Primary Care Support problems
There have been significant problems with support services for general practice. At the BMA’s July meeting of the General Practitioners’ Committee (GPC) a vote of no confidence was passed in Capita’s handling of its contract to deliver Primary Care Support Services. LLR LMC and the GPC are working to resolve problems, to raise awareness and to advise practices of the practical steps which can be taken. Capita has released figures which show that since 1 April 2016 their performance against expected demand has been suboptimal. It is also clear that the demand for primary care services has been higher than the activity forecast.
Some practices have been waiting many months to receive the paper medical records of newly registered patients. Capita have acknowledged the problem with up to 380,000 sets of records delayed in this backlog and practices across the country have reported routine waits for sets of notes running to almost six months. This can present serious challenges to deliver safe care to patients.
Problems have included:
- Some practices have had to hold on to medical records for many weeks after patients have left their care.
- Issues with the electronic registration link has meant that some practices have been unable to register new patients to the spine. This can result in incomplete screening lists, which has led to reports of some patients not being called for routine disease screening such as that for bowel cancer and practices unable to perform vital screening tests such as cervical smears due 6 to the system refusing to log the request on the basis that the patient is not registered.
- Recent suggestions that Capita will be central to a national list cleansing process to remove socalled ‘ghost patients’ has caused widespread concern and vulnerable patients may be inadvertently de-registered.
LLR LMC advice to practices is as follows:
- Notify patients by waiting room posters, etc. of the medical records difficulties being experienced, with examples of some of the consequences.
- Warn patients who ask to register of the likely delay in receiving their notes and the possible risks from providing months of care delivered without any access to their records
- Inform newly registered patients that any pre-employment medicals or private reports for life insurance relating to mortgage applications may delayed. This might result in them losing job opportunities or house buying offers falling through.
- Mark temporary records with a clear record entry when the full record is received. This would make actions in the absence of notes more easily identifiable in retrospect which may provide more medico-legal protection in the event of a mistake being made due to lack of proper records access.
- Consider making an emergency closure of the practice list which you may believe can be justified by the concerns listed above. This is a serious step to take, but would ensure that practice staff are exposed to as little medico-legal risk as possible and would protect patients from GPs and practice nurses acting in an environment of ‘record blindness’.
- Report instances of failures with primary care services to LLR LMC so that we can log and collate the scale and impact of any system failures.
- Write to your MP- a template for you to use has been circulated to our member practices.
We advise that you consider all of the actions to mitigate the potential risks to GPs, staff and patients. Please contact us if you wish to discuss any of these matters or to send us details of any problems with which you have been dealing.