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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.

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‘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.’