Newsletters

The LMC is aware that at least 17 practices have lodged notices of dispute with the PCT over the results of the recent and widely discredited survey. The LMC has already indicated to the PCT that we believe their arbitrary deadline of the 7^th August was inappropriate. It is our impression that the regulations actually allow three years for such appeals to be made. Nevertheless we think it is appropriate to get this sorted out as soon as possible and would encourage all practices who believe that they have a case to put together their case and these will be considered in due course. Anybody who has a confidence interval greater than 7% for PE7 and/or PE8 or can make other reasonable argument why the survey did not give an accurate result for their practice should apply. 

 

However, until we have a change of government these surveys look likely to continue and practices need to consider if there is anything they can do that will either improve their performance or patients perception of their performance. Competition in the marketplace for healthcare seems to be something all politicians like. We all have to recognise that is the world we now live in.

 

Thankfully since the schools have broken up it does seem to have got quieter and the LMC is not aware of any practices currently experiencing any problems. This pause may be very useful and give us time to put together business continuity plans and collaborative arrangements for the likely increases in cases in September/October. We are aware that many areas are getting together and forming clusters to plan for joint working and support. If that is not happening in your area we encourage all practices to consider this and talk to their colleagues. This bit of respite could be very useful for us all!

 

Negotiations nationally are continuing to work out emergency SFEs that would operate in the event of a pandemic. It has been suggested that two separate sets are needed, one for severe mass attack pandemic which will render many practices unable to deliver anything like a normal service and one for a pandemic which will stress the NHS severely but does not stop most practices working. We will be watching this, it is important that this is sorted sensibly and soon.

 

Concern has been expressed that an increase this year in the total deducted for opting out of Out of Hours provision will affect practices income in such a way that some GMS practices will not receive the minimum 0.7% uplift. The GPC has advised us that this will not happen. The Out of Hours opt out deduction remains at 6% of global sum. As global sum payments have increased this year, the total amount of money deducted from global sum payments for practices that have opted out of Out of Hours will increase. This will not have the effect of reducing overall practice income in practices with correction factors because the global sum is offset against corrective factor payments after such opt outs have been deducted. The SFE is read in such a way that all GMS practices will still receive a minimum of 0.7% uplift. The GPC is confident that the Exeter system will translate the SFEs provisions accurately. If any practice believes that they are receiving less than the minimum 0.7% uplift this year please let the LMC know and we will forward this on to the GPC.

 

Just a reminder that the GMC is bringing in the Licence to Practice on the 16^th November 2009. From this date any doctor wishing to practice medicine in the UK will by law need to hold both hold registration and also have a licence to practice. At the beginning of July half of all the UK doctors told the GMC about their licensing decision. Further letters are going out and we strongly encourage everybody to respond as soon as possible to the GMC with your requirements. Failure to do so will mean you will not be able to work after the 16^th November!

 

At the last LMC meeting Dr Harris from Elgar Healthcare came to brief the LMC about the plans for the new GP Led Health Centre. We understand that it has not yet open and for some reason the opening date has been put back again. Two particular issues was discussed with the LMC. One was information sharing and the other was referrals. Elgar Healthcare have confirmed that GPs will receive notification of consultations that take place when patients attend the walk in part of the centre. The committee discussed with them the issue of referrals. There were mixed feelings about the appropriateness of the walk in centre making any referrals to secondary care. Whilst we feel that it is completely appropriate for any emergency referrals to be made we have mixed feelings about routine referrals or even “two week waits”. It was agreed that where possible referrals would be passed back to registered GPs for them to make referrals but there may be circumstances where referral is appropriate by the doctor at the walk in centre. We will monitor this once the centre is up and running. All practices have by now received notification form for at risk patients. This is obviously an issue for Worcester City GPs. It is hard to know how many patients from further around the county will attend the walk in centre.

 

The Secretary has met with Annie Dickson, Chairman of the Safeguarding Adults Committee and one of her staff. This is a new organisation working along similar lines to the Safeguarding Children’s Board. At the moment it does not have any statutory role unlike the Children’s Board but indications from the Department of Health are that this will change. The Board will look at the death of vulnerable adults and will look if there are any issues of abuse or neglect and will mirror the work taking place with children. The LMC has suggested to them that it would be appropriate to have a GP representative on the Board and a panel of GPs able to give advice and review cases. This has served us very well with the Children’s Board where Dr Felix Borchardt has for some years been the GP representative. If there is a GP in the county who would be prepared to take on this work and attend approximately four meetings a year perhaps they could contact the LMC. We are awaiting a definite response from the Board that they support such a post and also they are prepared to fund it. We believe this is the appropriate way forward. Similarly a panel of three or four GPs from across the county who will be prepared to take part in the review process where GPs work is of concern would be very useful. Again possible volunteers are being sought. Once the Safeguarding Adults Board has discussed this and firmed up their proposals we will inform you.

 

The National Collaborating Centre for Cancer (NCC-C) has been commissioned by NICE to update its guidance. They are looking to recruit members to an expert Guidance Development Group to review formerly the original recommendations which relate to the management of low risk BCCs in the community. It is vital that the voice of genuine GPs is heard and that those who apply to do this are not intimidated by the volume of work or the volume of invective from hospital colleagues. If anybody is interested in applying please let us know and we will forward your details onto the GPC. 

 

The new guidance is available on our website and on the BMA and supersedes the previous interim advice for Locum GPs on death benefits during the Flu Pandemic. For many months the BMA has been working with officials to assure that the dependents of Locum GPs will be fully protected should the Locum GP die whilst working for the NHS. The English Department of Health has issued a letter to Primary Care Trusts setting out how it considers the matter should be dealt with and this guidance relates to that.

 

 WORCESTERSHIRE I.T. PRIMARY CARE WORKING GROUP

Dr Kinsman, our LMC representative on this group has made a plea for an additional GP representative. Redditch and Bromsgrove is under-represented particularly and an additional GP would be very welcome. If anybody is interested please contact the LMC and we will pass on your details. If you wish to find out more about this you can contact Dr Richard Kinsman at Spa Medical Practice in Droitwich.

 

 IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES (IAPT)

Three quarters of PCTs in England will be delivering improved access to psychological therapies in primary care this year. The NHS has produced a CD Rom to enable GPs and their team to make the most of this opportunity for patients.  The involvement of general practice is essential to the development of the new services. The CD Rom contains useful information about how to use PBC to maximise this valuable development. and strong evidence of the effectiveness of the service in treating people with long term conditions and medically unexplained symptoms, as well as treating the common mental health conditions of anxiety and depression. More information is available at www.iapt.nhs.uk and copies of the CD are available from the LMC office. (PBC leads may well be intested in the CD Rom).
  

 PBC LEGAL ADVICE

The LMC has entered into an arrangement with BMA Law whereby they will provide expert legal advice on PBC matters including things such as contracts and negotiation issues. This will be provided at the special rates available via BMA Law. If any practice in the county embarking on PBC and are in need of legal advice we would strongly suggest you contact the Secretary to discuss this. It is anticipated over time this will spread out across the country but we are very fortunate to be in the forefront of this development which we think could be very advantageous for our PBC work. 

 

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

 

 

BMA/GPC guidance: