Newsletters

We understand that the PCT is near to deciding on the final details for the job description for its Medical Director role. This is clearly a very important post within the PCT, not least because this person will be the responsible officer who will deal with revalidation issues. The LMC is watching this process with great interest. On the issue of revalidation continued meetings are taking place with the PCT to discuss the implementation of the new scheme within the county. However at a national level much of the proposals seem to be now being questioned and the roll out of the scheme looks increasingly delayed. At the recently held LMC Conference Professor Mike Pringle led a discussion on this issue which clearly showed how much of this is frankly a total shambles. Even the RCGP’s proposals are now being rethought. We will keep you informed of any definite information.

 

Referral management is back on the Agenda again. The PCT has been doing some work on this area. Surprisingly it appears that the PBC clusters have not been consulted. The LMC pointed out at our meeting that there were no GPs on the group that had started this work. This seems frankly ludicrous. If any appropriate referral management systems are to take place, then right at the beginning there needs to be a lot of GP input to lead it in an appropriate and worthwhile direction. 

 

Vascular checks were very much on the Governments agenda and the PCTs were supposed to have this implemented by April. National guidance has gone woolly and even the name of the scheme keeps changing. Frankly we have no idea of what is going on at a national level and it is very hard to advise GPs if and when this scheme will see the light of day. Like many of the Governments so called good ideas, it has major implications of work load for practices and cost implications for PCTs. Maybe that is why it is all going quiet! 

 

At the LMCs instigation the PCT has agreed to review the Violent Patient Scheme. It is at least four years since this was set up and has never been reviewed. There are certainly some areas that do need to be revamped.

 

Lynda Dando gave us an update on the situation regarding the current enhanced services and possible developments for the coming year. It is anticipated that this work will be completed by the end of June. 

 

The PCT Board has agreed with the development of a new Clinical Forum. This will separate out the Clinical Senate from executive positions and re-establish a role for the PEC. The LMC has broadly supported this development and it is anticipated that regular monthly meetings will start in the next two months. Recently the LMC officers met with the PBC leads across the county and discussed this and other issues retaining to PBC and how we believe GPs should be taking forward this agenda.

 

We have been keeping you informed of the developments regarding this discredited survey. We are aware that at least 19 practices have informed the PCT that they are disputing the result of this part of the QOF. We recently circulated the Department of Health’s further guidance which seems to accept that there are problems with this but rather than taking a decision nationally has dumped the problem on PCTs. The LMC has already spoken to the PCT about this and we hope to have further discussion of how the PCT will manage this. If you have not already done so we would encourage all practices that are unhappy with the results of the survey to lodge their concerns with the PCT. We have circulated GPC guidance on this matter and it is available on our website. 

 

The AGM was held on the 4^th June. Dr David Dickson, the LMC Secretary from South Staffordshire will continue as Chairman and his Vice-Chairman is Dr Jamie Macpherson, Coventry LMC Secretary. The GPCWM Secretary, Dr Grant Ingrams continues in post. The Committee have planned some of its work for the coming year, particularly training areas for LMCs. The annual Nuts & Bolts training session has been booked for September. Dr Laurence Buckman will be coming to give us an update on national issues. 

 

The LMC Secretary is almost relieved that pandemic flu has now arrived! A great many meetings have been held over the last two years which many people have treated with some degree of cynicism. However it was always felt that this was going to happen one day and we should have proposals in place. Further meetings are taking place with the PCT and probably by the time this newsletter reaches you the countywide briefing meeting will have taken place. Clearly the rise in flu cases will have a tremendous impact on practices. Whether the proposals and the scheme outlined will work is hard to assess but at least nobody can criticise us for not having tried to plan for this event. The response of patients in the hotspots so far, notably Birmingham suggest that demand and workload on practices could be phenomenal. We will all need to work together and make some major compromises if we are all to cope with the possible onslaught later in the year.

 

A pandemic flue page with information specifically aimed at GPs has now been set up on the BMA web site at:

 

Other Pandemic Flu websites:

 Department of Health:

 Royal College of General Practitioners:

      http://www.rcgp.org.uk/clinical_and_research/pandemic_planning.aspx

 Health Protection Agency:

 

At the last LMC meeting Dr Martin Ounsted stood down as elected member from Evesham. The Chairman thanked Martin for many years of sterling service to the LMC not least on dispensing matters. He retires from practice in September. The Committee wished him very well for the future. A retirement dinner in planned in due course for both Martin Ounsted and Richard Horton.

 

Unusually two volunteers came forward to take over Dr Horton’s seat on the LMC. Dr Matt Davis has taken over as one of the Wyre Forest representatives. The Committee was delighted to welcome Dr Lynne Butcher back to the LMC and it was agreed that she should be co-opted as a member. Her previous role as a PCT Medical Director will no doubt give her very useful expertise and aid the working of the LMC. Finally it has been agreed by the GPs in Evesham that at the next meeting Dr David Herold will replace Dr Ounsted.

  

ATOS who provide the medical service for the Benefits Agency recently contacted a Worcestershire doctor requesting an urgent fax of information to confirm the patient needed a home visit for a medical. We feel that this is inappropriate. The fact that ATOS are asking for the information to be faxed directly to them means that they are asking for the information, rather than asking the claimant to supply evidence of inability to attend. Therefore the practice can charge ATOS at their normal rate for a report and opinion. 

 

ESA Regs 2008, Reg 22(2) "...where a claimant fails without good cause to attend for or submit to an examination.... the claimant is to be treated as not having limited capability for work" ie he is unlikely to be given ESA in the first instance by a Decision Maker of the Department of Work and Pensions. But he will already be getting ESA by virtue of his Med3 and that continues to be paid until any appeal he makes has been determined.

 

As a Tribunal member, if he appealed and if it emerged that he was unable to attend for examination by virtue of his ill health I would expect his appeal to be allowed on the grounds of good cause. The Tribunal can call for evidence from the GP and will pay for it at fixed (not very high) rates.

 

So, if ATOS were to suggest that by failing to send them a fax, a GP was disadvantaging the patient we believe they would be wrong. In conclusion we feel the simplest thing is to decline to do this.

 

The GPC annual report for 2009 is now on the BMA website and both the full report and executive summary can be accessed at:

http://www.bma.org.uk/about_bma/annual_reports/gpcannreport09.jsp.

 

The Deanery is running a Sports Medicine Qualification to produce specialists for the 2012 Olympics, this will open to GPs to apply. Dr Martin Wilkinson, Director of Postgraduate General Practice Education is currently forming an advisory e-panel to help with delivering the programme and possibly to provide clinical attachments in sports medicine.  He is looking for GPs with sports medicine qualifications or a strong occupational interest eg sports club doctor to contact him at:

 gpeducation@westmidlands.nhs.uk or 0121695 2376.

 

The LMC is dismayed to find that people are still not using nhs.net accounts. If you have concerns about your email do contact the I.T. service desk. Please find below a link to a diagram detailing what our secure forms of email communication are as there has been some confusion about this. We are grateful to Dr Kinsman for producing this for us.

 

It is that time of year again. We are aware of somebody even requesting a home visit for a child with D&V so that they could be certified unfit for exams. It simply is a waste of GPs time. The Joint Committee on Qualifications has advised that face to face contact with GPs is not required. It makes sense for a number of conditions, not just infectious diseases where contact with others may not be in anyone’s best interest. Obviously if the patient should be visited that remains a separate issue of clinical judgement. Guidance on the Joint Council of Qualifications Frequently Asked Questions can be found at http://www.jcq.org.uk/faqs/special_consideration/ and this states that “Does an awarding body need medical notes in each case?” And the answer is “no”. Only for part absence and for circumstances that cannot be verified. If a medical note is not forthcoming, is there a label from the prescription which can be used or part of a computer prescription sheet? It needs the candidate's name and the date. There is also a self-certification form and notes for its use (Form 14 on the JCQ website).   If a candidate misses a unit which can be taken at a later date, they would suggest not to ask for a medical note and submit an application. They can simply re-enter the candidate at the next available opportunity.

 

On the 16^th April the Kings Fund announced that it was launching an 18 months enquiry into the Quality of General Practice. On their website www.kingsfund.org.uk can be found the introduction to this enquiry. Later in the year there will be a possibility for input from GPs and other health professionals working in general practices along with patients and the public. This is something else to watch with interest.

 

All GPs must not forget that they will need a license to continue in practice by 16^th November 2009. If you have not had a letter from the GMC you must contact them and complete the required paperwork. Email them on licensing@gmc-uk.org.

 

We have outlined an agreement with the BMA to organise a special scheme for Worcestershire GPs to use BMA Law to handle their PBC legal affairs. The pilot started in London and we hope to be on line relatively soon. The BMA’s team of lawyers will therefore be able to advise on limited liability partnerships; company law; contracting and a whole host of issues. Practices involved in PBC in Worcestershire will be able to use this at the BMA’s special rate. This will not just save money but should provide a high level of expertise in this particular area. More details will follow shortly.

 

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