Non-Clinical FAQs for Covid-19

This is a list of questions that are frequently asked by GPs and practice staff, with responses where possible to the non-clinical queries and issues you face in the current emergency. It will be updated regularly, for clinical issues please see our clinical guide, which is at the top of our main Covid-19 resources page.

Index

Workload issues

Workforce/HR

Indemnity

GP and practice finances/payments

 

Workload issues

Confirmation of the suspension of non-covid related work: LCSs/LIS/LES/PMS KPIs, DESs and QOF

Updated 28.04.2020

Q. I am receiving requests from commissioners/CCGs to carry out non-core non-Covid work, such as LCSs, LESs, LISs, PMS KPIs, DESs and QOF; and/or to provide information in relation to this work – what should I do? 

A. Your entire effort at practice level should be in line with the joint RCGP, BMA and NHSE guidance on workload prioritisation on this link: BMA, RCGP and NHSEI guidance outlining workload prioritisation during covid-19The BMA have recently restated their position on QOF here and specifically QOF in relation to Covid-19

If you (GPs, practice managers and GPNs) have any queries regarding what you should, shouldn't, can or cannot do, please contact our GP support team and we will guide you through, or signpost you to an appropriate resource.

Payments will continue to support the essential priorities listed in the above workload guidance. All QOF, DES and LCS/LES/LIS/PMS KPI funding to general practices is now being diverted to the essential priorities listed in it. For full details, please see our MWord 49.

 

Transfer of un-resourced workload

Added 6.04.2020

Q. My practice is being expected to do non-core and non-Covid work by my local hospital/trust/commissioner. How can I push back?

A. Please let your local LMC or mword@lmc.org.uk know if you are being asked to carry out inappropriate non-core General Practice work, eg if secondary care work is being moved out into your practice so that we can take this up with local commissioners on your behalf and, if necessary, escalate regionally to NHSE London or nationally to the GPC.

 

Changes to death certification

Updated 6.4.2020

Q. Do I need to see the patient after death?

A. Coroners’ offices have confirmed that there is no need for the doctor to see the patient after death as long as any doctor saw them in the 28 days before death (including for verification of death). The doctor should write 'N/A' on the Cremation Form 4 where it asks about what examination was made of the body. Ideally they should say who did see the patient when alive.

Any doctor can now complete the MCCD as long as a doctor saw them in the 28 days before death. They do not have to have seen the patient alive and they can also complete Cremation Form 4, with some caveats: Section 8 of the form should be completed as NA; the doctor completing the form should indicate (if possible) which doctor saw the patient in the 28 days prior to death, and; if no doctor saw the deceased within the 28 days before death, the body should be seen after death to avoid referral to the Coroner - this is the only circumstance in which the body may need to be seen after death.

Video/telemedicine counts for 'attending' a patient during life but not after death – please refer to the information at the following link: Advice from the General Register Office.

 

Data subject access requests and freedom of information requests

Added 6.04.2020

Q. I have received a data subject access request (DSAR) or freedom of information request (FoI), do I have to respond given the current pressures on my practice?

A. Please see our guidance and template letter to use in responding to DSARs, which also includes current advice from the ICO on enforcement of FoI requirements during the coronavirus outbreak.

 

New patient registrations

Added 16.04.2020

Q. A new patient has approached the practice asking to register, are we required to register new patients during the current Covid-19 situation?

A. Practices should continue to register new patients, including those with no fixed address, asylum seekers and refugees (note that absence of photo identification and proof of address is not a reason to refuse registration). They should facilitate this through online registration wherever possible.

For more information on how to receive delivery of applications is detailed in the 6 April 2020 Primary Care SOP.

 

PCN DES

Added 28.04.2020

Q. Must I confirm my sign-up/participation in the 2020/21 PCN DES by 31 May 2020

A. Please refer to the FAQ which has been produced in relation to the PCN DES which gives advice on this question and other areas

 

May Bank Holiday working

Added 28.04.2020

Q. Do I need to work on the next May Bank Holidays?

A. Please note that the early May Bank Holiday is on Friday 8 May. Our MWord 58 includes an early May Bank Holiday update.  NHSE is treating this as a working day under the Emergency Regulations. Please liaise with your PCN and CCG. If you need advice contact gpsupport@lmc.org.uk.

 

Undertaking medicals for bus and lorry drivers

Added 28.04.2020

Q. Do I have to undertake medicals for bus and lorry drivers for the purposes of licence renewal during the Covid-19 pandemic?

A. On Friday 17 April 2020, the government announced a relaxation of the licensing regulations surrounding the obligation to provide medical evidence in order to renew their licences. 

A link to the announcement can be found here: Government takes further action to support bus and lorry drivers who are keeping the country moving

The scheme allows bus and lorry drivers to receive a temporary 1-year licence, providing they do not have any medical conditions that affect their driving, and their current licence expires in 2020.

Drivers with health issues will still need to declare them, and those with health issues that prevent them from driving safely will not have their licence renewed.

Bus and lorry drivers can be referred to the following link: Renew or change a lorry or bus licence

 

List reconcilliation (aka 'list cleansing')

Added 28.04.2020

Q. Can I postpone ‘list cleansing/validation’ during the pandemic as we do not have the time to carry this out?

A. Yes, the NHSE/I preparedness letter of 14 April states the following:

‘We have instructed Primary Care Support England (PCSE) to pause all routine list reconciliation and data quality checks. This does not include activities required to ensure new patient registrations are processed in a timely manner (for example responding to rejected registration queries or processing changes of identity such as adoptions), which are essential to ensure patients are registered and therefore able to access primary medical services.’

Please note that practices are expected to continue to register new patients, and should do this through remote registration procedures during the pandemic period.

 

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Workforce/HR

Unused statutory leave entitlement

Added 6.04.2020

Q. Will i be entitled to carry over my annual leave as we respond to Covid19 pandemic? 

A. You might be getting queries from staff members worrying about what will happen to their annual leave entitlement this year due to the Covid 19 crisis. The Government has produced guidance on relaxing the rules on carrying over the annual leave entitlement so that workers who have not used their statutory annual leave entitlement due to COVID-19 will now be able to carry it over into the next 2 leave years. Further advice can be obtained here.

 

NHS Staff in high risk categories

Added 6.04.2020

Q. What support is there for staff and their family who fall into the high-risk category i.e. pregnant, underlying health conditions or on immunosuppressants?

A. Staff should follow guidance on self-isolation, shielding and safe practicing. Please see latest advice on our website Mword50 and Mword51 Practices and PCNs should prevent unnecessary face-to-face contact, which is a risk to both patients and clinicians. Please also refer to our Londonwide clinical guide for further information.

NHS Employers have stated that ‘it is important that staff do not feel forced to work if they have underlying health conditions or become unwell and that they are given as much flexibility as is possible, working remotely or moved to clinical settings with less risk in the fight against Covid-19’.

‘The Government is actively reviewing the advice to protect those people who are at significantly increased risk from Covid-19 due to underlying health conditions. The national guidance should be referenced and applied to staff who are in these groups’. The staff groupings can be found in the National guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from Covid-19.

 

Confidentiality and remote working

Added 16.04.2020

Q. How can i maintain confidentiality when working remotely?

A. The BMA has produced guidance in relation to Covid-19: video consultations and homeworking

It is important when undertaking a video consultation (or a telephone conversation that may be overheard) to take the following steps:

  • To be clear (and record in the records) who is a party to the consultations at both ends (for example; the patient may want to involve a relative or a carer in the consultation and the doctor [with appropriate consent] may want to involve a colleague [for example to act in the capacity of a chaperone or for a second opinion]).
  • To make sure that the patient is comfortable consulting in their current home environment (for example, it is possible that the patient may wish to move to another room or ask others to leave the room so that the consultation cannot be overheard).

 

Redeployment of staff

Added 28.04.2020

Q. Who is responsible for redeployed staff?

A. This needs to be agreed between the employer, employee and ‘host’ prior to any redeployment.

The employer is accountable for the work of their staff and needs to take staff limitations into consideration when delegation or temporarily moving staff.

The employer needs to make sure individual staff have the appropriate skills and knowledge for the role into which they will be redeployed. It may be covered by an existing contract of employment, or it may need to be negotiated.

Where the work of the individual will be overseen by someone who is not their normal line manager, the roles and responsibilities, as well as policies and procedures to be utilised, will need to be agreed between the individual, the employer and the host. These should be clearly set out in writing so all are aware.

Further information can be found in the recently published BMA COVID-19: toolkit for GPs and GP practices.

 

Bank holiday working

Q. Do I need to work on the May Bank Holidays?

A. The Easter weekend and Early May Bank Holiday were treated as normal working days by NHS England under the Emergency Regulations. The Spring Bank Holiday on 25 May is to be treated as a normal bank holiday, with no additional requirements for practices to open.

 

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Indemnity

Additional sessions

Added 6.04.2020

Q. What is the stance of the MDOs pertaining to GPs who are working increased sessions due to the Covid-19 pandemic?

A. Individual MDO positions are below:

MPS state:

"We are happy that GPs do not need to update their practice details during this period to reflect increased work related to the COVID-19 response. We do not require state indemnified GPs to tell us about any increase in their state-indemnified work-oad during this time and we will not charge them any more for their professional protection."

MPS - Coronavirus questions and answers

MDDUS state:

"...know that counting hours and sessions will be one of the last things on your mind as you respond to the emergency. So we will enable retrospective adjustments where you either cannot sensibly forecast your workload or it varies suddenly and unexpectedly"

MDDUS CEO Chris Kenny reassures members on COVID-19 response

MDU state:

NHS work will be covered by NHS indemnity. You need to tell us details of the additional work you will be doing, just email membership@themdu.com or call us on 0800 716 376.

MDU - Frequently asked questions

 

Clinical negligence claims

Added 6.04.2020

The Clinical Negligence Scheme for General Practice (CNSGP) provides comprehensive indemnity for clinical negligence liabilities arising in NHS general practice in relation to incidents that occur on or after 1 April 2019.

All providers of NHS primary medical services will be covered under CNSGP – further details as to the nature and extent of the scheme can be found at the following link:

CNSGP – What is in, what is out and who do I approach for help?

The cover is not dependent on sessions worked and GPs should be reassured of assistance from the scheme in relation to claims arising from the provision of NHS primary medical services.

CNSGP does not cover everything and GPs will still need to contact and confirm with their MDOs regarding indemnity cover.

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GP and practice finances/payments

Practice funding security

Added 6.04.2020

Q. Will practices still get paid for QOF, DES and LES/LCS?

A. All QOF, DES and LES funding to general practices is now being diverted to the essential priorities as set out in MWord49. For further clarity on this, please see this letter from the Chair of the BMA’s GP Committee, Richard Vautrey.

The Government has also issued a directive to local authorities to the effect that practices should continue to be paid as normal for services commissioned by Public Health when service delivery is disrupted or temporarily suspended until at least the end of June.

 

Additional costs reimbursement

Added 6.04.2020

Q. My practice is generating a lot of additional costs – will I be reimbursed?

A. Whilst there is no national confirmation yet that practices will be reimbursed for any additional costs incurred due to Covid-19, practices should keep a detailed record of costs along with supporting evidence/receipts, to enable them to claim these costs back at a later stage. Examples of possible additional costs are: GP locum costs, agency staff, IT not funded by CCG, professional deep cleaning, additional cleaning materials, equipment e.g. infrared thermometer, intercom installation, changes to telephone system, etc.

Please note there may be other costs that are not included in this list.

We have created a spreadsheet to assist you in how to record these costs.

 

QOF year-end process

Added 28.04.2020

Q. I have seen lower than normal QOF year-end actual achievement data for my practice, due to my Covid work. Will I lose out financially?

A. No, NHSEI will be carrying out a planned analysis in order to make a one-off adjustment for practices who earned less in 2019/20 than 2018/19 as a result of COVID-19 activities.

 

Practice expenses for bank holidays

Added 28.04.2020

Q. How can I calculate the reimbursement needed for my practice expenses for the Bank Holidays?

A. With the support of the Association of Independent Specialist and Medical Accountants, the BMA has produced a template that practices in England can use to claim for the expense of opening as normal on bank holidays. This includes staff expenses, salaried GPs, locum (up to maximum rate), partners, and an amount to cover daily non-staff expenses. These are able to be amended if a local arrangement was more favourable. Access the template.

 

NHS pension scheme’s death in service benefit guide for sessional GPs (sessional, salaried and freelance locum)

Q. I work as a locum GP and am concerned about terms and conditions and pension arrangements, including death in service benefits,  whilst working during the COVID-19 crisis situations. Do you have any information that you can share on this?

A. Dr Krishan Aggarwal, Vice Chair, Kensington, Chelsea and Westminster LMC, has produced a mini guide on the Death in Service Benefit (DiS) within the NHS scheme. This covers what DiS offers, what locums receive when not in service and three workarounds for locums in order to be able to achieve DiS benefit.

 

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Last updated : 19 May 2020

 

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