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Coronavirus - Vaccination Enhanced Service and Model Collaboration Agreement

on Wednesday, 09 December 2020.

At the start of the month, NHS England published the coronavirus (COVID-19) Enhanced Service (ES) Specification together with a model collaboration agreement for use by practices as part of the COVID-19 vaccination programme.

The ES required all GP practices to sign up by midnight on 7 December and required practices to have in place a collaboration agreement (no later than the date of first administration of the vaccinations). GP practices are not required to be part of an established PCN, but are expected to collaborate with neighbouring practices and established PCNs as part of a ‘PCN Grouping’ to deliver the ES.

What Are the Key Requirements for the Collaboration Agreement?

The ES specification requires the collaboration agreement cover the following requirements (as a minimum):

  • "appropriate arrangements for patient record sharing in line with data protection legislation
  • appropriate arrangements for reporting of activity data, vaccine stock (to include stock use and stock forecasting, which must include the brand of vaccine delivered and required by the PCN grouping), available capacity and submission of required data to the Commissioner (NHSE). Where appropriate access to mandatory national systems is required, these will be made available free of charge.
  • appropriate arrangements for communicating with patients, including but not limited to call/re-call
  • arrangements for any sharing and deployment of staff as agreed by the 'PCN Grouping' in relation to the efficient delivery of the services pursuant to this ES
  • financial arrangements between the collaborating GP practices and, if relevant, financial arrangements relating to other healthcare providers (such as community pharmacies) outside of its 'PCN Grouping' involved in local delivery of this ES
  • arrangements in relation to use of the Designated Site and any other relevant premises (as required)
  • sub-contracting arrangements (as required)
  • a lead contact email address for the 'PCN Grouping' which shall be supplied to the Commissioner (NHSE) for use in disseminating information urgently, and
  • appropriate indemnity arrangements. The Clinical Negligence Scheme for General Practice (CNSGP) provides clinical negligence indemnity cover for all staff engaged by a GP practice under the CNSGP Regulations. It covers NHS activities delivered by a Part 4 contractor under a Primary Medical Services contract (including an NHS standard contract with Schedule 2L), a Primary Medical Services subcontractor, or the provision of ‘Ancillary Health Services’ for a Part 4 contractor or Primary Medical Services sub-contractor such as an ES. Cover under CNSGP is not restricted to a GP practice’s registered patients so would apply to the provision of an ES by a GP practice to a person such as practice staff who are not on the registered list of that GP practice."

The Collaboration Agreement - Next Steps

The Collaboration Agreement which was published alongside the ES is not mandated but is intended to cover the above. However, as with the PCN Network Agreement, much of the detail is left for the 'PCN Grouping' to populate. 

If anyone had thought that the timeframe for tailoring Network Agreement Schedules was tight back in 2019, the timeframes here make that initial lead in look like a lifetime! 

It will be a source of frustration to have to agree new governance frameworks for any 'PCN Grouping', which mirrors the PCN in membership and perhaps though more frustrating where the PCN and 'PCN Grouping' membership does not align. 

Taking a Pragmatic View

Consequently, it is likely that PCNs will need to take a pragmatic view to ensure compliance with the specification given the timing and duration of this ES.

The key areas, as with the PCN Network Agreement, will be decision making, payment, staffing and how liability is dealt with and apportioned. The model Collaboration Agreement is a legally binding document and so the practices will want to ensure that areas of risk are covered off as best as they can.

Governance

Where the 'PCN Grouping' mirrors the PCN in membership, it may be possible to reference the decision making process set out in their Network Agreement. If not the participating practices may need to draw out relevant extracts (if acceptable to the other parties).

Subcontracting

As with the Network DES, where the 'PCN Grouping' is using a third party to deliver the ES, the practices will need to have in place an appropriate subcontract and have obtained the relevant consent/given the appropriate notifications to the Commissioner.

Staff Sharing

In relation to staff sharing between 'PCN Grouping' practices, the model collaboration agreement includes a 'Memorandum of Understanding' which is stated to not be legally binding save for provisions on confidentiality and data protection. Bizarrely, the cross indemnities between practices and liability provisions are excluded from being legally binding so if practices are intending to use this, then they should think carefully about including legally binding indemnities. GP practices should always be mindful of their obligations to employees and workers.

Property

It is assumed that the Designated Site(s) will either be a practice's or subcontractor's premises, but if the 'PCN Grouping' is intended to utilise a third party's premises as their Designated Site, then they may need to enter into property/licence arrangements.

Data Protection

It is possible that current PCN data sharing arrangements may work for this ES, but it will need to be updated to cover any additional processing activities and sharing with third parties outside the PCN.

Whilst we would always advise on taking specialist legal and financial advice on these arrangements, given the timeframes, we recognise that practices are likely to have to take a practical approach to cover off the above requirements. 


If you do need any assistance on your Collaboration Agreement, please do not hesitate to contact Mark Jarvis in our Healthcare team on 020 7665 0880, or complete the form below.

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