Category: Practice issues

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Future of Partnerships

8-Aug-19

Dr Nigel Watson's study into the Future of Partnerships has published its final report

Tier 2 Sponsorship

1-Feb-19

We had been under the impression that NHS England would only reimburse the application fee for those practices that were successful in applying for Tier 2 Sponsorship. I am glad to report that this was a misinterpretation. NHS England will reimburse all practice applications, successful or otherwise. They are trying to promote more practices becoming Tier 2 sponsors, via the regional teams. On an allied note, NHS England are currently also engaged with GP trainees at ST3 level who require visa sponsorship to remain in the UK to practice as a GP, offering a "practice matching" service for these GPs for their area of choice.

Cremation forms and funeral directors

3-Dec-18

There is no statutory obligation to complete a cremation form and no set statutory fee. It is up to the GP to charge what is appropriate and this will cover both time and travel costs.

The GP does not have to see the body after death to complete the part 4 cremation forms. All the doctor must do is to write legibly in the boxes on the form. It is then up to the medical referee of the particular crematorium to decide whether to accept the form or not. The referee can legally refuse to accept a form that is illegible but cannot refuse to accept a form just because they don't like the (legible) written content. They have to decide whether the information on the forms is sufficient for the body to be cremated. It is their decision alone. Any consequence arising from their refusing to accept a form (delay, anguish for the family, extra fees etc) is theirs alone. If they refuse to accept a form then it will have to be replaced by another that is acceptable to them, i.e. one written after the body has been seen.

If the body is out of area then simply contact the medical referee of the relevant crematorium, explain the situation and suggest you complete the forms indicating in the relevant boxes why you were unable to see the body after death. Explain to them that this is legally allowable and that there is no legal reason why they should not accept this.

Equally, if a funeral director outside your area is unwilling to move the body to a funeral director's parlour near your practice then you can tell them that if they are not going to be reasonable and move the body closer to the practice (they all have facilities and/or arrangements to be able to do this) then you will not be able to complete the certificate and will have to advise the relatives as to where the fault lies for the funeral being delayed.

Any problems with PCSE (Capita)?

2-Oct-18

The official guidance about PCSE from the BMA is at:

https://www.bma.org.uk/collective-voice/committees/general-practitioners-committee/gpc-current-issues/capita-service-failure from which a useful extract is:

Process

1. If a practice or individual has any issue due to the service provided by PCSE, such as delays or errors in payment, they should contact PCSE in the first instance to resolve the issues pcse.enquiries@nhs.net, putting appropriate details in the header to ensure PCSE can pass details on to the relevant back office team.

2. If the issue is not resolved by PCSE in a timely manner then you should contact NHS England to make a claim at their designated email address pcse.ppinfo@nhs.net. We suggest that you include the following details in your email:

Your name and address (or the name of the practice and its address)
The reason for your claim
A clear explanation of the facts
What losses are you are claiming (these may be direct losses such as your contractual payments, or indirect losses such as costs incurred because of having to take out a loan to pay for practice expenses)
Attach any supporting documents which verify the facts in the letter and the amount claimed
A date by which you want a full response, we recommend 28 days
Any other relevant information

NHS England should then be in contact about your claim. You should note that by accepting an offer of compensation it could mean you forego the right to seek any further redress, so please consider fully all losses that you suffered because of failings by PCSE.

You may also wish to consider taking up your claim via the small claims court, however not all claims are suitable for this route. See guidance on bringing a small claim to the court

If you cannot reach agreement with NHS England over your claim, please contact GPC England (info.gpc@bma.org.uk ) and we can escalate the issue on your behalf. Please include the previous correspondence and a clear outline of the issue and the desired outcome.

If you are unsure about the terms of any offer or your legal rights you may wish to seek independent legal advice, however, depending on the financial loss you have suffered, this may not be financially prudent. BMA Law offers expert legal advice at preferential rates for BMA members. They can be contacted on info@bmalaw.co.uk or 0300 123 2014.

CQC inspections - how to improve your grading

3-Jul-18

There is a lengthy report on the CQC website about 10 named GP practices that moved from 'Inadequate' to 'Good' or even 'Outstanding'. To achieve this improvement they all relied on:

Strong leadership from a practice manager with the time and skills to lead the practice team.
Addressing staffing and training issues such as poor recruitment or training practices.
Making sure every member of the practice team understood their own and others roles and responsibilities.
Involving the whole team in running the practice.
Involving patients and the local community.
Using external support to help improvement.

If you need some practical tips then you might take a look at it.

NHS Property Services (NHSPS)

5-Jun-18

NHSPS have been issuing threatening letters to some practices about claims for unpaid charges. GPC regard the tone of these letters as threatening and completely unacceptable and have asked NHSPS to recall the letters urgently. GPC will stand with any affected practice if, despite there being no legal basis to do so, NHSPS seek to enforce these charges. So, if NHSPS takes action to enforce charges against you, please let us know immediately. GPC are pushing to reach a negotiated agreement nationally to establish a fair and reasonable process for calculating service charges, which has due regard to historic arrangements and does not result in practices having to fund the historic neglect of buildings. If your practice is threatened with legal action you should also seek independent legal advice on the particulars of your situation. Further guidance is available here.

Violent patients

6-Apr-18

Nationally there have been reported examples of PCSE not informing local NHSE/CCG teams of patients who have been removed from practice lists under S.13.11.1 due to violence or aggression. There is then a risk that potentially violent patients may register with practices not set up to care for them. To avoid this risk practices should inform the CCG as well as PCSE when they request removal of a patient due to threats of violence.

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