The BMA has issued a series of guidance on what steps practices should take to manage the escalating coronavirus situation. Pulse Intelligence summarises the key points on activities practices can stop to help free up capacity, what to do on QOF now that this income is protected and what Network DES work to prioritise.
Activities practices
can stop
The BMA has advised that all ‘non-urgent’ work should be postponed until
further notice, and provides the following list of activities as examples:
- travel advice
and travel vaccinations
- new patient
reviews
- over-75
health checks
- minor surgery
- clinical
reviews of frailty
- friends and
family tests
- engagement
with PPGs
- phlebotomy
(non-essential to be suspended)
- dispensing
services quality scheme to stop (with funding protected)
- dispensing
list cleansing
- routine
medication reviews (essential ones to be conducted by phone)
- all other
non-urgent provision (DESs and LISs/LESs) to be postponed until further notice
- funding will
be protected for practices
- audit and
assurance activities
- data
collection requests (unless considered essential to support the COVID-19
efforts)
- all other
routine nurse appointments will be subject to telephone triage by nurses
- appraisal and
revalidation
- all routine
CQC inspections (already enacted)
- all
non-essential paperwork.
QOF activities
NHS England has said that QOF income will be protected for the duration of
the COVID-19 outbreak – with practices paid for 2019/20 in based on their QOF
submissions to date (with a top-up if this leads to a shortfall compared with 18/19
payments).
The BMA advises practices:
- Care that is
clinically necessary, relevant and possible, should be delivered, primarily by
telephone or digital consultation.
- Guaranteed
income for 2019/20. Payments will be protected and made in-line with best of
2018/19 or 2019/20 achievements.
- NHS England
has committed that QOF income for practices for 2020/21 will be protected and
information will be provided as soon as possible.
Network DES
Two of the three new service specifications (Structured Medication Reviews
and Enhanced Health in Care Homes) have been postponed for six months, but NHS
England wants practices to start work on the ‘Early cancer diagnosis’ service specification
from April, if possible.
However, the BMA is advising practices strongly to delay work on all these services to focus on their COVID-19 response. It states:
- While NHS England
/ Improvement have stated that the cancer service specification will begin in
April, and the SMR (structured medication review) and care home specifications
could commence in October, work associated with these have no time limits or
targets and should be delayed to focus on COVID-19. GPC England believes it
will be necessary to suspend these service specifications for 2020/21.
The BMA further advises, in line with NHS England’s announcement:
- Some clinical
director responsibilities may be delegated to others (including non-clinicians)
as appropriate.
- Payments will
be protected and made in line with the contract agreement.
- IIF (impact
and investment fund) is on hold for at least six months, with the funding
retained for PCNs to use as they see fit.
- Recruit the
expanded workforce you need using ARRS (additional role reimbursement scheme)
funds.
- Extended
hours funding will continue but practices should work flexibly in response to
the current COVID-19 situation.
- Practices
should prioritise COVID-related care first.
Activities to continue
The BMA advises practices to keep essential services going as well as
routine immunisations.
- Essential
services as determined clinically relevant by the practice and based on the
available workforce, capacity and PPE.
- Immunisations
for children, influenza and pneumococcal infection.
- All staff are
covered by the full CNSGP (Clinical Negligence Scheme for General Practice
indemnity scheme currently.
Further guidance has been produced jointly by the RCGP and BMA, to advise
practices on what clinical work to focus on to ensure appropriate care is still
delivered to practice populations.
Source: BMA – COVID-19: steps for GP practices to take
