Motions on Superannuation, CHPs, Quality and Outcomes, Pension Scheme, Out of Hours were all included in the day’s debate. In speaking about the Quality and Outcomes Framework negotiations, Dr Mary Church highlighted that any proposed government changes would need to be fully funded, that there would have to be good evidence based reasons for removing anything, that GPs would retain the choice on whether to participate or not and that GPs would also have to retain an open mind to any new proposals. Conference was told that superannuation was still under discussion and delegates asked that this be attended to as a matter of urgency. The setting up of remotely managed servers was also announced at conference. Practices will be given the prospect to move to the new ‘server farms’ where systems will be upgraded and managed remotely. In addition such a move will give practices a window of opportunity to change software systems if they wish. All clinical systems in Scotland will now require to meet the new national functionality protocol. Practices have until the 31st October to submit a business plan to the PCD IT department to support their application for system change. The new GPASS Clinical system will eventually also only be available via a managed server facility. Dr Alan McDevitt was elected conference vice-chairman for next year. Dr Sandy Sutherland, Lothian LMC being chair. Payment Verification and TRs We have been asked by the PCD to remind practices that any forms that require a patient signature must actually be signed by the patient (or the guardian if the patient is a child). In rare circumstances, apparently, this is checked up on. Also a reminder, which you will have received in your latest QMAS newsletter, to notify the PCD of any temporary residents you have. This may affect your remuneration in the fullness of time if you don’t do it. Ian@glasgow-lmc.co.uk Visitors from Overseas Following the recent sessions I ran about this, I have now put the slides from the presentation onto the LMC Website. To access them go to the Information Page. At the bottom of the page is a new section “Download LMC Presentations”. Here you will find this presentation. If you would like to see the notes I wrote to accompany each slide, click on the link. This will open the presentation as a Word document. If you are looking for help or advice about Visitors from Overseas please continue to contact us. Training We are now coming to the end of the Training year. When we restart in September in addition to GPASS and Office training we hope to be offering Vision training as well. We are planning to revise the training being offered for GPASS 5.5, and look toward the new GPASS Clinical Front End. We will be continuing to send out the course schedules and details by e-mail. If you have not been receiving these, could you please let us have a current e-mail address? We are updating your new NHS Net addresses as we become aware of them. Phlebotomy Training There had been a waiting list for this training which has now been cleared and the course list is open once again to general practice. Just a reminder that the training consists of 10 sessions over a two week period totalling 30 hours. The course will cover:-
At the end of the training course the trainees will be able to go back to their practices and safely and confidently take bloods from patients. The course fee is £540. If you are interested please contact Kay Sinclair on 201 3662 after 11:30 am Monday to Friday or telephone 201 3000 and ask for page no 1635. It is important that any staff member undertaking this training has had the Hep B injection. IT&M NHS Contact is the new NHS web-based email/messaging system which is to be introduced by September. It does away with the ‘Scottish office Box’ which is used to run and store your current emails. This new system has some advantages in that it can be accessed via the web but the current main disadvantage seems to be that it doesn’t operate through Microsoft Outlook (which is what most of us use). Glasgow IT Dept is trying to sort this and delay the roll-out meantime. Paperlight Practices There are now 40 paperlight practices in Glasgow with another 20-25 having expressed an interest. Docman is the software system which is supported in Scotland. A number of issues such as shredding policy and verification of backup tapes (to make sure they actually work!) are being discussed with the MDDUS. SCI Gateway This system is now used by the majority of practices for referrals. It continues to need development to meet practice needs if it is to be the key referral software for GPs in Glasgow. Through SCI gateway, the ‘Emergency Care Summary’ will be produced from your computerised practice records so that A&E services will be able to view some basic information from the patient’s practice record when they attend A&E. Staring date for this is September. Exception codes for Quality and Outcomes As you know, GGHB agreed exception codes for some of the Q&O points last year. This year we expect a system to be applied which will allow only the specific points to be excepted rather than the ‘high level codes’ which were used last year. We will issue joint advice with the Board on how to remove these high-level codes in an auditable way so that your software will again prompt you about inhaler technique etc. Pre Chemotherapy bloods via central lines Some patients expect, that if they have a line in place, their blood sample will be removed from it. This is not part of this LES and we would advise against doing this unless the staff member has adequate training and experience. We have written to the Beatson on this issue. Patient Group Directives GPC advice is that these are not required for vaccines given in General Practice. Practice protocols should suffice. However, we are engaged with the PCD to develop relevant PGDs which practices could adopt as best practice. Confidentiality and Practice Visits Joint advice between GPC and the Dept of Health has now been issued and a Scottish version is expected shortly. VAT on PCD employed Practice Staff There has been a ruling that VAT is chargeable on these staff but a legal challenge has been made so the decision seems not to be final. Apparently, the previous advice that having a joint contract with the Board would side step this VAT is not true Psst.. Guess What It wasn’t just Charles and Camilla who married on the 9th April! Congratulations to Drs Barbara West and Ken Harden and Dr Jane Connelly and Mr David Gray who also tied the knot on that day. Must be something in Drumchapel Health Centre’s water!! And finally... To make you laugh! A woman went to doctor's office one morning. She was seen by one of the new doctors, but after about five minutes in the examination room, she burst out, screaming as she ran down the hall. An older doctor stopped and asked her what the problem was, and she explained. He had her sit down and relax in another room. The older doctor marched back to the first and demanded, "What's the matter with you? Mrs. Terry is 63 years old, she has four grown children and seven grandchildren, and you told her she was pregnant?" The new doctor smiled smugly "Cured her hiccups though, didn't it?" Have a great summer! Alan McDevitt Barbara West Mary Fingland Ian Mackie Elaine McLaren
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