This document provides a summary of the consultation findings and a response to the comments received.

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In this final edition to be issued by the Department of Health, Dame Barbara Hakin writes about the final stages of transition to the new commissing system.

News highlights include an update on the Cadiovascular Disease Strategy. the RCGP’s new guidance for Patient Online and the CMO’s second volume of her annual report.

This edition also features news on public health campaigns and the latest resources.

Click on a link to view the section:

• Update from Barbara Hakin
• News
• Commissioning developments
• Consultations
• Clinical
• Public health
• Workforce, education and training
• Practice management
• Resources
• News in brief

Download the GP and Practice Team Bulletin: March 2013 edition (PDF, 262KB)

Gateway reference number: 18890

Disclaimer: Unless otherwise stated, guidance referred to in the bulletin has not been commissioned or endorsed by the Department of Health – it is evidence that organisations and professionals may find helpful in improving practice. The National Institute for Health and Clinical Excellence is the Department’s provider of accredited evidence and guidance. This information can be found on the Institute’s website at www.nice.org.uk

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The Board will work with the Department of Health and with other national bodies such as the Care Quality Commission, Public Health England, Health Education England and Monitor to make sure that you continue to get updates on all key developments.

From April, the NHS CB will take over from PCTs the responsibility for commissioning primary care services and its 27 area teams will be your new point of contact.  Contracts will be transferred from PCTs to the NHS CB at the end of this month. The NHS CB will also become responsible at this point for the Responsible Officer role and for the performers list.

The NHS CB has committed to working with primary care providers – and with clinical commissioning groups (CCGs) – in ways that focus on outcomes and on promoting local clinical leadership and innovation. Clearly much of the focus over the last few months has been on securing a stable transition to the new arrangements, but the focus will now start to shift towards looking to the future and understanding how best the NHS CB can support you in providing and securing the very best care for patients.

As you will know, the Department announced recently that GP practices will receive a 1.32 per cent increase in funding for 2013/14 and that most of the proposed changes to the 2013/14 GP contract will go ahead, but with some changes to reflect issues raised during consultation. The NHS CB will be working with the profession to support effective implementation of these new arrangements, particularly in relation to the four new enhanced services.

These new enhanced services are for improving care management for those patients most at risk of emergency admissions, promoting timely assessment of – and support for – people who may be at risk of developing dementia, enabling patients to book appointments and order repeat prescriptions online, and looking at how best to use technologies to help patients with long term but relatively stable conditions manage their health without having to visit the GP surgery as often.

I’m delighted to report that a full complement of 211 CCGs will be taking over their commissioning responsibilities on 1 April following their authorisation. This is a tremendous achievement by CCGs, who have shown remarkable enthusiasm for and commitment to bringing the benefits of clinical commissioning to their local communities.

The advent of clinical commissioning opens up new opportunities for bringing together health and care professionals to redesign care and make it more responsive to the needs of local populations. This is a new opportunity for everyone who works in general practice to help make sure that patients have access to the services they need and to work together collaboratively to be ready to challenge any problems with quality of care.

It is worth highlighting the recent changes to the secondary legislation covering procurement of NHS services. The Department has amended these regulations to put beyond any doubt that:

• the position on procurement remains the same as now – there is no requirement to put all contracts out to competitive tender: this means that commissioners are able to offer contracts to a single provider where only that provider is capable of providing the services;

• Monitor – the healthcare sector regulator – has no power to force the competitive tendering of services: decisions about how and when to introduce competition to improve services are for commissioners (CCGs or the NHS CB) to make;

• competition should not trump integration: commissioners have a duty to promote integration where it is in the interest of patients.

Finally, it’s good to hear that the NHS CB has appointed another GP to one of its most senior medical director posts. Dr Mike Bewick will be deputy medical director – England as well as regional medical director – North. Dr Bewick was previously medical director for NHS North of England, medical director at NHS Cumbria and prior to that a GP partner in Cumbria. Congratulations to him in his new role.

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In a video, Jeremy Hunt outlines his ambition to cut avoidable deaths from the five major causes – cancer, heart, stroke, respiratory and liver disease – and to make life expectancy in England among the best in Europe.

• More information is available here

In addition, the Cardiovascular Disease (CVD) Outcomes Strategy sets out 10 actions to deliver improvements in outcomes for people with or at risk of developing CVD. The strategy:

• shows how premature mortality rates, patients’ quality of life, patient experience and patient safety could be improved by taking action on prevention, diagnosis, care management and treatment, and bringing all services up to the standards of the best
• sets out a work programme for the new improvement body in the NHS Commissioning Board (NHS CB) – NHS Improving Quality – to support the NHS and local authorities in delivering these improvements
• describes further work to be carried out into developing and testing new models to manage CVD as a single family of diseases
• sets out plans for improving intelligence on CVD services and outcomes, as a way of supporting improvements.

A key action is to improve case finding in primary care for people with and at risk of CVD.  NHS Improving Quality will work with interested parties to develop new tools to support case finding in primary care and, with Strategic Clinical Networks, will support GP practices with low CVD detection rates.

Another action is to achieve better management of those with and at risk of CVD, including secondary prevention in the community.

• Read the strategy

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• Read the report

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• Further information is available here

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Patient Online: a Roadmap covers transactional services such as the booking and cancelling of GP appointments and the ordering of repeat prescriptions, secure online communication with the practice and access to online records. It is a means by which patients can improve engagement with their GP practice and become more involved in choices about their own healthcare.

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The strategy is supported by Secretary of State for Health Jeremy Hunt, who described it as “an important step towards our ambition to make the UK a global leader in dementia research.”

• Read the announcement

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• More information is available here

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• More information is available here

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