Newsletters

As you will all be aware the Strategic Health Authority have had road shows to advertise this service to potential bidders and the adverts have now gone out. The LMC has been watching this process with interest and in particular the total lack of any consultation or apparent discussion about what these centres will provide. On Monday, 9^th May Lord Darzi gave an interview with John Humphries on the BBC Radio 4 ‘Today’ programme. In that interview he was pressed and certainly gave the impression to listeners that local consultation would take place before changes in service would be implemented. Clearly that is not the case with the GP Led Health Centre. The LMC has already highlighted this to the media, Members of Parliament and the PCT. The latter have advised us that they are not aware of any change to central policy and as far as they are concerned they have no option but to implement this proposal. We have also written to Lord Darzi expressing our concern that what is happening on the ground is very much at odds with his statements on the Today programme. We will let you know what reply we receive, if any!

All practices should now have received a pack from the BMA. If nothing has arrived please contact the LMC and we will get you the material. The packs contain some hard hitting posters, leaflets, stickers and also the 60^th anniversary birthday card. This is a petition which will be handed in to Downing Street on the first day of our LMC Conference. A great many of you supported our previous petition and we had over 4,000 signatories. We very much hope every practice will put up the posters, write to MPs, highlight issues to patients and most particularly get the petition going. It is really important that ordinary patients understand that government policy could have a real impact on their local service provision. It is not just GPs that are under threat, the recent government White Paper on pharmacy and dispensing has potential to seriously undermine small local pharmacies. It is all a bit like the post offices; we are likely to see a centralisation of services and closure of locality based facilities. The LMC does not believe that is in the best interest of patients. We are certainly watching the Pharmacy White Paper developments with a great deal of interest. We are meeting the LPC shortly on this matter. This does not just affect dispensing doctors; all of us will be seriously affected by these changes.

 

The LMC understands that the PCT have seconded Trevor Netherway from a Welsh PCO to come and be Acting Head of Primary Care. Adverts are in place for a substantive Head of Primary Care post and also another Primary Care locality post. The LMC welcomes these appointments and clearly there is a need to strengthen the Primary Care department at the PCT. Unfortunately no progress seems to have been made on the INR LES, although we have had a number of very useful discussions and have supplied the PCT with a lot of information which came from practices about workload. Similarly no progress has been made tying up the last loose ends with the new PMS contract. However the LMC is pleased to report that we have had some very useful discussions about the Extended Hours LES and that this went to the PEC last week. We hope that a reasonably flexible LES will be offered for 12 months that should allow practices recoup the money that was taken off them in the first place. We hope that this will make the best that we can of this bad job. The IM&T DES issue appears to have been clarified and we expect the PCT will be contacting practices shortly on this matter.    However there does seem to be some concern that the PCT will be requiring the PRIMIS Facilitators to visit every practice to monitor their work on the IM&T DES. Part of the requirement will be that practices have uploaded CHART or something similar and will be running electronic audits to clean up practice data. If practices want to try and get CHART running in their practices to work towards the IM&T DES and would like to volunteer they should contact Dr Richard Kinsman (the LMC representative on the Primary Care IT Working Group).

 

The Primary Care Working Group has reported that it has been agreed that touchscreens will be funded, patient call boards, document management and scanning systems, automated patient check-in systems along with appointment management systems. It has also been agreed that handheld devices for portable access to clinical systems will be available with one device per 3,000 patients. The LMC has very much welcomed these proposals. It is clear that our Primary Care IT Working Group is doing its utmost to make the most of its resources and support the work of local practices. 

 

The LMC was dismayed to learn that the tendering process for the Out of Hours Service for Worcestershire has been completed and a contract has been awarded to TCM. This is a private provider based in Ipswich and has no real local involvement. The LMC had hoped that the consortium of local organisations might be successful as we thought that the more local involvement in this service the better. TCM will be given a five year contract and clearly all of us need to watch carefully to see what kind of service is being provided by them for our patients. We are awaiting further information on when they will take over the service. Of concern, particularly to the LMC are the employment rights for the GPs who currently work for the service. One of the pitfalls of a transfer to a private provider is that they will lose their rights to an NHS pension. This is obviously a major problem for anybody transferring from NHS employment or GMS or PMS employment to private providers or APMS. Loss of NHS pension rights is a serious issue which obviously individuals need to bear in mind.

 

We have been very keen to try and work more closely with our colleagues in different parts of Worcestershire’s health economy. We thought it was appropriate to ask if a representative of the PEC would like to attend the open meetings of the LMC. Dr Bill Borastero the Chairman has written back to us informing us that this was discussed by the PEC who welcomed this opportunity. Dr Anthony Kelly from Droitwich will now be the PEC observer at the LMC meetings.

 

We have been informed by Dr Abudu at the PCT that an inspection visit in Worcestershire will take place in June. Inspectors have selected 10 children or closer inspection of case notes and of those 3 or 4 may come in for closer scrutiny. Inspectors are from Offsted and the Healthcare Commission and are looking at a selection of children from the looked after system, i.e. those with disability or difficulties and those with safeguarding issues. We understand from JAR inspections elsewhere might request to see the GP medical case notes as part of the process. The County Council will send out consent letters (there is an approved Offsted Healthcare Commission letter) if this is required. It is not very likely that GPs themselves will need to be involved or interviewed.

 

Dr Felix Borchardt has been involved in the Steering Group in this work on behalf of the LMC and continues this role. A detailed document has been produced on the processes and there is a GP summary and a flowchart. These are available on the LMC website. We have pointed out a couple of errors on the flowchart and a new improved version should be due out shortly. We hope that all practices are aware of the new procedures, both in case they are actively involved and also so they can support the parents at this most difficult time. 

 

One day this will just go away but in the meantime it continues to plague both GPs and your LMC Secretary. A useful link for this is the official documentation and a link is shown below and is available on our website. We continue to raise this with the County Council but have no idea why they cannot administer the system properly.

 

The LMC Secretary recently met up with Dr Chris Heath who leads the Redditch & Bromsgrove PBC Consortium. Following this meeting the LMC discussed the issue of communication between doctors countywide particularly with regard to PBC issues. It is clear that the different localities are working on issues and frequently duplicating. Although this is not essentially an LMC matter, maybe it is something the committee could coordinate to allow the various consortia to work together more closely and share ideas. Indeed there ought to be a better sharing of ideas across a wider locality so as to avoid duplication of work and share good practice. Has anybody any thoughts about this and how we can take this forward? The matter will be discussed again at the next LMC meeting in more detail.

 

The LMC wishes to remind practices that the old fashion practice of practice nurses stocking up the treatment room supply of dressings from patients prescriptions is illegal. Patients should be supplied with prescriptions for dressings and these remain the property of the patient. If they are kept in the surgery for a patients use they should be labelled and clearly identified as such. If practices provide dressings for patients when they are on the premises from stock, those stocks will have to be funded by the practice themselves. We are aware of a number of instances where this perhaps traditional way of working has been investigated. Practices who have any concerns about this should contact the LMC directly. 

 

Over the last couple of LMC meetings there have been discussions about the pay structure for the LMC Secretary, Officers and the Honoraria that we pay. Our existing payment scheme has clearly led to the situation that practices are not being appropriately remunerated for the time spent by doctors working for the LMC. Therefore a new pay scheme has been arranged and is being currently finalised whereby the honorarium will be based directly on GP earnings. The National Association of Specialist Medical Accountants (AISMA) produces figures and these will be used to come up with an annual figure which we will base our payscale. As this and a number of other calculations are yet to be completed we are yet been able to finalise the levy for this year. We hope to have this work completed and supported by the LMC at our next meeting and put in place. We hope that practices will support this development.

 

You may have noticed that we have updated our website. The main change is within our document store section. All documents can now be searched on in a much easier way, so you can sort by either subject area or organisation and we have also added an archive area so we can store our older documents. We hope that you like the new look and find it helpful. Obviously feedback is very important to us and if you do experience any problems please do get in touch and let us know.

 

The following guidance has been added to the LMC website during the last month: