NAPC News For Practices 15 June 2012

Twenty Per Cent Increase In GP Training Places

Ministers plan to boost the number of GP trainees by 20 per cent over the next three years, as part of a radical reshaping of the medical workforce.

Health Secretary, Andrew Lansley, said he wanted to see a sharp increase in the proportion of specialty training places taken by GP registrars, from 41 per cent currently to 50 per cent by 2015.

The move is intended to equip the medical profession for the shift of workload from hospital into primary care and address the severed shortage of GPs, which has seen vacancy rates double in a little over a year.

The number is places is set to rise from the current 2,700 to 3,250 in the next three years, assuming the overall number of medical specialty places remains at the present level of 6,600.  A separate government review is examining how many medical school places should be made available.

Health Secretary Andrew Lansley told a Reform conference recently, that a further expansion of the GP workforce was known to be needed, with 50 per cent of the newly trained medical workforce in the future going into general practice.  He also said he was backing plans to extend GP training to four years, claiming the move, which was subject to Treasury approval, would help the government in getting general practice to place it wanted.

Ministers also met with the RCGP last month to discuss plans to address the severe shortage of GPs on the ground, with a particular emphasis on getting more working across London.

The Centre of Workforce Intelligence recommended there should be 3,250 GP placements by 2015.  However, last year deaneries were forced to cut the number of GP training places by 7 per cent because of a fall of more than 40 per cent in applications for general practice over three years had meant there was a dearth of quality candidates.

GP Records Site Plan Revealed

A new website called My Health, likely to be run by an independent contractor, looks set to be used to give the public access to GP records.

Plans for the project are revealed in a job description for a senior post at the NHS Commissioning Board, which is currently appointing to a series of senior posts, including several in its patients and information directorate.

GPs Must Offer Email Access By 2015

GPs will have to arrange online appointment booking and a secure email system for patients to contact their practice by 2015, in a move to make the NHS more ‘customer friendly’.

Health Secretary announced plans as part of a pledge to end the ‘8am rush’ of people phoning GP surgeries to get an appointment.  He also promised that repeat prescriptions and tests results would be accessible online.  Additionally, he went on to reiterate a government promise for all patients to be able to access their full medical records within three years, although he stopped short of the NHS Future Forum proposals for patients to be able to add to and correct their notes.

Practices will have to appoint a lead GP to organise better electronic access, arrange secure lines of communication for patients and direct access to records for ‘anyone registered with the practice’ requesting these services.

NICE To Lose Rationing Role

NICE will no longer make ‘yes’ or ‘no’ decisions on access to drugs from 2014, with the Department of Health instead setting a maximum price the NHS will pay.

Mr Lansley said patients’ right to approved drugs would remain, but would no longer be determined by NICE appraisals.  Instead, the Department of Health and manufacturers would agree a price that should be paid for them.  The change, he said, would allow more innovative medicines to be available, but critics branded the move as a political fix that would make it harder to balance budgets.

Mr Lansley added that the Pharmaceutical Regulation Scheme, which expires in January 2014, had failed to ensure NHS patients had access to new treatments.  He said that the government would open talks with companies later this year on the introduction of value based pricing.

Under the scheme, NICE will still make technology appraisals of new drugs, but as advisory reports to ministers, who will dictate the terms under which they are funded through negotiations with manufacturers.  The Department of Health will determine how QALYS are weighed, potentially paying more for treatments showing additional benefits, more innovation or other ‘societal benefits’.

Boundary Pilot Faces 120,00 New Patients

The abolition of practice boundaries will see inner city practices potentially overwhelmed with commuters, with 120,000 patients set to register in the City of London alone, according to research.

A report drawn up for the City of London Corporation and NHS North East London warned that allowing patients to register near their workplace could stretch existing services to breaking point and create additional demand for more than a dozen GP practices.

A survey of 2,519 workers included in the report found that 33 per cent would prefer to register close to work, and 82 per cent backed dual registration.  If all patients who wished to register near to work did o, there would be an extra 120,000 registrations, requiring 14 practices to be opened to add to the one currently in the Square Mile, the report warned.

CCGs To Link Up With Pharma

GPs will be expected to work with drug companies on the commissioning screening services and designing care pathways, under a government backed plan to promote partnerships between CCGs and the pharmaceutical industry.

A new scheme aims to make it easier for pharmaceutical companies to ‘move beyond sponsorship’ in working with CCGs and funding NHS case finding projects. The guide to ‘joint working agreements’ has been drawn up by the Association of the British Pharmaceutical Industry (ABPI) with the support of the Department of Health.

The ABPI last year altered its code of practice to allow pharmaceutical companies to develop so-called risk sharing agreements with CCGs, which would only pay full price for drugs if targets on clinical outcomes were met.  The new document aims to expand on this.  It lists a number of joint projects between drug companies and the NHS, including review of patients with COPD, a GP-led angina clinic and provision of care managers for patients with CVD.

A spokesperson for the ABPI said it wanted to ensure collaborations like these could continue after CCGs were authorised.

Local Focus For GP Services

GP services are to be commissioned by local teams of manages after the NHS Commissioning Board delegated responsibility to them.

Minutes from the NHS Commissioning Board’s May meeting revealed its plans to discharge some £22bn worth of direct commissioning responsibilities, with all local area teams taking on direct commissioning responsibilities for GP services, dental and pharmacy services.  The new structure, the minutes said, would result in a ‘significant reduction’ from the 50 local offices of the Board initially proposed, to a smaller number of local teams that would each oversee a handful of CCGs.

The Board revealed that a third of local area teams across England would lead on specialised commissioning, with a smaller number carrying out the direct commissioning of optometric services, military health services and offender health services.

The smaller teams will also commission public health services and interventions, with ‘some most likely commissioned on a larger geography than individual teams (such as screening programmes) and others possible at individual local area team level (such as public health and under fives)’.

It was revealed in HSJ yesterday that the NHS Commissioning Board is to have 27 local arms and is one fewer than the number of strategic health authorities during the middle of the last decade.

The names and make-up of the teams have not yet been confirmed.  However, there are likely to be three teams in London, and between seven and nine in each of the Board’s North, South and Midlands and East regions.

In addition to medical, nursing and finance directors, each team will have some very senior general managers reporting directly to the team director.

The teams will be created as staff are appointed to the Board in coming months, although the Board does not take on its full role until April.  Many will have more than one physical office, making it easier for staff to transfer.

Checks Missed On Diabetic Patients

An NHS audit has found that about a million diabetes patients face a great risk of stroke, blindness, amputation and heart attacks because they are receiving too few medical checks.

Little more than half of those with diabetes in England are receiving all nine checks.  In Wales this rises to 60 per cent.

Alzheimer Hope

A single vaccination could one day protect people from Alzheimer’s disease, researchers have claimed.

Tests on mice show the chemical ankG helps destroy a protein called beta-amyloid, which forms a waxy ‘brainclogging’ plaque in sufferers.

Experts in Zurich, Switzerland, said the tests suggested that ankG was a ‘key player’ in the disease, which affects 500,000 people in Britain alone.

The Alzheimer’s Society Welcomed the results but said ‘further research is needed.’