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December 2025 Update

OpenSAFELY – Mandatory Activation Reminder

Practices using SystmOne or EMIS Web are reminded of their obligation to activate the NHS OpenSAFELY Data Analytics Service within their clinical systems. This follows the formal Data Direction issued on 9 June 2025 by the Department of Health & Social Care.

  • NHS England correspondence: We understand that NHS England has written directly to practices this week who have not yet completed activation, reinforcing the requirement and providing further guidance.
  • Activation guidance: Clear step‑by‑step instructions are available via NHS England Digital: How to activate the OpenSAFELY analytics platform.
  • Legal requirement: Activation is not optional. It is a statutory duty under the Health and Social Care Act, and practices must ensure compliance without delay.
  • Professional support: OpenSAFELY has the full backing of the profession, reflecting its value in enabling secure, transparent, and population‑level insights to improve patient care and system planning.

Why this matters

OpenSAFELY provides a trusted, privacy‑preserving environment for analysing NHS data at scale. By activating the service, practices contribute to:

  • Improved patient safety through rapid identification of risks and outcomes.
  • Evidence‑based planning for workforce and service design.
  • Transparency and accountability in how health data is used for public good.

Action for practices

  • Confirm activation of OpenSAFELY within your clinical system (SystmOne or EMIS Web).
  • If you have not yet acted, please prioritise this immediately.
  • Refer to the NHS England Digital guidance for technical steps and support.

Mental Health Problems in Huntington’s Disease – Free GP Webinar

Mental Health Problems in Huntington’s Disease – Free GP Webinar

The Huntington’s Disease Association (HDA) is hosting a free lunchtime webinar specifically for GPs:

Date & Time: Wednesday 22 January 2025, 1:00pm
Topic: Mental health problems in Huntington’s disease – what every GP needs to know
Platform: Zoom

Why attend?

Mental health problems are common in Huntington’s disease and can cause significant distress both to the individual and to their families. GPs are often the first point of contact, and understanding the psychiatric and behavioural aspects of Huntington’s is crucial for providing effective, compassionate care.

This webinar will explore:

  • The range of mental health problems experienced by people with Huntington’s disease.
  • Practical steps GPs can take to support patients and families.
  • How to recognise, manage, and refer appropriately within the wider care pathway.

Expert speaker

The session will be led by Professor Hugh Rickard (MD FRCPsych), Consultant in Neuropsychiatry and Honorary Professor of Neuropsychiatry at the University of Birmingham. Professor Rickard brings extensive expertise in the psychiatric dimensions of neurodegenerative conditions, offering practical insights tailored to primary care.

Registration & certification

  • To register, visit: HDA Event Registration
  • A certificate of attendance will be provided, making this a valuable CPD opportunity.

Further information

For queries, please contact:
John Gregor – Education Lead, Huntington’s Disease Association
📞 Direct dial: 0191 338 8123

Redesign of the DRI Front Door Assessment and Signposting Service

Work has now begun on the redesign of the Front Door Assessment and Signposting Service at Doncaster Royal Infirmary (DRI), located at the entrance to the Emergency Department (ED) and Urgent Treatment Centre (UTC).

This initiative is being delivered in partnership between FCMS and Doncaster & Bassetlaw Teaching Hospitals (DBTH), and forms part of the wider Doncaster Urgent and Emergency Care Redesign Programme led by the Integrated Care Board (ICB).

Background and engagement

  • FCMS recently attended local TARGET sessions to share the proposed changes with practices and gather feedback.
  • The redesign will be implemented in phases, ensuring safe transition and alignment with the broader urgent and emergency care strategy.
  • Phase 1 commenced on Monday 1 December 2025, marking the first step in moving Primary Care presence to the front door of the service.

What Phase 1 involves

Patients who self-present at the DRI site will now experience a new assessment process:

  • Digital streaming: Patients will be asked to use iPads to access the NHS Pathway Streaming and Redirection Tool.
  • Clinical oversight: A Primary Care Urgent Treatment Desk clinician will be stationed at reception to support the process.
  • Patient flow: The tool will guide patients to the most appropriate service — UTC, Minor Injuries, or ED.
  • Clinical triage: Where the tool requires clarification or is unsuitable, the Urgent Treatment Desk clinician will carry out an initial triage to ensure safe and appropriate redirection.

Exemptions

Patients who have been directed to attend DRI following a prior consultation with a healthcare professional in the community will be exempt from this streaming process.

To avoid delays or duplication:

  • Patients should bring a copy of their referral letter or documentation for the receiving specialist.
  • Alternatively, referral details can be emailed directly to: DRI.urgenttreatmentdesk@nhs.net.

Why this matters

This redesign aims to:

  • Improve patient flow and reduce unnecessary waits.
  • Ensure patients are streamed safely and appropriately to the right service.
  • Strengthen the role of Primary Care at the front door, supporting integrated urgent and emergency care.

Protecting Premises Against Terrorist Attack – Martyn’s Law

Martyn’s Law, officially the Terrorism (Protection of Premises) Act 2025, received Royal Assent on 3 April 2025. This landmark legislation has been introduced to strengthen protective security and preparedness across the UK, ensuring that organisations are better equipped to respond in the event of a terrorist attack.

The Act places a legal duty on those responsible for certain premises and events to:

  • Assess the risk of terrorism.
  • Put in place proportionate plans to respond effectively should an attack occur.

Healthcare premises are explicitly included within the scope of the Act – covering hospitals, GP surgeries, health centres, and other NHS buildings.

Implementation timeline

The Act will not come into force immediately. The government has set an implementation period of at least 24 months, meaning enforcement is expected to begin around early 2027.

This period is designed to allow time for:

  • Establishing the new regulator function within the Security Industry Authority (SIA).
  • Publishing detailed guidance and compliance frameworks.
  • Giving organisations sufficient time to prepare, plan, and embed protective measures.

How the Act works – tiered approach

The Act introduces a tiered duty system based on the expected occupancy of premises:

  • Standard Duty Premises (200–799 capacity)
    Must implement basic emergency preparedness measures, including:

    • Evacuation, invacuation, and lockdown procedures.
    • Clear communication protocols.
    • Staff training on safe routes and use of security equipment.

  • Enhanced Duty Premises (800+ capacity)
    Must meet all the above requirements, plus additional measures such as:

    • Formal risk assessments.
    • Physical security measures (e.g., CCTV, controlled access).
    • Consideration of dedicated security staff.

What this means for primary care

  • Most GP surgeries, dental practices, community pharmacies, opticians, and smaller primary care centres will not meet the 200-person threshold and are therefore likely out of scope for mandatory duties.
  • Larger health centres or hubs, particularly those hosting multiple practices or services, may fall under the Standard Duty category if they can reasonably expect 200+ people (staff and patients combined) on site at the same time.

If a premises is assessed as in scope, it must:

  • Appoint a Designated Senior Individual (DSI) responsible for compliance.
  • Implement protective measures and staff training.
  • Prepare and maintain response plans for terrorist incidents.

Voluntary adoption for smaller premises

Even if below the threshold, the Home Office and NHS guidance strongly encourage voluntary adoption of basic preparedness measures. This reflects the reality that terrorist attacks are unpredictable, and smaller premises may still be directly or indirectly affected.

Voluntary steps include:

  • Developing evacuation and lockdown plans.
  • Staff awareness training, such as ACT (Action Counters Terrorism) e-learning.
  • Establishing clear communication protocols for emergencies.

Key actions for primary care providers

  • Check occupancy levels to determine whether your premises meets the threshold.
  • If in scope:
    • Identify and appoint a Designated Senior Individual (DSI).
    • Develop and rehearse emergency procedures (evacuation, lockdown, communication).
    • Train staff in terrorism awareness and response.
  • If out of scope:
    • Consider voluntary adoption of preparedness measures.
  • Stay updated with forthcoming Home Office guidance and NHS Estates updates for detailed compliance requirements.

Immunisation Consent Update – Immediate Workflow Review Required

The UK Health Security Agency (UKHSA) has issued a clarification on immunisation consent processes. While the policy itself has not changed, expectations are now stated more explicitly, requiring practices to review workflows without delay.

What has changed

  • Healthcare Assistants (HCAs) cannot:
    • Carry out a clinical assessment for vaccination.
    • Seek informed consent.
    • Work under a Patient Group Direction (PGD).
  • Only a registered healthcare professional (doctor, nurse, pharmacist, or other prescriber) can undertake these responsibilities.
  • HCAs can still administer vaccines under a Patient Specific Direction (PSD), but only once informed consent has already been taken by a clinician.
  • The BMA and RCN have updated their positions, and the Green Book wording now reflects this clarification.

PGDs vs PSDs – a reminder

  • Patient Group Direction (PGD):
    • Allows certain registered clinicians to administer medicines without a prescriber assessing each patient individually.
    • HCAs have never been permitted to use PGDs.
  • Patient Specific Direction (PSD):
    • Requires a prescriber to assess the patient and obtain informed consent.
    • The prescriber then delegates administration to an HCA, who must confirm nothing has changed before giving the vaccine.

 Training and responsibilities

  • The 2025 standards recommend that only experienced Healthcare Support Workers (HCSWs) at Level Three or equivalent administer vaccines.
  • While not mandatory, these standards reflect the wider legal requirement for staff to be appropriately trained and supervised.
  • Practices must ensure that PSDs are signed before clinics start. Electronic time stamps mean signing afterwards could expose staff and the practice to risk if an incident occurred earlier in the session.

What Practice Managers say needs to happen now

To remain compliant without disrupting clinics mid-season, Practice Managers advise:

  • Reviewing workflows to ensure HCAs are never assumed to have taken consent.
  • Ensuring a clinician completes the assessment and informed consent before or during clinics.
  • Making the consent pathway explicit in documentation.
  • Refreshing staff training so HCAs understand their role in confirming willingness to proceed, not seeking consent.
  • Guaranteeing PSDs are signed before clinics commence.
  • Sharing information with patients ahead of appointments and offering opportunities for questions.

 Reassurance and next steps

  • The role of HCAs in administering vaccines has not been removed.
  • The clarification ensures that the clinical elements of consent remain with registered professionals and that documentation is robust.
  • Practices are awaiting further clarification on whether HCAs can continue to enter vaccinations into clinical systems under local protocols.
  • National bodies are aware of the operational challenges, and further updates are expected.

BMA Analysis of the Autumn Budget – Key Implications for General Practice

The Autumn Budget, published this week, sets out a range of measures with direct and indirect consequences for GPs and primary care employers. The BMA has issued its analysis, highlighting areas of concern and priorities for negotiation.

Workforce costs – National Living Wage

  • The National Living Wage for workers aged 21 and over will rise by 4%.
  • For GP practices as employers, this represents a significant increase in staffing costs.
  • The BMA has made clear that these additional costs must be fully reimbursed within NHS funding streams, to avoid further financial strain on practices.

Tax and National Insurance

  • Tax thresholds remain frozen, meaning that as salaries rise, employees will pay a greater proportion of their income in tax.
  • The threshold at which employer National Insurance Contributions (NICs) are payable is also frozen, placing upward pressure on GP employer costs.
  • Together, these measures increase the financial burden on practices, particularly in the context of already tight budgets.

Inflation and NHS budgets

  • Higher than expected inflation means that NHS budgets will grow more slowly than anticipated.
  • This compounds existing pressures on service delivery, workforce sustainability, and investment in primary care.
  • While the government announced £300 million in additional capital investment to support new technologies across the NHS, this is unlikely to offset the wider impact of inflation on day‑to‑day budgets.

Neighbourhood Health Centres

  • The government has committed to delivering 120 operational Neighbourhood Health Centres by 2030.
  • These will be funded via a Public Private Partnership (PPP) model, raising questions about long‑term sustainability and the balance between public and private investment in healthcare infrastructure.
  • The BMA will continue to scrutinise this commitment to ensure it aligns with patient needs and workforce realities.

Pensions

  • Pension changes announced in the Budget will not affect the vast majority of GPs, as the NHS Pension Scheme is not a salary sacrifice scheme.
  • This provides reassurance that existing pension arrangements remain stable.

What this means for practices

  • Practices should prepare for increased staffing costs linked to the Living Wage rise.
  • Employers must factor in higher NIC liabilities due to frozen thresholds.
  • Inflationary pressures will continue to squeeze budgets, making efficiency and advocacy for fair reimbursement critical.
  • Infrastructure commitments may reshape the landscape of primary care delivery, but details on implementation remain limited.

Read the full BMA analysis here: Budgets and fiscal events – Budget – BMA

Doncaster Place and Bassetlaw Place Medicines Optimisation Bulletin

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LMC Buying Group

Doncaster LMC is been a member of the LMC Buying Groups Federation.

Buying Group membership entitles practices to discounts on products and services provided by the Buying Group’s suppliers.

Membership is free and there is no obligation on practices to use all the suppliers. However, practices can save thousands of pounds a year just by switching to Buying Group suppliers. To view the pricing and discounts on offer you need to register for access to the Buying Group’s online portal: https://buying.plexusportal.co.uk/Register.

What is the purpose of the Buying Group and how does it work?

The sole purpose of the Buying Group is to save its member practices money by negotiating discounts on goods and services which practices regularly purchase. The Buying Group team negotiate with suppliers, after which they identify ‘approved’ suppliers, who guarantee to give you significant discounts over what you would otherwise pay for their services, in return for the Buying Group’s endorsement and help in making you aware of what they offer.

Does it cost us anything to be part of the group?

No, membership is free and members are free to use as many discounts as they wish.

Is there any obligation to take up the deals offered?

No. Each practice is free to take up or decline any of the deals the Buying Group have negotiated. If you wish to take advantage of any of the offers in question, you will be given contact details, and all communications take place between you and the individual supplier*.

*The Buying Group accepts no liability for any contract willingly entered into by a practice with an approved supplier. Practices are advised to check that the terms of any contract with suppliers are consistent with those the Buying Group have negotiated and are advised to inform the Buying Group team of any discrepancy. The Buying Group do not, however, accept any responsibility for any member practices’ failure to check the terms of the relevant contract and the principle of caveat emptor (buyer beware) applies in all cases. Your rights as a consumer under the Consumer Protection Act are unaffected. With respect to any services to which the provisions of the Financial Services Act 2000 might apply practices are advised to seek independent financial advice as may be appropriate.

What happens to my details?

When a practice signs up for Buying Group membership, they will keep your basic contact details (practice address) on a secure system. On the membership application form, they also ask you how they can use your personal data (i.e. your email address) but even if you do sign up to receive their emails you can stop them at any time by clicking the unsubscribe button.

What if I am not happy with the quality of goods and services supplied?

Always let the Buying Group know if you encounter any problems getting what you want, and they will endeavour to sort it out.

Contact the Buying Group

The Buying Group is managed by Plexus Support Services Ltd:

Tel: 0115 979 6910

Email: info@plexussupport.co.uk

Website: https://www.plexussupport.co.uk

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