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GP practices slapped with automatic breach notices over e-declarations by 'officious' local area teams

Exclusive GP practices in two areas of England have been hit with contractual breach notices after failing to meet the 7 November deadline for submitting their ‘e-declaration’, in a move GP leaders say demonstrate local area teams’ increasing ‘officiousness’ and willingness to issue contract breaches.

At least six practices in Essex were hit with automatic notices after failing to submit on time their annual self-declaration of their practice arrangements, such as staffing and opening hours, while at least one practice in Birmingham has been hit with a breach notice.

However, 64 practices in the south of England were given extra time to submit their e-declaration after missing the deadline, and the local area team said it will not be issuing any breach notices as a result

GP leaders criticised the variations in approaches, and said there was a move by NHS England to issue more notices.

Practices who receive two breach notices can be shut down, and this is not the first time that NHS England’s area teams have taken vastly different approaches to contractual breaches, with recent examples including last year’s Christmas closure row.

Essex LMC chair Dr Brian Balmer said his local area team said it had no choice but to automatically issue six breach notices.

He said: ‘Our area team director said that the regulations around information governance mean that “when this happens we automatically have to issue a breach”. I remember him very clearly saying it.’

Birmingham LMC executive secretary Dr Robert Morley said: ‘In Birmingham the area team advised me that they intended to issue two breach notices. With one practice the area team already knew there might be some mitigating factors, indeed the LMC was involved in providing practice support.

‘I asked the area team to reconsider the decision and don’t yet know what they are going to do. I am also questioning the legal position in respect of such breach notices as, while there is a contractual obligation under the regulations to provide information reasonably required by NHS England, this does not explicitly cover the e-declarations.’

A spokesperson from the local area team told Pulse that one practice has now submitted, but added: ‘NHS England’s guidance is that e-declaration is a requirement under the contract.  Non-completion therefore may be considered a breach.  The area team is reviewing the practice that is non-compliant throughout normal processes and will be taking into account any mitigating circumstances before making a final decision.’

However, the approach taken by the local area teams differs from the approach taken elsewhere.

In London alone, 45 practices failed to meet the November e-declaration deadline - representing 3.3% of practices – but despite this a spokesperson for NHS England in London said no breach notices were issued.

She said: ‘We are checking with practices on any mitigating circumstances and will consult with the LMC on any decision to issue a breach notice. No breach notices have been issued to date.’

A further 18 practices missed the deadline in Thames Valley, while one late-reporting practice was also spared from a notice in the Bristol, North Somerset, Somerset and South Gloucestershire area.

An NHS England spokesperson said: ‘The one delayed case in BNSSSG was given another week to respond. The practice met this deadline and a breach notice will not be issue.

‘In Thames Valley, although 18 practices failed to meet the deadline, this does not mean that 18 breach notices will be issued. The team are aware that some practices experienced technical problems or had extenuating circumstances. Additionally, one of the 18 practices is also due to close by the end of December.’

She added: ‘There won’t be any automatic breach notices issued in the South.’

GPC deputy chair Dr Richard Vautrey said: ‘We are aware of NHS England being more ready to issue breach notices than previously and I think this reflects their increasing remoteness from practices as their capacity is reduced. They are moving away from the more supportive and developmental role that they and many PCTs before them once had and becoming more officious in their way of operating.’

A spokesperson for NHS England in Essex said: ‘NHS England has made it very clear to contractors in Essex that the submission of an e-declaration is a contractual matter. This is the second year that practices are required to submit a declaration in this form. Last year we allowed for the fact that the requirement was new and did not breach any contract, but made it clear that if the same thing happened this year it would be treated as a contractual matter. NHS England in Essex has not yet issued any breach notices to contractors but will be issuing six notices in line with NHS England national guidance as we had given practices regular reminders regarding the deadline for the submission.’

The row over Christmas closures saw NHS England’s London area team uphold breach notices for 12 practices failing to stay open in core hours last December, despite other area teams allowing practices to close early on the same dates.

Readers' comments (10)

  • I would love to see them just close those practices. My understanding is that conditions in essex are so difficult for GPs that it is impossible to attract new practitioners/ partners/ etc. If I was in one of these practices, I would be looking across borders to other areas and seeing if there are any vacancies - there will be plenty.

    Does the Local Area Team, who are ultimately responsible for making sure the patients have access to primary care, think they are helping with this issue. Or are they just getting high on their power trip.

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  • 9.05

    They don't give a flying f**k.

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  • Why are the authorities always so heavy handed with healthcare professionals???

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  • bullying again..typical of myopic insane nhse bureaucracy.
    no doubt this will encourage more practitioners to leave essex..already near a tipping point to a real crisis.
    this behavior ,this insensitive high handed jobsworth nonsense from pen pushers is a complete disgrace and would be astounding in other countries where professional doctors do not have to suffer the ludicrous dead weight of useless brain dead bureaucrats that thereby are directly damaging patient care and wasting public money.
    ninety per cent should be dismissed forthwith and money saved go to desperately underfunded front line care.
    ?do these mangers believe that the tax paying electorate pays its taxes for this completely deranged nonsense....and very many similar scandals.?do they think their families waiting for nhs care approve?do they reside in an alternate universe?do they not think their role should be to SUPPORT gp in its crisis?do they care?just who are these people who refuse to use common sense?
    please gpc,bma..name and shame.

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  • But why didn't they submit on time? It's a requirement of their contract. Practice managers do this bit of work, I did it, and it's not a big job. We are all overloaded and having to decide what to do and what NHSE/LAT/CCG rubbish to ignore or postpone and await their final demands, but doing a contract requirement that isn't actually too time consuming and doing by the deadline isn't something to ignore.

    Sorry but I have limited sympathy for them.

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  • Local area teams had nothing to do with this, there was a national NHS England directive to breach practices who failed to complete the e-Dec.

    Why didn't the practices do that?

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  • Of course the flip side is that LATs and CCGs should have been slapped with thousands of contract breach notices for the debacles in late and missing payments to practices following the Lansley chaos, but I don't remember NHS E being so quick off the mark then.
    One rule for us, a different rule for them.

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  • For late payments, sue NHSE...stop being apathetic.....

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  • I have worked 26 years full time in my local community. I have recently shown duty of candour honesty transparency apologised in person to 50 of my patients involved in a data breach and almost driven myself to exhuastion to meet the stringent deadlines set by NHS England. Despite all that I am still served with a remedial notice with the threat of closure should my practice breach again. A remedial and breach notice are different ,but despite asking, there seems to be no way of bringing them to a close or being lifted. They sit on file forever. I am assured that my practice is not on the radar of poor performance, that we are respected locally, but NHS England say they have no choice but to serve the notice. I will be 55 in the summer and whilst I would have liked to carry on, enough is enough. I cannot focus on patient care when my thoughts are constantly worrying about a further data breach, which I assure you are very easy indeed to let slip, despite ones best efforts. I am also still waiting to hear from Infomation Governance Commissioner, e mails from them include the threat of criminal prosecution and large fines. I reluctantly signed the remedial notice and returned it within the time frame set, but I will retire in the summer at age 55. It is such a shame, my GP colleagues of similar age also retiring, have so much more to offer the ailing NHS and support the younger members of our profession.
    I phoned the BMA to seek counselling and initially the girl thought I was seeking cancellation of my membership! Spelling out you wanted counselling and not cancelling at least made me laugh. I was then told by a very gentle man that he could offer me an appointment in the middle of the following week. I of course was back in surgery thrashing through a days work with the patients I love to see and aim to help and support. The relentlessness of unedited data coming into and out of my practice, has in the end got the better of me !

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  • NHSE takes up more than a billion of the healthcare budget. Which normal system would want to have a parasite with such a a big tummy? Unless, of course, you have political push to feed cronies and squeeze and channel funds into private pockets.

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