Newsletters

The LMC is in regular discussion with the PCT and the current issues that are being discussed are as follows:

 

1.         QOF Losers

We have raised this a number of times with the PCT and are glad to hear that discussion is taking place within the PCT about how to address this issue which does seriously affect at least three practices in the county.

 

2.         DDRB Award:

The LMC has raised with the PCT the issue of pay awards for PMS practices. Guidance document has been received from the DOH suggesting to PCTs how they might approach this for PMS practices and we have suggested to the PCT that this would not be an unreasonable way forward. We expect a decision shortly. 

 

3.         Clinical Senate

Lynda Dando, the Head of Primary Care has put forward plans for a Clinical Senate that hopefully will be an effective forum to deal with issues relating to new enhanced services, county wide practice based commissioning issues and indeed an interface between the different PBC groups. The LMC has a representative on this group which we believe is a sensible proposal. Dates are not set in place yet for regular meetings but we are encouraging the PCT to start this process as soon as possible. 

 

4.         MRSA Screening

Concern has been raised around the county about the increasing work from MRSA screening and the number of faxes and letters being received by practices instructing them to manage patients on behalf of secondary care. The LMC feels that either this should be entirely the responsibility of the secondary care organisation or should be appropriately delegated to us perhaps as a LES. This has been raised with the PCT. 

 

5.         Vascular Screening

The Government has indicated that vascular screening or now called ‘Health Checks’ is an ongoing thing and the PCT will have to put in place a scheme for this to be done. The LMC believes that primary care is the best place for this to happen and is awaiting news from the subgroup at the PCT looking at this matter. The workload for this could have serious implications for practices on time and resources and we flagged up a range of issues with the PCT.

 

6.         QOF and PMS visits

These are more or less now completed and we will be looking forward to seeing the report from Lynda Dando detailing the responses from the PMS practices. This will be an interesting summary of the different views relating to practices around the county. On the issue of the QOF visits there will be a meeting in due course to discuss how these have gone and the management of QOF for the coming year.

 

In summary there is a great deal happening and steady progress is now being made across a wide range of areas. We will keep you posted with developments as usual.

Over the last few months a lot of work has taken place locally trying to plan towards the implementation of revalidation and reaccreditation. The appraisal team have been particularly busy. The new enhanced appraisal will form a key part of the revalidation process. The RCGP has published an interesting guidance document entitled ‘RCGP guide to the revalidation of general practitioners’. This is version 1 and we are led to believe it is the first draft. There are a great many holes within the process and still a lot of uncertainty. The LMC are watching these developments with great interest. A key part of the process is the appointment of a responsible officer and all PCTs are in effect having to appoint a Medical Directors to take on this role. We believe our PCT will be pursuing this shortly. Apparently it is anticipated that the process will start in 2010 but indications from the GPC this week has suggested that this is unrealistic and 2011 looks more likely.

 

As you can imagine of particular concern for the LMC is what happens to doctors who fall foul of this process. This could be for health reasons, performance reasons or system failures within their practice. This definitely does not mean that all the doctors failed by the system will be unfit for practice. There will be an increase need for support mechanisms, advisors, mentors and help to support doctors and their practices who find themselves in an extremely difficult position. It is sad that there is no mention of this in the process and nothing is in place. The LMC has raised this with the BMA, RCGP and the GPC and will try and push this particular agenda. There is a strong case for saying that support mechanisms should be put in place across more than the one PCT area and maybe the whole of the SHA. As the plans develop and are finalised there will be a great deal more information coming out to discuss with GPs.

 

At the last LMC meeting representatives of the Mental Health Trust attended the meeting to tell us about their Foundation Trust bid and also to discuss issues around Mental Health services in Worcestershire. This was the first time in living memory that anybody from the Mental Health Services has been to an LMC meeting and is to be welcomed. They seem keen to have regular dialogue and the LMC was particularly gratified that they have agreed that there should be an LMC representative on the Board of the new Foundation Trust. Sadly having initially felt the same the Acute Trust has taken the LMC representative off their Board! We will be meeting with their Chief Executive shortly to express our continued dismay at the lack of real dialogue between primary and secondary care. Why it has always been like this in Worcestershire is extraordinary. It is not for want of us trying to change things.

 

Many of you will remember that in the past fees for a range of services were agreed under the so called ‘collaborative arrangements’. The Review Body some years ago cancelled this arrangement so we would like to remind practices that it is entirely up to you to set these fees. An example is fees for Emergency Mental Health Act Assessment. Neither the PCT nor the LMC can set fees. Practices have to do these themselves. The LMC would suggest that all practices produce a list of all their fees for these various services and notify the appropriate authorities what their fees will be for the coming year. This may be something to do every year at this time of the year when the Review Body and others report. Guidance document is available on the BMA website but only for BMA members!

  

The last LMC meeting at the beginning of April was Dr Richard Horton’s final meeting as a member of the LMC. He first joined the committee in 1988 and has been a valuable member ever since. He has served both as Vice-Chairman and Chairman. The Committee thanked Richard for all his work and undoubtedly he will be greatly missed. We have written to all practices in Wyre Forest with a view to co-opting a replacement until elections for that seat are held next year. In due course the LMC will be organising a dinner to celebrate Richards retirement. We all wish him the best for a long, happy, healthy, (and hopefully prosperous) retirement. 

 

As you should be aware we recently circulated to you a guidance document we have put together about the new complaints procedure. This is available on our website as is a frequently asked questions document we have just received from the GPC. Every practice needs to have a Complaints Procedure which will need to be updated in view of the new regulations. At least somebody in each practice needs to review all this and make the appropriate changes.

 

The GPC has received a series of complaints in recent months from GPs and LMCs concerning the procedures adopted by Acute Trusts when dealing with referral letters from GPs. The common complaint is that Trusts address all referral correspondence to the senior partner of a practice. This policy impedes administration within practices and can potentially compromise clinical safety. In addition it appears to run counter to the Government’s policy of improving services, putting patients first. The LMC would welcome information from practices if this appears to be a problem for local GPs.

 

For information – how the GP Registrars Supplied is applied, and which GP Registrars are eligible for this supplement.

 

The GP Registrars supplement is paid to all GP registrars who are in a GP practice placement, regardless of whether they are in year ST1, ST2 or ST3. This supplement is added to each GP Registrar's basic salary. GP Registrars beginning a General Practice placement from 1st April 2009 will receive a supplement of 45%.

 

The GP Registrars supplement used to be called the Out of Hours Supplement, and was paid to reflect the out of hours work undertaken by GP Registrars. However, with the introduction of practice-based GMS/PMS contracts and the decision by many practices to opt out of providing out of hours services, GP Registrars working patterns changed. The GP Registrars Supplement is now paid to GP registrars in order to ensure parity between GP registrars and hospital junior doctors' salaries. Although the supplement does not reflect absolute hours worked by GP Registrars, it does go some way towards reflecting the intensity and risk management involved in being a GP registrar in modern general practice.

 

The DDRB, in their report this year, recommended a further drop in the GP registrars supplement from 50% to 45%. This drop followed reductions in the supplement in 2006, 2007 and 2008 which have significantly reduced the overall level of GP registrar remuneration. The GP Trainees subcommittee of GPC are extremely disappointed by the DDRB's 2009 recommendation, as we believe that the continual erosion of the GP Registrars supplement will have a negative impact on GP trainee recruitment at a time when the Government is seeking to expand the number of GP Trainees.

 

Full details of GP Registrars remuneration can be found in the following documents:

 

GP Registrar Directions (Schedules 1 and 2)

 

 

Please find below a link to the flyer on the ‘Fund for Innovation’ being provided as a joint venture by NHS West Midlands the Queens Nursing Institute(QNI).  NHS West Midlands is one of the first SHAs to join forces with the QNI to develop innovation and leadership skills in the health care workforce at a regional level. This is a great opportunity for the development of the health care workforce at any stage of their career who want to make a difference to their patients.  It includes a professional development programme for successful applicants and they intend to develop local networks of support for the teams.

 

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

 

 

Clinical DESs for GMS contract (BMA & NHS Employers guidance)

Available on BMA website and LMC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

World Class Commissioning: Improving Pharmaceutical Services