FGM Mandatory Reporting for healthcare professionals

FGM - ReportingFGM Mandatory Reporting – support pack for health professionals

 As you will be aware, the new professional duty to report cases of FGM in girls u18 to the police will commence tomorrow, 31 October 2015.

 We, with our partners at NHS E and professional bodies, have developed a package of support including:

·        Quick guidance – a 2-page summary of the duty including a process flowchart

·        Poster – a poster for health organisations to display about the duty

·        Training slides – a training presentation organisations can use to help them deliver 10 – 15 minute updates to staff to explain the duty

·        Video interviews with Vanessa Lodge, NHS E National FGM Prevention lead

 An information leaflet for patients and their families which professionals can use to help when discussing making a report to the police.

 The website for written materials is: https://www.gov.uk/government/publications/fgm-mandatory-reporting-in-healthcare

The video can also be found at www.nhs.uk/fgmguidelines   

Please access these links and download the materials.

 Very many thanks to all our partners who have contributed to this work.

 We are going to be distributed hard copies around the NHS shortly, but please use this digital versions in the meantime.  More materials and updates are also in the pipeline.

GP Practices Consider John Lewis type partnership with local Trust

Pulse Exclusive Nine practices in an English coastal town are considering relinquishing their independent contractor status to join up with the local community trust.

Under the proposals, GPs in Gosport, Hampshire, would form a new organisation with NHS Southern Hampshire Foundation Trust, which would own premises and would pay the GPs a fixed annual salary while removing their personal risk.

The practices have gone as far as submitting financial records to an accountant to see whether it would be viable for the GPs to relinquish their partnerships.

It comes as GPC has strongly backed practices to work together to form ’super practices’ as part of its vision for the future of primary care.

NHS England has also advocated integrated primary and secondary care as part of its Five Year Forward View, and these new proposals are part of the South Hampshire multispecialty community provider (MCP) vanguard, which received funding from NHS England.

Dr Donal Collins, chairman of the Fareham and Gosport Primary Care Alliance and GP lead at the South Hampshire MCP vanguard, said that the structure could be a social enterprise, or a ‘John Lewis-style’ model that would see the employees part-owning the company.

He said that recruitment problems and fears over pending retirements had led practices to consider giving up their independent contractor status, but only as part of a larger organisation.

He added: ’I think if we were just looking at the practices and came up with a salary option that probably isn’t going to change much, but if we all get together and the whole business model changes, then we should be able to make a better, more attractive financial offer than what you are currently receiving.’

Dr Collins said that nine out of 11 practices in Gosport are looking into the model, which could take the form of a ‘John Lewis-style’ structure.

He said: ‘You could have a John Lewis model where all of us, the workers, own it and that is something to be decided by the workers in the area. It is my preference but not necessarily what the majority might want.

Practices have been asked to send their accounts to a medical specialist accountant, with the view to combine these with the NHS Southern Hampshire Foundation Trust, and come back with a firm financial offer to GPs to work in a new ‘risk-free’ model.

NHS Southern Hampshire Foundation Trust, has already taken over premises and staff of one GP practice in the area struggling to keep afloat amid pressures, but Dr Collins said this was a temporary measure to shore up the practice until the MCP model develops.

A spokesman for Fareham and Gosport CCG said: ’The CCG recognises the current sustainability challenges of general practice in all areas of Fareham and Gosport, which are particularly acute in Gosport.

’We have recognised and supported the opportunity of practices working collaboratively and to scale to enhance sustainability and to enable new ways of delivering care for local people that improves their experience, reduces costs and enhances the quality of services.’

25% of GP appointments potentially avoidable

Here is a new report from NHS Alliance. Here is a summary.

you can download the full report here Making-Time-in-General-Practice-FULL-REPORT-01-10-15Avoidable GP Consultations Budens in General Practice



A new report published today argues that perhaps 27% of GP appointments could potentially be avoided if there was more coordinated working between GPs and hospitals, wider use of other primary care staff, better use of technology to streamline administrative burdens, and wider system changes.

The Making Time In General Practice study by NHS Alliance and the Primary Care Foundation was commissioned as part of the work NHS England is doing with its partners to implement the NHS Five Year Forward View, and expand and strengthen GP services and primary care across England. The report was overseen by a steering group including the Royal College of GPs and the BMA GPs’ Committee.

The report finds that a significant amount of GP time could be freed up if family doctors were not having to spend time rearranging hospital appointments, and chasing up test results from local hospitals. This accounted for 4.5% of appointments in the study, an estimated 15 million appointments if repeated across England.

The report also estimated 1 in 6 of the patients in the study could potentially have been seen by someone else in the wider primary care team, such as clinical pharmacists, practice nurses or physician assistants, or by being supported to meet their own health needs.

The report states:

  • 6.5% of their appointments could have been seen by another professional within the practice;
  • 5.5% could have been seen by community pharmacy or the patient could have been given support to deal with the problem through self-care, and;
  • 4% of appointments might have been dealt with through social prescribing / navigation.

In July, NHS England launched a £15m scheme to fund, recruit and employ clinical pharmacists in GP surgeries.

The study argues that the reduction of bureaucracy in general practice should be made a national priority; freeing up time for practices to work together, improving communication between general practice and hospitals, unlocking the potential for the whole system to work together, as well as supporting changes and improvements within individual practices. In particular the report calls for streamlined payment systems that GPs use, to simplify and speed up how much time practice managers spend on entering data.

Immediate practical steps to cut down on bureaucracy suggested by the report include:

  • Patients who are unable to attend a hospital appointment should be able to re-book within two weeks without going back to the GP.  Booking and rearranging hospital appointments should be simpler without the patient needing to go back to the GP;
  • Practices should employ a wider range of staff within the practice team, with the decision on the type of staff left to the discretion of individual practices and federations;
  • NHS England will work with doctors to streamline communication, particularly between hospitals and practices, and reduce the workload of processing information within practices;
  • Practices should free up time for GPs and other leaders in the practice to think through how they can work differently, learning the lessons from the PM’s Challenge Fund sites and the Vanguard sites as they become available – creating the ‘headroom’ needed to plan new ways of working and clinical innovation, and;
  • GP federations should be funded to work across their practices to build practical social prescribing projects that offer real alternatives to taking up GP time with patients whose needs can be better met by other kinds of support in the wider community.

Dr Jonathan Serjeant, GP, co-director and co-founder of Brighton and Hove Integrated Care Service and National lead for NHS Alliance’s Accelerate programme, argues that using today’s IT patients should be given more control over their own patient records rather than this burden staying with GPs.

Dr Serjeant said: “GPs and their colleagues are experts in listening, supporting and diagnosing their patients. This is what we’ve been trained to do, and what we want to do.

“If applied quickly, the recommendations set out in this report, particularly those around extending the GP team to incorporate other health professionals, will help reduce the current levels of bureaucracy GPs face on a daily basis.

“The end result is that GP time is freed up, and people have access to all their information whenever they need it.”

Rick Stern, chief executive of NHS Alliance, and a director of the Primary Care Foundation said: “This report documents how general practice is struggling with an increasing workload and the urgent action required to relieve this burden. We want to ensure that GPs and their colleagues in general practice are freed up to deliver the job they were trained to do and care so passionately about.”

Dr Robert Varnam, Head of general practice development for NHS England, said: “General practice is the bedrock of healthcare and NHS England commissioned this report because we are determined to support GPs in reducing the pressures they face.  The findings include helpful suggestions which should free GPs to spend more time with patients most in need and further ways to reduce the administrative burden.”


 For further information please contact Sarah Wrixon, sarah.wrixon@salixandco.com, 07976 747067 or the NHS England Media Team on nhsengland.media@nhs.net, 0113 8250958 (office hours), or 07768 901293 (emergency out of hours)

The full report is attached to this release, and is online at: http://www.nhsalliance.org/mediacentre/making-time-in-general-practice/


An audit of GP consultations was undertaken, with results provided from 5,128 consultations across England.

A survey of practice managers was also undertaken, to estimate the time taken by different types of externally mandated work. Results were provided by 250 practice managers.

The quantitative results were then discussed in detail through qualitative interviews and focus groups with clinicians and managers, including a roundtable event with NHS providers. There has been ongoing review of results and key themes by a national steering group with all the relevant professional bodies and leaders from seven organisations representing primary care have jointly signed a Foreword to the report.

  • Dr Chaand Nagpaul, GP Committee, BMA
  • Dr Maureen Baker, RCGP
  • Dr Amanda Doyle, NHS Clinical Commissioners
  • Dr Michael Dixon, NHS Alliance
  • Dr Nav Chana, National Associationof Primary Care
  • Russell Vine, Practice Managers Network
  • Dr Peter Swinyard Family Doctors Association

NHS England has launched a £15m scheme to fund, recruit and employ clinical pharmacists in GP surgeries. The scheme is an important part of the New Deal for General Practice and is the result of close collaborative work with Royal College of General Practice, the BMA’s General Practice Committee, the Royal Pharmaceutical Society and Health Education England. More details are available here – http://www.england.nhs.uk/commissioning/primary-care-comm/gp-action-plan/cp-gp-pilot/

NHS England is investing £1bn over four years (from 2015/16) in a primary care infrastructure fund, with £10million being used to kick start the initiatives in the GP workforce action plan, developed by NHS England, Health Education England, the Royal College of General Practitioners and the BMA GP committee. This complements work that is already underway to strengthen the GP workforce. Full details can be found here: http://www.england.nhs.uk/commissioning/primary-care-comm/gp-action-plan/

NHS Alliance is an independent, not-for-profit, leadership organisation representing progressive providers of care outside hospital. Neither professional body nor trade union, it is an entirely solutions focused organisation, unique in its approach bringing together more than 10,000 passionate individuals and organisations across primary care who believe innovation, connections and integration are key to the sustainability of a health service that remains free to all at the point of need.

The Primary Care Foundation was established in 2006 to support the development of best practice in primary and urgent care. The foundation specialises in carrying out reviews, based on analysing a range of data sources and examining local practice, that make local and national recommendations.  It also look for opportunities to share learning, building resources that can solve problems more widely across the NHS.  The foundation has worked with over 1,300 practices in the last 4 years on managing access and urgent care, using a specially designed web-based tool to prepare reports for practices, and discuss ways of making improvements.

Heatwave plan for England

Here is the Heatwave plan for England by Public Health England.

A document can be downloaded below.


As we approach summer, this letter is intended to draw your attention to the Heatwave plan for England (background Annexe 1). No changes have been made to the plan this year, apart from removing the calendar year from the title, amending broken links, and reflecting new NHS England structures. This plan will remain in place until further notice. The following documents are available online at: www.gov.uk/government/publications/heatwave-plan-for-england:  the Heatwave plan for England  Making the Case: why long-term strategic planning for heatwaves is essential for health and wellbeing  three information pamphlets containing action cards for easy use by organisations, staff and the public  existing advice on looking after children in school and early year’s settings now in a stand-alone leaflet  easy read version Page 2 of 4 Recommended next steps The plan is a good practice guide and the actions denoted within it are illustrative. There are five key messages we recommend to all local areas: 1. All local organisations should consider this document and satisfy themselves that the suggested actions and heat-health watch alerts are understood across the system, and that local plans are adapted as appropriate to the local context. Local health resilience partnerships (LHRPs) may wish to use the plan to review their own heatwave plans 2. NHS, social care and local authority commissioners, together with local resilience forums and LHRPs, should satisfy themselves that the distribution of heat-health watch alerts will reach those that need to take action 3. NHS, social care and local authority commissioners should satisfy themselves that providers and stakeholders take appropriate action according to the Heat-Health Watch level in place and their professional judgements, noting the dates of Ramadan Thursday 18 June to 18 July 2015 (approximately) when many Muslims will be fasting during daylight hours 4. Opportunities should be taken for closer partnership working with the voluntary and community sector to help reduce vulnerability and to support the planning and response to heatwaves. This should include organisations with remits that are not specifically related to health and social care, since their engagement can help to communicate messages, provide additional resources, and identify and engage vulnerable people, who may not be already linked into statutory services 5. Long-term planning and commissioning to reduce heat-related harm, in view of the evidence on climate change is considered core business by health and wellbeing boards and included in joint strategic needs assessments and joint health and wellbeing strategies where appropriate

Heatwave Plan - Pic

Changes to Ealing maternity and interdependent services confirmed

For Information

Changes to Ealing maternity and interdependent services confirmed

 At its meeting in public on Wednesday 20 May 2015, Ealing CCG’s Governing Body confirmed that the closure of the maternity unit should be completed on 1 July 2015.  As well as the timing of the closure, the Governing Body discussed the planned improvements to community provision of antenatal and postnatal care in the borough of Ealing and the impact of the decision on paediatrics, neonatology and gynaecology.  In summary the changes to those services will be as follows:


No change to existing paediatric services until June 2016 

Introduction of a new Rapid Access Clinic at Ealing Hospital

Paediatric inpatients will transition on 30 June 2016


Neonatal care will be relocated to the six remaining neonatal units in NW London

Changes will take place at the same time as the maternity transition


All gynaecology services will remain at Ealing Hospital

More senior clinical cover during core hours (changing from 9am-1pm to 9am-5pm on weekdays) and also cover on weekends (from zero hours to 9am-1pm) in Ealing’s Emergency Gynaecology Unit

Out-of-hours, emergency gynaecology consultant cover will be provided at Northwick Park

The timetable for the changes is as follows

Last  induction at Ealing hospital  and Maternity unit closes to all new admissions (24 June)

Last elective C-section  at Ealing hospital (25 June)

Ealing divert spontaneous deliveries & babies to other providers (24 June onwards)

All babies discharged from Ealing neonatal unit (29 June)

All mothers discharged from Ealing maternity unit (1 July)

Final closure of labour ward, birth centre and neonatal unit at Ealing (1 July)

Last group of staff to transfer will be neonatal nurses, medical team, the reduced number of staff on labour ward, birth centre and postnatal staff (1 July)

2 July onwards

Maternity transitional team stay on Ealing site for 24 hours post closure

All women requiring transfer will be relocated back to their receiving trust if it safe to do so

Ealing Hospital open for service with all other receiving units for antenatal outpatient appointments.


We will be sending practices a number of materials to assist them with their conversations with women including a new Giving birth in North West London Booklet setting out the choices available to them. Also attached is an FAQ being provided to GPs and midwifes to aid them in conversations with women.


A press release announcing the decision has been placed on each CCG website and we will be carrying out a wide spread communication exercise to providers, and political and partner stakeholders to let them know of the outcome of the meeting.  This will be followed by more bespoke communication and engagement to targeted audiences, including the women at Ealing Hospital affected.

At the heart of this work is the desire to improve maternity care in North West London. We believe these important but difficult changes will do so.  We would like to thank staff, governing body members and our partners in our NWL hospitals and beyond for all their hard work and commitment in delivering this important change.

Changes to maternity and interdependent services at Ealing Hospital FAQ

Jeremy Hunt to lead seven-day GP revolution after Tory election win

Jeremy Hunt to lead seven-day GP revolution after Tory election win

General practice will be transformed into a seven-day service as part of Jeremy Hunt’s promised NHS ‘revolution’ after the Conservative party secured a shock majority in the UK general election.

Jeremy Hunt: plans GP services revolution (Photo: JH Lancy)
Jeremy Hunt: plans GP services revolution (Photo: JH Lancy)

Health leaders broadly welcomed the reappointment of Jeremy Hunt as health secretary, with many arguing it will provide continuity.

But the GPC has appealed for the government to abandon key manifesto commitments and focus on tackling the crisis in general practice.

GPC chairman Dr Chaand Nagpaul called on Mr Hunt to scrap ‘unrealistic’ and ‘populist’ access plans. The Tory party has promised 8am to 8pm, seven-day access for every patient in England by 2020, and same-day appointments for over 75s.

Read more: RCGP demands support package for GPs

Dr Nagpaul said the immediate crisis in workforce and workload meant the secretary of state should ‘jettison the populist pledges and deal with the harsh, bleak reality that we simply don’t have a general practice workforce that can meet current pressures’.

However, Dr Paul Charlson, vice chairman of the Tory party-affiliated Conservative Health group said expanding access was what patients wanted. ‘Whether GPs want it is another matter,’ he added. ‘We have to do what the taxpayers, our paymasters, want.’

King’s Fund senior research fellow Rachael Addicott said that while plans to expand access could be technically possible it was ‘questionable’ whether GPs could deliver them with current resources and capacity.

The Conservative party faced criticism from GP leaders during the general election campaign for failing to explain where the 5,000 new GPs it had pledged to ‘train and retain’ would come from.

We don’t know if 5,000 GPs will be the right number for the NHS.’

Rachael Addicott, King’s Fund senior researcher

Given the time and expense of training GPs, Ms Addicott said she understood doubts over whether the target could be met. She questioned whether 5,000 GPs would meet the needs of the NHS, given the lack of data to base this on. ‘At the moment we don’t know enough about what the right number is or how much it might cost,’ she warned.

Dr Charlson said it was ‘difficult to say’ whether the 5,000 target was achievable. It could be met through reducing the number of consultant places, and developing models of working to create more career options, he said.

Following his reappointment Mr Hunt said transforming out-of-hospital care was his top priority. ‘We need a step change in services offered through GP surgeries,’ he said. The statement echoed comments in an exclusive interview with GPonline before the election, in which Mr Hunt pledged that GPs would be at the heart of a revolution to transform primary care.

Tory support for GPs

Dr Charlson said a stable, majority government would be good for the NHS, and argued that the Conservatives support general practice.

Ms Addicott added that she was ‘encouraged’ that the government does not appear to want to work against the NHS’s own vision. ‘There has been a lot of instability and fragmentation over the past few years, so with Jeremy Hunt back in the post, it does provide some much needed continuity,’ she said. ‘Hopefully everybody can get on with trying to achieve the ambitions of the Five Year Forward View without concentrating on structural upheavals.’

Former RCGP chairwoman, professor Clare Gerada, however, slammed Tory plans. Same-day appointments for the elderly would increase inequalities by ignoring the effects of deprivations, she told GPonline. ‘Access isn’t the most important thing that equates to outcome; it’s continuity. We don’t need seven-day general practice’, she said.

The south London GP, who quit her position at NHS England London to speak out against the Conservatives ahead of the election, said she was ‘very anxious’ about the future of the health service under Tory majority rule.

The result could lead to more practice closures, marginalisation of GPs and privatisation of the NHS, she warned. Her comments were dismissed by a Conservative party source as ‘baseless scaremongering’.

The King’s Fund called on the government to use the forthcoming spending review to put the NHS on a sustainable financial footing. The £8bn-a-year funding rise pledged by the Tories to help plug a projected £30bn black hole was welcome, the thinktank said, ‘but is the bare minimum needed to maintain standards of care and will not pay for new initiatives such as seven-day working’. NHS England has committed itself to £22bn efficiencies over five years. The King’s Fund called for additional funding this year and a ‘renewed drive to improve productivity’.

Conservative plans
  • Spend at least an additional £8bn by 2020 above inflation to fund NHS England’s Five Year Forward View
  • Continue to increase spending on the NHS so it remains free to use
  • 5,000 extra GPs by 2020
  • Invest more in primary care to help prevent health problems
  • GP access 8am to 8pm, seven days a week for all patients by 2020
  • Same-day GP appointments for over-75s
  • A named GP for all
  • Ensure GP appointments and repeat prescriptions are routinely available online
  • Integration of health and care through the Better Care Fund
  • Increased funding for mental health
  • Ensure English GP practices are the safest in the world
  • Ensure the CQC rates all practices
  • Patients will have full access to information about the safety record of all NHS providers
  • Full patient access to electronic health records