BACKGROUND
The LMC receives a number of complaints from practices in relation to ongoing expectation on general practices to provide reviews to children 48 hours after being admitted or being seen in ED with wheeze.
Whilst these are small numbers it is a clear indication of a commissioning gap that despite discussions for over 2 years has never been resolved.
The LMC has gained legal opinion, and our solicitors have drawn up two documents – one which has been sent from the LMC to the ICB, and the other a notice that each practice should send to the ICB. Both of these documents are included in the same email with this newsletter and will be available on the LMC website.
Once your practice has issued the notice to the ICB, every time the practice carries out a 48 check after the child was seen in the hospital, then the practice should send an invoice to the ICB. The legal advice is that the LMC cannot set the price, and this is up to individual practices. We recommend that practices refer to the BMA guide regarding setting fees. Invoices should include the usual terms for a commercial invoice.
The ICB have advised that they are working on a solution. We invited them to provide wording for this newsletter, but despite a delay in sending it out we have not received any.
As the ICB accepts that this service is non-core we expect that they will pay invoices without issue. We included template letter for practices to send to ICB, if/when sees this cohort of patients.
LEI0090002 re Unresourced GP Work letter GPs to ICB.docx
LEI0090002 Re Unresourced GP Work Letter LMC-ICB (002).pdf
AGREED POSITON
the LLR ICB approved the commissioning of the Children’s and Young People (CYP): 48 Hour Wheeze and Asthma Follow-up Review service.
Please see further details below:
Guidelines | CYP should be assessed within 2 working days following A&E visit / hospital admission due to acute wheeze / asthma. National and international guidance requires that CYP (0-18 year old) to be assessed within two working days following attendance at the Accident & Emergency Department or a hospital admission for acute wheeze/asthma to ensure: the patient’s condition has not deteriorated; the treatment is working; the patient’s wheezing and asthma symptoms have improved; to explore the possible reasons for the attack to give support / advice about reducing the risk of further attacks. Currently, the patient’s parents / carer’s are advised to contact their GP within 48 hours of discharge for a follow-up as per the discharge letter, however, this is not routinely available at the practice. |
Service delivery | Face-to-face primary care reviews for CYP diagnosed with viral-induced wheeze, asthma, bronchiolitis, or other respiratory issues, following an A&E visit or hospital admission. LLR registered patients (0-18 year olds only) 48hr Wheezy Children Service specification |
Service timeline | 1 October 2024 – 31 March 2025 |
Activity / performance | 48h Wheeze Monitoring Templates |
Remuneration (activity based) | £24.98 per completed 48-hour review |
CQRS Local (quarterly submission) |