Avon LMCs Newsletter on 23-10-24

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The ALMC Newsletter

Welcome to our weekly newsletter, sharing the latest news and topics of interest for practices.

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– LATEST NEWS –

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As the clocks go back on Sunday, we firmly enter the grips of the darker months and all that brings in terms of illnesses. I would like to take this opportunity to remind all of our local GPs of the availability of the Avon LMC Benevolent Fund. This fund has been in existence for many decades to support GPs, who work in the BNSSG area, should they face financial hardship, irrespective of the cause.
 
If you or a colleague need to apply to the Avon LMC Benevolent Fund, please e-mail info@almc.co.uk and your information will be passed on to the Chair of Trustees who will contact you directly.

The LMC contacted the Clinical Negligence Scheme for General Practice (CNSGP) asking for clarification regarding the scope of the role of Physician Associates working in General Practice:
 
CNSGP will cover NHS activities commissioned under a Primary Care contract.   
 
By way of explanation, cover under the CNSGP scheme is linked to the form of contract the services are provided under. It covers NHS activities which are commissioned under a GMS, PMS or APMS contract or as enhanced primary care elements under Schedule 2L of the NHS Standard Contract (each a “Primary Care Contract”). Cover also extends to services that are delivered under a direct sub-contract to a Primary Care Contract.
 
In either case, all those contracted to deliver the services who provide care commissioned under a Primary Care Contract or its direct sub-contract will receive cover under CNSGP.
 
Therefore, if the services you are providing are being provided under a Primary Care Contract (as above) or a direct sub-contract of a Primary Care Contract, you will be eligible for cover under CNSGP.  Please note the cover provided under this scheme is in respect of the services you provide to your GP practice.
 
If the services are not being provided under a Primary Care Contract, or a direct sub-contract to a Primary Care Contract, the services may still be covered as an ancillary health service under CNSGP if you can answer “yes” to the following:
 
(1) Are you carrying out an activity that consists of, or is in connection with, the provision of NHS services?
(2) Are those NHS services being provided by, or under a contract with, a person or organisation whose principal activity is to provide primary care under a Primary Care Contract?
(3) Is the activity in question connected to the diagnosis, care or treatment of a patient?
 
Please note that CNSGP only provides cover for clinical negligence liabilities. Therefore, even if you are covered by CNSGP, you may want to consider whether alternative indemnity arrangements are still required in relation to other risks or liabilities which may arise, e.g. fitness to practise investigations, and inquests.
 
We understand that indemnity under CNSGP is very different to traditional indemnity provided by an MDO because it is linked to the type of contract under which an activity is performed rather than just the nature of the activity. 
 
If you would like to review additional information, this can be located online:

• Frequently asked queries – https://resolution.nhs.uk/scheme-documents/scheme-scope/ ;
• The indemnity scheme rules – https://resolution.nhs.uk/scheme-documents/cnsgp-scheme-rules/; and
• The relevant indemnity legislation – https://www.legislation.gov.uk/uksi/2019/334/contents/made  

 
To reiterate, coverage under the state backed indemnity scheme is automatic and linked to the form of the contract that services are provided under.  You may wish to consider alternative indemnity arrangements in relation to other risks or liabilities which may arise, e.g. fitness to practise investigations, and inquests.
 
With regards to your query about the scope of activities carried out by Physician Associates working in General Practice, as long as the care they are providing is related to the Primary Care contract the Practice is operating under, then any clinical negligence claim that arises is likely to fall under the scope of CNSGP and will be covered by NHS Resolution. 

The go-live for Collective Action focussing on the use of a generic standard referral form and returning inappropriate transfers of work starts in just under 2 weeks. Please refer to resources on our website which will be updated regularly.
 
Today we would specifically like to share a simple guide on how to find the generic standard referral form and the LMC Collective Action letters in EMIS.
Please click here
 
We also wanted to help practices to explain Collective Action to their staff. Shaba has put together a 6 minute video to be shared with your practice teams. The video will be available on our website and it will be emailed directly to Practice Managers.
 
Avon LMC is emailing Clinical Directors of all Trusts and Providers, including AQP (Any Qualified Provider)  that we use in BNSSG. This is informing them that General Practice will be using Single Generic Referral Form from 4th November 2024. We are requesting they cascade the email down to all relevant departments to ensure everyone in their Trust/ Provider is aware. The ICB has seen the referral templates and RAG rating. Avon LMC Committee PCN reps have been involved and thank you for all their support and feedback.
 
The email to the Clinical Directors contains a copy of: 
1. Notification of the use of a Single Generic Referral form letter 
2. ICB BNSSG Standard referral form template 
3. The link to the RAG Rating 
All three can be found on our LMC website below by scrolling down and clicking on each one. The most up to date RAG Rating including an explanation is on our website too.
https://avonlmc.co.uk/collective-action-2/
 
We ask that General Practice from the 4th November use the ICB BNSSG Standard referral form template (Note: Search for “standard” in EMIS to find it!).
 
Finally, we want to help set realistic expectations for patients about the what they should expect from their outpatient appointments. Attached is an LMC-badged pdf that you can put up in your waiting rooms or send to patients via AccuRx so that patients are aware of the responsibilities of their hospital teams.

Question: The practice has been contacted by private providers of weight loss injections asking for general practice to provide information about patient’s BMI and history of anorexia.
 
Answer: Whilst it has never been the responsibility of general practice to ensure the safe prescribing of another clinician or organisation, if general practice is aware of significant risks that a patient is not disclosing due to ill health or the possibility of impaired capacity, then we would have a duty of care to share this information. The GMC and clinical negligence lawyers would take a dim view if the practice was aware that a patient with anorexia was being prescribed weight loss injections and we chose not to share this information.
 
The LMC suggests that you only have a duty to share information if it addresses a patient safety risk. You do not have to respond to requests for BMIs or other measurement parameters that may be in your clinical record. 

The next LMC virtual drop-in session will be on Tuesday 12th November. Due to IT mishaps which affected attendance at the previous drop-in meeting, we will ask you, via a future bulletin, to sign up for the drop-in session using a form. The 12th November session will be the first session after the go-live on Collective Action so it promises to be an interesting forum.

Read the latest GPC England bulletin here.

Make savings on products and services by utilising the Buying Group approved suppliers
 
The LMC Buying Group has an impressive list of suppliers that cover a variety of products and services, from stationery and office equipment to medical consumables and confidential information shredding.
 
We regularly identify savings between 20% and 45% made on office items from our supplier, Whittaker Workplace Solutions. They can supply your practice with everything it needs to run smoothly, including stationery and office products, catering and cleaning supplies and printer cartridges. To order from them, you can phone, email, fax or order online at all times.
 
If you are looking for a company that can provide confidential information protection and secure document shredding, hard-drive destruction and associated recycling services, the Buying Group have the perfect supplier for you. Through Shred-it’s partnership with the Buying Group, all members can access 50% off standard rates. Shred-it supplies their services to organizations of all sizes in the private, public and third sectors.
 
To access the discounts, you would have to sign up with the Buying Group. Membership is completely free for practices. For those of you who are already members, accessing these discounts is incredibly simple, all you have to do is visit the Buying Group’s website and click onto the supplier page you are interested in.

• 12th November 2024: Virtual LMC drop in, 13.00 – 14.00
• 22nd November 2024: England LMC Conference – London, all day
• 14th January 2025: Virtual LMC drop in, 13.00 – 14.00
• 11th March 2025: Virtual LMC drop in, 13.00 – 14.00

• Tuesday 22 October General practice bulletin (mailchi.mp)
• Thursday 17 October General practice bulletin (mailchi.mp)

• 12th November 2024: Virtual LMC drop in, 13.00 – 14.00
• 22nd November 2024: England LMC Conference – London, all day
• 14th January 2025: Virtual LMC drop in, 13.00 – 14.00
• 11th March 2025: Virtual LMC drop in, 13.00 – 14.00

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– LATEST TRAINING AND EVENTS –

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• 24th October – BNSSG Cancer Lead Education Day 2024
  Signup Form
• 24th October – Dermoscopy Training – Part 2
  Signup Form
• 24th October – Blood Interpretation in Primary Care (Day 1 of 4)
  Signup Form

Please see here for full event details.
For further information please contact Bnssg.training.hub@nhs.net

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