GPs to provide greater range of services to under 6s

The proposed new contract for GPs to provide free medical services for children under age 6 is more comprehensive and includes a greater level of specific services than the current agreement under the medical card scheme.

The draft contract says the proposed scope of the service for young children is not limited to “diagnosis” and “treatment” but also includes participation by the doctor in active health promotion, disease surveillance as well as prevention and appropriate management of chronic conditions.

The level of fees to apply for providing the new services are not included in the draft proposals.

The draft document says that “for the avoidance of doubt, in addition to the treatment of acute conditions, the services required to be provided shall include (without limitation) health surveillance and health promotion activities and the provision of information appropriate to high quality primary care for epidemiological purposes, the prevention, diagnosis, treatment and management of all conditions; routine phlebotomy services, the administration of the flu and pneumoccal vaccines to high risk patients; palliative care and the treatment of minor injuries”.

The document says that some of these services could attract specific payments.

The draft contract says that the GP providing services “shall take an active approach towards promoting health and preventing disease and shall use every consultation as an opportunity to detect early warning signs that could prevent illness and disease.

Service providers would be required to carry out periodic wellness assessments - age based preventive checks that are focused on health and well-being and prevention of disease.

The draft contract also proposes that GPs would be required to comply with cost-effective drug prescribing guidelines and to comply with reporting of adverse drug reactions.

The draft contract would introduce annual medication reviews and a requirement for the service provider to have due regard to patient safety and public health in prescribing to patients including the control and prevention of antimicrobial resistance.

The document also says that GPs should be routinely available for consultation at his/her practice premises and for home visits for 40 hours each week over five days or more.

“In line with the objective of ensuring that the services are provided in a patient-centred manner and that the medical needs of all child patients are to the fullest extent possible met in a primary care context, the service provider shall organise his/ her normal contracted surgery hours and normal/routine surgery hours in a manner which aims to best meet the needs of the child patients.”

It says the service provider as well as any doctor or member of staff needs to be able to show that their competence in English meets the minimum requirements of the HSE.

The draft contract also sets out minimum standards for practice premises.

“All rooms within the practice premises shall be decorated to adequate standards, with no flaking paint, peeling wallpaper or dampness.”