OpenSAFELY:-
Is a secure data analytics platform that enables access to pseudonymised patient information for research and medical services planning.
All GP practices using EMIS Web (Optum) or SystemOne (TPP) are legally required to activate access,
If your practice has not already activated access you should consider doing so straight away. The BMA and RCGP have endorsed this platform, and the NHS England website has been updated this week with what are clearer instructions:
Helpfully, agreement has been reached over a single national Data Protection Impact Assessment (DPIA) which practices can refer to this, reducing any need to construct their own. The Joint GP IT Committee reviews are now referenced within this national DPIA. No additional work is needed by practices. The national DPIA is available via the above web page.
There is also a link to a 2-page “easy read” version of what OpenSAFELY is, (https://digital.nhs.uk/binaries/content/assets/website-assets/services/opensafely/the-nhs-opensafely-data-analytics-service.pdf
including a link to a short video (https://www.youtube.com/watch?v=GRjRqOAIVy8) which explains the purpose and operation of OpenSAFELY to patients
So, all practices need to do now is activate the service, note the national DPIA, update their website privacy notice (suggested text is in the above web page) and update their Record of Processing Activity (ROPA).
Winter pressures additional funding/festive period operating – Christmas and New Year’s Eves
The LMC and the GM ICB Place Team recently discussed winter pressures additional funding options and also the operating arrangements which apply to the festive period.
Practices will be invited to take up an offer of funding to provide an additional 25 appointments per 1000 patients during the ‘winter ‘ period, with scope to increase this should the overall take up allow or demand surge.
Practice will shortly be receiving an invite letter with details from the Place Team.
As in previous years the festive eves are normal working days and practices can, based on their judgment of their patients’ demand, avail themselves of subcontracted cover arrangements during these periods to provide arrangement for urgent care, the means of booking appointments, telephone enquiries, collecting scripts.
Practices are well able early in the day of the festive eves, to organise the collection and delivery of medications and scripts needed to cover the break.
The Wigan GP Alliance has confirmed it will be providing cover as in years past.
An additional factor in the forthcoming period is the requirement to keep switched on throughout core hours the online consultation portal for routine and administrative patient contact ( see below).
Practices will have already made clear to patients in their online consultation access form that ‘urgent conditions’ should be reported by contacting the practice by telephone and that certain symptoms will require A&E attention, and that an ambulance should be called. If these instructions are followed practices can deal with routine online consultation contacts during the period of subcontracted festive eves cover, on Monday 29th December and Friday 2nd January.
Those not confident that patients will heed the instructions may feel the need to provide a ‘safety net’ surveillance of the online consultation portal all day on the festive eves.
Online Consultation Tool requirements from 1 Oct 2025-
(Ref A Otley Head of Terms and Conditions of Service ( Independent Contractors) BMA )
The relevant regulation/contract clause is about ‘contact with the practice’ and how a practice should respond to that contact.
- For clarity, from 1 October 2025, the online consultation tool must be available to patients throughout core hours. If it isn’t, that risks a contract remedial or breach notice from the ICB.
- There is no requirement to respond to online consultation requests or queries in real-time (provision 71ZD(2)(b) in the GMS regulations)
- The regulations also do not prevent restriction on how online consultation tools are used by patients. 71ZD(2) states:
(2) An “online consultation tool” is an online facility provided using appropriate software—
(a) through which—
(i) a patient, or
(ii) where the patient is a person to whom paragraph (4) applies, an appropriate person acting on behalf of the patient,
may, in writing in electronic form, seek advice or information related to the patient’s health or make a clinical or administrative request, but
(b) which does not require the response to be given by the contractor in real time.
There is no specific requirement in (2)(a)(ii) above for this to include one of or both non-urgent and urgent requests.
4. The regulations/contract also includes four possible appropriate responses that can be used to respond to any patient contact, including:
(2) The appropriate response is that the contractor must—
(d) communicate with the patient—
(ii) as to when and how the patient will receive further information on the services that may be provided to them, having regard to the urgency of their clinical needs and other relevant circumstances.
Further down, it states:
(4) The appropriate response must take into account—
(a) the needs of the patient [including the need to avoid jeopardising the patient’s health]
5. However, the regulations do not say that a member of the practice team must talk to the patient in communicating (2)(d)(ii) above. Therefore:
- If online consultation tools prevent patients from erroneously submitting an urgent request
- which DHSC and NHSE themselves confirmed in writing would be ‘avoided’ by ‘necessary safeguards’
- that is a way to ensure the tool is only used by patients for non-urgent requests and queries only, as DHSC confirmed publicly that it should be today.
6. Patients can therefore instead be directed to always be sure to call the practice – via on-screen message on the online consultation tool or the practice website, via poster in waiting rooms etc – for anything they believe to be urgent.
7. In the same way they do for attendance at the practice or online consultation tools, any of the four ‘appropriate responses’ in the regulations/contract also apply to telephone calls.
8. The most recent letter to GPCE from Stephen Kinnock, Minister of State for Care, also confirmed that:
“this change does not mean that all online requests require an immediate response. Practices retain discretion to triage and prioritise based on clinical need as they do for telephone or walk in queries.”
9. Furthermore, although the new wording requires practices:
- to have all three means of contact – attendance at the practice (it does notspecify patient entry to the practice), telephone and online consultation tool
- available to patients throughout core hours (8am to 6.30pm)
there is no specific requirement to keep any of the three means of contact open out of hours, i.e. 6.30pm to 8am, as practices are required to ensure that the three means of contacting the practice are available for patients throughout core hours.
10. Practices are not specifically required to ensure the three means of contact are available to patients outside of core hours
1. although they are required to respond in the following core hours if they continue to enable patients to make contact with the practice out of hours.
11. Major outstanding concerns remain, however. Not restricting patients from submitting urgent requests / queries via online consultation tools risks:
- patient safety – if something urgent is missed – and
- staff safety – if:
- requests / queries in any given day are many
- checking through them to capture and triage anything urgent becomes overwhelming
- practice staff are forced to work beyond core hours to go through unchecked online consultation requests / queries from that day and
- waiting lists for routine activity increases to enable practices to review / triage online requests to ensure nothing urgent is missed.
If you have any queries about any of the above please contact us at the LMC Office:
Tel.no 01942 366801