Updated Primary Medical Care Policy and Guidance Manual

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The Primary Medical Care Policy and Guidance Manual (PGM) has been updated to version four, this is the first update since December 2020. The updated document and a summary of guidance changes are available on the NHS England website. Should anyone need to compare it with the previous version, version three can be viewed here.

We have summarised the changes below, but those people working in practices with responsibility for any of these areas should still read the full guidance contained in the PGM.

Registering Civil servants and their dependants, and the dependants of members of the Armed Forces, returning from overseas postings

Part A, section 4.15, pages 161-162.

Covers greater obligations to register civil servants, armed services personnel and their families who have returned to the UK or are about to. This includes an obligation for their previous practice (or successor practice) to register them even if the practice list is closed.

Managing [non-violent] inappropriate and unacceptable patient behaviours, including protecting against discrimination, harassment or victimisation

 Part A, section 6, pages 178-184.

Section 6 is new and covers what behaviours may justify the removal of a patient from the practice list based on a breakdown of the relationship between the practice and the patient. It also sets out expectations on what steps practices should take to deescalate tensions and manage difficult patients in cases where the relationship has deteriorated, but not to the point where de-registration is permitted. The final page of the section includes template letters for sending to patients.

Note: The pre-existing section on violent patients and assigning them to the Special Allocation Scheme (SAS) is unchanged and follows in section 7.

Provision of occupation health services – services funded by the GP practice

Part D, section 4, pages 449-453.

This new section sets out the occupational health (OH) activity practices are responsible for funding and providing to their staff. The obligations for funding OH services are summarised in the form of this table.