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A significant part of the last LMC meeting was taken up over the discussion regarding the PCTs change in policy about Surgery Premises Development. In December Paul Bates wrote to the affected practices explaining his proposed policy and despite a number attempts by the LMC the Board adopted this policy at their last meeting on the 20^th January. The LMC remains concerned whether indeed the PCT is allowed to alter the cost rent regulations in the way they have indicated. We have had their assertions they can do this but we have not had evidence to back up that assertion. Fundamentally the LMC believes that to link new surgery development with reductions in referral rates and prescribing is unfair and indeed sets a very bad precedent. We have always objected to referral management schemes that directly reimburse GPs for referring less work. Clearly there are a number of surgery developments that will be affected by this and we already understand that at least one of them is in jeopardy because the developers are very unhappy about such restrictions being put on the cost rent part of the contract. At least one of these developments is absolutely essential. That is a practice that is currently in substandard premises. We have continued to push the PCT with our real concern about this. Maybe the bottom line is that the PCT in its new cash strapped situation simply does not want to fund any surgery developments.   If that is the case maybe a more honest debate on the issue would be appropriate. The LMC has written formally to all practices involved on this matter.

 

The GMS/PMS Commissioning Group at the PCT is now meeting on a Monthly basis and has taken on board some very significant work which will have real implications for general practice. The PCT is making progress on its LES update and work is taking place to develop the Health Checks LES. This used to be called ‘Vascular Screening’. It is hoped that draft details should be made available to all practices shortly. Other work is taking place on a proposed care home LES. The LMC has had discussions with the PCT on some modifications on the existing Violent Patient Scheme and again we hope this should ready shortly. A long discussion took place at the last GMS/PMS meeting regarding the commissioning outlook and approach for the PCT and more specifically looking at quality issues in general practice. It was very gratifying to see that statistics had been collated comparing practices in Worcestershire with practices in equivalent PCTs across the country. This shows that primary care in this county is performing very well.   The LMC has already suggested to the PCT that when this work is more formalised, a meeting is organised to share it with all of primary care. One of the deficiencies of general practice is that we all work in our own little unit and frequently have little idea what is going on elsewhere in our own locality let alone across the country. Making comparisons on the delivery of services in this way is very informative. The LMC Secretary is repeatedly heard saying that ‘if you think it is bad in Worcestershire you should go to ....’

 

 HMRC – MEDICAL PROFESSIONALS OFFERED TAX HEALTH PLAN

Medical professionals are being encouraged under a new Tax Health Plan to tell HM Revenue & Customs if they have understated income.   Those who contact HMRC by 31 March 2010 to make a voluntary disclosure will be able to put their tax affairs in order simply and on the best available terms.   After that date, using information it holds about how much is paid to them, HMRC will carry out targeted investigations aimed at medical professionals who have not come forward. Substantial penalties or even criminal prosecution could follow for those who have undeclared tax liabilities.

The Health Plan is the first initiative in a new HMRC campaign focused on professionals. It is designed to make it easy for customers to put their tax affairs right and keep them that way. Launching the campaign, Mike Wells, HMRC's Director of Risk and Intelligence, said:
 

"Our aim is to make it as easy as possible for people to come forward, make a full disclosure and benefit from the certainty of a reduced 10 per cent penalty that HMRC is making available to those who qualify for this opportunity.

"From April we will be using the information at our disposal to investigate medical professionals who have not declared their full income. I therefore strongly urge any in this group who think they may have outstanding tax liabilities on their income to get in touch with HMRC and get their tax affairs in order simply and on the best available terms.

"This is the first step in enabling those with undisclosed income or gains to avoid a full tax investigation together with much higher penalties. The message is clear: contact us before we contact you."

 

The Health Plan will operate in two stages:

· From 11 January to 31 March 2010, medical professionals can register their intention to make a voluntary disclosure with HMRC.

· By 30 June, those who have registered must have made their disclosure as well as arrangements to pay all tax interest and penalties due.

What do you have to do to notify your intention to make a disclosure?

· Ring HMRC on 0845 600 4508, or

· Use the e-form available via the link on the HMRC website: http://www.hmrc.gov.uk/tax-health-plan/

A dedicated team will be on hand to help.

 

If HMRC receives a full and accurate disclosure of any income on which tax hasn’t been paid, along with payment, by 30 June, those who qualify can expect a reduced penalty of 10 per cent.

The benefits of the Tax Health Plan are that you can avoid the possibility of:

Following negotiations between the GPC and NHS Employers for 2010/11, the Extended Hours Access Scheme DES and four clinical DESs will be rolled over to 2010/11.   There will be no other changes to the GMS contract next year, with the intention that practices experience a period of contract stability.

 

The five DESs that will be extended to 2010/11 are the:

 

There will be a cut off date for practices to inform the PCT if they wish to take up the Extended Hours Access Scheme DES, after which practices will no longer have an automatic right to participate.  We will inform you of this date as soon as it has been agreed. Please note that existing arrangements will apply to all these DESs.

 

Details can be found here:

http://www.nhsemployers.org/PressReleases/2010/Pages/GMCContract.aspx
There will be no changes to QOF in 2010/11 in line with the H1N1 vaccination agreement. 
 

The original DDA guidance for GPs was published in 2003 and has now been updated. You can access the revised guidance, The Disability Discrimination Act: Physical adjustments to GP premises required under the Act can be found on the BMA and LMC websites at:

and

In December 2008, the Department of Health published a consultation on “The use of 084 telephone numbers in the NHS”. The DH published their response to the consultation in September 2009, which concluded that the use of phone numbers that charge the public or patients a premium rate to contact the NHS were to be banned in England. However, 084 numbers could continue to be used if call charges were no more expensive that those of the equivalent local calls.

 

The DH’s response to the consultation can be read here:

 

The ban came into force on 21 December 2009 when the Directions to NHS bodies concerning the cost of telephone calls in relation to health services 2009, were issued:

 

The GPC Practice Finance subcommittee has published guidance on the use of 084 numbers in the NHS, which is available on the BMA and LMC website:

or http://www.worcslmc.co.uk/documents/get_file/084_numbers_guidance_and_FAQs_8_1_10.doc

 

The Secretaries Saga.....

 

For the entire time I have been LMC Secretary the issue of Orange and now Blue Badges has continued to plague me. I have been totally unable to resolve this despite numerous attempts. Maybe at last a solution has arrived. Rather than go over old ground again can I propose a solution which I hope will meet with the satisfaction of colleagues. I have been in touch with Dr George Lord, the leader of Worcestershire County Council and he has sent me a document which the County Council has produced and will be given out to people who wish to apply for a Blue Badge. We have put this on our website and we would strongly encourage all practices to co-operate with this policy and in addition to have this available in your own practice to give to patients should they attend in the surgery.

 

As you will see on the document it clearly states in bold ‘please do not request evidence from your GP’. Indeed the advice from the County Council is that local department guidance from the Department of Transport states that evidence from a GP should not be sought due to the conflict of interest that this potentially causes for the individuals concerned. Furthermore do not advise people that they are eligible for a Blue Badge. If they raise the issue or you feel it may be appropriate simply print out a copy of the guidance document and give it to the patient.

 

Maybe this will work!

 

The document can be found at:

 

Last year the government imposed, against GPC advice, several changes to the patient experience survey. A by-product of these changes was that some practices ended up losing a significant element of their funding, partially because of low response rates among patients.

In order to help address this problem, GPC has developed the 'Your Surgery, Your Say' poster and leaflet for practices to display in their surgery. The poster and leaflet explain what the practice is doing to offer patients the best possible access, and also explains how patients can give their views directly to the practice. The poster also reminds patients of the importance of completing the Government's patient survey, and explains directly what many might not understand - that their practice's funding depends on their responses.

Copies of the poster and leaflet have been sent to all GP practices in England and Northern Ireland (not Scotland and Wales).

Electronic copies of the poster and leaflet are available on the BMA website, and practices can use these to print out additional copies for display.

http://www.bma.org.uk/employmentandcontracts/independent_contractors/general_medical_services_contract/yoursurgyoursay.jsp 
 

The Cameron Fund has now launched its new website at www.cameronfund.org.uk, this will also be available through our website.

 

The Cameron Fund is the only medical benevolent charity which solely supports general practitioners and their dependants, GP Registrars and retired GPs.   They provide support to GPs and their dependants in times of financial need, whether through ill-health, disability, death or loss of employment. There has been increasing demands on the charity and without donations from individuals and organisations they would need to use their capital to continue their good work. If you would like to make a donation please visit their website where there is full information on how to do this.

 

The new Complaints Procedure was introduced in April 2009. The GPC has heard mixed reports from different PCT areas. The LMC has certainly had no feedback of any concerns in this area but if practices have had any particular problems about the Complaints Procedure in Worcestershire please can you make this known to the LMC so we can feed this back to the GPC office.

 

The following guidance has been added to the LMC website during the last month: