News In Brief 1 May 2009

News From NAPC

This week saw the first NAPC London meeting in the journey towards regionalisation. Delegates attended from more than 50 practices, and Mark Britnell, Director General of System Management and Commissioning, address delegates on the growing importance of primary and community care in the changing world in which we find ourselves.

PBC Survey 

Colleagues from Practical Commissioning are conducting a survey on practice based commissioning. It is important that as many of you as possible complete it, so that we are well informed in our discussions with the Department of Health about any changes needed to the scheme, its challenges and opportunities and the future direction travel.  Please help us to help you.

http://www.zoomerang.com/Survey/survey-intro.zgi?p=WEB2295A8QGZRY

Body Of Evidence

The National Institute for Health and Clinical Excellence has launched information portal, NHS Evidence.

The site, promised in Lord Darzi’s next stage review, will consolidate information on commissioning, public health, clinical issues, drugs, technology, social care and education in one place.  Users can browse, upload and share content.

IT Progress Check

The national programme for IT has seven months to show ‘significant progress’ in getting working IT systems into hospitals ore else a new plan will be adopted, the Department of Health has said.

The deadline came as the DH made movers to open the programme to more flexible IT packages.

First Among Equals

The top NHS trusts on equality and diversity were announced yesterday at the London launch of Equality and Diversity partners, which has been set up to support trusts by sharing good practice, learning and expertise.

It will work with NHS Employers to share ideas, run learning events and support the development of guidance.

Failing PCTs To Lose Commissioning Role

Primary care trusts (PCTs) that fail to get to grips with World Class Commissioning (WCC) could have their commissioning powers stripped from them, the Department of Health has warned.

Speaking at a conference last week, Bob Ricketts, Director of System Management at the Department of Health, said that WCC was ‘getting serious now’. PCTs could not afford to continue with business as usual.

He told delegates that from this summer there would be a commissioning ‘failure regime’ for tackling PCTs whose commissioning was not up to scratch.

The move could mean that GPs bidding for APMS tenders or other new contracts could find themselves negotiating with private commissioners.

Government policy is for PCTs to hive off directly provided services into independent ‘arms length’ bodies.  Stripping PCTs of commissioning power, too, would leave them as skeleton organisations, responsible mainly for managing budgets and contracts.

Hospitals Take On PCT Services

Hospitals trusts are hovering up community services, because of the speed with which the Department of Health expects PCTs to outsource their provider arm.

PCTs must finalise their plans to separate their provider and commissioning functions by this October.  The tight timetable is encouraging PCTs to direct services to local hospitals.

Many PCTs see vertical integration with acute services as a way of strengthening faltering foundation trusts.  Such moves also sidestep staff fears about losing out on terms and conditions when outsourced to non-NHS bodies.

In many areas, money was moving into secondary care, the exact opposite of the vision articulated by the Department of Health

Couple Sue NHS For Failed Scan Of Disabled Son

A couple who claims they were not given a chance to abort their severely disabled son are suing Blackpool, Fylde and Wyre Hospitals NHS Trust for more than £1 million because of an antenatal scan, which did not pick up the child’s brain abnormalities.

The claimants say that a 20 week scan at the Blackpool Victoria Hospital 14 years ago, was carried out in a light-hearted and casual manner.  They are now claiming damages for the ‘wrongful birth’ of their son and seeking compensation to fund his full time care.

Ambulance Crews Told Not To Rely On Satnav

Ambulance drivers have been told to use maps and local knowledge because satellite navigation device could delay response times.

A leaked memo from the North East Ambulance Service director of ambulance services, Paul Liversidge said that satnav should only be used as a guide.  Addresses should be checked with A to Z to ensure satnav location was correct.

First Purpose Built Polyclinic Opens In London

Loxford Polyclinic in Redbridge was yesterday the first purpose built clinic to open in London. Patients will be able to see a GP seven days a week and access a range of health and social care under one roof.

Loxford Polyclinic is the biggest polyclinic in London and will serve a population of 50,000. 

Ruth Carnall, Chief Executive of NHS London, said polyclinics would transform primary and community care in London for the better, delivering accessible high quality services, which would ultimately reduce health inequalities.

GPs Face 60 Per Cent Top Rate Of Tax

Thousands of GPs are facing a marginal rate of tax of 60 per cent on every extra pound earned.

Plans to claw back personal allowances from high earners from April 2010, set out in last’s week’s budget, mean that GPs who earn between £100,000 and £112,590 will receive just 40 per for every extra pound earned.

Average pay for partners was £107,667 in 2006.7, according to the NHS Information Centre.

The taxation changes could deter many from taking on extra work, such as out of hours, said Dr Richard Vautrey, Deputy Chairman of the General Practice Committee (GPC).  Doctors, whose incomes were close to the threshold, would look much more closely at taking on extra work.

Personal allowances currently permit tax-free earnings up to £6,475   a year.  However, last week’s budget said that from April 2010 allowances would be reduced by £1 for every extra £2 earned about £100,000.  In effect this raises the rate at which that money is taxed from 40 to 60 per cent.  When superannuation was included, extra take-home pay would fall to less than 30 p in the pound.

BMA Chairman Calls For Re-Think On GMS Contract

BMA Chairman, Dr Hamish Meldrum, has called for a re-think on the GMS contract, warning that it had encouraged GPs to take on too many patients,

Giving evidence to the All Party Parliamentary Group for Primary care and Public Health, Dr Meldrum said income should be linked to the number of GPS rather than just workload.

General Practice Committee To Hand Bradshaw PCO Prevalence Blacklist

Primary care organisations (PCOs) that refuse to discuss support for prevalence users will be reported to the health minister, Ben Bradshaw the GPC has said.

Some practices will lose huge sums from the move to raw prevalence.  The expectation was that PCOs would discuss alternative revenue streams, such as local enhanced services, to ensure that practices were not forced to cut services.  In some areas, particularly London, this had not happened.

Dr Laurence Buckman, Chairman of the GPC, and Dr Barbara Hakin, NHS Employers’ chief negotiator, have now written to all PCOs to remind them of their responsibility.

Dr Buckman denied PCOs were acting out of malice and said many simply did not realise it was an issue.  He also stressed that practices were not guaranteed replacement of all lost funding.

PCT Funding Clawbacks Make Future Of PBC Unclear

Primary care trusts are undermining practice based commissioning by clawing back any savings PBC groups have made, according to GPs.

PBC allows practices to band together to commission the services that will most benefit their communities.  But despite the fact that the initiative increases practices’ control over health services, support has been slow to build.

One GP at a recent King’s Fund conference told delegates that her consortium, Stockport Managed Care, had felt invigorated after it saved £1 million through PBC, but when the PCT went into deficit, it refused to surrender the savings.

RCGP Slams Nurse Training

According to Professor Steve Field, Chairman of the Royal College of General Practitioners, the Department of Health’s apparent disinterest in practice nurses, health visitors and school nurses has held back primary care over the past decade.

Professor Field branded practice nurse training as a disgrace as he gave evidence to the All Party Parliamentary Group on Primary Care and Public Health.

Debating the progress lf Labour’s 10 year NHS plan, published in 2000, Professor Field said primary care could have achieved much more if more effort had been made to improve skill mix.  He went on to say that if an effort had been made to increase nurses’ training and their continued professional development, much more could have been achieved.

GP IT Systems Will Have Link To Drug Watchdog

GPs will be able to report adverse drug reactions directly to the MHRS from practice IT systems by next year.

The agency will also launch an internet awareness campaign outlining the dangers of obtaining medicines from unregulated websites.

AS part of business and corporate plans set out last week, the MHRA revealed ideas to work with Connecting for Health on the introduction of direct to database reporting of adverse drug reactions from practice IT systems.