Newsletters

 

Summer holidays are approaching fast and the LMC office will be closed, with nobody there at all to answer any messages or queries between the 4^th and the 15^th August. 

 

The LMC was pleased to welcome Trevor Neatherway, our current Acting Head of Primary Care to the last meeting. Trevor has moved from Wales and is busy looking at all the areas outstanding. He came to the LMC meeting and discussed some of the particular issues and was keen to stress the need for building the working relationship between practices and the PCT once the primary care team is all in post. There has been a big turnover of staff and clearly a lot of local knowledge has been lost. He also expressed his desire to have a close working relationship with the LMC. 

 

One issue on the Agenda at the moment is the matter of INR’s. A meeting has already taken place to discuss this and a further one is planned for the 1^st August. Whether the new LES will be ready this financial year is not yet clear. In the meantime there have been some concerns expressed from GPs about the change in service provision at the Alexandra Hospital. This has been relayed to the PCT. This is clearly a commissioning issue for them.

 

Another matter high on his agenda is to finalise and sign off the PMS contracts. We hope that all practices have now signed their copies and sent them back but there are a couple of outstanding areas. This relates to the level of minor surgery and coil fitting in the baselines. Clearly documentation at the PCT about this is a problem. It would be helpful if practices could look within their own files and see if they have any communications from the PCT and more specifically figures on this issue. If you have these it would be very helpful if you could send copies to the LMC. We will need to resolve this shortly. We anticipate this is only a tidying up exercise and will leave us with a clear working PMS contract which can be adapted as appropriate for the future. 

 

There was a long discussion at the LMC meeting about the Choose & Book LES. For some practices that have been doing significant work on Choose & Book the income under the new LES will drop so they have little incentive to keep going or even expand their service. Other practices who have not been so adventurous continue to find Choose & Book unworkable in Worcestershire. This does seem to relate entirely to the Acute Trust and this has been put to the PCT on a number of occasions now by the LMC. If the PCT has any hope of meeting its Choose & Book target it really needs to push the Acute Trust to put the right slots on the system. Otherwise practices are going to have no choice but to use Choose & Book and send patients out of the county. 

 

The LMC would commend to practices the Annual Public Health Report which is a very good, clear and interesting document. The LMC was also interested to read the PCT’s ‘Developing a Strategy for Health’ document which was very interesting and possibly the first time a primary care organisation in the county has mentioned the LMC and our particular concerns about issues. It is a frank and honest document which we felt was good to see. 

 

There was further discussion at the LMC meeting about the dispensing white paper which potentially has a major impact on small pharmacies and also dispensing in small towns. A lot of work is taking place nationally on this issue and our vice-chairman Dr Ounsted is particularly active in this area. Comments and concerns have been fed back to the GPC who are watching this area closely. The LMC is arranging a meeting with the LPC shortly to discuss our shared concerns.

 

The LMC is absolutely dismayed that already two issues have arisen with the newly TCN managed service. Prior to the tendering process we expressed real concern that whoever took over should be encouraged to develop the service in such a way that more Worcestershire doctors would wish to work in OOH. Secondly a related matter is the issue of training for GP Registrars in OOH. Despite this, within weeks of taking over TCN has reduced the payment levels for doctors. We have raised this formally with the PCT as we believe this will have a negative effect on the service. Dropping the rates of pay could reduce the calibre of doctors working in the service which will have a negative effect on the existing salaried doctors who may choose not to continue to work in Worcestershire. It will undoubtedly be a major disincentive for local GPs to continue to provide OOH work. If this happens there will be problems with training for our GP Registrars. A representative from TCN is coming to the next LMC meeting in September. In the meantime we have written to both TCN and to Paul Bates at the PCT expressing our dismay at these developments so early on in the contract.

 

Back-up tape encryption is coming soon. It is proposed to have encryption software on all practice servers so that back-up tapes are automatically encrypted. There is a national procurement plan to reduce the cost and we would like to advise practices that when this happens it is considered to be best practice and will be funded by the NHS and we have no doubt that our local I.T. group will manage this in their usual sensible way. 

 

There has been some continuing concern about the IM&T DES. A PCT letter seems to suggest that particular standards of data quality are being looked at. We don’t believe this is in line with the documentation in the Brown Book and have raised this with the PCT. We just want to clarify how the DES is being interpreted locally.

 

We have been made aware that elsewhere in the country there are problems with the supply of Pediacel vaccine. Apparently this is partly due to the HIB catch up campaign and in part to practices bringing forward the pre-school booster as requested by the Department of Health. If any practice has insufficient vaccine for their requirements they should email Movianto UK at vaccine.supply@dh.gsi.gov.uk including their account number. The DH will get additional vaccine to them.

 

GPs may be interested to know that an interview on forthcoming pension changes across the four nations with Dr Andrew Dearden, the Chairman of the BMA’s Pension Committee is available on both BMAtv and the BMA website as follows:

 

 

 

Whilst on the issue of pensions there is a BMA Focus Document on the dynamising factor which is available on both the BMA and LMC website.

 

We understand practices have received large invoices from companies offering directory services. The companies often contact small businesses offering to list them in their paper or web based directory. The way the offer is worded usually makes it seem as though the listing is free of charge, although buried somewhere in the small print is a clause allowing the company to charge a hefty fee for the listing. Practices should always exercise due caution when sending their details for inclusion in such directories. If they do receive a large unexpected invoice they should contact their local Trading Standards office for further information.

 

The GPC has heard report that some PCTs have been instructed that the Extended Hours DES will be viewed as a minimum requirement and that flexible LES arrangements which do not match the requirements of the DES specification will not count towards PCT 50% targets. The GPC is looking into this as a matter of urgency and further guidance will be issued when necessary. The LMC is meeting the PCT next week and will be discussing this. We don’t know yet if and when the DES will actually be published but the latest rumour says September or October. Clearly if the current Worcestershire PCTs flexible LES is rejected nationally this will have a major implication. No doubt many practices will not choose to provide extended hours in the terms of the very onerous DES which was forced on us at the beginning of the year.

 

 

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