december & january 2014/2015 jeremy · pdf filejeremy hunt supports innovative care...

#73

December & January 2014/2015

www.tpp-uk.com

JEREMY HUNT SUPPORTS INNOVATIVE

CARE HOME PROJECT

Richard Vautrey, Deputy Chair of the British Medical Association’s GP committee.

From the TPP Product Specialists

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5 MINUTES WITH... TOP TEN TIPS

JEREMY HUNT SUPPORTS INNOVATIVE CARE HOME PROJECT

T he visit marked the launch of the SystmOne Care Homes solution, developed by TPP and piloted by Donisthorpe Hall Care Home.

The project has proved to be invaluable in delivering safe, proactive and more personalised care to some of the most vulnerable people.

Donisthorpe Hall use SystmOne Care Homes to access residents’ electronic medical records, which contain vital data from other services caring for them. This allows more informed, timely and consistent care, tailored to the individual. The software further builds on TPP’s patient-centric shared record model, giving citizens more control over their health.

The minister met with the team involved in the project from TPP and Donisthorpe Hall as well as residents and family members who have truly embraced the benefits of the system. Staff at Donisthorpe Hall also emphasised how they can better communicate with other health profes-sionals and make more informed decisions, based on accurate and up to date infor-mation. Over the last few months, Donisthorpe staff and residents have seen some fantastic benefits from using the

system. The care home has reduced hospital admissions and enabled residents to access their health record online using SystmOnline.

Secretary of State Jeremy Hunt said “Technology is the key to 21st century, personalised healthcare, so it is great to see companies like TPP leading the way with new software which will put residents in control of their health and crucially, which will lead to better, more responsive, joined-up care.”

Suzy Musgrave, Care Home Manager at Donisthorpe said, “Adopting new technology has already provided numerous benefits for our residents. For example, it has improved the communication between health organisations, which results in faster outcomes. In one instance, by using SystmOne, the time to fully process a prescription was cut down from 24 hours to 25 minutes. SystmOne has helped to streamline our processes and has saved us a lot of administrative time, allowing us to spend more time with our residents.”

The SystmOne Care Home project began following a discussion between Jeremy Hunt and Frank Hester, TPP’s Founder & CEO, during a trade mission in

China last year. Frank commented, “In order to provide the best care, you need to have a complete picture of a person’s health and social care needs. Historically, there has been a disconnect between residential care homes and NHS services, meaning those caring for a patient do not always have the most up to date infor-mation. By offering all care homes this software, free of charge, I believe that this will enable further integration with the NHS whilst improving care for the elderly.”

On 11th December, the Secretary of State for Health, Jeremy Hunt MP visited TPP’s office and Donisthorpe Hall Care Home in Leeds, showing support for an innovative care home project.

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Jeremy Hunt speaks to one of the residents at Donisthorpe

Hall Care Home

| TPP News Stories |

2 TPP Times Issue 73 - December & January 2014/2015

H avens Hospices, based in Southend on Sea, was the last of the

palliative care services in the CCG to move over to SystmOne. Since the go-live in September, they have seen significant improvements for both patients and carers.

Jackie Wiggins, Information Governance Manager at Havens Hospices, said “The move to SystmOne is generating real benefits. Clinical information can be accessed so easily now we have patients’ full medical history available. This infor-mation allows our clinicians and carers to give the most informed and appropriate care. For example, now when we send a patient home we can ensure that the most suitable support networks are in place for them, as well as having a holistic picture of the support they are receiving”.

Another benefit is the ability to easily and efficiently communicate with other healthcare settings on SystmOne in the area, including GP, 111, Out Of Hours, Hospital In-Patient Palliative Care and Community services. Jackie said “Being able to contact staff through SystmOne from other services, such as district nurses, has saved us so much time. Before, we would have to send faxes to and from the hospital,

but now we are able to send tasks on SystmOne instantly.”

The transition to SystmOne was incredibly smooth for Havens Hospices, a charity which also incorporates Little Havens Hospice for children. Jackie commented “Moving to SystmOne from our previous system went so much better than we could have imagined. We received so much support throughout the process and we are really pleased with how the go-live went”.

Havens Hospices is currently looking to bring its children’s service, Little Havens, on early next year.

Having integrated, connected palliative care across an area ensures that a patient’s end of life wishes are more likely to be realised. South East Essex Advanced care register is also hosted on SystmOne and the Benefits of this were demonstrated In the most recent Electronic Palliative Care Co-ordination System (EPaCCS) report. It was shown that between 1 June 2012 and 31 May 2013, 81% of people with an EPaCCS record in Southend, Castle Point and Rochford CCG’s died in their preferred place of care. Following the Havens Deployment the Palliative pathway is now complete across South East Essex.

SYSTMONE PALLIATIVE CARE COVERAGE

NHS Castle Point and Rochford CCG and NHS Southend CCG is now

offering truly integrated, end-to-end palliative care thanks to SystmOne.

RNOH SIGN UP FOR

SYSTMONETPP have signed a contract with Royal

National Orthopaedic Hospital (RNOH) NHS Trust to deploy the SystmOne

e-prescribing and e-discharge modules.

T his deployment will provide RNOH with an Electronic Prescriptions and Medicines Administration (ePMA) system to ensure safer, timely and efficient optimisation of

medicines to patients. The RNOH is the largest specialist orthopaedic

hospital in the UK, with 13 wards and more than 200 inpatient beds. The full roll out of the ePMA across the hospital will provide a single comprehensive prescribing system for all patients. It will significantly improve communication between prescribers, pharmacy, GP and other healthcare providers.

The trust plan to use the data collected from the ePMA to support research and audits to underpin their international reputation.

The ePMA will also integrate with the Silverlink Patient Administration System (PAS) which is used across the hospital and the Bedford Pharmacy system.

RNOH Chief Executive, Rob Hurd said “We are delighted that the RNOH and TPP have come together on this important project. The safety of our patients is our top priority and medicines management is a crucial part of delivering the very best patient experience. The new ePMA can only enhance our worldwide reputation for providing the very best care to our patients. It’s a very exciting step into the future and I’m confident that the combined expertise of the RNOH and TPP will ensure we continue to be a worldwide leader in orthopaedic medicine”.

Dr John Parry, Clinical Director, TPP said “The RNOH offers a great opportunity to demonstrate the benefits of TPP SystmOne Hospital e-prescribing. The hospital operates at the forefront of orthopaedic care and we look forward to working with them to show the benefits.”

The full roll out of SystmOne across RNOH is expected to be complete by November 2015.

“It’s a very exciting step into the future”

| TPP News Stories |

3Visit us at www.tpp-uk.com

Richard Vautrey5minutes with...

Q What was your path to becoming deputy chair of the BMA?

A I was encouraged to join Leeds LMC by my former senior partner who was then the

LMC treasurer. I didn’t get elected but they saw I was enthusiastic and so they co-opted me to the committee anyway. It wasn’t long before I was the LMC secretary and attending the Annual Conference of LMCs on a regular basis which gave me the opportunity to see leading members of the BMA’s GP committee (or GMSC as it was then) in action. I was elected to represent GPs in Calderdale, Kirklees, Leeds and Wakefield in 2001. Three years later I was elected to join the negotiating team and since 2007 I’ve had the privilege of being the deputy chair.

Q What is the BMA’s role in promoting better care?

A The BMA is both a trade union and a professional organisation which is

something politicians and some in the media try to ignore. However the BMA gains a lot of its credibility with patients and the public because of this dual role and the fact that they see doctors campaigning for and promoting better care for patients and improved public health in general. One of my roles in recent years has been to negotiate QOF changes. There are many problems with QOF, not least the attempts by various governments to manipulate it for their own agenda, but I believe it has led to an improvement in long-term condition management across the UK and is one of the reasons why we are a world leader as judged by the Commonwealth Fund.

Dr Richard Vautrey is the Deputy Chair of the British Medical Association’s General Practice committee.

He is a nationally elected member of the BMA Council and the RCGP Council and is involved in all aspects of GP contract negotiations. He is a GP in Leeds and assistant medical secretary of Leeds LMC.

| Interview |


Q What do you think are the main challenges facing primary care?

A Primary care, and general practice in particular, have been the poor relations in the NHS for too long. We’ve seen the

proportion of NHS spending on general practice fall from around 11% to less than 8% and at the same time had to cope with rapidly rising workload demands due to a rising population, an increased number of elderly people living with more complex long-term conditions and a steady flow of work being transferred from hospital in to general practice. In addition there has been an unwillingness to fund practice premises developments at anything like the level required. Older doctors are leaving as quickly as they can because of workload pressures, low morale and punitive pensions changes and at the same time young doctors don’t want to be GPs in enough numbers. We therefore have a recruitment and retention crisis to compound the workload crisis. It’s the reason we launched the “Your GP Cares” campaign earlier this year as we need to see a fundamental change in the NHS for it to be able to rise to the challenges facing us. We need general practice to be prioritised for funding and development, as if the foundation cracks the whole building risks falling down.

Q How can IT suppliers help to make primary care better?

A General practice has a proud history of leading IT developments in the NHS. In 20 years as a GP I’ve never

worked without a computer on my desk, something few working in hospital could say. However we cannot rest on our laurels. My biggest fear is that as IT system suppliers become more focused on the needs of hospitals and integrated organisations they will lose their ability to act rapidly and innovate in ways that large organisations find it hard to do. However if system suppliers remain in tune with the needs of GPs and their patients and really listen to what we are saying they won’t go too far wrong.

Q What do you think the future of primary care is?

A Despite the current doom and gloom surrounding general practice, I remain optimistic about our future. Regardless of

the speed of change or the latest idea of a secretary of state for health, patients will always need to be seen, and GPs will remain best placed to see them. We need to talk up our specialist generalist skills and be proud of what we achieve. We are starting to win the argument and the NHS Five Year Forward View is clear of the need not only to develop general practice but to fund it too. We need to ensure that the words are turned in to action.

| Interview |


A L L • Y O U • N E E D • T O • K N O W • A B O U T

Electronic repeat dispensing allows prescribers to authorise and issue a batch of repeat prescriptions electronically for a patient.

The patient can then pick up the supplies they need without having to go to their prescriber for authorisation each time. The

prescriptions will be available at the dispensary for the patient at the specified interval, until the patient needs to be reviewed.

The ability to repeat dispense electroni-cally is one of the major benefits of using Electronic Prescription Service Release 2 (EPS2) on SystmOne. This method is safe, secure and gives the GP much greater control of the prescription than if it were issued on paper.

Below are some of the main benefits for a GP using electronic repeat dispensing: Process prescriptions more efficiently:

® Reduce workload associated with issuing and re-authorising repeat prescriptions.

® Decrease footfall in reception as patients won’t be visiting to collect prescriptions.

® Spend less time answering telephone queries, as patients will be going straight to the pharmacy each month to collect their prescription items.

“Electronic repeat dispensing, using EPS Release 2, eliminates the need for the prescriber to hand sign the batch of repeat

prescriptions. I have found that the most significant advantage,

however, of electronic repeat dispensing, kicks in when

changes are needed due to alterations in required therapy.

I can cancel all or part of an electronic repeat dispensing

prescription. This will cancel the relevant items from all future

issues of that prescription without the hassle of retrieving and re-

issuing bundles of paper scripts.”

ELECTRONIC REPEAT DISPENSING

— Dr John Connolly, Clinical Lead, TPP

Spend less time signing prescriptions: ® Sign only once electronically for 3, 6 & 12

month prescriptions.

Have greater control of the prescription: ® Cancel prescriptions at any point during

the regime.

® Send replacements electronically without the patient having to come back to the practice to collect a paper prescription.

® Reduce the risk of duplicate prescriptions being generated.

® Guarantee prescriptions are not lost.

® Ensure the prescription is secure, as electronic prescriptions can be instantly tracked and traced.

® Removes the need for ‘managed repeats’ by pharmacy.

How do I request getting enabled for EPS?

For your organisation to be enabled for EPS, you will need to make a request via HSCIC. Once approval has been granted and all relevant training has taken place, you can go to ‘Organisation Preferences’ in SystmOne to switch ETP2 on.

| Systm Stories |


HOW TO RECORD REPEAT DISPENSING

ON SYSTMONE

The repeat templates screen shows the repeats that a patient is on. Pressing the ‘RD’ button at the top when highlighting a drug will repeat dispense it.

For more information and resources to get the most out of EPS, go to the HSCIC website at http://systems.hscic.gov.uk/eps

Sign up to the EPS mailing list:http://systems.hscic.gov.uk/eps/

contacts/signup

Choose whether you want to specify issues or repeat dispense until the review date.

To stop the repeat, right-click and select ‘Stop’. You can also mark the repeat in error. Doing

either of these things will trigger a cancellation, and a

message will be received confirming which issues will

be cancelled.

You will then get confirmation that the drug has been repeat dispensed. The issue count on

the Repeat Templates screen will reflect how many issues you

have repeat dispensed.

You then sign the prescription, either when saving the record or

from the Prescription Search and Bulk Signing screens.

Any patient data shown is fictitious.

| Systm Stories |


You can view a list of the last 5 patients you retrieved using Patient Menu> Recent Patients. But if you want a list of all patients you have searched for since you logged on select the History Button on the Quick Patient Search.

If you are struggling to find a template or a particular screen or part of the system, hold Ctrl + Shift and press \ to put your cursor in to Search Features, type in what you are looking for and a list matching your search will be displayed.

Tips on quick patient search: ® to search for a post code: ,,LS18 5TN

® to search for house number and road: ,6 Green Road

Appointment Setting – there is a user preference which allows you to change what double clicking on an appointment does.

When on a particular option in the tree of a patients record, Ctrl + Shift + 1 will save this current screen as your continue option on the patients home screen or the 1st screen you go into if the patient has nothing to show on the patients home.To add a quick action

button to your home screen for the screen you are currently viewing, hold Ctrl + Shift and press F8. This can save you time by not having to hunt through menu paths for screens you use regularly.

To separate the events in the journal with lines instead of shading, go to user > user preferences > patient record > new journal > colours > do not shade any events. This can make it easier to see the different events in the journal.

If you think that the consultation you are recording with a patient would make a great Auto Consultation then go to the Auto Consultation screen and press the Copy Current Consultation button at the top of that window. This will create an Auto Consultation, available for other users, based on the information you have just entered.

FROM THE TPP PRODUCT SPECIALISTS

TOP TEN TIPS

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You can add any action you want to the right click in the clinical or administrative tree. To do this, go to Tree Configuration in Organisation Preferences.

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To quickly add a readcode during a consultation to the problems or summary, use:

® Major problem: Ctrl+;

® Minor problem: Ctrl+’

® Summary: Ctrl+#These keys are all located directly above the shift key.

| Systm Stories |


?2nd & 3rd June 2015

N umbers recently released by NHS England’s Patient Online team show that as of September 2014, 99% of GP

surgeries have the capability to allow patients to book or cancel appointments online and 98% of practices have the capability to view or order prescriptions online. Another 21% of patients have the ability to view their own records through an online service.

NHS England’s Patient Online team has been working closely with practices across England to ensure they have the support they need to confidently offer transactional online services to patients.

Although more than 2,000 SystmOne practices are offering patients access to SystmOnline functionality, that means there are still around 400 practices who have not yet decided to take the leap. Some practices are also only offering

limited functionality to their patients (e.g. booking appointments) when they can also switch on prescription tools, questionnaires and access to online records. So far, only around 500 SystmOne practices have made the decision to turn on access to online records for patients.

The benefits of SystmOnline for a practice can be huge. Not only does it reduce the number of phone calls to the surgery, but evidence from case studies with SystmOne practices shows it can also reduce DNAs. It also helps patients to feel more empowered in their care and makes tasks such as ordering prescriptions a much more efficient, paper-lite process.

Practices who are considering turning on SystmOnline (or using more of the available functionality) can access help and guidance through the F1 help tool within SystmOne, including links to posters for advertising the service to

patients. Information is also available through the recently published NHS England Patient Online Support and Resources Guide (http://www.england.nhs.uk/wp-content/uploads/2014/10/npo-guidance-291014.pdf ) on the NHS England website. This brochure includes guidance and tools developed by the RCGP, as well as materials for patients and FAQs.

The NHS England Patient Online team are now turning their attention to those practices in England who aren’t currently offering online services, to find out what the barriers are and what we can do to help overcome them.

You can contact NHS England with any questions, comments or feedback using the contact form on the Patient Online section of their website: www.england.nhs.uk/patient-online

SNUG Conference 2015Hilton Metropole, Birmingham NEC

With new dates and a new location, the 2015 SystmOne NationalUser Group (SNUG) Conference is set to be the biggest and best yet. Put the dates in your diary and get your tickets in the New Year!

NHS England’s Patient Online Programme Team has been working closely with practices across England to ensure they have the support they need to confidently offer transactional online services to patients.

SAVE DATE

ARE YOU USING SYSTMONLINE YET

THE

| Systm Stories |


T his year’s Annual King’s Fund Conference on the 13th November saw Secretary of State for

Health, Jeremy Hunt, announce the appointment of Dame Fiona Caldicott as the National Data Guardian for health and care. As a GP and SystmOne user, I welcome this new role for Dame Fiona which will see her acting independently to oversee the safe use of personal health and care information.

When I have had the privilege to hear her speak, I have been inspired by her vision to ensure that data is shared reliably and robustly whenever this is expected to enhance the care of our patients. She makes it clear that we have a duty to share relevant details between colleagues and teams to support the delivery of services; to keep citizens informed about how their records are shared; and to respect their individual sharing preferences. She also makes it very clear that we should not create spurious information governance blockers which risk undermining this duty and cause the fragmentation of service delivery which has blighted the health and care service for so long.

My personal experience, over recent years, (supporting those with complex care needs, multiple long-term conditions or end-of-life problems) is that patients expect me to share their electronic records with their other carers; that they resent the inconvenience of serial clerking at every interface, endlessly repeating their story; and that they appreciate the continuity and reassurance which a connected or integrated service can achieve.

Where I work in West Yorkshire, and across many other health economies which have good SystmOne coverage, much effort has gone into exploiting SystmOne functionality to ensure that, unless patients explicitly dissent, clinical data is shared promptly and reliably. This

makes it possible for carers with diverse roles, locations and employers to contribute seamlessly to the care of the patient, creating a virtual team of carers arranged around the particular needs of the patient. This team is then able to see each others’ contributions, minute by minute, and respond to communications in a timely way. As soon as the patient’s needs become complex, whenever timeliness, accuracy and attention to detail becomes crucial, the constant availability of the detailed electronic record, with all its attributes, becomes an essential tool to deliver care that is properly integrated.

National strategy including the ‘Five Year Forward View’ and the ‘National Information Board’s Personalised Health and Care 2020’ framework strongly recommend transformational change to address the gaps in quality, efficiency and funding. We are reminded that there are better ways of organising care, breaking out of the artificial bound-aries between hospitals and primary care, between health and social care, between generalists and specialists. We are encouraged to embrace technology solutions to develop improved models of service delivery underpinned by shared electronic health and care data.

So how should TPP Times readers respond? When I meet clinical teams around the country I am hugely encouraged to find that those who are actively promoting SystmOne sharing functions are drowning out those who have yet to understand and implement Dame Fiona’s i vanise and genuinely integrate services around the needs and preferences of their patients.

So, let’s build on this progress. Let’s eliminate archaic working practices and methods of communi-cating about patients. Let’s make it normal for patients to be informed, consulted and respected when it comes to decisions about sharing vital data about their care.

By Dr John Connolly, Clinical Lead, TPP

A CLINICAL PERSPECTIVE ON DATA SHARING

| Systm Stories |


FESTIVE COMPETITION

ARAB HEALTH AND

TPP will be attending the Arab Health exhibition—one of the largest healthcare exhibitions in the world and presenting on ‘creative collaboration’ at the Big Data Conference.

I n January, TPP will be attending the Arab Health exhibition for the third year in a row. The event,

held in Dubai, is one of the largest healthcare exhibitions in the world and regularly attracts over 90,000 attendees during the course of the week.

TPP will be one of over 3,000 exhibitors from around the world taking part. Located in the Zabeel Hall of the Dubai Exhibition Centre, our stand will form part of the UK pavilion, established by Government organisation UK trade and investment.

TPP’s Head of Data and Analytics (and ResearchOne’s Chief Data Scientist) Dr Chris Bates has also been invited out to the region during the same week to speak at the Big Data Conference, which runs alongside the event. His topic of ‘creative collaboration’ will cover the importance of working together with academic and private partners on big data

projects, and will include a case study of the ResearchOne work with the University of Leeds.

Cairen Ball, Director - Middle East, TPP has been leading on new business ventures in the Middle East for nearly two years believes the exhibition is a great way to talk about the success of the UK. “The rest of the world really does see the UK as a leader in healthcare, particularly when it comes to IT and electronic patient records. At Arab Health, we can share what we’ve achieved in the UK so far and explore ways that organisa-tions in the Middle East can learn from our successes.”

The Arab Health event runs from 26th-29th January at the Dubai World Trade Centre and Exhibition Centre.

For more information visit www.arabhealthonline.com

Have a go at this word wheel to discover the Christmas word concealed within it (using all the letters).

We also want to know how many words you can make from the wheel, beginning with the letter ‘T’.

Submit both answers to [email protected] for a chance to win a Brother Label Printer for you or your organisation.

L

T

I

EM

T

E

O

S

BIG DATA CONFERENCE

Congratulations to Wendy Murraywho won the last competition!

| Events | Puzzle |


© TPP 2014

DEMENTIA STATUS REPORTS Following the implementation of the Dementia Identification Scheme by NHS England, TPP have created clinical reports to identify patients who are considered at risk of developing dementia. This follows the Dementia Identification Scheme specification. A status alert has been created which displays a blue triangle underneath the demographics box for at risk patients; double clicking on the icon launches the Dementia Screening Enhanced Service template. The template provides additional resources to facilitate detection and recording of patients who have dementia.

REPORT OUTPUT MAINTENANCE

Report Output Maintenance allows you to configure the columns displayed when showing a list of patients returned in a clinical report. Output templates can be created and used on multiple reports, improving efficiency and saving time. Previously, when combining more than one clinical item into one report, you had to create separate reports and join them together. Using Report Output Maintenance, you can create a single report to find patients on a specific drug and then include the 3 most recent blood pressure readings when showing patients.

For a step-by-step guide on how to use this, please go to the reporting section on F1 Help.

LINKED APPOINTMENTS

Primary care users are now able to link appointments on SystmOne. This can be used to schedule multiple future appointments for a patient all at once, to save administrative time. When using the Free Slot Search, you can choose an initial appointment and then specify the minimum time between the selected appointment and the next in the sequence. Pressing ‘link’ will open a new tab with the Date & Time section automatically updated, meaning you don’t have to manually search the calendar for available time slots. You can then highlight the next appointment to book. A series of up to ten linked appointments can be booked in this way.

For more information about Linked Appointments, please see the two change messages posted on the 3rd November 2014.

NEW FUNCTIONALITY

DID YOU KNOW The rules on GP registration is due to change in 2015.

Following pilot schemes led by the Department of Health on patient choice during 2012 and 2013, the rules on GP registration are changing in January 2015. From January 5th, all GP practices in England will be free to register new patients who live outside their practice boundary area, with the responsibility for home visits and OOH care removed. This means that patients may be able to join practices in more convenient locations, such as near their place of work. [National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) Amendment Regulations 2014]

The idea is to provide patients with greater choice and to improve the quality of GP services over time, as GPs providing a good service are naturally more popular. The new rules are voluntary for GP practices and any practice can refuse to register a patient but the reason must be explained to the patient in detail.

The NHS England website has some details at http://www.england.nhs.uk/wp-content/uploads/2014/11/gp-con-enhanced-service-out-area-reg.pdf (Publications gateway reference: 02351). The full details are published by NHS England on the https://www.england.nhs.uk/commissioning/gp-contract/ page - it is a word document (unusually) and NHSE suggest that local and area NHSE teams may adapt the advice for local circumstances.

There are a few things to consider: ® Because the patient’s home is likely to be further away, GPs are not

obliged to offer a home visit in most cases.

® As the patient may now be receiving care at more than one GP practice, it’s wise to consider how those two practices can share information about the practice – at a basic level this can be through the SCR, but for practices on SystmOne, encouraging patients to permit sharing of their detailed care record will make care safer, more accurate and informed.

How does this work in SystmOne?

For patients registering out of area: ® The practice enters details of the patient registration onto

SystmOne as normal

® The registering staff member then includes a manual note on the registration page using free text

® The agreed text string is “OUT OF AREA REG”;”OUT OF AREA SCHEME”; “OOA REG”; “PC-OOA”; “PCS-OOA”; “PCS-OOA”; “OOAR”

® The free text should be added prior to sending the registration via the LINKS software

® A Read code of XaZ4g (Registered patient lives outside practice area) can also be added to the patient record to enable the practice to run a report to find which patients are registered as ‘out of area’.

Payment details for any consultations or home home visits performed by a practice offering these services for patients reistered elseewhere are included in the NHSE document, but not the details for claiming the fees.

| Did you know | New functionality |


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