Dr Elliott Singer, Medical Director at Londonwide LMCs, recently wrote to the local authorities (LAs) in the 27 London boroughs covered by Londonwide LMCs to raise the issue of practices not being reimbursed for work done for LAs in the fields of education, social services and public health. Practices have an obligation to do this work under ‘collaborative arrangements’, but it is not part of their NHS contract and therefor needs to be resourced by the LA requesting a report, letters, etc.
Template letters and forms for practices can be downloaded here, the wording of Dr Singer’s letter is below.
- Letter and invoice template to Local Authority regarding requests for Collaborative Arrangement payments safeguarding
- Letter and invoice template to Local Authority regarding requests for Collaborative Arrangement payments
Background on GPs and LAs’ obligations under collaborative arrangements can be found in this newsletter item from 2017.
Child safeguarding reports and other collaborative arrangement payments
I am writing to you on behalf of [name of LMC] LMC, the statutory body which represents local general practitioners in your area, regarding payments for child safeguarding reports and other collaborative payments.
Primary care demand has been increasing year on year both in volume and complexity, with less than 8% of the NHS budget being invested in general practice. Patients frequently attend GP appointments with requests which do not form part of their NHS provisioned healthcare.
Collaborative arrangements refer to work that doctors can undertake on behalf of local authorities in the fields of education, social services and public health. This is to enable general practices to be appropriately resourced to undertake tasks that are not covered by the GP NHS contract, examples include family planning, psychiatric work, reports for adoption, fostering, children in care and priority housing, Community service certificates for offenders who fail to attend, visiting medical officers to local authority-maintained establishments, and attendance at case conference arranged by social services. Services provided under the ‘collaborative arrangements’ have been negotiated at a local level dependent upon the individual needs of an area. This work, that goes beyond the provision of basic health care, does attract a fee.
NHS England will be conducting an audit into the legacy arrangements for collaborative fees and seeking to agree with local authorities, a more consistent approach. However currently, Area Teams, pending the development of more consistent future arrangements, have been told to maintain any arrangements for collaborative fees that were previously managed by PCTs.
Disappointingly, we are receiving reports from general practices across the capital that despite the arrangements in place, as set out above, practices are not receiving payments for the work they do under collaborative arrangements. It is imperative that GPs and our practice teams are paid to undertake this work and do not divert resources away from their primary role of providing expert generalist care to individual patients in order to complete the statutory tasks of other bodies. We respectfully request that [name of borough] honours these collaborative arrangements. I attach copies of the template invoices that general practices are being encouraged to utilise.
Many thanks for your help and support.
Dr Elliott Singer
Medical Director Londonwide LMCs and General Practice State of Emergency Lead
Last updated : 10 Dec 2018