Child safeguarding reports – where does your practice stand with local authorities?

This item was originally published in April 2017, following feedback from LMCs we can now add that Hammersmith and Fulham Council do pay GPs for child protection reports and have a mechanism for practices to claim for the service. Ealing and Hounslow LMC are currently in discussion to clarify that the service is non-contractual and practices are allowed to charge for child protection reports. Ealing Hammersmith and Hounslow LMC is currently conducting a survey across London to determine which local authorities currently pay GP practices for this work. So far they have confirmed that Hammersmith & Fulham, Bromley and Islington Councils definitely pay practices.

 

With resources squeezed many practices are looking to make sure all the services they provide are properly funded. A number of practices have asked about child safeguarding reports, Vicky Ferlia our Director of GP Support Services, explains what all parties’ obligations are and how they arose.

Providing safeguarding reports is not a contractual requirement for GPs. In fact, it comes under what is called ‘collaborative arrangements’.

The collaborative arrangements were established under legislation in 1974 [current legislation is contained in sections 26-28 of the NHS Act 1977 and the Children’s Act 1989, mirrored in the Health & Social Care Act 2012 (Schedule 5, para 51)]. This required that health authorities (later known as primary care organisations, or NHS England/CCGs now) should provide certain medical services to local authorities (LAs) to enable the latter to carry out their responsibilities in the fields of education, social services and public health.

So essentially practices undertake this extra-contractual work to enable NHS England/CCGs and the LA to comply with their obligations under the legislation. Services covered under collaborative arrangements include medical assessments for blue badge applications, attendance at child protection case conferences and provision of reports, medical reports to support adoption applications etc.

In 2014 David Geddes of NHS England confirmed to Area Teams that ‘these services form no part of the NHS’s relationship with General Practice and as such are not included in the GP contract’. This means that they are non-contractual work and GPs are entitled to charge for providing such services.

The problem is that collaborative arrangements have varied extensively between different areas across the country, and NHS England’s promise of a national solution has yet to materialise, despite ongoing efforts from the BMA’s GPC.

In the absence of a nationally negotiated agreement, practices find themselves in a situation where they are professionally bound (the GMC places a professional duty on doctors to participate fully in child protection procedures, attend meetings, share information etc) and ethically compelled (they feel they have a duty to act in the best interests of their patients) to provide this non-contractual work without having any approved mechanism for getting paid for it.

This has been raised a number of times with national LMC leaders over the years and the advice is always the same for practices – do the work for the professional and ethical reasons we have explained, but be aware that you are entitled to charge for it and should have a process in place for doing so, which includes setting your own fees for collaborative work. In most cases practices will do it free of charge because they haven’t got the energy to argue with their LA or spend valuable staff resources in chasing them up for payment. Some practices do feel very strongly about being reimbursed so they will invoice the LA and then chase them up for payment. Non-existent or slow responses are frequent sources of frustration for practices.

It might be possible for an LMC to have this conversation locally with their CCG to stress that practices need to be paid for this work and the CCG should step up to the plate and enable this to happen. Having said that, LMCs should be very careful about negotiating collaborative fees for an area, because of competition law and the potential for ‘price fixing’. The BMA has urged caution having sought legal advice on the matter). Generally the safest way is for practices to set their own fees, but as we have said there is no guarantee that an LA will pay them.

Ultimately it should not be down to practices to chase LAs for payment as this is an arrangement between the NHS and LAs. What should happen is that the CCG should pay the practice for this work and then claim the money back from the LA, but disappointingly there has been no progress in reaching a national agreement about how this should be done.

However, we live in the real world and there are myriad different local arrangements, so practices need to check exactly how the process works with their LA before sending out invoices. If your practice has patients from more than one LA area, then you’ll need to be familiar with each LA’s individual arrangements.

Last updated : 22 Jan 2018

 

GP State of Emergency success: TFL change fees advice (16 Jul 2018)

Following a letter from our GP State of Emergency team, Transport for London have updated their advice to applying for a private hire driver licence to reflect that the charge...
Read more »

Dr Michelle Drage's statement on the new Secretary of State for Health and Social Care (10 Jul 2018)

Dr Michelle Drage responds to the appointment of Matthew Hancock as Secretary of State for Health and Social Care. "Congratulations and welcome to new Health Secretary Matthew Hancock. "I’d love...
Read more »

Perinatal mental health access variation (06 Jul 2018)

The Pan-London Perinatal Mental Health Network are gathering information on disparities in access to, and funding for, perinatal mental health within secondary and tertiary care. This map produced by the...
Read more »

Salisbury Novichok 1 incident - Public Health England interim guidance (05 Jul 2018)

Following the recent Salisbury Novichok 1 incident, Public Health England have issued interim guidance on the diagnosis and early management in organophosphate chemical incidents. This guidance can be downloaded 
Read more »

Tips of the month June 2018 (20 Jun 2018)

We provide weekly tips based on common queries which come through to us from London GPs and practice teams. These are shared via social media and collated for...
Read more »

Free online mindfulness course for patients (19 Jun 2018)

Londoners can now access a free online mindfulness tool via the Good Thinking website. The website signposts individuals to resources to help deal with depression, anxiety, stress and insomnia...
Read more »

GP State of Emergency continues (19 Jun 2018)

Since April 2016 when GPs in London and across the country declared a GP State of Emergency, our campaign has been a great success. However, we recognise that the...
Read more »

SNOMED CT update for SystmOne practices (19 Jun 2018)

The first phase of the national deployment of SNOMED CT has now taken place with approximately 20 pilot sites taking part. The wider roll-out for SystmOne GP practices will be...
Read more »

Publication of Integrated Care - Organisations, Partnerships and Systems (19 Jun 2018)

  Online report   PDF download The Committee considered the increasing reliance on a range of health and care services, which are mostly...
Read more »
Next Page »
« Previous Page