The number of points available in the clinical QOF Domain has reduced from 407 points at 2016/17 to 367 points at 2017/18. The Domain has been split into Active QOF and Inactive QOF. Approximately 50% of clinical QOF, representing 202 points, has been designated as active QOF; approximately 40% of clinical QOF, representing 165 points has been designated as inactive QOF and approximately 10% clinical QOF, representing 40 points, have been retired and the points value transferred to the Cluster Network Domain.
Patients who die while subject to an authorisation under the Deprivation of Liberty Safeguards (DoLS) no longer require automatic referral to the coroners
From the 3rd of April 2017, it will no longer be necessary to refer all patients who die while subject to an authorisation under the Deprivation of Liberty Safeguards (DoLS) to the coroner.
Before that date, patients who died subject to DoLS were regarded as dying while in state detention, triggering an automatic requirement for an inquest. From Monday the 3rd of April the Coroners and Justice Act 2009 will be amended so that coroners will no longer be under a duty to investigate a death solely because the individual was subject to the DoLS at the time. These deaths will only require reporting to the coroner if the cause of death was unknown, or where the cause of death was violent or unnatural.
All deaths while subject to a DoLS authorisation that occur prior to the 3rd of April will still need to be reported to the Coroner.
From 1 April 2016 new information sharing processes between GPs and the police were introduced in an attempt to ensure those licensed to possess firearm and shotgun certificates are medically fit to carry arms. We have significant concerns about these arrangements and we continue to raise them with the Home Office with the aim of agreeing a process that is fair to GPs in particular, and doctors in general, and safe for the wider public. Discussions are ongoing and any future improvements may necessitate the revision of this guidance.
The following advice on the current system takes into account our discussions with the Home Office, the police and the British Association for Shooting and Conservation (BASC), as well as external legal advice.
Health Secretary Vaughan Gething has today taken action to relieve pressure on GPs during the busier than usual winter period.
Vaughan Gething, in partnership with BMA Wales, has taken the decision that the Quality and Outcomes Framework (QOF) element of the GP contract will be relaxed until 31 March 2017.
This move will create more capacity for GPs and practice nurses to manage their most vulnerable and chronically sick patients during the winter period where there is a significant increase in demand for their services.
The Health Secretary said: “The positive action we’ve taken today will help ease pressure on primary care. I’d like to thank GP and practice nurses across Wales for their hard work and commitment to their patients during this busy winter period.
“Instead of patients being called in for routine appointments automatically at the busiest time of the year, doctor and practice nurse’s time will be freed up to see patients, prioritising those urgently requesting appointments because they are ill.
“Both BMA Wales and Welsh Government remain committed to working positively and collaboratively to improve access to services. No GP practice will lose out financially as a result of QOF relaxation.
“I hope that both primary care and patients in Wales will feel the benefits of this decision. It’s a common sense approach that shows the agility of NHS Wales – especially when it’s under pressure.”
Chair of GPC Wales, Dr Charlotte Jones said: “This welcome move will have a positive effect on practices by reducing bureaucracy and box ticking, as well as releasing capacity which will enable GPs and practice nurses to focus on the complex care needs of their patients at a particularly busy time.
“We are committed to working in partnership with Welsh Government to continue improving working conditions for GPs in Wales, and this agreement demonstrates what can be achieved through collaboration on an agreed vision.”
URGENT CONTRACT UPDATE from Charlotte Jones.
On behalf of the GPC Wales negotiating team I wanted to update you on where we are with regard to progress on the current status of contract negotiations.
So far, the contract talks have not progressed as quickly as we would want them to - and you will appreciate that, after our detailed preparations, this is proving highly frustrating and disappointing. That said, we continue to engage in a constructive way with Welsh Government and Health Boards, and all meetings have been in good faith. Our mandate, however, is to ensure that the profession has the best outcome possible, given the unprecedented pressures and constraints General Practice is currently facing. It is fair to say that GPC Wales and Welsh Government have been working to find an agreed way forward, however, completion (albeit being near) is being held up at the Health Board level.
As you will no doubt be aware, I am constrained in what I can say as “nothing is agreed until everything is agreed” but here is a brief update:
There are 4 outstanding areas yet to be concluded:
· Care Home DES – virtually fully agreed pending a review of the final wording
· Anticoagulation ES – two of the Health Boards have stated they would have difficulties in delivering a DES – they are supposed to be providing further information on this given that this piece of work was part of the negotiated agreement back in 2015 – this information has not yet been received.
THIS IS HOLDING UP NEGOTIATIONS.
· Diabetes ES – this is going to be more complex as there is some ongoing lack of clarity of the whole delivery of diabetes care (not just within primary care). This is going to take longer to deliver and we have raised a need to ensure there is no loss of progress and have advised that in order to conclude this quickly, that this simply requires a small working group taking forward the GP and primary care elements. We have agreed that this may take up to end March but that, provided other areas are agreed for 15-17, then this work can take place in parallel with 17-18 negotiations but has to be concluded during this time..
· Phlebotomy resources for work generated outside of GMS – despite GPC Wales having prepared a very clear briefing on why the costing of the WG proposal was inadequate there was no further progress on this until Dec 2016. Following resurrection of these meetings and with a revision to the personnel involved in this work on the Health Board side, we now believe that we can find an acceptable way forward. However, if this proves impossible, there is always the possibility that we may pursue other avenues in order to achieve a satisfactory resolution
17-18 & BEYOND
· GPC Wales believes it would send entirely the wrong message to move forward with 17-18 negotiations without a clear agreement on the outstanding areas of the 15-17 negotiated agreement. We hope you agree.
A brief summary of our wants for 17-18 include:
a. resources for practices (financial /workforce / premises etc), b. reduction of workload and look at safe working options
c. reduction of bureaucracy and last man standing liabilities,
c. resources to enable sustainability
d. solution for indemnity
· Both Welsh Government and ourselves recognise that the future of the GMS contract is in need of review – as many of you are aware, the usual shelf life of a contract is 7 years and that we have had the nGMS contract in place now for 12 years.
However, any change to contract involves considerable resources and expertise– this is something we will be progressing with Welsh Government in the near future once 17-18 negotiations are complete.
The key message I want to convey to you today is: Please rest assured that the team is not sitting on its laurels awaiting events – we have chased up the timeline for completion and highlighted our concerns on the obstacles that need overcoming. We will continue to push hard to get the resources that General Practice needs and hope to have some further information in the near future.