Further to the earlier message of 8th July, as copied at the bottom of this news item, and to the letter from the LMC as attached, the LMC has recently had an extremely constructive meeting with Alan Lotinga and David Gray from Birmingham City Council and its Adult safeguarding Board. Following that please see below an email message from David and a revised Adult Safeguarding Board standard Community DOLS request letter as attached.
The revised wording has satisfied the LMC’s concerns in that GPs will no longer have to make a nebulous judgment that a patient is of “unsound mind”. Practices merely need to provide a statement of fact, if they are in a position to do so, that the patient has an impairment of mind or brain based on a specific diagnosis, and in most cases this should be easily done by reference to the medical record. In addition the wording is explicit that the certifying GP must have seen the patient within 12 months, otherwise they are not in a position to complete the form.
We have stressed the clear position that this is extra-contractual work for GPs, but that GPs fees will be paid by the NHS through the collaborative arrangements, and all requesting social workers will be instructed that these request letters must be accompanied by an appropriately signed medical fee claim form. Needless to say consent issues must have been appropriately dealt with too. We hope therefore that generally speaking most practices will have no difficulty co-operating with this request for information – sharing, though, of course, it is another potentially additional workload increase for practices.
We have also made clear that should a GP not be in a position to complete a statement solely by reference to the patient record, or where no GP within the practice has seen the patient within the previous twelve months, then if they were still happy to provide the service it would be necessary for the patient to be seen, and in some cases this might conceivably require a home visit. In these situations the requesting social worker should be advised, in order that a medical examination in addition to a report is requested on the medical fee claim form, and the practice should then invoice its CCG accordingly. It is understood though that some GPs may simply not have the capacity to carry out such additional extra-contractual work, and it would be helpful if they could clearly explain this to the requesting social worker.
Click here to download the document "Safeguarding Mental Capacity".
Click here to download the document "Community DOLS GP request".
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