• GPs advised to notify trusts and CCGs when providers fail to comly with six new requirements in NHS standard contract

The British Medical Association GP committee is advising GPs on how to raise formal concerns with trusts and commissioning groups when hospitals fail to comply with new requirements to help reduce workload, HSJ has been told.

NHS England’s 2016-17 NHS standard contract includes six new requirements on trusts in relation to the hospital/general practice relationship. These include a ban on automatically referring patients who do not attend appointments, requirement to supply patients with medication on discharge and requirement to send details discharge summaries no later then 14 days after the appointment.

In July 2016 NHS England sent a letter to trusts reminding them of the six new requirements for the standard contract, following reports they were not being followed.

The GPC is now providing GPs and local medicl committees with templates to alert providers when they breach any of the six new contract requirements. GPs will also be advised to notify their CCG about non compliant trusts. This information is due to be issues today.

It is encouraging GPs to raise concerns, so that trusts can be held to account. Breaches could theoretically lead to formal challenges under the contract.

HSJ also understands that NHS England is working with the GPC to set up a primary care interest group, due to meet in coming weeks, which will look at the problems that occur across the hospital and GP interface.

New requirements 16/17 NHS standard contract requirements

  1. Hospitals are not able to adopt “blanket policies” under which patients who do not attend an outpatient clinical appointment are automatically discharged back to their GP. Hospitals must also publish access policies and demonstrate evidence of having taken account GP feedback on service development and redesign.
  2. Hospitals are required to send discharge summaries to GPs by direct electronic or email transmission for inpatient, day case, or A&E care within 24 hours.Commissioners are required to assist providers in implementing this.
  3. Hospitals are required to communicate clearly and promptly with GPs following outpatient clinic attendance, no later the 14 days after the appointment. (2017-18 standard contract may require electronic transition of this within 24 hours)
  4. Unless a CCG states requests otherwise, onward referral- for non-urgent directly related conditions- to another professional within the same provider is permitted, there is no need to refer back the GP. Re-referral is only required for onward referral of non-urgent, unrelated conditions.
  5. Providers to supply patients with medication following discharge form inpatient or day case care. Medication must be supplied for a minimum of seven days (unless a shorter period is clinically necessary).
  6. Hospitals required to organise the different steps in a care pathway promptly and to communicate clearly with patients and GPs. This includes a requirement to notify patients of the results of clinical investigations and treatments in an appropriate and cost-effective manner.