1. www.england.nhs.uk General Practice Annual Declaration Summary of Changes 15 September 2014

2. www.england.nhs.uk Introduction Questions asked in the annual electronic declaration have been updated to account for: Changes in the contract. Changes in referencing. Changes relevant to where CQC Essential Standards will be replaced by Fundamental Standards Changes made by request of GP practices to improve their understanding of the questions. This translates to: 11 revisions to questions which were asked last year. 19 new questions have been introduced ( 7 of these are only necessary to respond to, depending on the response provided to a previous new question asked). 4 question have been removed 46 questions remain unchanged.

3. www.england.nhs.uk Questions revised: Why changed? CRB no longer exists and has been replaced by DBS. Question 2C (r)Response All relevant staff have been subject to the necessary Disclosure and Barring Service (DBS) checks. The DBS has replaced the Criminal Records Bureau (https://www.gov.uk/government/organisations/disclosure-and- barring-service/about).https://www.gov.uk/government/organisations/disclosure-and- barring-service/about Yes/No

4. www.england.nhs.uk Questions revised: Why changed? By request of practices to clarify meaning of 084 guidance requirements which was referred to in the question asked last year. Not all 084 numbers are premium rate. The question and response options have been improved to reflect this. Access by PhoneResponse – selection 4C (r). Does the practice use a premium rate telephone number for patients? (e.g. a premium rate 084 or other number) i.Yes – premium only ii.Yes – premium and local iii.No - local only

5. www.england.nhs.uk Questions revised: Response options: Ref. 1: Website Feature: If selecting ‘not able to confirm ’ a ‘pop up’ message will appear to say that: “declaring not able to confirm, means that you are not able to provide evidence from patient sources, this does not necessarily mean you are not meeting the reasonable needs of your patients”. Why Changed? Increased profile of patient dissatisfaction in access. Question has been revised to be specific to evidence which has been “obtained from patient sources”. Question 4Q (r) has been revised in response from feedback to help improve clarity In case of Emergency (during core contract hours) The contract states that “the Contractor must provide the services described in Part 8 (namely essential services) at such times, within core hours, as are appropriate to meet the reasonable needs of its patients, and to have in place arrangements for its patients to access such services throughout the core hours in case of emergency” (2014, NHS England, Standard GMS Contract) 4Q (r) During the preceding 12 months, the practice can confirm, that it can evidence (if requested), how it is meeting the reasonable needs of its patient population and the practice has arrangements in place for its patients to access such services throughout the core hours (08:00 – 18:30 Monday to Friday) in case of emergency? 1.The practice can confirm with evidence which has been obtained from patient sources in the preceding 12 months from: (select all that apply from list) Patient Participation Group, GP Patient Survey, Local Survey, Combination of PPG/GPPS/Local Survey, Other: FREE TEXT entry: 2. The practice is not able to confirm 1 4R (r). The practice can confirm it has arrangements in place for its patients to access essential services in case of emergency if the practice is not open during core contract hours. Yes/No

6. www.england.nhs.uk Questions revised: Why changed? By request of practices to clarify the meaning of last year’s question which asked if practices were responsible for care in the Out of Hours period (I.e. yes/opted in or no/opted out). Out of Hours 4T (r). Is the practice responsible for the provision/commissioning of care in the Out of Hours period? (i.e. care which is provided by the practice or commissioned by the practice. This does not refer to Out of Hours Care commissioned by the CCG). Yes / No (opted out)

7. www.england.nhs.uk Questions revised: Three questions: 5L, 5M and 5N are unchanged other than the addition of the prefix starting statement “With regard to dispensing doctors…” Why changed? By request of practices to clarify these questions are specific to having dispensing doctors. Also introduced “N/A” as a response option.

8. www.england.nhs.uk Questions revised: Why Changed? Question previously asked about CQC Essential Standards. In April 2015, CQC Essential Standards will be replaced by Fundamental Standards. This revision to the question helps to maintain alignment with CQC whilst not been invalidated when Fundamental Standards are introduced later. Question 7A (r)Response Have you registered with CQC each location at which you provide services? Yes / No

9. www.england.nhs.uk New Questions Ref.1: “This means that there has been a change in the contractual entity of the practice” Ref. 2: N/A, applies if the practice is new and was not able to complete an electronic declaration last year. Why introduce this question? Helps to account for changes in a practice configuration when practices declare a second time under the same organisation code. 1F (n). Since your practice last completed this declaration, have you changed configuration 1 or structure? (e.g. the practice is declaring under the same organisation code as for last year’s declaration and since this time, the practice has merged or divided from another practice). Yes / No/ N/A 2

10. www.england.nhs.uk New Questions Why Introduce 4D? It remains unacceptable for patients to be phoning premium rate phone numbers to reach their GP practice. Question helps to understand extent the issue is likely to continue for owing to contract duration with telephone providers. Access by PhoneResponse – selection 4C (r). Does the practice use a premium rate telephone number for patients? (e.g. a premium rate 084 or other number). i.Yes – premium only ii.Yes – premium and local iii.No - local only 4D (n) If responding ‘yes’ to question 4C (r) please indicate by which date your current contract with your premium rate 084 provider will expire Select from: i.By 31/03/2015 ii.By 31/03/2016 iii.Later than 31/03/2016

11. www.england.nhs.uk New Questions Why introduced? Necessary to understand access to General practice Closing HoursResponse 4E (n). Are there any regular periods during each week that the practice is closed to patients between the hours of 8.00 and 6.30pm Monday to Friday (except bank holidays)? Yes/no Question 4F (n). If yes, please provide details of days and times Response Monday Tuesday Wednesday Thursday Friday 4G (n). Are there any other intermittent periods during each month that the practice is closed to patients between the hours of 8.00 and 6.30pm Monday to Friday (except bank holidays)? Yes/no Question 4H (n). If responding yes to question 4G(n), please indicate frequency of intermittent closure period and provide details of days and times Day Frequency of intermittent closure time: select from list: fortnightly / once every three weeks / once a month / once every other month / other (free text) Time: select a.m / p.m Monday Tuesday Wednesday Thursday Friday

12. www.england.nhs.uk New Questions Why asked? Necessary to reflect changes in the contract [1] [1] Question 4O (n) is applicable if responding No to question 4N only. Patient online access It is a contractual requirement for GP practices to offer and promote to patients: online booking of appointments, ordering of repeat prescriptions and by 31st of March 2015 access to summary information (as a minimum) in their patient record, subject to the necessary GP systems and software being made available to practices by NHS England. If you need any guidance, advice or support (including contact details), please visit NHS England’s Patient Online Programme’s web pages for more information http://www.england.nhs.uk/ourwork/pe/patient-online/ (GMS Schedule 6, part 5, new paragraph 74C, PMS Schedule 5, part 5, paragraph 70D) 4L (n). Patients at this practice can book appointments online. Yes/No 4M (n). Patients at this practice can order their repeat prescriptions online. Yes/No 4N (n). Patients at this practice can access summary information from their medical record online. Yes/No 4O (n). If ‘No’ does the practice have a plan to enable this facility by 31 March 2015? Yes/No

13. www.england.nhs.uk New Questions Why Introduced? Necessary to reflect changes in the contract. New Out of area patients (GMS Regulations, part 5, revised regulation 26B, PMS Regulations, part 5, regulation 18B) 4P (n).The practice intends to offer primary medical services (excluding home visits) to new patients who are seeking to register with the practice and reside outside their usual practice boundary area. Yes / No / Don’t Know

14. www.england.nhs.uk New Questions Why Introduced? Necessary to be assured that patients have access to services during an emergency when the practice is not available during core contract hours In case of Emergency (during core contract hours) The contract states that “the Contractor must provide the services described in Part 8 (namely essential services) at such times, within core hours, as are appropriate to meet the reasonable needs of its patients, and to have in place arrangements for its patients to access such services throughout the core hours in case of emergency” (2014, NHS England, Standard GMS Contract) 4S (n) If practice services are not available to patients during core contract hours what arrangements are in place? Select response from drop down list:  Same OOH provider as that commissioned by CCG,  Sub contracted provider: (enter name and select from list provided),  Provided directly by the practice,  Other free text entry:,  None

15. www.england.nhs.uk New Question Friends and Family Test: Why introduced? Necessary to reflect changes in the contract and provide further support where necessary. Question 5Q (n)Response The practice is confident that sufficient arrangements are in place to implement the Friends and Family Test, as per the guidance, from 1 December 2014? The FFT will be a contractual requirement from 1 December and is described in the guidance published by NHS England, NHS Employers and the BMA General Practitioners Committee www.nhsemployers.org/FFT. If you need advice or support you can find it here www.england.nhs.uk/ourwork/pe/fft/ (including contact details), or in the FAQs - see link www.england.nhs.uk/wp- content/uploads/2014/07/fft-imp-guid-faqs-14.pdf ).”www.nhsemployers.org/FFTwww.england.nhs.uk/ourwork/pe/fft/www.england.nhs.uk/wp- content/uploads/2014/07/fft-imp-guid-faqs-14.pdf Yes/No

16. www.england.nhs.uk New Question Why Introduced? Necessary to reflect changes in the contract

17. www.england.nhs.uk New Question Why introduced? This question previously referred to the practice’s action plans for meeting the CQC Essential Standards. This revision to the question helps to maintain alignment with CQC whilst not been invalidated when Fundamental Standards are introduced later. Question 7B (n)Response The practice has notified CQC of any changes to partnerships, regulated activities, locations from which you provide them or any conditions placed upon you. Yes 1 / No 2 / N/A 3 [1] [1] Declaring Yes means a change has occurred and the practice has informed CQC. [2] [2] Declaring No means a change has occurred but the practice has not yet notified CQC. [3] [3] Declaring N/A means no changes have occurred