In-Reply-To: <[log in to unmask]>
Margaret
> I was out of the practice last thursday. On friday morning the practice
> manager told me that someone from the finance dept. at the HA had been
> in thepractice for 5 hours to verify our claims and had asked to inspect
> patientrecords to verify night visits. She said she had allowed this as
> "they had aletter of verification". They had not left a copy of this
> letter so I rangthe HA and asked for a copy to be faxed over. 3 hours
> later --no response--another phone call met with the response that the
> letter would not bereleased and if I had a complaint to put it in
> writing to the HA.
Yes please, put it in writing and send a copy to Dr Ian Bogle, GMSC with
a covering letter explaining what has gone on.
On the simple practical level:
This plainly could have been anybody, not just a HA person, and so your
practice should have told them to 'XXXXX off' in no uncertain terms,
whatever their letters of apparent verification. If they didn't arrange
it with you first, it shouldn't have happened. Check they really were
the HA, and then if the letter doesn't come, suggest to them that
presumably the visiting person was actually impersonating an HA member,
and that you will inform the police forthwith.
We have little other recourse in law so far as I am aware, so I wouldn't
pursue that one at present.
I would pursue the line that as they have shown themselves to be
incapable of reasonable behaviour on all counts, then no further access
will be allowed. If they refuse to pay you, they can always test the
strength of their commitment in the small claims court first. The issue
is, as far as I am aware, that you have done the work. If they are
unable to verify it by a particular method chosen by them which is
ethically unacceptable, that is their problem. I do not believe they
have the right to withhold payment on those grounds, but I haven't had
the chance to check this with the lawyers yet.
> I find this amazing-- as far as I'm concerned the only person who can
> authorise the release of their records is the patient. If the HA want to
> verify claims they can ask the patient as the old FHSA used to.
Correct. This is the agreement your LMC should have in place with them.
> I am very disturbed by this action which flouts an agreement with the
> LMCthat if it were ever necessary to inspect records it would only be by
> medically qualified HA staff who had the same principles of
> confidentiality.
and only at specified moments with the agreement of yourself, and with
written consent from the patient, at a maximum of once every three years,
to be carried out with the IMA of the HA doing the record looking and at
the specified pages only.
I would ask your LMC to take the matter up with them, with a view to its
instructing all practices to refuse access completely until the matter
has been resolved to your satisfaction. If you don't get this one right
at the start you may as well give up and go home as far as being an
independent patient's advocate is concerned. This is where you really do
have to stand up as a GP and be counted, or regret it at your leisure.
> Needless to say this will be an ongoing discussion with the HA and I
> willkeep the list informed if anyone is interested but has anyone else
> hadproblems like this? I would appreciate any info regarding
> policies/problemsin other areas .
Continue to point out to them that you don't have to allow them access if
you are not satisfied with the proposal they put forward. Your interests
are with the patient here, and not with the civil service. Very many HA's
have now understood there is a problem, and have fully accepted the need
for medical eyes only to see the notes. If your area is incapable of
organising this, perhaps they need help. If they really do have a
problem with no medical adviser, then they need to sort that, and in the
interim, LMC members should be able to stand in to help the HA visiting
staff. Failing that, we should perhaps chuck away IoS links and go back
to the FP1001 paper claims.
To put it rather more simply, "Just say NO"
Grant Kelly
Chair, GMSC IT Subcommittee
Chair, GMSC/RCGP Joint Computing Group
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