This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

GPs told to specify counter-terrorism lead when applying for enhanced services contracts

Exclusive: All practices will have to appoint a counter-terrorism lead in order to apply for enhanced services in a move that GP leaders say highlights the ‘enormous bureaucratic hoop’ GPs are having to jump through, Pulse has learnt.

An NHS England letter to all CCGs said all providers of commissioned services, including enhanced services, will need to specify their lead on the ‘Prevent’ scheme – the Government’s strategy for preventing radicalisation.

GP leaders have warned that this is a ‘totally pointless gimmick’ that epitomises the added bureaucracy that has resulted from the implementation of the Health and Social Care Act, which has already seen GPs burdened with 300-page tender documents to win enhanced services.

Other GPs raised concerns about the effect of the scheme on the doctor-patient relationship.

Pulse reported in 2011 that GPs were being asked to flag up patients who were ‘vulnerable to radicalism’ as part of the Prevent strategy.

However, CCGs are now actively asking practices to name their lead before signing the NHS Standard Contract, which is used all services commissioned by CCGs, including enhanced services.

An email sent by Southampton City CCG to all member practices states that in order to create a ‘bespoke [NHS standard] e-contract for each practice…a number of items of information are required’, including the name of the Prevent lead.

It continues: ‘Health is one of the sectors supported by this strategy. There are no requirements for small providers at this stage other than to identify a lead. This is likely to be the same as the safeguarding lead (Prevent is part of the Safeguarding agenda within health).’

A spokeswoman for Southampton City CCG said this ‘is stipulated in the NHS Standard Contract, which is expected to be used as a replacement for former enhanced services agreements which are being phased out nationally’. 

According to the national contract, Prevent leads will be expected to ensure that they have read and understand the Government’s Prevent strategy on counter-terrorism and make all practice employees aware of the strategy.

The spokesperson for Southampton City CCG added: ‘This is not an onerous requirement and one that the CCG considers to be a reasonable step towards raising awareness of the Prevent approach among health professionals.

‘Prevent is a national multi-agency strategy developed in the wake of events such as the Exeter bombing  and it is important that NHS professionals know how best to respond in the event that concerns are raised about any individuals who may be involved in or contemplating terrorist activity. The CCG supports this strategy and has adopted a local policy to this effect.’

This followed a letter from NHS England to all CCG clinical leads in September, informing them that they must ensure all providers of commissioned services – including GPs providing enhanced services – must have a named lead on the Prevent strategy in place in order to sign the standard contract.

The letter stated: ‘As commissioners, you will be aware that Prevent delivery for each provider organisation is now included within the NHS Standard Contract for 2013/14 within Service Conditions paragraph 32.’

‘Please note this is mandated for all providers who deliver NHS services including non-NHS organisations.’

Former GPC chair Dr Laurence Buckman questioned whether the requirement was meant to be a joke.

‘I think this a silly, totally pointless gimmick and I can see no inherent value in asking people who know nothing about something that is extremely serious to do this.’

‘It is so silly and ridiculous that I can’t believe NHS England are requiring this or making CCGs responsible for it.’

Dr Robert Morley, chair of the GPC contracts and regulations subcommittee, said that the requirement, along with the NHS Standard Contract as a whole, was yet another ‘enormous bureaucratic hoop’ that practices were being expected to jump through.

He added: ‘This is complete and utter nonsense and the contract is not fit for purpose and yet practices are being told that they cannot provide any enhanced services until they have signed this contract.

‘It is just mindless, mindless bureaucracy with no sense of proportionality.’

Meanwhile, Dr John Glasspool a Southampton GP raised the question of what the Prevent lead would be required to do in future and whether it was ethical.

‘I don’t see what role a GP should play in preventing radical Islam…we will lose the trust of our Muslim patients and it also raises the issue of patient confidentiality,’ he said.

An NHS England spokesperson said: ‘The health sector’s contribution to the Prevent strategy is one strand of the Government’s counter-terrorism strategy (CONTEST). Prevent seeks to respond to the ideological challenge of terrorism to prevent individuals from being drawn into terrorism by ensuring they are given appropriate advice and support, and works with sectors and institutions, including, for example, healthcare, education and prisons where there are risks of radicalisation. 

‘It is important that the heath sector can respond to these risks and enable healthcare workers to identify and provide support for those vulnerable to radicalisation. So far 44,112 health staff have received Prevent awareness training.’

‘Given the importance of the agenda and the role that healthcare staff have to play in protecting vulnerable people, Prevent is now part of the standard NHS contract. Any provider delivering NHS-funded services is required to ensure that Prevent is explicit within Safeguarding induction training for staff.’

Readers' comments (54)

  • Una Coales

    Satire but you get the drift...

    Government mission: how to get all NHS GP partners to resign their partnerships and hand them all over to APMS?

    Background: We want to keep cozy with our US global healthcare leaders who can take the NHS £106 billion cost per year off our hands and run UK healthcare for the millions instead. We can't stop the NHS haemorrhaging funds as we simply cannot say no to the EU influx and work shy UK pop on benefits as we need their votes to stay in power. We must do everything we can to ensure votes from the aged pop so let's make named GPs singly responsible for their care 24/7.

    GPs will always have a job, mind you, working as cheap salaried pairs of hands for APMS and assuming all the medicolegal risk of the army of nurse practitioners they will man and still see their own patients while doing concomitant email and telephone consultations for £44/h. Yes this will win more votes for us from the public, 24/7 access to GPs, after all patients come first.

    Brainstorm: appoint a counter terrorism lead when applying for enhanced services, ensure the tender is no more or no less than 300 pages long, eliminate any tenders that do not tick all the boxes so 80%? Will they buy it? Of course they will as they are tied to a ball and chain NHS pension. Note to self, must reduce pot we pay out in 20 years time, make that 10. Don't tell anyone until year 2023. In fact let's sell off the NHS pension to private companies and give them rights to half pay out.

    Are there any GP partners left? Really, still after all the work and brainstorming we have done?

    Tactic 2: Increase power to CQC to close GP surgeries and make up rules like disposable sphyg cuffs, no coats on backs of surgery room doors, no toys. You get the drift. In fact make the list so long that one breach and you may close the surgery without any warning.

    Tactic 3: empower NHS England to cancel contracts. Find and fine for any breach. Ring up all surgeries on Xmas eve. Catch out any who switch their phones over to OOHs. No Xmas for GPs. Hang on a minute. Swell idea. We missed that one. No Xmas for GPs! Must open 365 days a year, 24/7. Oh you don't have to necessarily be on call yourself, if you can find someone else to cover for £3/year/pt. Hm maybe that is too much.

    Tactic 3: time for another cut in GP pay. When will they get the picture? Boy these GPs are thick.

    Phew that was a lot of work for our brains. Time to request a pay rise for MPs.

    This is a satire. This is a satire. This is a satire. You think?

    Unsuitable or offensive? Report this comment

  • Una Coales

    PS that's 'halve pay out' and 'tactic 4' not 3 twice. As an IMG, I wouldn't want to be labelled as illiterate, unable to speak English, be understood or have cultural and identity problems because I grew up in an ethnic family. Now that's another satire in itself. How many stereotypes can you come up with to put down IMGs and pretend we literate, comprehensible, exam passing IMGs do not exist under your very noses because if we did, it would smash your beloved stereotypes of IMG GPs.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    On a serious tone , history rewrites itself many times. In times of global financial crisis , ring winged ideology always tries to creep back to the mainstream. It is the responsibility of the government to check on that. But what has it done????
    I suppose nobody really wants to talk about the nightmare possibility of a coalition government of Conservative and UKIP!!!!!!!??

    Unsuitable or offensive? Report this comment

  • Chimes exactly with yesterday's pr offensive in the Daily Mail no doubt sponsored by Mr Hunt, see their letters page GP waiting times are due it immigrants. Ipso facto if gps stop seeing these people A and E wait times will be sorted.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    ....right winged ideology.....

    Unsuitable or offensive? Report this comment

  • I saw a woman with wires in her bra the other day.....should I report her?

    Unsuitable or offensive? Report this comment

  • Feel free to cite my brief letter to BMJ in your response.

    1. English PM. Doctors should not agree to identify potential terrorists. BMJ 2011;343. 10.1136/bmj.d4211 (

    Unsuitable or offensive? Report this comment

  • personally I don't think NHS England is going far enough, how about;

    1. Stethoscope cleaning lead - as thanks to the media we all know they carry dangerous bugs and on the way out thanks to 'technology'

    2. Caring / Empathy / 'sugar coating' lead as we need to be sensitive to every single issue that the public has 'cos we don't want to offend their sensibilities.

    3. Jeremy Hunt appreciation lead - job to erect a life size cardboard cut out of JH to be worshiped by staff four times a day.

    4. stupid ideas lead - job to feedback to NHS England any bureaucratic demoralizing half-baked idea so it can become policy with absolutely no evidence backing it.

    5. blame the GP lead - job is to accept blame for everything. A&E pressure then blame the GP. 111 mess up then blame the GP. Extinction of the dinosaurs then blame the GP etc ...

    Unsuitable or offensive? Report this comment

  • Is there anyone in this increasingly benighted country whose life this government does not what to render intolerable? Except their own, of course, and those of their "donors".

    Unsuitable or offensive? Report this comment

  • Sorry - want to render - not what.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say