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Gold, incentives and meh

GP services face extra scrutiny from local government under DH guidelines

GP practices face an extra layer of scrutiny from local government after new DH guidance said practices had a duty to provide councils with information on performance, waiting times and even non-identifiable patient data to prove they are offering ‘effective and safe’ care.

The guidance said that NHS reforms gave councils extended powers of scrutiny to ensure services were ‘safe and effective’, and for the first time this included GP providers, who were previously not subject to health scrutiny regulations.

As a result, GPs had to ‘cooperate’ with local authorities in their scrutiny function, which could include handing over information on performance, waiting times and even non-identifiable patient data.

But the GPC said that GP services were already heavily scrutinised and it ‘doesn’t make sense to add to that’.

The DH said the guidance provides local authorities with advice about how to ‘strengthen the voice of local people’ and ensure that health services are ‘effective and safe’.

The guidance said that the NHS Act 2006 imposes duties on ‘responsible persons’ to provide local authorities with ‘such information about the planning, provision and operation of health services in the area of the authority as it may reasonably require to discharge its health scrutiny functions’.

However, it added that since the NHS reforms last year, these ‘responsible persons’ now include GP practices, who were ‘previously not subject to specific duties under health scrutiny regulations as independent contractors, they are now subject to duties under the new regulations as they are providers of NHS services’.

As a result, it said: ‘All relevant NHS bodies and health service providers (including GP practices and other primary care providers and any private, independent or third sector providers delivering services under arrangements made by clinical commissioning groups, NHS England or the local authority) have a duty to provide such information.’

This included ‘information about performance against targets or quality standards, waiting times’, ‘patient information such as patient flows, patient satisfaction surveys, numbers and types of complaints and action taken to address them’, and ‘any other information relating to the topic of a health scrutiny review which can reasonably be requested’.

But the GPC warned that this did not make sense.

Chair Dr Chaand Nagpaul said: ‘I think it is worth pointing out that GP services, especially in England, are already heavily scrutinised. We have scrutiny from CQC, NHS England and CCGs and this is already an excessive level of scrutiny. I can’t see any logic in adding to that. We are over-scrutinised and it doesn’t make sense to add to that.’

It comes as last week NAPC chair Dr Charles Alessi suggested councils could hold GP contracts.

Readers' comments (32)

  • Oh for God's sake, when does the all-out attack on general practice ever come to an end?
    And the GPC is the worst trade union in the history of the world.

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  • And what are the sanctions for not complying?

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  • How long before any two of these scrutineers come up with directly contradictory requirements and some poor practice is stuck in the middle? Or all their requirements match exactly, in which case what on earth is the point?

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  • Good idea!

    If they managed to put this in the contract, primary care can continue without me - I'm not even 40 yet but I'm not prepared to work in this environment. Some one else can have a go in my seat.

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  • FFFFFFFFFFFF@@@@@@CCCCKKKKKK OFFFFF

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  • left ribs - right ribs - left ribs -right ribs- left ribs - right ribs

    uppercut

    haymaker

    GP out for the count

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  • Does that mean the council have a duty to pay all the invoices for this work?

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  • a mass walkout is the only option to stop this madness.

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  • My bin didn't get emptied this morning. Could I please have access to all the local council refuse collection data so I can police their activities? After all, I am a GP. It's probably my fault the waste collection service missed it. Is it their fault if i miss a cancer diagnosis? Will someone please stop this madness?!!!

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  • Very Simple - I say no to any pointless and unfunded work.

    If no GP co-operates and does this or any similar politically driven nonsense - what can the politicians do???

    Nada! They only hold power or sway if there is a majority who blindly do as they are asked.

    If you don't co-operate eventually even the politicians listen - POLL TAX, so far Care.pointless waste of time.

    Please stop agreeing to all the Cr@p and it will stop.

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  • I though the whole point of the last NHS upheaval was to reduce over management and put GPs in charge. I have never been so micromanaged in 25 years of doing this increasingly impossible job

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  • These guys are. Often teenagers who use a tick box and fail if answers don't match or they don't know .
    What a mess

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  • Step 1 - no appraisals ;we don't have enough time . Step 2 - no OOH work ; we're too tired .
    Step 3 - no hope / mass resignation .

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  • It's not in our NHS contract to provide this, so if the council does not pay me for providing it they will get a short answer involving the letters N and O.

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  • Er why don`t they just ask the CQC/our appraisers for that data. Why should we collect it again.
    After seeing my drawings for this year, the only reason I have put up with this has been providing for my family. Being on significantly less pay now than I was 10 years ago, in my early 40`s I am also seriously considering getting out.The Dentists didn`t put up with any of this and left at the outset. Thats what this Goverment want, i.e us all to leave, so they can apportion the blame on us. What they forget is that is that when we are gone and no longer care, the voting public will.

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  • Very simple I am 42 and have already started working privately on the side so that I am ready when it all collapses, if I was older I would have retired, any younger emigrated. The future is GET OUT OF THE NHS BY ANY MEANS POSSIBLE

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  • Don't panic guys this is a PLUS !!!
    Just pass on all the problems GP is facing at this time to the new level of scrutineers.
    NO LONGER our problem - it will be theirs.

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  • This kind of stuff will continue until such time as our union the BMA stands up and threatens action.

    Being mild and acceeding to all and sundy simply leads to more bullying.

    So BMA when are you going to stand up for your members?

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  • any younger than 42?! I'm 43 and planning an exit by this time next year, to warmer climes!

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  • 01 July 2014 11:54pm - Request under an FOI.

    As for me, I think its time to quit. This is one too far

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  • I'm 44...I've been a locum for over a year...I'm never coming back into this broken system...I dont want a salaried job and I don't want a partnership. I have nothing but contempt for Mr Hunt and his cronies, I wouldnt releave my bladder to extinguish the falmes if he found himself on fire.

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  • Hopefully, in that case, Mr Hunt will never go up in "falmes"!!

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  • This is nothing to do with patient care, just politics. if they really care about people's' health, why are they not talking about air pollution, from traffic,which is killing thousands from chronic obstructive pulmonary disease.
    Oh of course, too difficult . G.P bashing the soft option.
    Totally useless the lot of them.

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  • Is there no end to this onslaught??

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  • I am a practice manager who can remember the fund holding days, so have been around for quite a while. I am now working towards a different career, as primary care continues to go from bad to worse, to worse, to worse, and when we reach a point where we think it can't get any worse, it does! When all of the GPs and managers have left, and nobody wants to replace them in this crazy primary care world we are now in, maybe they will realise what they have lost.

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  • I will not be supplying the local authority patient identifiable data without specifc consent as for the rest - Well I will be sending them a bill for the admin time it takes - fed up with having every tom dick and harry looking in every nook and cranny of my practice.

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  • From the point of view of accountability not covering primary care means health scrutiny committees can only see part of the picture (and the part on which all others depend).

    LMCs / CCGs / BMA need to come to some agreement with councils to minimize information requests to practices for data that has already been collected (councils would much rather go to 2 CCGs for information than chase 80 practices).

    There are a few areas relating to primary care services that scrutiny committees will want to look into (GP access being the obvious one) - they are obliged to consider all the secondary care reconfigurations, CCG annual reports, DPH reports etc.

    Scrutiny committees might give an opportunity to get the message across to councillors, who do feed back into national politics. All the pressure you can put on the government for proper investment in primary care, or to highlight the unintended consequences of targets can't hurt. Neither will flagging up the impact of social care not working / being cut. Some councillors won't get it, but some will.

    Paul (ex - city councillor)

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  • But since local authorities have shed all their performance staff who will be doing the asking, examining and explaining to the ignorant councillors who only attend meetings for the allowances .........
    Bring it on they are too thick to understand anyway

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  • Sure, I can provide the data, make changes to meet the scrutiny committee's criteria.

    But with that, you will loose clinical time from GPs and we well be working to meet the needs of the committee's tick boxes, not the patient's. I will also work to the rule so add soon as it is remotely near out side off my contractual obligations, I'll be praying the buck.

    I'm sorry Paul, what you mention applies very well to a corporate entities and massive organizations but you forget a lot of primary care is propped up by individual GPs good will. If you think this is a good idea, bring it on and we'll show you what nhs without or good will looks like.

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  • Who the go vernment wish to destroy they first make mad!

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  • Bureaucracy gone mad. They trying to drive out all GPs.

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  • completely insane wasteful duplicating bureauceatic feeble minded nonsense ...doh is crazy

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