News Items
Humberside LMC Manifesto for General Practice in our Integrated Care System
Date published: Monday 13 June 2022
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Today we are publishing our new manifesto setting out our vision for general practice as we approach the implementation of Integrated Care Systems on 1 July 2022.
Humberside LMC Manifesto for General Practice in our Integrated Care System
Workforce and wellbeing
• We need to retain the excellent workforce we have and urgently recruit new GPs by widening the funding to attract doctors to parts of our region where there have been consistent shortages of trainees. ARRS plays an important role but must not be allowed to detract from the crisis in GP recruitment and retention. The Fuller stocktake report references the workforce crisis and we need to see engagement across the general practice workforce to co-create a local and ICS workforce plan.
• Our survey of local GPs told us that high workload, fear of complaints and low staffing levels are leading to low morale & burnout across the profession. The LMC believe we need continuous funding for resilience support for GPs and the wider medical and support workforce in primary care.
Primary/Secondary Interface
• The LMC believe that primary and secondary healthcare providers in our region could work better together. Whilst relationships are developing across providers, we need to see urgent action to stop uncontracted work flowing into primary care and a greater system understanding of primary care pressures. We know there is a willingness from practitioners across our system to communicate, integrate and evolve to provide a better patient care experience. The LMC want to work with ICS at Place and providers to improve this integration and invite all stakeholders to embrace this opportunity and call to action. ICS and Place are critical to the success of this.
Premises
• An historical underinvestment in premises and increasing demand for accommodation for new PCN and ARRS roles is placing an unsustainable demand on our primary care estate. The current NHS three year capital funding equates to £6,000 per practice per year for BAU and GPIT and this is simply not enough. The LMC would like long term realistic capital funding to meet the needs of patient care and a premises charging administration which is responsive, transparent and fair. Estates strategies at neighbourhood and Place need external support and funding to develop – this burden cannot sit with PCNs and CDs who have insufficient resources. Funding processes need to be simple and agile.
IT and Infrastructure
• The LMC is concerned about the impact of digital health providers on our local system and the impact of a digital gateway to access healthcare which could amplify health inequalities. Continuity of care lies at the centre of traditional general practice, with local surgeries or scaled providers providing person-centred care from the heart of communities. We want to see a well-integrated and mixed provision which serves the need of all of our patient population.
• Effective primary care should be built on a stable and integrated IT platform. The LMC supports a case for fast and reliable infrastructure integrated across the whole healthcare system with controlled access to patient records by all practitioners.
You can also download our manifesto for general practice in our Integrated Care System.
LMC Podcast - June Practice Managers' Update
Date published: Monday 13 June 2022
The latest edition of our regular update for Practice Managers includes updates on primary/secondary care interface issues, ICS update, training and development, and more! Jonathan Appleton, Communications Manager, is joined by Maddie Clifford-Roper, Business Support Officer, and Dr Rolan Screiber, Medical Secretary to bring you the latest news.
You can listen and subscribe via podcast apps including Apple and Spotify. You can also listen online at podcast hosting site Anchor FM.
Links for this episode:
Relay UK - system helping people with hearing and speech difficulties communicate with anyone over the phone.
FIT Testing for 2ww Lower GI Referrals
Date published: Wednesday 8 June 2022
The LMC continues to be contacted by practices who are experiencing issues with 2ww referrals for lower GI cancers being rejected or delayed if a FIT test has not been carried out. A recent email from the HNY Cancer Alliance has caused further confusion and the LMC wish to clarify the situation.
The NICE 2ww guidance sets out how GPs should:
Refer adults using a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer if:
- They are aged 40 years and over with unexplained weight loss and abdominal pain, or
- They are aged 50 years and over with unexplained rectal bleeding, or
- They are aged 60 years and over with: iron-deficiency anaemia, or changes in their bowel habit, or
- Tests show occult blood in their faeces.
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in people with a rectal or abdominal mass.
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in adults aged under 50 years with rectal bleeding and any of the following unexplained symptoms or findings:
- Abdominal pain.
- Change in bowel habit.
- Weight loss.
- Iron-deficiency anaemia
While there is a NICE diagnostics guideline on the use of faecal immunochemical testing (FIT) to guide referral for colorectal cancer in primary care (Overview | Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care | Guidance | NICE), this is not part of the 2ww guidance. Many areas use FIT testing as a helpful adjunct to triage referrals, particularly during the pandemic.
The LMC has always taken the position that while primary care can be asked to request a FIT at the point of referral, or include a FIT result in a 2ww lower GI referral, it cannot be mandated. No cancer referral should be rejected or delayed due to lack of the test. This is the current agreement with all acute trusts in our region.
In the event that a FIT test has been requested but the result is not available at the time of booking an appointment, the clinical responsibility remains with secondary care.
If you or your colleagues have experienced any issues around FIT testing and access to care, please contact the LMC via our main inbox humberside.lmcgroup@nhs.net and we will escalate these immediately on your behalf.
LMC Newsletter May 2022
Date published: Tuesday 31 May 2022
The May edition of the LMC newsletter is out now. In this issue you'll find all our news, events and updates for general practice in the Humber region. Included in this issue:
- Our LMC hot topics this month include changes to our constitution, and our work to raise awareness of the issues facing general practice among our region's MPs
- How to access a care navigation toolkit - free for all Humber and North Yorkshire practices
- News on the Rebuild General Practice Campaign which is appealing for the public's support in tackling the crisis facing primary care
Dr Bushra Ali Appointed New GP Board Member for Humber and North Yorkshire Health and Care Partnership
Date published: Monday 30 May 2022
In March 2022 we invited nominations for GPs to become the GP member of the Integrated Care Board for Humber and North Yorkshire Health and Care Partnership.
This is an important role as it gives a strong GP voice at the highest level within the new ICS, which replaces our CCGs on 1 July 2022. Nominations were received from 14 GPs with very strong experience and impressive credentials to deliver this role. A two stage recruitment process involving further submissions and interviews took place in May 2022. Both Humberside LMC and YORLMC took part in this recruitment process.
We are pleased to announce that Dr Bushra Ali will be taking on this role. Bushra became a GP partner in 2017, has been a GP Board member for NHS Hull CCG, before becoming their first clinical member with responsibility for health inequalities. Bushra has also taken an active role in the Primary and Secondary Care Interface Group, collaborating with HUTHT to improve the interface between the two and improve the experience for patients.
Humberside LMC will be supporting Bushra in this new role, we hope you will also offer your support.
Next Steps for Integrating Primary Care: Fuller Stocktake Report Published
Date published: Thursday 26 May 2022
The final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, has been published. Dr Fuller has been looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
The introduction to the report summarises the issues facing primary care:
"Every day, more than a million people benefit from the advice and support of primary care professionals – acting as a first point of contact for most people accessing the NHS and also providing an ongoing relationship to those who need it. This enduring connection to people is what makes primary care so valued by the communities it serves.
Despite this, there are real signs of genuine and growing discontent with primary care – both from the public who use it and the professionals who work within it. Inadequate access to urgent care is having a direct impact on GPs’ ability to provide continuity of care to those patients who need it most. In large part because of this, patient satisfaction with access to general practice is at an all-time low, despite record numbers of appointments: the 8am Monday scramble for appointments has now become synonymous with patient frustration."
The report goes on to set out a vision for integrating primary care:
"It is the collective judgement of the people who have engaged closely in our stocktake that the vision for integrating primary care set out in this report is achievable if we create both the conditions to enable locally led change and the supporting infrastructure to implement it: indeed, as demonstrated by many of the case studies contained in this report, systems are already working in this way."
Read the Fuller Stocktake Report.
We will post further developments regarding the stocktake report as news becomes available.
Rebuild General Practice - GPs Sign Open Letter to Patients
Date published: Tuesday 24 May 2022
GPs across the country have signed an open letter to patients to ask for their support to improve the difficulties facing general practice.
The letter is part of the Rebuild General Practice Campaign, which aims to deliver the general practice service that patients and staff deserve. The campaign, funded by the BMA and GPDF, calls for improvements to recruitment, retention and safety.
You can view the letter below, and you can add your name to the signatories by emailling hello@rebuildgp.co.uk.
Please like, comment and retweet the open letter on Twitter.
Free Staff Satisfaction Survey for GP Practices
Date published: Wednesday 18 May 2022
A free staff satisfaction survey and analysis is available for 50 GP practices in England from Qualitas. The survey aims to help you identify the key issues facing your staff and how you can make tangible improvements to their day-to-day working lives. Practices taking part will receive a detailed report containing key findings and collated staff insights from the survey.
The key dates are:
1. A kick-off webinar on Tuesday 7th June 2022, which will explain the entire process - how staff views will be gathered, how you can engage your team so they see the benefit in participating, what pitfalls to avoid, and what will happen at each stage.
2. After the kick-off webinar, we will share with you the link to our online survey. You will need to share this link with both clinical and non-clinical staff in your practice. The survey will be live for 3 weeks from 27th June to the 15th July 2022.
3. Once staff have completed the survey, Qualitas will analyse the results. Each practice will receive a detailed report, containing key findings, easy-to-read data, and collated staff insights from the survey.
4. The process will conclude with a follow-up webinar on the 9th August 2022 which sets out the overall benchmarked results - allowing you to see how your practice compares with others in your peer group - as well as practical tips and recommendations for how you can implement the survey findings in your practice.
This offer is completely free to the first 50 practices to sign-up – so hurry, as places are limited. More details including how to sign up can be found on the Qualitas offer sign up page.
LMC Update 12 May 2022
Date published: Monday 16 May 2022
You Matter! Free Lunchtime Workshops for Front of House Staff
Online events for primary care front line reception and administration staff members.
A series of six 75-minute bitesize resilience and wellbeing webinars facilitated by two experienced resilience and wellbeing coaches. You can choose to attend all six sessions or the ones that most appeal to you. Various dates are available between 25 May and 25 June, for more information and online registration visit: Humberside LMC: Events.
‘Coffee Connect Event’
Take a virtual coffee break with a colleague working in the Humber and North Yorkshire region as part of the Mental Health Awareness Week 9-15 May. Visit the sign up page to take part, register your details, and you will receive a wellbeing gift.
On sign-up, you’ll be matched with someone else participating, an email will be sent to confirm along with some guiding questions. It’s then up to both parties to organise a convenient time for a 30-minute coffee break to have a chat. Given the geographical spread of Humber and North Yorkshire, and the fact that many colleagues may be front line or working from home/offices, participants will need to be flexible about the form their coffee break takes – possibly on MS Teams or a phone call might be best.
The theme for this year’s Mental Health Awareness Week is tackling loneliness. For more information, including tips on practical steps to address loneliness, visit Mental Health Awareness Week.
Free Care Navigation Toolkit for All HNY ICS Practices
This free care navigation toolkit is available to all practices in the HNY ICS (supported by Winter Access funding.) This system is designed by a working practice manager and is for reception staff to use when booking an appointment on behalf of a patient. It is simple to use and requires minimal training or set-up time. The care navigation signposting can be adapted for each individual practice as we recognise there is no “one size fits all” solution.
Please note, this is an optional offer which is completely free to practices. For more information on how to access this toolkit, including a video demonstration, please email humberside.lmcgroup@nhs.net.
Free Staff Satisfaction Survey for GP Practices
A free staff satisfaction survey and analysis is available from Qualitas for 50 GP practices in England. This aims to help you identify the key issues facing your staff and how you can make tangible improvements to their day-to-day working lives. Practices taking part will receive a detailed report containing key findings and collated staff insights from the survey.
More details of what’s involved and how to sign up can be found on the Qualitas offer sign up page.
Free Centralised HR Recruitment Service for Humber and North Yorkshire Practices
Date published: Tuesday 10 May 2022
Yorkshire Health Partners have established a free HR centralised recruitment and onboarding service to help practices recruit for their ARRS roles. The service is available free of charge to all practices in the Humber and North Yorkshire area. They are now scheduling assessment centres for June, July and August – if you’d like to discuss this further please email yhp.centralisedhr@nhs.net and one of the team will give you a call back to see how they can help you.
You matter! - Free Lunchtime Workshops for Front of House Staff
Date published: Monday 9 May 2022
Online events for primary care front line reception and administration staff members.
A series of six 75-minute bite size resilience and wellbeing webinars facilitated by two experienced resilience and wellbeing coaches. All sessions are free, and you can choose to attend all six sessions or the ones that most appeal to you.
Webinar 1: How to Manage Stress and be Kinder to Yourself
Wednesday 25th May, 1pm – 2:15pm
For more information and to book please visit: www.humbersidelmc.org.uk/events/13537
Webinar 2: How to Change Perspectives to Achieve Clarity and Focus
Wednesday 8th June, 1pm – 2:15pm
For more information and to book please visit: www.humbersidelmc.org.uk/events/13539
Webinar 3: How to Build Resilience in your Team
Tuesday 21st June, 1pm – 2:15pm
For more information and to book please visit: www.humbersidelmc.org.uk/events/13540
Webinar 4: Thrive – Identify Key Resilience Factors
Wednesday 6th July, 1pm – 2:15pm
For more information and to book please visit: www.humbersidelmc.org.uk/events/13541
Webinar 5: Use the Power of your Mind to Boost Resilience
Thursday 21st July, 1pm – 2:15pm
For more information and to book please visit: www.humbersidelmc.org.uk/events/13542
Webinar 6: Shift your Thinking for a more Resilient Mindset
Monday 25th July, 1pm – 2:15pm
For more information and to book please visit: www.humbersidelmc.org.uk/events/13543
LMC Update 05 May 2022
Date published: Thursday 5 May 2022
Hull Hospitals Reintroduces Partial Booking
Hull University Teaching Hospitals NHS Trust is to reintroduce partial booking for new patients. Partial booking is the process of where, once the hospital accepts and triages a referral, in accordance with waiting list volumes the patient will be invited to contact the hospital to book an appointment. The aim is to enable patients to agree an appointment date that is convenient for them and reduce the number of patients not arriving for appointments.
The trust will be initially piloting partial booking in Neurology before rolling out to other specialities. Certain services will be excluded from partial booking including 2WW services and Rapid Access Service. Also, as part of the triage process, clinicians are able to notify the booking team of patients unsuitable for partial booking. Patients will be sent an invite to book letter to their correspondence address, asking for them to contact the hospital within 14 days to arrange their appointment.
Read more in this communication for practices.
Free Care Navigation Toolkit for All HNY ICS Practices
This free care navigation toolkit is available to all practices in the HNY ICS (supported by Winter Access funding.) This system is designed by a working practice manager, and is for reception staff to use when booking an appointment on behalf of a patient. It is simple to use and requires minimal training or set-up time. The care navigation signposting can be bespoke to each individual practice as we recognise there is no “one size fits all” solution.
Please note, this is an optional offer which is completely free to practices. For more information on how to access this offer including a video demonstration of the toolkit please email humberside.lmcgroup@nhs.net.
LMC Newsletter April 2022
Date published: Thursday 28 April 2022
The April edition of the LMC newsletter is out now. Included in this issue:
- New IPC guidance, plus the latest guidance on symptomatic and asymptomatic testing
- A new support offer for locum GPs
- Get your copy of the care navigation toolkit
Every month the newsletter is sent to GPs and practice managers across the Humber area. If you don't currently receive if please contact us and we will add you to the recipients.
New IPC Guidance Summary
Date published: Thursday 28 April 2022
The LMC has published a short summary of the revised Infection Prevention Control (IPC) guidance, which the UKHSA released in April 2022. The revised guidance now advises returning to pre-pandemic physical distancing in all healthcare settings, including primary care.
Organisations should undertake local risk assessments to ensure safe working. Importantly, all patients, visitors and staff should continue to practise good hand and respiratory hygiene, including the continued use of face masks by staff and face masks / coverings by visitors and patients where clinically tolerated.
Download our IPC guidance summary. The full guidance can be found here: Infection prevention and control for seasonal respiratory infections in health and care settings.
FREE CPD, Booking Platform and Admin Support for Locum GPs
Date published: Friday 22 April 2022
Would you like to access a Locum GP Support Programme free of charge?
If you are a Locum GP working within the Humber, Coast and Vale ICS, you are eligible to take part in this programme, supported by Humberside LMC.
What’s on offer?
FREE CPD - Regular meetings which will cover a mix of educational content, guideline reviews, and broader issues such as managing complaints, leadership and career development. The meetings also provide you with an opportunity for peer and pastoral support and enable you to benchmark your practice. A Clinical Lead will also be available to support you with any complaints, significant events and case reviews and support and guide you through any processes. We will work with you to review your PDPs and help you meet your targets.
FREE BOOKING PLATFORM - Access to ImpaxHub, an easy-to-use online booking platform where you can upload all of your important documentation, add your availability and find your invoices and pension information.
FREE ADMIN SUPPORT - Access to an administration team who will make bookings on your behalf; issue invoices to practices and provide you with day-to-day operational support. You will continue to be paid directly by practices and you remain self-employed. We will also upload all of your pension forms onto PCSE online if you are in the pension scheme.
The programme will run during a six-month period as a pilot with evaluation taking place to help inform future projects of this nature. We will therefore ask you to provide feedback about the programme.
Background
The nature of locum work, which is an increasingly popular choice for newly qualified GPs, means that colleagues may have no support network and have only brief contact with a place of work. This makes it challenging to reflect on your own performance due to the lack of feedback from patients and colleagues.
Part of improving wellbeing includes providing support to colleagues before they encounter difficulties. While this applies to all GPs, our strategy identified freelance locums as being a particularly isolated and vulnerable group.
As part of Humberside LMC’s Wellbeing strategy, we are also undertaking work on the challenges faced by certain groups of GPs within the workforce. Our recent racism survey highlighted the additional challenges that doctors who experience racism face, and the GMC has published findings into its own referrals after a continuing difference between the referrals and outcomes for international medical graduates and those from a black and minority ethnic background.
Locum GPs in the Humber Coast and Vale ICS have a much higher percentage of international medical graduates and those from black and ethnically diverse backgrounds compared to those GPs in substantive posts. Both groups are more likely to receive more patient complaints and be represented more in GMC investigations.
The programme is funded as a Humber, Coast and Vale ICS Primary Care Health and Wellbeing Project.
How to apply
Places are limited and will be allocated on a first come, first served basis. Please complete the expression of interest form and e-mail it to Humberside LMCs by Friday 13th May 2022 in the first instance at humberside.lmcgroup@nhs.net
For the purposes of administering and delivering the programme, Humberside LMCs are working in partnership with organisations including The Medical Chambers and ImpaxHub and will be required to share the information you provide.
Local GPs Benefit from Accelerate Programme
Date published: Thursday 21 April 2022
GPs in the Humber area who have undertaken the Accelerate Programme have been talking about how it they have benefited from it in these new videos. The Accelerate Programme is designed to support personal and professional development, taking into account the additional barriers you may face due to ethnicity, race and discrimination.
"By joining this programme I wanted to learn ways in which I could amplify my impact as a leader at the workplace." - Dr Yasmin Zaidy, Gilberdyke Health Centre
"I've got to know other GPs within the area, I've got to know what's going on locally, and also how we can support our patients as well." - Dr Stephen Opare-Satkyi, Hutton Manor Surgery
Look out for news on further runs of the Accelerate Programme in our newsletter and email bulletins.
LMC Podcast - Update for Practice Managers
Date published: Tuesday 19 April 2022
The latest episode of the LMC podcast is now available. This edition is another update for Practice Managers, including:
- Covid-19 update
- Interface issues
- CCG matters
- IT update
- Practice Manager training and development
The podcast is a great way to catch up on topical updates if you missed the March Practice Managers' reference group or you'd like a quick refresher.
You can listen online at Anchor or listen and subscribe via podcast apps including Apple, Google and Spotify.
LMC Newsletter March 2022
Date published: Thursday 31 March 2022
The latest edition of the LMC newsletter is out now, including all the latest updates, events and guidance.
Download the March newsletter here.
Medical Certificate Cause of Death Guidance Post-COVID
Date published: Thursday 24 March 2022
We have received an update on new MCCD guidance following changes which came into force on Friday 25 March 2022:
Medical certificate of cause of death
- Only a medical practitioner who has attended the deceased for their last illness will be allowed to complete a MCCD. A medical practitioner with GMC registration will be able to sign the MCCD if they attended the deceased during their final illness up to 28 days before death, or viewed the body in person after death, and can state the cause of death to the best of their knowledge and belief.
i. The 28 day provision (the ‘last seen alive’ requirement), initially introduced in response to the coronavirus pandemic, has now been made permanent through a change to regulations and included in the MCCD guidance. ‘Seen’ in the context of attendance includes consultation using video technology. However, it does not include consultation by telephone/audio only.
ii. Attendance after death (i.e. viewing the body) will need to be in person and includes verifying the death.
It should be noted that the provision for any medical practitioner to complete the MCCD, introduced as a temporary measure by the Coronavirus Act, will be discontinued when the Act expires at midnight on 24 March 2022.
b. Requirements are different if the medical practitioner did not attend the deceased in the 28 days before death, or the deceased was not seen after death by the medical practitioner. After 24 March 2022, the MCCD can still be completed by the medical practitioner if they can state the cause of death to the best of their knowledge and belief, but this will require coroner notification at registration, or preferably by the medical practitioner beforehand to avoid distress to the bereaved. The coroner may then complete Form 100A and send this to the registrar to allow registration.
The following resources and links will be useful in interpreting the rules:
- Coronavirus Act expiry: Death certification and registration easements from 25 March 2022 - this document summarises arrangements for death certification and registration after the Coronavirus Act expires on 24 March 2022.
- Completing a Medical Certificate of Cause of Death: process from 25 March 2022 - flowchart from the Royal College of Pathologists on completion of the medical certificate cause of death.
- COVID-19: death certification and cremation - link to BMA guidance page on verification and certification of death and cremation.
All these resources can also be found on the LMC’s Coronavirus guidance page.
LMC Update March 17 2022
Date published: Thursday 17 March 2022
LMC Response to Policy Exchange Publication
You may have recently seen coverage of a new report, At Your Service – A Proposal to Reform General Practice and Enable Digital Healthcare at Scale, by the think tank Policy Exchange which outlines proposals for the future of primary care. Recommendations include the phasing out of the GMS contract over 10 years, increasing the number of GPs employed by large scale providers, and a much-enhanced role for digital healthcare. The publication is noteworthy as the foreword is written by Sajid Javid, the Secretary of State for Health.
We have prepared a response to the report covering its implications for patients, GPs, practices and PCNs, and for LMCs. We are keen to get your views on this so do email with any comments. Download the LMC response (PDF).
Mandatory Vaccinations for Healthcare Staff Revoked
The proposed requirement of mandatory vaccinations for health and social care staff, which was supposed to come into force in England on 1 April, were revoked on 15 March 2022. More details can be found on this page at gov.uk.
GP Contract 2022/23
A reminder that you can still download our summary of key information in the 2022/23 contract here.
Free Accelerate Leadership Programme for GPs, Dentists, Optometrists and Pharmacists from Black, Asian and Minority Ethnic Backgrounds
Date published: Wednesday 16 March 2022
Colleagues who experience racism and discrimination are often absent from senior roles and management structures within the NHS. We want to make a small step towards addressing this by offering a programme designed to support you in accelerating your career and personal development as part of the Humberside LMCs’ Wellbeing Strategy, funded by NHSEI.
The programme is available to colleagues from Black, Asian and minority ethnic backgrounds to support personal and professional development, taking into account the additional barriers you may face due to ethnicity, race and discrimination.
This is a unique opportunity to help you carve out your own career path, become more empowered in pursuing your aspirations and be supported in embracing your background as a positive tool for progression.
The programme will be delivered by a team of executive coaches from diverse backgrounds, working as a partnership between The Hobbs Consultancy and the Good Business Initiative arm of Executive Coaching Company.
During the programme you should expect to:
- Examine the myths and realities of confidence and how to use neuroscience and self-belief to build confidence levels.
- Examine common derailers for your talent and learn practical tools to maximise energy, resilience and impact.
- Use Strengths theory to bring more of your natural, rather than learned, strengths to your career, leveraging both performance levels and resilience.
- Use a combination of diagnostics, feedback and discussion to increase self-awareness.
The programme comprises three full-day modules and three follow up one-to-one coaching sessions.
The modules will be delivered virtually over 3 separate days on the following dates:
Day 1: Tuesday, 10th May
Day 2: Tuesday, 17th May
Day 3: Wednesday 25th May
The 1:1 coaching sessions following on from the programme will support you in deepening the learning and forwarding the action.
How to apply
This programme is fully funded but limited in places due to this. We would welcome expressions of interest from individuals who meet the above description and are able to commit to attend all the course dates. To apply, please complete the expression of interest form and e-mail it for the attention of Dr Zoe Norris, Humberside Primary Care Lead, to Humberside LMCs by Wednesday 13th April 2022 in the first instance at humberside.lmcgroup@nhs.net. Places will be allocated on a first come, first served basis to those colleagues who meet the criteria described above and are able to confirm their availability at all 3 of the training dates. A waiting list will be held for applications over the number of places available.
Deadline for expression of interest: Wednesday 13th April 2022
Help for Ukraine
Date published: Monday 14 March 2022
The LMC has been asked about how best practices, PCNs and individuals can support colleagues in Ukraine. The Academy of Medical Royal Colleges have advised that sponsorship of individuals or families should remain a route for those with specific links either personal or professional. The main shortage is in funding direct to agencies on the ground. While a large amount of donations of food and clothing are being sent, these are challenging to organise and distribute with needs changing rapidly.
If your practice or you as an individual wish to support those suffering as a result of the war, please donate to the Disasters Emergency Committees Ukraine Humanitarian Appeal.
Our Latest Update on the GP Contract 2022/23
Date published: Monday 14 March 2022
The LMC has been contacted by practices since the imposition of the 2022/23 GP contract by NHSEI on 1st March 2022. Many of your questions have been around the access requirements for this new contract. The full details of the contract have not yet been published and we will provide more information when they are. In the meantime, we have summarised some key information around the access requirements, and clinical requirements that we think colleagues need to be aware of now. With thanks to Cambs LMC.
GP Contract Update 2022/23
Date published: Wednesday 2 March 2022
NHS England and Improvement issued a letter yesterday (01 March 2022) regarding GP contract arrangements in 2022/23. This follows what the BMA described as a ‘stalemate’ in negotiations with NHSE earlier this year with no agreement reached.
Under the changes outlined in the letter, PCNs will be required to provide a full range of services from 9am to 5pm on Saturdays from October, and practices will have to allow more appointments to be booked online. You can read a summary of the changes in our LMC update issued to constituents today.
We anticipate constituents will have queries about this – please contact us via email and we will respond as quickly as we can. We are talking to our GPC rep about this matter and will publish more information as we get it.
LMC Newsletter February 2022
Date published: Monday 28 February 2022
The February edition of the LMC newsletter is now available, featuring all the latest news and updates for general practice in the Humber area. Included in this month's edition:
- Update on NHS Pension Type 2 forms
- Potential development of a national association of LMCs
- Update on 2022/23 GP contract negotiations
Download the newsletter. You can find all previous editions on our Newsletter Archive page.
LMC Update 10 February 2022
Date published: Thursday 10 February 2022
This update can be downloaded as a PDF from our Newsletter Archive page.
Vaccine as a Condition of Deployment – Resources
This week we hosted a webinar for practice managers with Capsticks solicitors on the latest position regarding vaccination as a condition of deployment.
As you will be aware, the government has suspended the implementation of the requirement for patient-facing staff to be vaccinated and is to consult on revoking the regulations. This has prompted a number of questions about what happens next and how employers and employees should proceed.
The session was useful in addressing these questions and Capsticks have shared two pieces of guidance to assist which can be downloaded below:
Accelerate Leadership Programme for GPs from Black, Asian and Minority Ethnic Backgrounds
Colleagues who experience racism and discrimination are often absent from senior roles and management structures within the NHS. We want to make a small step towards addressing this by offering a programme designed to support you in accelerating your career and personal development as part of the Humberside LMCs’ Wellbeing Strategy, funded by NHSEI.
The programme is available to colleagues from Black, Asian and minority ethnic backgrounds to support personal and professional development, taking into account the additional barriers you may face due to ethnicity, race, and discrimination.
The modules will be delivered virtually over 3 separate days on the following dates:
- Day 1: Tuesday, 15th March
- Day 2: Tuesday, 22nd March
- Day 3: Thursday, 31st March
Full details of the programme can be found on our website.
How to apply
This programme is fully funded but limited in places due to this. We would welcome expressions of interest from individuals who meet the above description and are able to commit to attend all the course dates. To apply, please complete the expression of interest form and e-mail it for the attention of Dr Zoe Norris, Humberside Primary Care Lead, to Humberside LMCs by Wednesday 23rd February 2022 in the first instance at humberside.lmcgroup@nhs.net. Places will be allocated on a first come, first served basis to those colleagues who meet the criteria described above and are able to confirm their availability at all 3 of the training dates. A waiting list will be held for applications over the number of places available.
Deadline for expression of interest: Wednesday 23rd February 2022
Humber, Coast and Vale Health and Wellbeing Survey
Humber, Coast and Vale Health and Care Partnership is seeking views from across all partner organisations in Humber, Coast and Vale including primary care. They are keen to ensure that their health and wellbeing work in 2022/23 supports the primary care workforce. Please complete the questionnaire yourself via this link What would help your wellbeing? (onlinesurveys.ac.uk) and please also share widely with your colleagues and teams. This survey is for all staff across all of health and care organisations in Humber, Coast and Vale. The survey closes on Monday 28th February.
GPC Regional Representative Elections - Nominations Open
Nominations for the vacant seat for the East Yorkshire/North Lincolnshire/Lincolnshire constituency in the BMA’s GPC regional representative elections 2022 are open until Monday 7th March 2022.
Successful candidates will take their regional seats at the start of the next session and will hold their seat for a three-year term (2022-2025). You must be a BMA member to stand in this election. However, member and non-member GPs are eligible to vote within their regions.
Download the elections guide for further details. If you would like to submit a nomination in this election, please go to https://elections.bma.org.uk/. For more information on the GPC, please go to the GPC UK webpage.
If you have any questions about the elections, please email elections@bma.org.uk.
LMC Podcast – Practice Managers’ Update
The latest edition of the Humberside LMCs podcast is now available. This podcast is an update for Practice Managers, with an overview of key news items including: Covid-19, PCNs, IT update, and training and events.
You can listen to our podcast online at Anchor FM or you can listen and subscribe via podcast apps including Apple, Google, and Spotify.
LMC Podcast - Practice Managers' Update
Date published: Thursday 3 February 2022
The latest edition of the Humberside LMCs podcast is now available. This podcast is an update for Practice Managers, with an overview of key news items including:
- Covid-19
- PCNs
- CCG updates
- IT update
- Training and events
You can listen to our podcast online at Anchor FM or you can listen and subscribe via podcast apps including Apple, Google and Spotify.
Face Mask Posters
Date published: Tuesday 1 February 2022
Although the rules on wearing of face masks have changed, wearing a mask is still required in healthcare settings by the IPC guidance.
We have updated our poster for practices to print and display. Download our poster.
The BMA has also published a poster which can be found here.
The updated government guidance on face masks, including when to wear one, can be found here.
Vaccination as a Condition of Deployment UPDATED
Date published: Tuesday 1 February 2022
As you may have seen in the news, the government now plans to drop the legal requirement for patient-facing staff to be vaccinated against Covid-19. This had been due to come into force on 1 April 2022. There will now be further consultation and a vote to be passed into legislation.
A new NHS England and NHS Improvement letter (31 January) advises that employers should now not go ahead with serving notice of termination to employees affected by the VCOD regulations.
It also asks that the live SITREP request due for submission on 2 February still be completed with the exception of the details in relation to service impact, which are no longer required.
LMC Newsletter January 2022
Date published: Thursday 27 January 2022
The January edition of the LMC newsletter is now available, featuring all the latest news and updates for general practice in the Humber area. Included in this first newsletter of 2022:
- Large selection of newly listed events and training opportunities
- Latest guidance on mandatory vaccination of patient-facing staff
- New guidance and resources, including newly published resources for our primary care campaign
Vaccination as a Condition of Deployment
Date published: Tuesday 18 January 2022
The deadline is approaching for health workers who have direct, face to face contact with service users to have the Covid-19 vaccine to comply with the new regulation. Unvaccinated individuals will need to have had their first dose by 3rd February in order to have had their second dose by the 1 April 2022 deadline.
NHSE has now issued phase 2 guidance on implementation of the regulation. This includes guidance on formal processes for those not fully vaccinated, plus a set of FAQs.
Our thanks to Peter Higgins at Lancashire & Cumbria Consortium of LMCs for sharing a template letter for practices to send to staff regarding their vaccination status. Download the template letter.
The BMA have updated their guidance on this issue which you can find here. They are also preparing FAQs for GPs and practices which will go into more detail and be more practical than the NHS guidance. We will share this as soon as it becomes available.
LMC Update January 13th 2022
Date published: Thursday 13 January 2022
Primary Care Campaign – New Materials
New communications materials for practices have been published in the third phase of the #wearegeneralpractice campaign.
The third phase of the campaign is about helping to educate patients about where to access treatment and answering some common questions people ask about general practice.
The graphics can be shared through social media or used on websites. You can view all the graphics on our website here and download a folder with all the graphics from Dropbox.
Guidance – Assessment, Monitoring and Management of Symptomatic COVID-19 Patients in the Community
This new NHS guidance has been developed to support frontline clinicians with the assessment, monitoring and treatment of patients who present to general practice with symptomatic COVID-19.
Updated UK Health Security Agency Guidance on Confirmatory PCR Tests
This letter provides confirmation that, from 11 January, those who receive positive lateral flow device (LFD) results for COVID-19 will be required to self-isolate immediately and will not be required to take a confirmatory PCR test. This is because the vast majority of people with positive LFD results will have COVID-19 at current high prevalence rates.
There are some exceptions outlined in the letter, including those patients who are at particular risk of becoming seriously ill from COVID-19 have been identified by the NHS as being potentially eligible for new treatments.
Webinars - Getting Ready for Patients to have Access to their Future Data
From April 2022, patients with online accounts such as through the NHS App will be able to read new entries in their health record. This applies to patients whose practices use the TPP and EMIS systems.
Information on what general practice staff need to know about the programme can be found here and there are webinars taking place in January and February – click here for dates and online booking.
HYMS / Hull Medical Society Debate, Thursday 27th January, 19:00-20:30
This free online event will feature a debate on a number of current medical issues:
a. Doctors will be replaced by AI in 20 years
b. The selection process for medical school is no longer fit for purpose
c. The study and practice of medicine have become 2 separate things
d. Being a doctor now is so much more difficult than it used to be
e. Free care at the point of delivery is no longer affordable or desirable
Click here for more information and online booking.
LMC Newsletter December 2021
Date published: Wednesday 22 December 2021
The December edition of the LMC newsletter is now available, featuring all the latest news and updates for general practice in the Humber area. In this month's newsletter:
- Guidance on private provider requests for investigations under the NHS
- Free CPD, booking platform and admin support for Locum GPs
- LMC Buying Group update - new discounts available for practices.
LMC Update - Booster Vaccine Programme 20 December 2021
Date published: Monday 20 December 2021
Our latest update on the vaccination programme, including details of temporary measures reducing the requirements regarding sick notes and firearms licenses, can be found here.
Free CPD, Booking Platform and Admin Support for Locum GPs
Date published: Monday 20 December 2021
Would you like to access a Locum GP Support Programme free of charge?
If you are a Locum GP working within the Humber, Coast and Vale ICS, you are eligible to take part in this programme, supported by Humberside LMC.
What’s on offer?
FREE CPD - Regular meetings which will cover a mix of educational content, guideline reviews, and broader issues such as managing complaints, leadership and career development. The meetings also provide you with an opportunity for peer and pastoral support and enable you to benchmark your practice. A Clinical Lead will also be available to support you with any complaints, significant events and case reviews and support and guide you through any processes. We will work with you to review your PDPs and help you meet your targets.
FREE BOOKING PLATFORM - Access to ImpaxHub, an easy-to-use online booking platform where you can upload all of your important documentation, add your availability and find your invoices and pension information.
FREE ADMIN SUPPORT - Access to an administration team who will make bookings on your behalf; issue invoices to practices and provide you with day-to-day operational support. You will continue to be paid directly by practices and you remain self-employed. We will also upload all of your pension forms onto PCSE online if you are in the pension scheme.
The programme will run during a six-month period as a pilot with evaluation taking place to help inform future projects of this nature. We will therefore ask you to provide feedback about the programme.
Background
The nature of locum work, which is an increasingly popular choice for newly qualified GPs, means that colleagues may have no support network and have only brief contact with a place of work. This makes it challenging to reflect on your own performance due to the lack of feedback from patients and colleagues.
Part of improving wellbeing includes providing support to colleagues before they encounter difficulties. While this applies to all GPs, our strategy identified freelance locums as being a particularly isolated and vulnerable group.
As part of Humberside LMC’s Wellbeing strategy, we are also undertaking work on the challenges faced by certain groups of GPs within the workforce. Our recent racism survey highlighted the additional challenges that doctors who experience racism face, and the GMC has published findings into its own referrals after a continuing difference between the referrals and outcomes for international medical graduates and those from a black and minority ethnic background.
Locum GPs in the Humber Coast and Vale ICS have a much higher percentage of international medical graduates and those from black and ethnically diverse backgrounds compared to those GPs in substantive posts. Both groups are more likely to receive more patient complaints and be represented more in GMC investigations.
The programme is funded as a Humber, Coast and Vale ICS Primary Care Health and Wellbeing Project.
How to apply
Places are limited and will be allocated on a first come, first served basis. Please complete the expression of interest form and e-mail it to Humberside LMCs by 31st January 2022 in the first instance at humberside.lmcgroup@nhs.net
For the purposes of administering and delivering the programme, Humberside LMCs are working in partnership with organisations including The Medical Chambers and ImpaxHub and will be required to share the information you provide.
LMC Update - Booster Vaccine Programme 15 December 2021
Date published: Wednesday 15 December 2021
We have published a short update following the Prime Minister's announcement that the rollout of the booster programme will be accelerated.
The focus of this update is on prioritising workload in general practice in the current circumstances.
LMC Newsletter November 2021
Date published: Wednesday 1 December 2021
The latest edition of the LMC newsletter, containing all the latest news and updates for general practice in the Humber area, is now available. Included in this issue:
- Update on our primary care campaign
- News updates including delays to the GP earnings declaration and TPP patient access to records
- Blood bottle update
GP Earnings Declaration Delayed
Date published: Monday 22 November 2021
As of 18 November 2021, the Department of Health has delayed the implementation of the requirements for GPs to declare earnings over £150,000. This means that the department will delay both the submission and publication of earnings declarations until at least next Spring.
This will provide an opportunity for further discussion on this in the future and will be something the newly elected GPCE chair, Dr Farah Jameel, and team will no doubt take forward. We will publish further updates on this as things progress.
You can view the BMA's briefing on the issue of declaring GP earnings over £150,000 here.
Campaign Highlights the Full Capabilities of General Practice
Date published: Wednesday 17 November 2021
A campaign has been launched to help patients better understand the roles of health professionals working in General Practice who are available to support them with their health care needs.
“We Are General Practice” is the latest in a series of campaigns by Humberside LMCs to inform people in the Humber area about how the ‘front door’ of the NHS operates and can be accessed.
This is the second phase in the “We Are Primary Care” initiative created with the support of the Clinical Commissioning Groups in Hull, East Riding of Yorkshire, and Northern Lincolnshire the newly launched campaign features films and graphics featuring local General Practice workers including physiotherapists, clinical pharmacists and advanced nurse practitioners.
The core message of We Are General Practice is to demonstrate that in addition to General Practitioners (GPs) many practices are also staffed with a wider team of health professionals with specialist skills and knowledge.
Another aspect of the campaign is to raise awareness that many receptionists have been trained as care navigators whose role is to ask a series of questions enabling them to refer patients to the professional within general practice best placed to provide them with the help they need.
Dr Zoe Norris, Humberside LMCs Medical Director and local GP said:
“This campaign aims to support an ongoing positive relationship between patients and general practice based on a shared understanding of how the front end of our NHS works today and going forward.”
“Us GPs understand that many people want and expect to see us. We’re still here and caring for patients, though the nature of health means that we may not always be the best person to help and the best thing for a patient could be to be offered specialist care by a professional trained for that very role.”
Launched in November the campaign will be rolled out online and through general practice to raise the profile of the benefits of support from roles including pharmacy technicians and practice nurses, as well as non-clinicals roles such as care coordinators and social prescribers.
It is hoped that by raising the profile of roles the campaign will also help strength Primary Care locally through the recruitment and training of people seeking a career in health care.
Find out more about how professionals working in general practice can help.
LMC Committee's Response to Winter Funding Plan
Date published: Wednesday 3 November 2021
The LMC Committee met on Tuesday 2 November when they discussed the Winter Access Fund plan and the BMA's subsequent proposals for actions to both convince NHSEI and Government of the need to withdraw the plan and work with the BMA on a genuine support package for practices.
Committee members were asked to vote on the proposed actions individually and the results were as follows:
The LMC is holding a virtual Q&A session by MS Teams on Thursday 4 November from 19.00 to 20.30 to focus on this issue. This will be an important opportunity to have your say and get answers to your questions. GPs and practice managers should have received an email with an invitation to the event - if you haven't received it please contact us.
LMC Newsletter October 2021
Date published: Thursday 28 October 2021
The latest edition of the LMC newsletter, containing all the latest news and updates for general practice in the Humber area, is now available. Included in this issue:
- new guidance on how practices can respond to abuse in social media posts
- new LMC staff who'll be working on our expanded support offer for GPs and all staff in primary care
- updates on LMC reports on the Primary/Secondary Care interface, and our consultation with PCN clinical directors
LMC Update: BMA Industrial Action Over NHSE Plan for Improving Access for Patients
Date published: Thursday 28 October 2021
Following the overwhelmingly negative reaction to the government's recently published plan for general practice, the BMA's GP committee has resolved that GPs, practices and LMCs should take immediate action to both convince NHSEI and Government of the need to withdraw the plan and work with the BMA on a genuine support package for practices. These are the actions called for, and our advice on them in light of the feedback we have received so far.
• BMA proposal: all practices in England to pause all ARRS recruitment and to disengage from the demands of the PCN DES
We have not seen strong support from practices to pause ARRS recruitment; some practices and PCNs are already disengaging from the PCN DES either on specific indicators or on all the requirements. Others worry this will impact on patients' views of general practice. The LMC will support all practices regardless of the position they choose to take and are happy to offer individual advice. To take this action after 31 October 2021 would be a breach of contract and would require the BMA to ballot its members on industrial action.
• BMA proposal: all practices in England to submit undated resignations from the PCN DES to be held by their LMCs, only to be issued on the condition that submissions by a critical mass of more than 50% of eligible practices is received
Some PCNs have already indicated they will be passing their undated resignation to the LMC, and this is a powerful action that has minimal impact on patient care whilst delivering a clear message to the government and NHSEI. The LMC will support you and update you on the process for this shortly if you choose to take this action.
• BMA proposal: LMCs to disengage from any participation in implementing the government’s plan.
The LMC have been spending time talking to local GPs and Clinical Directors to gauge their views. We have refused to be involved in any work around measurement of performance by appointment data. We believe this is a flawed and divisive method of allocating support and have called for a more qualitative and considered method of allocation.
Our constituents are also telling us that they want to continue dialogue with Humber Coast and Vale ICS and CCGs to invest the promised £250m primary care funding wisely, with the practices which need most support and make this sustainable beyond the period of the government’s plan. The LMC will work to secure the best support possible for practices while opposing punitive measures and the use of inaccurate data.
Virtual Q&A Session - Thursday 4 November 2021
The LMC held a virtual Q&A session on Thursday 4 November 19.00 - 20.30. The LMC shared their Winter Access Fund Plan presentation and invited attendees to discuss and ask questions. Attendees were asked to vote on the proposed actions individually and the results were as follows:
Next Steps
• We will continue to work with commissioners to ensure funding is invested to support all our GPs and practices, irrespective of their individual decisions and we remain focussed on safe, quality patient care and safe protected practice teams.
• The LMC will collect and collate your practices undated resignations from the PCN DES, should you choose to take this action.
• We will continue to focus on capacity, workload, premises and workforce and will provide practical advice to support everyone over the coming weeks and months.
• We know how difficult it is in general practice at the moment. That’s why we are increasing our support offer for all of your team members. Please keep in touch and let us know how we can help you.
• We will keep you updated with new advice as this develops.
LMC Podcast Explores Sessional GPs
Date published: Monday 25 October 2021
The latest episode of the Humberside LMCs podcast explores being a sessional GP.
Sessional GPs now make up almost half of the total GP headcount* so what do GPs doing sessional work (either salaried or locum) need to know? In this edition we're joined by Humberside LMC Medical Secretary Dr Rolan Schreiber to explore the pros and cons of working as a sessional GP including:
- Stability of work and income
- Employment rights
- Work commitments and control over workload
- CPD and revalidation Portfolio career opportunities
*In November 2020, GP Online gave the proportions of the total GP headcount as 53% partners, 36% salaried, 12% locums, and 1% retainers.
You can listen online at Anchor and subscribe to our podcast on all major podcast platforms including Apple, Google and Spotify - search for Humberside LMC.
GPs Overwhelmingly Reject Government Plan
Date published: Tuesday 19 October 2021
93% of respondents surveyed by the BMA say the government's recently announced Winter Access Fund plan for general practice is an unacceptable response to the current crisis.
Almost 3,500 GPs in England took part in the snap poll after Health Secretary Sajid Javid published details of a package which he claimed was to improve access to GPs. However, doctors made clear it would in fact increase workload and bureaucracy on GPs and their colleagues, reduce the number of appointments available, and impact the quality of patient care, while threatening to name-and-shame and penalise practices that need the most help.
The 93% figure is the clearest articulation yet that frontline GPs working across the country do not believe the plan will go any way to addressing the pressures facing general practice, staff and patients.
The BMA is warning that the impact of such a damaging move from the Government on staffing levels could be disastrous. The latest GP workforce figures show that England has lost around 1,800 full-time equivalent, fully-qualified GPs since 2015, despite the Government promising 6,000 more.
Dr Richard Vautrey, BMA GP committee England chair, said:
“This shows the profession has out and out rejected this shambles of a plan from the Government and NHS England. If the Health Secretary thinks it is enough to provide a lifeline to surgeries this winter, let alone save general practice in the long term, this response shows how wrong he is. The BMA provided the Health Secretary with a clear plan to help address the crisis in the short term, that could improve patient access and guarantee safe, high quality care, while also putting forward longer term solutions. He chose to ignore that and instead we have a shambolic plan that has failed before it has begun. These survey results show how angry and despondent GPs are. The profession clearly sees the Government’s name and shame approach as a bully’s charter, which will intensify existing problems."
The BMA’s England GP committee will meet later this week to discuss the package and what steps they, and the Association, wish to take next. Humberside LMCs will be taking part in these discussions and will report back on next steps. You can read the LMC's own response to the governement announcement, including a detailed analysis of the plans, here.
Our Response to the Winter Access Fund Announcement
Date published: Thursday 14 October 2021
Today the government announced a £250million Winter Access Fund which they say is designed to increase capacity in general practice, address variation in general practice, and improve communication with the public.
The LMC has summarised the document - Access Improvement Plan LMC Summary
Our response, like that of most people in general practice, is that the announcement will do nothing to address the very real issues facing primary care.
1800 GPs have been lost since 2015 and many practices are unable to recruit the GPs and other practice team members they need. £250million access funding cannot recruit GPs that do not exist.
The package asks general practice to increase face to face consultations and at the same time they have failed to remove metrics in the contract that force GPs to increase online consultations.
None of the workload initiatives mentioned in the support package can be delivered quickly and will make little to no difference in supporting general practice workload.
We are concerned that the government is out of touch with the reality of general practice, where long-terms problems of recruitment, funding, and workload, combined with the impact of the pandemic, have placed unsustainable pressures on the system.
The LMC is here to support GPs and practice teams - if you are concerned and in need of support please get in touch. We have a wide range of support which can be accessed via our support pages.
Update on Local CAS Provision
Date published: Wednesday 13 October 2021
For Yorkshire and Humber, the 111 service is provided by YAS and, as part of this, a Clinical Assessment Service (CAS) using nurses and paramedics (and a subcontract with Vocare for additional clinical support) is provided for patients who need advice from a clinician.
This service supports decision making to ensure patients reach the right disposition/triage outcome for their need as described in the call to 111 or use of 111 online. Patients go through to this clinical assessment service if the disposition is unclear or if NHS pathways tool recommends a clinical review.
The local CAS – an enhanced offer of the existing HCV wide service – is now managing Primary Care 1 and 2 hour “speak to” dispositions through NHS 111.
This part of the service went live on Monday 27 September, with further ED and online dispositions to go live in the coming weeks.
This means that all NHS111 calls (during core GP hours) - for which the outcome is the need to speak to Primary Care within 1 or 2 hours - will be triaged initially by a GP working on behalf of the CAS service.
- The advantage of this approach is that 70% of volumes are either closed as self-care or redirected to alternate provision for face to face (e.g. UTC).
- Using GPs to deal with this primary care call ensures consistency of approach and seamless services, leading to a reduced number needing physical face to face care.
- The service will operate between Monday to Friday 8am to 6pm, in line with primary care core access.
- This service is expected to handle 150 cases per week and redirect / close 70% of these (105 cases) that would historically have atttended and called upon primary care GPs.
Ultimately the CAS should reduce the number of GP one and two-hour dispositions from NHS111 to primary care, and ensure that those which are signposted to General Practices genuinely require a face-to-face appointment.
The new pathways should work as below:
PCN Clinical Director Survey Results
Date published: Tuesday 12 October 2021
The LMC has published the results of our survey of PCN Clinical Directors which was conducted in August 2021.
The survey was conducted to help us understand the situation on the frontline in primary care. We wanted to gain the insights of our area’s PCN leaders into how networks are developing, including additional roles recruitment, relationships with the wider NHS, and support needs.
Key findings from the survey:
• The additional roles most recruited for have been Social Prescribers, Clinical Pharmacists, First Contact Physiotherapists and Pharmacy Technicians.
• A lack of suitably qualified or experienced candidates was the most quoted barrier to recruiting for additional roles.
• A lack of adequate premises was the most quoted barrier to future success for PCNs, followed by being able to recruit sufficient wider workforce.
• Improved collaborative working with secondary care and developing relationships with stakeholders were the most requested areas for the LMC to develop to support PCNs.
The responses will help the LMC plan how we can tailor support to ensure we meet the needs of PCNs, and in our discussions with healthcare leaders.
LMC Publishes Report on Primary-Secondary Interface
Date published: Tuesday 5 October 2021
A new report published by the LMC highlights continuing issues with the interface between primary and secondary care which are causing significant extra workload for GPs and practice teams.
The report, 270 Appointments a Week: A report on the Primary-Secondary Interface, is based on a survey of GPs, practice managers and other practice staff conducted over two weeks in August 2021. 401 responses were received, highlighting a number of areas where there is a significant impact on primary care including:
- requests for primary care to arrange follow up tests or investigations on behalf of secondary care (these were most commonly blood tests but did include radiology investigations also)
- issues with onward referral to another team
- medication issues
The responses received from this survey are likely to represent a small number of cases involving interface issues across the area. As expected, the majority of responses came from those practices on the North bank of the Humber whose main interaction is with Hull University Teaching Hospitals NHS Trust (HUTH). However responses were received for all hospital trusts in the area as well as some community providers, mental health providers and tertiary referral centres.
We asked survey respondents to estimate how long addressing each interface issue had taken them, and which role within the practice had needed to deal with it. Over the 10 working days of the survey, the total time spent addressing interface issues in general practice by all roles was almost 101 hours.
The total time spent by clinical staff on resolving these was almost 54 hours. This equates to at least 270 appointments every week in primary care being lost to managing interface problems that should have been dealt with by other providers in line with their NHS standard contract.
Primary care reception staff are losing 70 hours a week to dealing with interface workload – this is time when they are unavailable to answer patient phone calls, arrange appointments, and respond to email queries, or support their clinicians in delivering care.
At a time when demand is exceeding pre-pandemic levels in primary care, and patient access is a high priority for the system, this represents significant and unnecessary inefficiency for the local NHS system.
Under the NHS Standard Contract, Secondary Care Providers must continually review and evaluate services including interface requirements and must act on lessons learned. Providers must work with their local commissioners to assess compliance by the end of September 2021, and annually thereafter. The commissioners and providers will agree an action plan to address any deficiencies identified by their assessment and ensure that this action plan is informed by discussion with and feedback from the relevant LMCs.
Humberside LMC covers an area which includes four CCGs, three acute hospital trusts and seven other providers. Interface meetings take place across these organisations on a regular basis, and it was agreed that the LMC would conduct a two week snapshot survey of interface issues in August 2021. This initial data collection is intended to help inform the action plan and priorities of local trusts over the coming year in line with their contractual obligations. A similar data gathering exercise was undertaken across North and North East Lincolnshire CCG areas in 2019 so while the survey was open to all practices, the expectation was that the responses would be weighted towards those practices in Hull and East Riding of Yorkshire CCGs.
We’d like to thank everyone who took the time to respond during an incredibly difficult time for primary care, and our trust colleagues for being willing to engage with this process so constructively.
Download 270 Appointments a Week: A report on the Primary-Secondary Interface report.
NHS England Guidance - Changes to Medical Contract Holders
Date published: Tuesday 5 October 2021
NHS England and NHS Improvement (NE and Yorkshire) have recently updated this guidance relating to changes of contract-holders to make it explicit that practices need to tell them in advance of a proposed “24-hour”/”technical” retirement.
This is necessary because the pensions agency, in advance of processing an application for payment of pension, asks NHSE to confirm that the (usually GP) partner did indeed retire from the practice’s contract for the requisite period.
In the case of a contract held by a single GP, NHSE need to have plenty of advance notice because important steps have to be taken to ensure that there is a contract for them to return to.
Download NHS England Guidance - Changes to Medical Contract Holders (September 2021)
LMC Celebrates Black History Month 2021
Date published: Monday 4 October 2021
Throughout October we're joining in the celebrations marking Black History Month to recognise the incredible richness and diversity of Black and Brown heritage in the UK.
People from African and Caribbean backgrounds have been a fundamental part of British history for centuries, but many people believe this contribution to society is often overlooked, ignored or distorted. Black History Month gives everyone the opportunity to share, celebrate and understand the impact of black heritage and culture.
All this month we'll be publishing stories illustrating the great contributions made to medicine by people of Black and Brown heritage, and also highlighting important medical stories and issues which many people won't be aware of.
Speak Up Month launches at Humberside LMC
Date published: Monday 4 October 2021
Speak Up Month 2021
Here at Humberside LMCs we will be sharing some short video clips and songs throughout October to celebrate Speak Up Month.
Look out on our Twitter feed and on our Freedom To Speak Up Guardian Service page, then take some time on your coffee break to think about the messages we share.
“We really want to capture people’s attention this year with something uplifting, thought-provoking and inspiring”
Amy Stathers, Freedom To Speak Up Guardian, Humberside LMCs
The pandemic has highlighted that speaking up has never been more important for the benefit of colleagues and patients. Speak Up Month in October is an opportunity to raise awareness of how much we value speaking up in our organisation.
Making speaking up business as usual will enhance all of our working lives and improve the quality and safety of care. Listening and acting upon matters raised means that Freedom to Speak Up will help us to be the best place to work.
Campaign Shows the Consequences of Abuse in Primary Care
Date published: Thursday 16 September 2021
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A campaign has been launched to help tackle a rise in abusive behaviour towards healthcare workers in primary care across the Humber area.
The initiative is led by Humberside Group of Local Medical Committees Ltd (Humberside LMC) with the support of the Clinical Commissioning Groups in Hull, East Riding of Yorkshire, and Northern Lincolnshire, and a range of partners who are standing together to say that abuse of primary care workers in any role will not be tolerated.
Primary care refers to general practice, community pharmacy, dental, and optometry (eye health) services which are sometimes described to act as the ‘front door’ of the NHS.
Research shows that increased pressures on primary services paired with modified ways of working made necessary due to COVID-19 have led to increased demand in services. Data published by NHS Digital shows a 3.5m increase in the number of general practice appointments provided during June this year compared to June 2019 (26.7m compared to 23.2m), with an additional 4m COVID vaccination appointments delivered on top of that.
Despite this evidence, research carried out with practices in the Humber area in July found that many patients perceive that primary care has been “almost closed” or working at reduced capacity over the past 18 months. Whilst primary care staff are working longer hours, some patients say that they can’t get through to practices to make appointments. This is frustrating for patients and in some cases unfortunately results in abusive behaviour towards practice staff members.
Surveys and consultations with workers in a variety of primary care roles uncovered examples of how abusive patient behaviour had negatively impacted upon staff morale and directly led to decreased patient care due to time spent on handling persistent callers and aggression in practice, on the telephone and online.
Repeat instances of aggression, prejudice, threats and offensive language, has led many professionals to feel dread, fear, disrespected, and questioning whether they wish to remain working in the profession.
Dr Zoe Norris, Humberside LMCs Medical Director and local GP said:
“We understand that patients have frustrations and fears around their own health though it doesn’t help anyone if they are abusive. It affects everyone, though it is particularly unfair that frontline workers who are doing their absolute best take the brunt of this. We’re all humans and need to do our bit to be reasonable and kind.”
“Pressures on primary care to meet demands are not new though are made more challenging by the pandemic. This campaign asks everyone to think about how their behaviour can impact others and understand that if you cross the line you can and will be refused treatment.”
Dr Dan Roper, Chair of NHS Hull CCG said:
“I know from conversations with colleagues across the spectrum of primary care that this is an increasing phenomenon. It is a constant source of anxiety for individuals working on the frontline in surgeries and health centres across the city.”
“Being subjected to verbal and (thankfully rarely) physical abuse is extremely traumatic and can cause professionals of any age and experience to question whether they want to continue working.”
“Hull CCG has supported this initiative from the very beginning, and we are confident that the work Humberside LMC is doing will be well received and successful.”
Tackling abuse is the first of a three-phase public awareness campaign around improving experiences for patients and staff. Media created by Hull-based eskimosoup has been developed with the help of primary care workers and features direct quotes taken from surveys and discussions that demonstrate the emotional impact that facing abuse has on workers.
It is hoped that the campaign will encourage patients to consider the impact their attitudes and behaviours have on the health care system and the people working hard to keep it going. The messages will be shared in primary care settings and promoted through targeted online advertising throughout East Yorkshire and Northern Lincolnshire.
More information on the campaign (including resources for practices and primary care providers to download) can be found here.
LMC Update 9 September 2021
Date published: Thursday 9 September 2021
Flu Vaccines Delay
Many practices will have been affected by the delays affecting delivery of the Seqirus flu vaccine. The company have stated that the problem is due to ‘unforeseen road freight challenges’ and told practices not to book any clinics until it has confirmed delivery seven days in advance.
Inevitably this has caused considerable difficulty and frustration for practices and patients, and has resulted in some cases in cancellation of vaccination sessions. Our understanding is that the delay is limited to Seqirus vaccines, and that the three other vaccine providers for the UK – Sanofi, Mylan, and Astra Zeneca – have not reported delays and are not anticipating any difficulties.
It is therefore advisable for practices which have not already done so to check with their suppliers on anticipated deliveries and make any necessary changes to their plans accordingly. Should you still experience difficulties please report this to the LMC and we will try to assist.
Blood Tube Supply Disruption
NHS England and Improvement’s guidance issued on 26 August 2021 regarding actions to protect the supply of test tubes for blood samples from Becton Dickinson (BD) still stands.
All primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing. Examples of clinically urgent testing include:
• Bloods that are required to facilitate a two week wait referral
• Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of condition
• Bloods that if taken could avoid a hospital admission or prevent an onward referral
• Those with suspected sepsis or conditions with a risk of death or disability
The guidance goes on to say that if organisations are likely to run out of products within 48 hours, please notify your pathology incident director and your NHS England and NHS Improvement regional team. The guidance advises practices not do any routine blood tests until the situation has been resolved and until then, urgent blood investigations can still be done as supplies allow (the national indemnity scheme, CNSGP, will cover this situation).
Survey of practices' experiences of using PCSE payments and pensions portal in August
The BMA continues to challenge PCSE at national level to ensure that their pay and pensions portal in England is fit for use by both GPs and practices. The portal has now been in use for three months and they are looking to gauge how effective the various ‘fixes’ put in place by PCSE to correct what they have described as ‘teething issues’.
This is now a critical time where PCSE and NHSE/I will be looking to end the transformation process and return to ‘business as usual’. It’s important to be confident that the many significant issues around payments to practices which blighted the first couple of months of the portal’s use are largely behind us. To this end, the BMA are launching a joint survey, with the Institute of General Practice Management, for practices and practice managers to learn of their experiences of using the system during August specifically. They are also keen to know about experiences of contacting PCSE for support around issues raised around the portal since it came into use on 1 June.
We know how incredibly busy practices are but completing the survey should take no longer than 10 minutes and will be invaluable in holding PCSE and NHSE accountable for the portal’s performance. The survey will remain open until Friday 17 September.
BMA GP survey
The BMA also want to hear directly from doctors about their experiences working as a GP. Their new survey asks about the issues affecting you most, including your workload, recruitment and your future career plans. The survey is primarily aimed at fully qualified GPs who are currently working. They will be running a survey for GP trainees separately later in the year.
This survey will support the BMA’s negotiations and lobbying. Your responses will also help them better understand the issues affecting GPs. The survey is open until 20 September and will take around 10-15 minutes to complete.
GPs Asked for Feeback on NHS111 Clinical Assessment Service
Date published: Thursday 2 September 2021
NHS England and NHS Improvement are asking GPs in the Humber area for their feedback on the NHS111 Clinical Assessment Service. GPs are asked to complete a short 2 question survey, which should take less than a minute.
The survey is to gauge GP awareness of the NHS111 CAS, prior to roll out of an enhanced, in-hours pilot of the service locally.
What is the CAS?
• For Yorkshire and Humber, the 111 service is provided by YAS and as part of this service a Clinical Assessment Service (CAS) using nurses and paramedics is provided for patients that need advice from a clinician
• This service supports decision making to ensure patients reach the right disposition/triage outcome for their need as described in the call to 111 or use of 111 online.
• Patients go through to this clinical assessment service if the disposition is unclear or if NHS pathways tool recommends a clinical review.
• Through the provider contract with 111 there is a requirement that 50% of all ED dispositions are reviewed clinically by the YAS 111 clinical team. This is in line with national expectation.
• The YAS 111 service is redirecting about 50% of these away from ED currently.
• So, if 100 people receive an ED disposition, 50 would be reviewed and 25 would be redirected on average from the core CAS run by 111.
• The wider offer (pilot) would increase this by 45 cases and redirects close to 70 cases having a significant system benefit, in addition increased clinical capacity that YAS would normally utilise for the 50 cases would be redirected to handle the growing clinical queues in core NHS 111.
The survey asks only 2 questions:
1. Are you aware of the CAS?
2. Do you have any comments on the CAS?
Please complete the survey below, by Friday 10 September.
LMC Newsletter August 2021
Date published: Tuesday 31 August 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Latest update on the blood tube shortage
- PCNs and planning for 2021/22 and 2022/23
- Updates from the LMC committee and also the ICS
Download the August newsletter.
LMC Newsletter July 2021
Date published: Tuesday 27 July 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Update on face masks and infection prevention control rules in primary care
- PCSE pay and pensions update
- ICS development update
Infection Prevention and Control in Primary Care
Date published: Wednesday 21 July 2021
NHS England have confirmed that the existing Covid-19 IPC guidance continues to apply in healthcare settings. The IPC guidance confirms that: “Patients in all care areas should still be encouraged and supported to wear a face mask, providing it is tolerated and is not detrimental to their medical or care needs”. NHS England state in a letter to primary care practitioners that 'contractors continue to have our support in enforcing the IPC guidance'.
The letter also confirms that practices 'should continue to offer a blended approach of face-to-face and remote appointments, with digital triage where possible'. The Standard Operating Procedure for general practice in the context of Covid-19 (Version 4.3) has been withdrawn as of 19 July as much of it has become standard practice or is now redundant.
You can read our earlier statement on the continued use of face masks, social distancing, and hand sanitising, accompanied by a downloadable poster here. The BMA has also published a poster which can be found here.
Enhanced Service Specification for Phase 3 Covid Vaccinations Published
Date published: Thursday 15 July 2021
NHS England has published the new enhanced service specification for phase 3 of the vaccination programme .
A letter to GPs accompanying the new specification states they have ruled out offering the vaccinations at individual practice level:
‘We have considered carefully whether we could support the administration of the Covid-19 booster vaccines at individual practice level. For a number of reasons, this is not operationally feasible.
This is largely due to the need to expand the capacity in the delivery network (to deliver the Covid booster programme alongside the flu programme) but it will only be possible to on-board a limited number of new sites during the summer; the supply chain cannot support deliveries to all practice sites; and it is possible the vaccine characteristics will require at scale working.
For these reasons practices that wish to participate in the booster programme will need to do so as part of a PCN grouping. We will also give practices the opportunity to change their PCN grouping in phase three if they so wish, taking account of feedback in phase two.’
In a statement the LMC endorses, the BMA has expressed disappointment at this:
‘Doctors and their teams should be given support and flexibility to take part in a way that works best for their patients… Elsewhere in the UK we have seen GPs giving COVID-19 vaccinations from within their surgery buildings, so there is no good reason for it not to happen in England. And while practices should be able to work together in the campaign, this should not be mandated.’
Practices have been given until 28 July to opt in to the programme, which is provisionally due to start on 6 September.
Continued Use of Face Masks in Health Premises
Date published: Tuesday 13 July 2021
A joint statement from:
- Humberside Local Medical Committees
- Community Pharmacy Humber
- Local Dental Committee
- Local Optometry Committee
"We are all committed to ensuring the health and welfare of patients, service users and staff. We’re aware of the lifting of the remaining Covid-19 legal restrictions from 19th July 2021.
But we still need to act cautiously to stop the spread of the virus. The delta variant is more transmissible, and people may be contagious without knowing it.
Face masks have helped to reduce the spread of the virus. Many people are still not yet fully vaccinated, so cutting virus transmissions is still important.
Health premises are a higher risk environment and we will need to maintain some control measures to keep everyone safe. We are therefore asking everyone visiting health premises to continue to wear a mask, unless they are exempt, and to observe social distancing and keep hands clean by using gel or handwashing."
Practices can download an A4 poster to print and display to help with patient messaging.
LMC Podcast Looks At Workload Pressures
Date published: Monday 12 July 2021
The latest episode of the Humberside LMCs podcast is now available.
In this episode we're looking at workload pressures in general practice in the light of the recent Health Select Committee report which said NHS and care staff in England are so burnt out that it has become an "emergency". Colleagues at Wolseley Medical Centre in Hull also recently invited cameras in from BBC Look North to show the reality of the pressures GPs and practice teams are facing every day.
Dr Zoe Norris, LMC Medical Director explains how the LMC can help staff deal with pressures, and sets out some of the services and resources which can be accessed via the LMC.
You can listen online and subscribe to our podcast on all major podcast platforms including Apple, Google and Spotify.
Delay in Roll-out of Patient Data Sharing Programme (GPDPR)
Date published: Thursday 24 June 2021
The government has announced that the planned roll-out of the GP Data for Planning and Research (GPDPR) in England is to be delayed by two months, from 1 July to 1 September 2021.
This follows extensive engagement by BMA and RCGP with NHS Digital and with the health minister, calling on NHS Digital and the Government to delay the introduction of their new data programme until patients and the public have had time to be aware of and understand the programme and choose to opt-out if they wish. Discussions are ongoing to ensure that there are appropriate safeguards in place as to how the data collected is used, and that the views of the profession are represented in all discussions pertaining to patient data. Read the BMA’s statement about the announcement to delay here.
LMC Newsletter June 2021
Date published: Thursday 24 June 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Events and opportunties across the Humber region
- Update on the delay to roll-out of the patient data sharing programme (GPDPR)
- Issues with the PCSE pay and pension system and what you should do to check your records
General Practice Pressures Featured on BBC Look North
Date published: Tuesday 15 June 2021
Dr Kanan Pande and the team at Wolseley Medical Centre in Hull appeared on BBC Look North on 9th June 2021 in a report illustrating the pressures facing general practice.
The visit was set up by the LMC to help explain to the public why practices are so busy, and how clinicians and support staff are working on their behalf. Journalist Anne-Marie Tasker spoke to GPs, admin staff and patients in a report which highlighted the scale of the workload facing Doctors and practice staff.
Clips from the report can be viewed via this Twitter thread. You can also view them on our Facebook page.
Well done to Dr Pande & team at @WolseleyMedical who on BBC Look North last week showed the reality of the pressures #generalpractice is under.
— Humberside LMC (@HumbersideLMC) June 15, 2021
"The phones are non-stop from eight o'clock in the morning..." pic.twitter.com/OonkD0tOKV
"We are now dealing with three times as much work as we did previously and we ask for some understanding," Dr Pande says. "We will see everybody who needs to be seen, it might just mean that you don't get your appointment today. However anyone who needs urgent help is clearly being seen."
Congratulations to Dr Pande and the team at Wolseley Medical Centre for giving up time in such a busy period to highlight the role of general practice.
Health and Care in and across the Humber and Place Partnerships
Date published: Tuesday 1 June 2021
Humber, Coast and Vale ICS have published a presentation which gives an overview of the transition to the new NHS body - NHS Humber, Coast and Vale - from April 2022.
It outlines how HCV will, subject to legislation, discharge its responsibilities through Place based and Sector based units of operation (Place Partnerships and Provider Collaboratives). It describes how Place Partnerships will operate and sets out proposed arrangements for funding will work.
Online Consultations Guidance for Practices – Contractual Position
Date published: Thursday 27 May 2021
The LMC continues to receive queries from practices about the contractual position around online consultations. Along with other LMCs, we have sought clarification from the GPC England team. While NHS England refers to online consultations in the latest SOP dated 4th May, the contractual position has been outlined by the BMA - see LMC UK conference | COVID vaccination | online consultations – contractual requirements (bma-mail.org.uk) (scroll down to the Online consultations – contractual requirements heading). This is an extract from the GPC advice:
The contractual position
Before the pandemic, as part of the 2019 GP contract deal paragraph 5.10 (i)) GPC England agreed that it would eventually become contractual for practices to offer online consultations during core hours. This agreement has not yet been added to the contract regulations, so is not currently a contractual requirement. However, GPCE also agreed that practices should offer online consultations as early as possible, provided that the necessary infrastructure is in place, but it would not become a requirement until it is entered into the contract regulations. It is therefore for practices to determine how best they use online consultation systems, including what hours they are available, and they should try to use them in such a way that helps with triage and workload management, enabling the delivery of a safer and more accessible service to all their patients.
The LMC wishes to reassure practices that they are under no contractual obligation to provide access to any online consulting platforms outside their core contracted hours of 8am-6:30pm (or 6pm if local arrangements are in place), Monday to Friday. We know that some practices find online platforms useful, however where a practice feels they are not helpful in the delivery of their services, or they are not yet fully ready for their implementation they may request that the provider deactivates them outside core hours or completely. Where deactivating these platforms is technically difficult (e.g. from the provider end), practices may wish to simply remove the link on their website as a temporary measure – you do not need to seek permission to do so but should inform the CCG so they are aware. Please feel free to copy the LMC in if you wish.
With thanks to BBO LMC for sharing their statement on this matter.
LMC Newsletter May 2021
Date published: Thursday 27 May 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Onlince consultations - our advice to practices
- Humberside LMC Leadership Programme for GPs from BAME backgrounds
- CQC update from recent LMC liaison meeting
Download the LMC Newsletter May 2021.
Majority of GP Receptionists Face Unprecedented Levels of Abuse at Work, New Research Shows
Date published: Monday 24 May 2021
“If I die, it will be your fault,” is just one of the abusive comments heard by GP reception staff, as a new survey* launched today shows 75% report experiencing daily abuse from patients.
With the majority (78%) facing threatening behaviour, racist or sexist abuse from patients, and 83% reporting having called the police for help, today the Institute of General Practice Management (IGPM) launch their campaign to end all abuse towards general practice staff.
The IGPM members have responded to the increase in physical, verbal, and written abuse towards practice staff over the Covid-19 pandemic, with a video of real-life examples of patient interactions from practices across the UK. These include:
- GP staff whose tyres were slashed by a patient who had not been able to get an appointment that day;
- A receptionist with Chinese heritage, who received racist abuse and was spat on in relation to the Covid-19 virus;
- Daily verbal threats including the common phrase: “If I die, it will be your fault”.
Robyn Clark, a practice manager in South Gloucestershire and one of the founders of the IGPM commented: “As demand for GP services has increased dramatically over the last year, sadly so has the amount of abuse practice staff have faced.
“The aim of our campaign is to highlight the good work practices are doing, and make a plea to the public to be patient with our staff, instead of attacking them. GP staff have worked throughout the pandemic and have done their absolute best to support patients. We’re calling for the abuse to end now.”
The survey of 571 GP practice managers showed that 83% have had to remove a patient from the surgery due to multiple incidents towards their team. Other recent research from an NHS Staff Survey showed that 14.9% of respondents had been subjected to physical violence while in work. Much abuse goes unreported and national annual data on physical assaults against NHS staff are no longer published. The ‘If I die it will be your fault’ campaign aims to raise awareness of the zero-tolerance approach to abuse and encourage all practice staff to feel confident about reporting incidents.
Nicola Davies, a practice manager in Cornwall and founding member of the IGPM said: “We hope that by raising the personal effect of abuse on staff, we can encourage patients to be tolerant and understanding. Our staff are doing their job. It is never a personal vendetta to stop a patient from accessing healthcare.”
Kay Keane, a practice manager in Stockport and Director of the IGPM said: “A man attended our practice with six knives because he didn’t get the treatment he wanted. He smashed up the waiting room and threatened staff members. It was a scene we never want repeated in GP practice. It was terrifying and unnecessary. But we also know this is extreme. Bad language and threats are an everyday occurrence, and it is unacceptable.”
Jo Wadey, a practice manager in Worthing and founding member of the IGPM commented: "Receptionists are leaving their roles because of the abuse they receive, which means we are continually trying to recruit and train, which puts a huge strain on practices."
The ‘If I die it will be your fault’ campaign video can be found here, with practices up and down the country joining forces to share the message that abuse towards practice staff must stop.
LMC Response to Standard Operating Procedure Update Letter
Date published: Monday 17 May 2021
Many people working in general practice will be concerned by the updated Standard Operating Procedure to support restoration of GP services, published on 13th May 2021, which advised GP practices on how to improve patient access. Dr Richard Vautrey issued a response on behalf of the GPC criticising the update on 14th May.
The NHSE letter was not discussed with the BMA General Practitioners Committee before it was published. This letter serves as guidance – it has no contractual force. We are expecting further clarification from the BMA and GPC regarding this matter and will share it as soon as it becomes available. Please be assured that Humberside LMCs have made our NHSE regional team aware of how unhelpful and counter-productive we feel this letter is.
To ensure that practices are in full compliance with the terms of their contract they should be:
- Offering patients access to your practice via telephone/online and your reception is also open;
- Offering patients face to face appointments based upon your assessment of clinical need following a discussion between the clinician and the patient;
- Offering on-line access for a proportion of your appointments;
- Offering a discretionary e-consultation (or equivalent) platform, which need only be during core hours Monday-Friday 08:00-18:30, and;
- Providing information about your services via your practice website
Practices are not obliged to offer patients a face-to-face appointment solely upon their request. The relevant parts of the Regulations are as follows:
Essential Services
4) The services described in this paragraph are services required for the management of a contractor’s registered patients and temporary residents who are, or believe themselves to be—
(a) ill, with conditions from which recovery is generally expected;
(b) terminally ill; or
(c) suffering from chronic disease,
which are delivered in the manner determined by the contractor’s practice in discussion with the patient.
(5) For the purposes of paragraph (4) “disease” means a disease included in the list of three character categories contained in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems; and “management” includes
(a) offering consultation and, where appropriate, physical examination for the purposes of identifying the need, if any, for treatment or further investigation; and
(b) making available such treatment or further investigation as is necessary and appropriate, including the referral of the patient for other services under the Act and liaison with other health care professionals involved in the patient’s treatment and care.
Since March 2020, practices in the Humber area have remained open and continued to offer face-to-face appointments based on clinical need – this should not change, and the LMC will support practices to continue to practice in this way. The LMC is very aware that many GP colleagues, practice managers and practice teams do not believe they are now able to offer a consistently safe service to all patients. It is very disappointing that after all the efforts of the past year, general practice is experiencing unparalleled demand.
This latest NHSE letter panders to the illusion that the NHS can meet the limitless pool of patient demand, rather than a service based on need, and throws general practice to the media wolves. It also ignores the continuing concerns about circulating Covid-19 variants, and the need to maintain appropriate infection prevention and control procedures.
The LMC will continue to work closely with the local CCGs and the NHSE regional team. Our system partners and PPGs need to better understand the detail and data behind the scale and challenge around GP access, patient demand and workload.
We would encourage all colleagues to prioritise their own health and well-being, and not sacrifice themselves (and their families) in an attempt to manage impossible, unlimited, patient demand.
Update 20/05/21
Richard Vautrey, Chair of the GPC has said in an update:
"Instead of knee-jerk responses to press headlines there needs to be proper acknowledgement from the Government and NHSE/I that practices are under huge pressure at the moment, that you are doing the right thing by working in line with national infection protection and control guidance as set out by the CMO and that you have been using telephone and online consultations appropriately to both keep patients and staff safe. This also needs to be much more clearly explained to the public."
"It is for practices to determine how best to manage and deliver their services and the best arrangements for appointments, based on their expert knowledge of their local community. Practices have the contractual freedom to do this taking in to account their capacity and workload pressures, and by doing so delivering a safe service to their patients."
"None of us trained to be call-centre GPs and we all want to get back to a time when we have the freedom to see more patients face to face but we need to do that in a way that matches capacity and safety within each practice. As covid-19 prevalence falls and, through the incredible efforts of general practice, vaccination levels rise practices are rightly and wisely adapting the arrangements they have had during the height of the pandemic. However, at present we know there is no spare capacity, there is no surplus workforce waiting to come and assist and the impact of the wider NHS backlog is having a massive impact on every practice. We know that Practices have been and will continue to offer face to face appointments for those patients who need them as well as trying to protect our patients and colleagues from becoming infected in our surgeries."
"We don’t just need our patients’ understanding, we have often had that throughout this last year, we need governments to act. We don’t just need short term fixes, or more letters and guidance telling us what to do, but a return to the freedom to deliver services in the way that best meets the needs of our patients, as well as long-term commitment to investment and development of general practice. That is what we will keep pushing for and what we expect government and NHSEI to deliver."
India Covid Crisis - An Update
Date published: Thursday 6 May 2021
We are deeply concerned by the Covid situation in India as the country's healthcare system struggles to cope with the number of cases there. Many colleagues in the Humber have friends and relatives directly affected and we appreciate this will be a deeply worrying time for them. This is a short summary of actions and services which are being put in place:
A. There is a central NHSE response being coordinated by Prerana Issar with an emphasis on:
1. Advice on surge hospitals
2. Remote monitoring and management
3. Clinician to clinician telelink
4. Equipment inventory
B. The SAHF (South Asian Health Foundation), Academic Health Science Network (AHSN Network), and Learn with Nurses are running a series of webinars sharing NHS experiences of COVID-19 with health and care professionals in other countries. The next webinar is on Friday 7th May, 16:00-17:00 with the theme of Hospital and ICU Management of Covid-19 - sign up here. Details of further sessions will be posted on the South Asian Health Foundation events page.
C. These are some of the charities providing support to India
British Asian Trust Oxygen for India Emergency Appeal
APNA South Asian Heritage NHS Staff Leaders Network Covid-19 India Appeal
BAPS India Covid Emergency Appeal
D. BAPIO is also planning to provide free telemedicine support to health care staff in India. If you are interested in helping, please register stating your area of expertise and local language skills. Sign up link.
E. Please also check in with your colleagues here who have family in India. They may be distressed and have to take additional breaks to stay connected with friends and family. Also please signpost them to help available through wellbeing schemes - our support page has information and links to sources of support.
New Report Calls for Action on Discrimination in General Practice
Date published: Tuesday 4 May 2021
A new report from a working group led by the LMC has highlighted discrimination faced by staff and patients from Black and Ethnic Minority backgrounds in general practice and calls for a zero tolerance approach to tackle racism in all its forms.
The report, Racism and Discrimination – the experience of primary care professionals in the Humberside region, is based on a survey of clinical staff, managers and administrators working in general practice in the Humber region.
The survey is part of a Humberside-wide strategy, supported by the four CCGs in the region, to address racial inequalities and barriers, and provide support for all those staff from ethnic minority backgrounds working in primary care.
238 people responded to the survey distributed by Humberside LMCs, the highest response rate for any consultation we have ever conducted. The responses highlighted respondents’ experiences of discrimination in areas including training, working patterns, and complaints.
For example, 22% of Black and Minority Ethnic respondents reported that their ability to train in their careers was affected by racism or discrimination. One respondent commented:
“Comments were made throughout my career that I was an inferior doctor…rather than seeing the positives - awareness of different cultures, languages and attitudes. My background was seen as a negative.”
The report has been compiled by a working group made up of representatives from general practice and led by Dr Zoe Norris, Medical Director at Humberside LMCs. She says:
“The report is not an easy read, and starkly illustrates the challenges our colleagues and patients are encountering every day due to racism and discrimination.”
“It’s based on the lived experience of both clinical and non-clinical staff working in primary care across the Humber region, and we’re incredibly grateful to all the staff who shared what are clearly very difficult experiences with us.”
“Despite the problems highlighted we hope that, through shining a light on these issues, this will be the beginning of a conversation between all of us working in primary care to tackle discrimination.”
Download the report (PDF).
Please contact us with any queries or comments.
LMC Newsletter April 2021
Date published: Thursday 29 April 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Racism and Discrimination Report - read the report on the responses to our recent survey on experiences of racism in general practice
- Details of the newly elected members of the LMC Committee
- Invitation to take part in the new Humber Primary Care Collaborative
Download the LMC Newsletter April 2021.
Freedom to Speak Up - New Poster
Date published: Wednesday 28 April 2021
You can now download a poster which promotes the new Freedom to Speak Up Guardian service which supports people working in the NHS to raise a concern.
Any members of staff from GP practices can speak up about concerns they have which they feel are not being listened to by their own management reporting. Reasons someone may wish to speak up might include if they feel they are being affected by racism or discrimination.
Download a Freedom to Speak Up Guardian service poster (PDF).
More information on the service, including how to raise a concern can be found here.
Integrated Care System - The Impact on Our Constituents
Date published: Monday 19 April 2021
You might already be aware that the next 12 months will bring significant change to how healthcare is commissioned and organised in the Humber region. This will bring about changes to General Practice and will impact on all of our constituents.
Humberside LMCs believe that Primary Care must have a strong voice and influence over how the ICS will be structured and the role of Primary care leadership going forward. We are working on your behalf to represent general practice and we propose to create a new Primary Care Collaborative body comprised of Clinical Directors, GPs, Federations, Primary Care providers, Commissioners and Humberside LMC (and
potentially other primary care stakeholders including Pharmacy/Optoms/Dentistry and Community Services) - to be this voice.
We would like your support to take this forward please. There is more information in this discussion paper. We have recently sent an email to constituents with more details along with information on how you can support, comment and perhaps even volunteer to be part of the collaborative group. Please let us know if you haven’t received this, or if you have any queries.
LMC Constituent Survey 2021
Date published: Thursday 15 April 2021
All our constituents are invited to give us their views by taking five minutes to complete this year’s LMC survey. The survey is one of the main ways we engage with GPs and practices in the Humber area and find out how we are doing in supporting general practice. Like other services, we have had to change how we work due to the pandemic and we’re really interested in your feedback on how we have performed, and how we can develop and improve.
The survey is open until 5pm on Friday 30 April 2021. Take the survey.
Could You Be A Mentor for Your Fellow GPs?
Date published: Monday 12 April 2021
A two year General Practice Fellowship programme is supporting the development of newly-qualified doctors and nurses entering general practice.
The overarching aim of the Supporting Mentors Scheme is to retain experienced GPs working in primary care through creating this portfolio working opportunity, while supporting newly qualified GPs through high quality mentoring.
GPMplus is working with the HCV programme partners to recruit GP Mentors and to deliver the supporting mentors scheme.
The Supporting Mentors Scheme will support GPs who currently deliver a minimum of three clinical sessions per week, and are looking to conduct an additional weekly session (4 hours 10 minutes) of mentoring. Mentors will be remunerated at a rate of £289 per session, which will be paid directly to the mentor’s practice on a quarterly basis from June 2021.
More information:
If you are eligible and interested in joining the scheme as a Mentor, please complete the application form and return it by email to info@gpmplus.co.uk by 5pm on Thursday 15 April.
LMC Newsletter March 2021
Date published: Tuesday 30 March 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Events and opportunities update - several new evets for general practice staff to attend
- Contract resources and updates
- Additional mentoring hours available via our new provider
Supporting Clinically Extremely Vulnerable Staff
Date published: Tuesday 23 March 2021
Although the shielding advice is to be paused nationally from April 1st, the government is still advising that people continue to work from home where possible. If individuals cannot work from home, employers should undertake a comprehensive individual workplace risk assessment.
NHS England have advised in a letter to all trusts and primary care organisations that employers should refresh their risk assessments for all clinically extremely vulnerable staff to determine the appropriate workplace arrangements from April 1st. Download the letter for more information on next steps: advice and support for staff.
GPC Roadshow 2021 - Resources and Q&A
Date published: Thursday 11 March 2021
We were delighted to welcome Dr Krishna Kasaraneni, GPC executive team member at the BMA, for our online GPC Contract Roadshow earlier this month. Krishna gave an overview of the changes agreed in this year's GP contract negotiations and we can now share the presentation and a summary of the Q and A session from the evening. These can be downloaded via the following links:
GP Contract Roadshow Presentation
You can also view a BMA webinar on the new contract on the BMA website.
Our thanks to Krishna for presenting at the event.
LMC Newsletter February 2021
Date published: Thursday 25 February 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Events and training coming up in March, including the online GPC roadshow
- The launch of our new mentoring service, provided by GPMplus
- The LMC constituent survey 2021 - take 5 minutes to give your views.
Vaccine Hesitancy
Date published: Thursday 18 February 2021
Surveys have shown stark differences by ethnic group in attitudes to COVID vaccines, and a quarter of younger women fear it would affect fertility. The BMA has published guidance and resources on how to communicate with different groups about the vaccine.
CCGs across the Humber, Coast and Vale area, have come together to coordinate video messages from local GPs, and are working to promote them to enhance confidence in the vaccine and to dispel any vaccine myths. These videos are currently available in English, Polish, Urdu, Hindi, Punjabi and Gujarati. The playlist can be found on the Humber, Coast and Vale YouTube channel here.
The British Fertility Society and Association of Reproductive and Clinical Scientists has also published some COVID-19 Vaccines FAQs to help address some of the vaccine hesitancy relating to fertility.
Read the BMA’s guidance on the COVID-19 vaccination programme which includes information about what is expected of practices and the support available to enable practices to prioritise vaccine delivery.
LMC Newsletter January 2021
Date published: Wednesday 27 January 2021
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- This year's GP contract - changes negotiated by GPC and NHS England.
- PCN DES ballot of GPs - outcome of the vote
- LMC elections 2021 - your chance to join the LMC committee and represent your GP colleagues
Primary Care Networks DES Ballot Outcome
Date published: Monday 25 January 2021
In November 2020 the LMC England conference passed the following resolution for the BMA's GPCE (General Practice Committee England) to ballot the profession regarding the mandate to continue to negotiate the PCN DES:
"Conference notes that the BMA GPC (GP committee) England has never secured a robust democratic mandate for the PCN DES and so again asks the GPC England to secure a firm mandate from the entire profession by means of ballot before negotiating any extension or changes to the PCN DES for the year 2021 / 2022."
The ballot was held in early January with the following question: "Prior to any further negotiations, extension or changes for 2021/22, do you give GPC England a mandate for the PCN directed enhanced service?"
Voting has closed and the results have been validated and verified.
Total votes: 4,534
Outcome:
Yes: 80% (3,619)
No: 20% (915)
Richard Vautrey, GPC Chair, said: "This outcome provides a clear mandate from the profession for the PCN DES, and GPC England will therefore continue to negotiate on this, seeking improvements and further developing it, as part of the whole GP contract, for the benefit of practices and our patients."
The LMC will continue to monitor progress with the PCN DES both locally and nationally. If you have any queries please contact us.
Face Mask Exemptions
Date published: Tuesday 12 January 2021
Following recent news coverage regarding supermarkets requiring 'medical exemption' from people not wearing a face covering in their stores, we'd like to remind practices that there is no need under the rules for people to seek proof of exemption from their GP.
Government guidance on face masks states “you do not need to seek advice or request a letter from a medical professional about your reason for not wearing a face covering.” Requests for such letters will only add to the heavy burden of work on practices and our advice is that such requests should be declined.
The guidance clearly sets out situations when people are exempt from the requirement to wear a mask. If someone has an age, health or disability reason for not wearing a mask they do not need to show proof of exemption. However, some people may feel more comfortable showing something that says they do not have to wear a face covering. In these cases an exemption card or badge can be downloaded from the gov.uk website here.
Our earlier advice to practices regarding requiring patients to wear face masks when attending appointments can be found here.
ICS Consultation - LMC Response
Date published: Thursday 7 January 2021
Humberside LMCs have submitted a response to the consultation on Integrated Care Systems. ICS's will present a significant change to the way the NHS is organised in England, with NHS organisations, in partnership with local councils and others, taking collective responsibility for managing resources, delivering NHS care, and improving the health of the population they serve.
As the professional voice of general practice in the Humber area we are keen to ensure that general practice is involved in the development of the proposals and the design of the consultation. We are concerned that the timing of the consultation and the proposed models do not address our concerns over what will be a hugely significant change for the delivery of primary care generally and for general practice in particular.
Read the LMC ICS consultation response.
Our next steps:
• Receive and review consultation responses.
• Work with YORLMC and seek a meeting with HCV ICS leadership to state our case for primary care representation and set out the role of GPs, CDs and the LMC in this and how we might put this in place
• Attend Humber Partnership PCN development session to form opinions on how the system can work with PCNs. All CDs are invited also.
• Raise the issue of ICS representation at the LMC meeting on 12th January. Matt De Hoest has agreed to lead this item from his perspective on the Professional Board
We will keep you informed of developments with this.
LMC Newsletter December 2020
Date published: Thursday 17 December 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Call for responses to the Integrated Care Systems consultation
- Latest news on our support services, including webinars to improve wellbeing
- Our wellbeing support packs, recently sent to every practice in the Humber region
COVID Vaccination Programme - Update 11 December
Date published: Friday 11 December 2020
A number of key documents and updates have been published in relation to the COVID 19 vaccination programme over the last couple of days:
The Standard Operating procedure: COVID-19 local vaccination services deployment in community settings has been published and describes the operating model and design requirements for the safe delivery of COVID-19 vaccines in the community.
View the document: https://www.england.nhs.uk/coronavirus/publication/standard-operating-procedure-covid-19-local-vaccination-services-deployment-in-community-settings/.
MHRA have issued further important guidance and advice about managing allergic reactions following COVID 19 vaccination with the Pfizer/ BionTech vaccine.
This updated guidance and advice can be viewed in full at https://www.gov.uk/government/news/confirmation-of-guidance-to-vaccination-centres-on-managing-allergic-reactions-following-covid-19-vaccination-with-the-pfizer-biontech-vaccine
The MHRA have also explicitly advised that a 15 minute observation period needs to be reinstated. NHSE has stated that they are considering the operational consequences of this for vaccination centres.
MHRA Confirmation of Guidance to vaccination centres on managing allergic reactions following COVID-19 vaccination with the Pfizer/BioNTech vaccine: https://www.gov.uk/government/news/confirmation-of-guidance-to-vaccination-centres-on-managing-allergic-reactions-following-covid-19-vaccination-with-the-pfizer-biontech-vaccine
COVID-19 vaccination: Governance, handling, and preparation of vaccines by GP led Local Vaccination Centres (PCN designated sites)
The chief pharmaceutical officer Dr Keith Ridge has written to CCG lead pharmacists and chief officers to set out the principles and expectations necessary to maintain integrity, and therefore safety, quality and effectiveness, of the COVID-19 vaccines. The novel characteristics of the first vaccine (Pfizer/BioNTech Covid-19 mRNA Vaccine BNT 162b2) make it essential that very careful attention is given to its receipt, storage, movement / transportation, and preparation.
The letter sets out the legal basis and expectations of The Human Medicines Regulations 2012, Regulation 174 for temporary authorisation of the supply of vaccine products, and what this means for lead GPs, CCG lead pharmacists and other registered healthcare professionals in primary care teams.
It also provides a model NHS COVID-19 Primary Care Vaccine Handling and Management Policy which will support practices and primary care networks to implement good governance. All staff responsible for planning and managing the primary care COVID-19 vaccination programme in 2020/21, and all Pharmacy staff engaged in supporting and delivering the COVID-19 vaccination programme in 2020/21 should read the policy. The policy includes sections on legal framework and practice standards, roles and responsibilities, accountability and responsibility for vaccines, associated medicines and their supply chain, handling and management of vaccine and medicines in vaccination sites, staff authorisation to be supplied with and administer COVID-19 Vaccines, storage and transportation of vaccines and other important details.
Governance, handling, and preparation of vaccines by GP led Local Vaccination Centres (PCN designated sites): https://www.england.nhs.uk/coronavirus/publication/governance-handling-and-preparation-of-vaccines-by-gp-led-local-vaccination-centres-pcn-designated-sites/
Local pharmacy teams are available to work with vaccination sites and lead GPs in regards to addressing the details of this policy and the LMC would encourage vaccination sites and lead GPs to take up this offer of support.
Supply Inventory List for primary care: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/12/C0914-Appendix-1_Supply-Inventory-List_Details_v2-7-December-2020.pdf
Standard operating procedure for the management of COVID-19 vaccination clinical incidents and enquiries: https://www.england.nhs.uk/coronavirus/publication/standard-operating-procedure-management-of-covid-19-vaccination-clinical-incidents-and-enquiries/
The NHSE documents can also be found on the NHSE website at https://www.england.nhs.uk/coronavirus/covid-19-vaccination-programme/primary-care-guidance/
This continues to be a swiftly developing process; a number of documents are being updated so please follow the links to find the latest version available on respective websites.The LMC will be monitoring this closely and will publish further updates as soon as more information is available. If you have any queries please contact us at humberside.lmcgroup@nhs.net.
COVID Vaccination Programme Update 7 December
Date published: Monday 7 December 2020
Please check our COVID-19 Vaccination Programme page for links to the latest resources.
A letter from Dr Nikita Kanani and Ed Waller of NHSEI outlining the latest position on Wave 1 mobilisation of the Primary Care COVID-19 Vaccination Programme 2020/21 was published on 4 December.
The Enhanced Service Specification has been re-published (4 December) to include modifications following discussion with MHRA and to ensure patients from non-participating practices can be provided vaccinations.
The COVID-19 Vaccine Collaboration Agreement has also been updated (4 December). This is designed to support the delivery of the CVP by setting out the responsibilities and relationships between collaborating practices.
Practices are asked to sign up to the Enhanced Service by 23:59 on Monday 7 December, and will be provided at least 10 days’ notice of the first vaccines becoming available.
NHSEI will be writing to sites identified as part of Wave 1 today (7 December), setting out full details of vaccine supply dates, delivery of other consumables and equipment to the site, and the process for assuring readiness before delivery of vaccines. This will include a delivery of IT equipment necessary to deliver the programme and a fridge for each site. Access to necessary training will be provided and sites will be given full support to mobilise within the timescale.
Sir Simon Stevens said last week that around 1000 GP group sites had indicated their willingness to take part in the programme. Once the vaccine becomes more widely available these other community sites will be able to start vaccinating. They will also be given at least 10 days’ notice of this. It is therefore important for practices not involved in the first wave to continue to review the enhanced service specification and indicate to their CCG as soon as possible their decision about involvement in the programme.
Rollout of the COVID-19 vaccination is a swiftly developing process; the LMC is monitoring this closely and will publish updates as soon as more information is available.
LMC Newsletter November 2020
Date published: Thursday 26 November 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Our new monthly 'Hot Topics' item which brings you up to date with the issues the LMC team have been working on to support local practices
- New Coroners Referral Form for East Riding of Yorkshire and Hull
- Information on how the LMC is now offering the Freedom to Speak Up Guardian Service
New Coroners Referral Form for East Riding and Hull
Date published: Tuesday 17 November 2020
The Coroner’s Office in the East Riding and Hull is currently progressing plans to move to a new version of the case management system used. The transition is due to take place later this month and the Go Live date for the new system is currently set as 24th November.
The new version of the software includes a web based version of the reporting form used when referring a death to the coroner. The new form will be accessed through the same link as the current form and so there will be no need for doctors to familiarise themselves with an alternative URL. A link to the form will also be made available on the coroner’s web page.
The new form will look and feel different to the current form, although the information to be completed will not significantly change. There will be the ability to provide a lot more information on the new form, so the form will look a lot more in depth , however not all questions will be mandatory to complete. Mandatory questions will be highlighted in red.
Hospital doctors and registrars will use the same form. Questions will differ depending on the referrer’s role and so one of the first new questions is to confirm your role i.e. GP or Hospital Doctor. The use of drop down lists, including one for causes of death will hopefully make the form more user friendly and easier to complete.
At the end of the form the doctor will have a clear view of the information provided and the ability to edit any section to make changes. When submitting the referral a confirmation will be displayed at the top of the screen to confirm it has been successfully submitted along with the option to print or save a copy of the form. This will replace the confirmation by email.
The Coroner’s office have stated that they appreciate that now is not an ideal time to make changes, however given problems with IT servers that concern the current system they cannot delay the change any longer and hope that this change will not cause any inconvenience at this difficult time for everyone.
The Coroners Officers are contactable on 01482 613009 for support and to discuss referrals. More guidance including screen shots of the new form can be downloaded on this guidance note.
COVID-19 Vaccination Programme Details Released - Updated
Date published: Wednesday 11 November 2020
Details have been released of the enhanced specification for the COVID-19 vaccination programme which has been agreed between the GPC and NHSEI.
You can view the letter to GPS, practice teams and CCGs on preparing general practice to contribute to a potential COVID-19 vaccination programme, along with an Indicative Enhanced Service Specification, on the NHSEI Updates for General Practice page.
We know practices are trying to make rapid decisions about the COVID-19 vaccination service specification – the LMC are already responding to queries about this, and actively engaging with our local CCGs and NHSEI teams to ensure practices have the support they need. This is a difficult and complex decision, on the background of nearly 9 months of constant work and pressure. With the timeline being extremely tight, practices will have a short amount of time to make some key decisions. The most helpful summary we have seen so far is on this link to the BMA website, under the section “Practical considerations for practices and PCNs”.
COVID-19 vaccination programme page - BMA
Discussing these issues between your colleagues and PCN should cover the main areas that need to be addressed before deciding. As an enhanced specification, it will be optional for practices to sign up to the service and it is separate to both your core contract, and the PCN DES. Whatever you decide the LMC will support local practices.
Please contact us if we can help and do check our website daily where we will share the latest local and national information.
We have created a new COVID-19 Vaccination programme guidance page which will be updated regularly with the latest documents, guidance and resources.
Freedom to Speak Up Guardian Service
Date published: Thursday 29 October 2020
Our Freedom to Speak Up Guardians
Humberside LMCs now offer a Freedom to Speak Up Guardian Service to anyone working in primary care in our four CCG areas who wishes to raise a concern. Any members of staff from GP practices can speak up about concerns they have which they feel are not being listened to by their own management reporting. Reasons you may wish to speak up might include if you feel you are being affected by racism or discrimination.
All constituents within the region covered by Humberside LMCs (East Yorkshire, Hull, North Lincolnshire, North East Lincolnshire) are included in the scope of our new policy to give everyone the confidence to speak up at the earliest possible opportunity, using Humberside LMCs’ Freedom to Speak up Guardians or your own organisational Freedom to Speak up Guardians.
For full details, including how to raise a concern, download our Freedom to Speak Up policy.
Download a Freedom to Speak Up Guardian Service poster (pdf) to print and display.
Download the 2021 Freedom To Speak Up Guardian Report here.
LMC Newsletter October 2020
Date published: Thursday 29 October 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Your chance to get involved with the work of the LMC by joining our committee
- Latest online events including Lighten the Load Coach Approach Skills and Practice Manager Buddying
- News including GP contract updates and GPDF/PCN Organisational Development Funding
Humber Primary Care COVID-19 Response Engagement Report
Date published: Monday 26 October 2020
This report presents the findings of a major engagement exercise conducted by CCGs in North Lincolnshire, North East Lincolnshire, Hull, and East Riding of Yorkshire between July and August 2020 which asked patients about their experience of primary care during the pandemic. Over 7,000 people responded and there are some very positive findings for general practice in the report, with the majority of people rating their experience good or very good. Read the report here.
LMC Annual Report Published
Date published: Wednesday 7 October 2020
The Humberside LMCs Annual Report 2019/20 has just been published and can be read online as a digital publication.
The report covers a very busy period for the LMC, with major changes to primary care with the creation of Primary Care Networks, as well as internal changes at our organisation. The document covers how we helped our constituent practices adapt to the new landscape, with links to a number of useful resources.
PPE Portal Order Limits for General Practice
Date published: Tuesday 6 October 2020
Practices are now able to order PPE through the central portal to meet the increased need that has arisen as a result of the COVID-19 pandemic.
From 1st October 2020 the following limits apply:
GPs with fewer than 5,000 patients can order up to (per week):
- 200 IIR masks
- 200 aprons
- 400 gloves (200 pairs)
- one bottle of hand hygiene (usually 500ml)
- one box of visors (usually 50 per box)
GPs with between 5,000 and 7,999 patients can order up to (per week):
- 400 IIR masks
- 400 aprons
- 800 gloves (400 pairs)
- 2 bottles of hand hygiene (usually 500ml)
- 2 boxes of visors (usually 50 per box)
GPs with between 8,000 and 10,999 patients can order up to (per week):
- 500 IIR masks
- 500 aprons
- 1,000 gloves (500 pairs)
- 4 bottles of hand hygiene (usually 500ml)
- 2 boxes of visors (usually 50 per box)
GPs with between 11,000 and 29,999 patients can order up to (per week):
- 1,100 IIR masks
- 1,100 aprons
- 2,200 gloves (1,100 pairs)
- 8 bottles of hand hygiene (usually 500ml)
- one box of visors (usually 200 per box)
GPs with 30,000 patients or more can order up to (per week):
- 2,600 IIR masks
- 2,600 aprons
- 5,200 gloves (2,600 pairs)
- 12 bottles of hand hygiene (usually 500ml)
- 2 boxes of visors (usually 200 per box)
Further details can be found at https://www.gov.uk/guidance/ppe-portal-how-to-order-emergency-personal-protective-equipment#order-limits.
Register and access the portal using your NHS registered email. Call the customer service team on 0800 876 6802 if you have any questions about using the PPE portal. The team is available from 7am to 7pm, 7 days a week.
Testing and PPE Issues in Primary Care
Date published: Thursday 1 October 2020
The LMC has today written to our four local CCG chairs, along the chair of the Humber, Coast and Vale Testing Group and NHS England to express concern about access to testing and supplies of PPE in primary care. This follows calls and messages from practices in the Humber region who are experiencing problems. The full text of our letter is below:
"The evolving second wave of the Covid-19 pandemic continues to cause significant pressure on primary care. The LMC is receiving calls from practices across the HCV area experiencing major issues in accessing testing for primary care staff, and in accessing adequate PPE.
There remains an ongoing discrepancy between the ability of the primary care workforce to access testing compared to those colleagues working in secondary care. This compounds the perception that primary care is undervalued at present, and we welcome your influence in accessing equitable testing for all healthcare staff. All staff working in the NHS need to be assured of the same access to timely testing; general practice will not function over the coming months without this based on the current levels of staff needing to isolate while awaiting testing or results. Given no national solution is forthcoming, we urge the HCV area to source a local solution or risk destabilising healthcare services.
PPE remains a problem, and while practices continue to order supplies via the portal as recommended, we request that additional supplies are procured at local level to support the increased need. The end of the Covid reimbursement fund means that practices cannot rely on reimbursement, and it is unfair to expect primary care staff to be personally funding their PPE when other parts of the NHS have it provided for free. We would urge all HCV CCGs to use local suppliers to secure adequate supplies and support primary care.
This is the beginning of another incredibly challenging time for the NHS; locally the workforce is tired, demoralised, and running on empty. Your public support and commitment to addressing these key areas would provide a vital boost to colleagues."
We will keep you updated with developments on these important issues. If you need advice or support from the LMC please contact us. Resources and information can be found on our Support and Coronavirus pages.
LMC Newsletter September 2020
Date published: Wednesday 30 September 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- CQC mythbusters to help with inspections
- Sending of death registration documents
- Revised Network DES published
Our Message to Practices in the Humber Area
Date published: Tuesday 15 September 2020
Humberside LMCs would like to thank all practices for their continued hard work in meeting unprecedented demand in primary care, and in the face of demoralising media coverage in response to NHS England's letter reiterating the importance of providing face-to-face appointments for those who need them.
We know that face-to-face appointments have been available to patients throughout the pandemic where there is a clinical need. We wholly reject any implication that practices are not seeing patients and subsequent negative stories in the media.
Should your practice be in need of additional support, please contact the LMC or visit the support page on our website for information, links and resources.
New Wellbeing Project to Support General Practice
Date published: Tuesday 8 September 2020
Humberside LMCs, supported by YORLMC, are delighted to announce the launch of their new project to improve the wellbeing of GPs and other staff working in general practice in the Humber, Coast and Vale ICS area.
Funded by NHS England, the project will involve developing new services, tools and resources to support wellbeing and enable individuals to look after their own health and know when to seek help before difficulties arise, or be signposted to help if problems have already arisen.
At this time of great stress and pressures for general practice, the wellbeing of people working in local health services – GPs, practice managers and all other practice staff – is particularly important.
The project is being led by Dr Zoe Norris of Humberside LMCs, recently recruited as Wellbeing lead. Dr Norris will be supported by Dr John Bibby of YORLMC whose Wellbeing project is well established. YORLMC is sharing knowledge & contact information to enable development of the project across Humberside. Dr Norris and Dr Bibby are working with their respective LMC teams to develop services in line with local priorities and feedback gathered from those working in general practice.
Services provided through the project will include mentoring for people working in practices, and learning events to support practice staff.
You can find details of resources, services and information for GPs and others working in general practice on our support page at www.humbersidelmc.org.uk/supportgpspracticemanagers.
If you’d like more information on the new wellbeing project at Humberside LMCs, please contact humbersidelmcgroup@nhs.net. Information about YORLMC’s project can be requested via info@yorlmcltd.co.uk.
LMC Newsletter August 2020
Date published: Monday 24 August 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Latest events and opportunities
- Updates for practices, including flu vaccines in 2020/21
- General news, including carer funding for GPs on the induction and refresher scheme
Advice for GP Surgeries Regarding Patients and Facemasks
Date published: Wednesday 5 August 2020
The Government website advises that all patients over the age of 11 years old wear face coverings in NHS settings, including community care settings, such as GP surgeries and hospitals. Face coverings can consist of a range of options, including cloth masks, scarves, face shields, or surgical masks and must cover the nose and mouth.
GP surgeries must protect all patients who attend the practice. As an employer, the practice has a duty of care to staff. Humberside LMC encourages practices to require patients to wear face coverings whenever they enter the practice premises. If a patient refuses to do so, despite being offered one and having the reasons explained to them, the LMC will support practices who offer non-face to face care until the patient complies.
There are very few valid medical reasons for not wearing a face covering; patients in whom there is a genuine exemption can be identified by the practice and managed accordingly. Please contact the LMC if you have any questions or concerns regarding this issue.
Update 18/08/2020
The BMA has issued the following statement regarding face coverings:
"The BMA believes that the government must do more to protect healthcare workers in community settings, including GP surgeries, and require those entering a healthcare facility to wear a face covering, as is the case for shops and other indoor settings.
It is for practices to decide how to deliver services to their patients. It is also a practice’s responsibility for them to protect their staff and patients, many of whom may be vulnerable to the most severe effects of Covid-19, from unnecessary risk. Therefore, if a patient refuses to wear a face covering inside a practice, without good reason, the practice can choose to provide services to that patient by means other than face-to-face consultation within the practice.
Practices should inform patients, in advance of their attendance, that a face covering will be required to protect other patients, clinicians and other staff who they will inevitably come into proximity with inside the building. If a patient has a legitimate reason for not wearing a face covering the practice will need to consider this on an individual basis."
LMC Team to Continue Remote Working
Date published: Tuesday 4 August 2020
Given the current COVID-19 situation Humberside LMCs will continue to work remotely. We will offer remote alternatives to all face to face
events, meetings and training where possible until January 2021.
Please continue to contact us in the usual ways. Details of LMC committee meetings can be found here.
LMC Newsletter July 2020
Date published: Tuesday 28 July 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Save the date for two upcoming LMC events
- Advice on responding to requests regarding face mask exemptions
- New to Partnership Payment Scheme details
Supporting Practice Managers
Date published: Tuesday 30 June 2020
Owing to support and funding from NHS England, the LMC were able to recruit and train a cohort of freelance Practice Manager Appraisers, all of whom are currently working as Practice Managers across the Humber area.
Many of our local Practice Managers report feeling over-burdened and isolated, receiving little formal or ongoing personal and professional development. The peer to peer appraisals on offer as part of this scheme are designed to address this developmental shortfall. These are not intended to be a performance review, but instead an opportunity for reflection on the manager’s work and approach, and to help identify areas for ongoing improvement and development. There is also the opportunity to repeat the review with the same Appraiser at agreed intervals, such as six-monthly or annually.
Several of these peer to peer reviews have been completed over the past year, and the feedback from participants has been very positive:
“It was really nice to be appraised by someone who understood how you felt and was able to provide some good supportive advice that wasn’t just ‘text book’ but from actual real life experiences. The whole process was really informal and [my appraiser] was great. Overall I found it a really positive experience and yes I would definitely do this again”
“It was quite useful to actually sit down and complete the form to enable me to evaluate what my role is. I did find meeting with [my appraiser] and talking through what I had written very useful, and for me to be away from my Practice to do this was of great value.”
“It was really helpful, almost therapeutic! I think the work will lie in being able to implement some of the suggestions. We agreed to keep in touch and meet again to review progress in 6 months.”
Our trained cohort of freelance Practice Manager Appraisers are keen to continue to connect with their local PM colleagues and facilitate these valuable sessions. If you are interested in being part of this scheme, then please contact the Humberside LMCs team by email on humberside.lmcgroup@nhs.net.
If you decide to go ahead and arrange a session, you will be matched with a PM from outside of your CCG area, who contact you directly to make all of the arrangements.
LMC Newsletter June 2020
Date published: Monday 29 June 2020
The latest edition of our regular monthly newsletter is now available, containing all the latest updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Could you be an LMC member?
- GP funding and contracts explained by The Kings Fund
- Update on GP revalidation
New GP Wellbeing Lead at the LMC
Date published: Monday 8 June 2020
We are delighted to announce the appointment of Dr Zoe Norris as the LMC’s new GP Wellbeing Lead. This is a new role dedicated to reaching out to GPs in the Humber region to help improve their wellbeing, working alongside our existing pastoral care team. She will be advising across a range of areas including workforce planning and developments, primary care management, system change and resilience of general practice.
Zoe already has a part-time post as Medical Director with the LMC and will be working an additional one day per week in this new role. She says: “I’m excited to start contributing to the increasing offering from the LMC around wellbeing, and to focus on practical and concrete improvements to the lives of our constituents. We have an amazing workforce in primary care locally, and I am looking forward to developing this role."
GP Guidance - Return of Schools
Date published: Thursday 4 June 2020
The Government mandated opening of schools for some year groups from 1st June 2020. The LMC would like to assist GPs in dealing with queries which may arise in connection with the return to school by providing the following links to trusted sources of information:
• The Royal College of Paediatric and Child Health has produced advice on returning to school.
• Clinically extremely vulnerable children are to remain shielded and not to return to school. The list of conditions included can be found here.
• Schools have received the following advice from the government to put in place where possible for pupils return.
• Specific advice with helpful links has been issued by the government for children and young people with special educational needs and disabilities.
The LMC will add updates and additional links to this guidance as they are available.
LMC Newsletter May 2020
Date published: Thursday 28 May 2020
The latest edition of our regular newsletter is now available with news, updates and opportunities for general practice in the Humber area. Included in this month's issue:
- Training and opportunities including our resilience webinars in June, plus access to rapid access mentoring
- Request for feedback re PCSE records
- Advice to GPs check performers list entries
Download the LMC's May newsletter.
LMC Statement - BAME Staff and Coronavirus
Date published: Monday 18 May 2020
Relative Risks from COVID – 19 for people from Black, Asian and Ethnic Minority Backgrounds (BAME)
We have all become aware over the last few weeks of an increasing number of deaths amongst health care workers from Black, Asian and minority ethnic backgrounds. Whilst every death from COVID 19 is a tragedy it has become obvious that a larger proportion than we would have expected come from BAME backgrounds.
Statistics that have been collected nationally by Public Health England have now confirmed that there is a real issue here. No reasons for this phenomenon have yet been found although urgent research is ongoing.
This must be very worrying for our colleagues from such backgrounds and we must do all we can to reassure them and minimise any risk to which they may be exposed. People from Black, Asian and Minority Ethnic (BAME) backgrounds make up 44% of the medical workforce.
Pending more definitive guidance coming out as a greater understanding of the issues develops the LMC would recommend the following approach:
• Practices should be supported to have thorough, sensitive and comprehensive conversations with members of the practice team from a BAME background. They should identify any existing underlying health conditions that may increase the risks for them in undertaking their frontline roles, in any capacity. Most importantly, the conversations should also, on an ongoing basis, consider the feelings of BAME colleagues, particularly with regard to their safety and their mental health.
• Practices should risk-assess staff at potentially greater risk and make appropriate arrangements accordingly. Practices should consider how they can do this and take action to protect members of their team. Here are some risk assessment tools available:
• The first thing for all workers is to stay safe. The vast majority of patient interactions are now done remotely and that is likely to remain the case for some time. Any patients that are seen, will require the health care workers to wear appropriate PPE. Even when seeing patients who are asymptomatic of a potential COVID infection but need to be seen for a non COVID condition, they should still be seen in a clean environment with appropriate PPE worn by the health care worker and the patient. (usually a mask)
• As we learn more about this and can understand the true level of increased risk for our BAME colleagues, we will be communicating with all our members. Until this is possible we ask that all doctors and their staff stay safe, don’t take any risks and follow robust protocols for infection control and use of PPE.
(Our thanks to Peter Higgins at Lancs and Cumbria LMC for sharing their document)
LMC Newsletter April 2020
Date published: Thursday 30 April 2020
The latest edition of our regular newsletter is now available with all new, updates and opportunities for general practice in the Humber area. Included in this month's issue:
- News on our mentoring service for GPs, including a new rapid access service that can be accessed online in the current restrictions
- Information for on temporary registration for GPs returning to work to respond to the pandemic
- More resilience services available to GPs and other practice staff
LMC Newsletter April 2020 (pdf).
Shielded Patients - LMC Update
Date published: Thursday 16 April 2020
The LMC shares practices’ concerns about the shielded patients project run by NHSE which has resulted in large amounts of work for primary care, an inconsistent approach from secondary care, and confusion for many patients.
We advise all practices to focus on ensuring any lists they are asked to review or generate are correct, rather than rushing to achieve a specific deadline.
The LMC has expressed this view to CCG colleagues, and will support practices who encounter any difficulties.
We have just produced a shielded patients update which summarises the latest guidance on shielding patients in higher risk groups, and provides information for practices to work from.
LMC Newsletter March 2020
Date published: Tuesday 31 March 2020
The March edition of our regular newsletter is now available. In this issue, which is shorter than usual due to the number of cancelled events and training courses, you will find:
- How the LMC can help you and your practice during the coronavirus pandemic
- Latest on the PCN DES
- Guidance on IR35 for sessional GPs
Coronavirus - Help from the LMC
Date published: Sunday 22 March 2020
The LMC is committed to helping our practices in the Humber region in this most difficult time for the health service. We'll be making sure you can access the latest updates and information, but we're also aware that you will already be receiving a huge volume of communications. We'll therefore approach things as follows:
- Our guidance page https://www.humbersidelmc.org.uk/coronavirus will be updated daily. It includes links to trusted sources of information and guidance (including NHSE/I, PHE, and government advice to the public) which are being updated daily.
- We will be issuing a weekly coronavirus bulletin on a Friday afternoon via email to GPs and practice managers. This will include a round-up of the week's updates and new guidance. This will also be available on the coronavirus guidance page as a PDF.
- We have published a list of FAQs which are based on queries we've received from practices. We'll be adding to this regularly as the situation develops. You will always find the latest version of the FAQs on the coronavirus guidance page. If you have a query it's worth taking a look at the FAQs as it may be answered there.
- The LMC social media feeds on Twitter and Facebook will be regularly updated with new information.
- The LMC team are all working as normal during this unprecedented situation and we're here to support you. If you need our help with your queries contact us in the usual ways and we'll respond as soon as we reasonably can.
Thank you for all your hard work and commitment to supporting patients at this most difficult time.
LMC Newsletter February 2020
Date published: Tuesday 3 March 2020
The February issue of the LMC newsletter is now available to download. In this edition you will find all our regular updates including:
- Latest news on the GP contract 2020/21
- VAT guidance for PCNs, commissioned for networks in the Humber, Coast and Vale area
- Updated guidance on Tier 2 visas for practices recruiting from overseas
GPC Contract Roadshow - Download the Event Presentation
Date published: Tuesday 3 March 2020
The presentation slides for this year's GPC Contract Roadshow, which was held in our region on Tuesday 3rd March 2020, are available to download on the BMA website.
Please follow the link and then click on “Download the briefing” in order to access the presentation.
Thanks to Doctor Krishna Kasaraneni of the BMA's GPC executive team for presenting at the roadshow.
Gender Prescribing Guidance
Date published: Monday 17 February 2020
Humberside LMCs has published new guidance for GPs regarding prescribing for patients with gender incongruence in primary care. This is a complex issue with several different pieces of relevant published guidance, and it's an area we continue to receive enquiries about. We have tried to summarise these into a more accessible Q&A document for constituents, which gives some of the background and common scenarios faced. If you have a particular query not covered here, please do get in touch with the LMC and we will try our best to advise.
Download our gender prescribing guidance (pdf).
GP Contract 2020/21 - Summary of Changes
Date published: Monday 10 February 2020
GPC England and NHSE/I have negotiated changes to the GP contract for 2020-21 following a GPC England meeting held on 6 February 2020.
Full details are available on the BMA website here.
Headlines are:
• The new value of Global Sum from 1st April will be £93.46.
• The new value of a QOF point will be £194.83.
• More roles added to the Additional Roles Reimbursement Scheme.
• Between 2020/21 and 2023/24, the scheme will expand to 26,000 additional roles.
• All roles to be reimbursed at 100%, freeing up the existing £1.50/head to contribute to management support for PCNs.
• Funding entitlements increase from £257m to £430m next year and, in 2023/24, from £891m to £1,412m.
• Extra investment will fund new GP training recruitment and retention measures with £20,000 plus training support for every new partner.
• Payment arrangements for vaccinations and immunisations to be reformed.
• QOF to be updated.
• PCN service specifications reduced and improved.
• Investment and Impact Fund introduced worth £40.5m in 2020/21.
The BMA and NHS England have published a new document Update to the GP Contract agreement 2020/21-2023/24 which includes the revised DES specifications, subject to approval at an LMC special conference which will discuss the changes. A date for this event will be announced shortly.
GPC exec will be presenting these changes at the GP Contract Roadshow on Tuesday 3rd March 2020, 19:00-21:00 (Food from 18:00) Lazaat Hotel, Cottingham HU16 5SX. Places can be booked here.
We welcome your comments on this package. Please email these to humberside.lmcgroup@nhs.net.
NHS England Publishes Summary of PCN DES Engagement
Date published: Tuesday 4 February 2020
NHS England has published its summary of the recent engagement on the draft PCN DES specifications.
Over 4,000 responses were received to the proposals, which has prompted an overwhelmingly negative reception from GPs when they were released in December. See our earlier news story on the national response from the BMA and how Humberside LMC is working to ensure that the concerns which our constituents have expressed are heard.
NHS England's summary concludes with this message:
"Our goal is to provide PCNs with certainty and confidence about their future as rapidly as
possible, as part of the process for agreeing the GP contract with the BMA GPC.The engagement feedback has already been informing discussions about the final contract
deal, with both NHSE&I and BMA GPC working to address the core concerns raised in a way
that continues to respect the existing five year deal, sustains general practice, and secures
improvements for patients.The scale and feedback received demands a clear response, in the form of an updated
overall contract package, as part of which we want to agree a significantly reworked set of
service specifications."
In other developments, the BMA has published the results of their recent survey of PCN Clinical Directors. The survey asked clinical directors about their experience of being involved in the creation of PCNs, recruitment of a new workforce, delivery of new services, and also views on the future of PCNs:
"The results reveal that whilst there is considerable optimism amongst clinical directors
about what PCNs can achieve if given the resources, time and practical support to thrive,
there are also concerns about the scale of the challenge facing these new structures and the
expectations being placed on them. This has most recently been evident in the widespread
serious concern raised following NHS England and NHS Improvement’s publication of draft
PCN service specifications."
We will keep you informed of further developments with the PCN DES specifications. Read NHS England's summary of engagement.
New LMC Service: Free Mentoring for GPs
Date published: Thursday 30 January 2020
A new peer mentoring service from Humberside LMCs in partnership with GP-S is due to launch in February. The service is free and open to all GPs in the Humber region. GPs can access up to 4 free confidential sessions over 12 months to:
Support development
Move forward with personal and career goals
Create a greater work life balance
Advance professional development
Build self confidence
Enhance abilities outside and inside work
Achieve aspirations
Enhance leadership skills and build resilience.
Contact details: GPs interested in pursuing the offer should either contact Humberside LMCs by telephone 01482 655111 or email humberside.lmcgroup@nhs.net or contact GP-S directly by telephone 0115 979 6917.
LMC Newsletter January 2020
Date published: Thursday 30 January 2020
The January issue of the LMC newsletter is out now and available to download. In a packed first edition of the year you will find all the latest news and updates including:
- Latest update on the draft PCN DES specifications
- Lots of new events and opportunities including new mentor service for GPs
Update - Draft PCN Specifications
Date published: Tuesday 28 January 2020
On 16th January BMA’s England GP committee voted not to accept a revised contract agreement with NHS England and condemned the recently-published DES draft service specifications outlining what is expected of Primary Care Networks over the next four years. Since the specifications were released for consultation at the end of December, the feedback from GPs was overwhelmingly negative, with practices concerned at the levels of workload involved, especially for those networks that were struggling to recruit additional staff.
Negotiations between GPC and NHS England are continuing and a further meeting of BMA’s England GP committee will take place on 6th February to review further changes to the draft service specifications. Revised DES service specifications will then be presented and debated at a Special Conference of English LMCs to allow GP reps from across the country to debate and consider the outcome of contract negotiations. No date has been set for this Special conference and it is possible that the planned date of 1 April 2020 for implementation of specifications will not be met.
Humberside LMCs will attend the Special Conference and represent the views of our constituents, who have called for:
• Time to develop more capacity to address the workforce legacy before committing to additional specifications.
• Specifications which have new supporting funding and can be delivered with the resources available in the PCN’s locality.
• A phased implementation of specifications which is achievable and commensurate with the development of supporting resources, and PCN maturity
• Meaningful and detailed consultation on any future specification proposals with a wider representative GP group and the negotiated specifications subject to a vote by the profession
• PCNs to remain focused on the wider workforce and their original ethos to move work away from GPs; GPs should not be asked to do any additional work without dedicated funding being included for this
• Future PCN DES changes to include a cost: benefit analysis for each specification, to ensure they are financially viable for practices to take up
Humberside LMCs have written to our CCGs requesting that they engage with PCNs when the agreed DES specifications are published and that they allow the LMC to contribute these discussions on behalf of constituents. It is possible that a small minority of practices may no longer wish to participate in the DES and choose to leave their PCN, in the event that they consider that the final negotiated specifications cannot be delivered. Whilst the LMC are committed to work with practices to ensure the sustainability of PCNs, we have asked CCGs to consider developing a shared contingency plan and set of actions in this event. This will include setting out liabilities for additional roles already employed, for PCNs, practices and CCGs.
Further updates will be published on the LMC website.
Constituent Response to Draft PCN DES Specifications
Date published: Wednesday 15 January 2020
Based on feedback received from our constituents, Humberside LMC has submitted a response to the draft service specifications for the PCN DES which were published in December 2019:
'Constituents are generally supportive of any initiatives aimed at improving patient care by reducing inequity of access and quality of care and can see clear benefits to working together practice to practice but also locally across disciplines. The current draft PCN specifications however are unacceptable to our practices, and if not modified we will be advising practices not so sign up for the 2020/2021 PCN DES.
Our practices believe that PCNs were designed to address the legacy of underfunding in primary care, not to force practices to take on additional services. There are serious concerns about lack of funding and the capacity to do the extra work and it appears that much is dependent on additional staff freeing up capacity to take up the extra services and working with other providers. Recruitment into additional roles has been limited by the available skills resource in our locality and the financial capacity of their organisations to subsidise the new role funding. As a result, the majority of PCNs in our localities have been unable to draw down their full additional roles reimbursement funding. The additional roles have an ongoing cost to practices, in both monetary terms and in terms of time for training. Despite the 100% funding for social prescribers, there is also an impact where CCGs provide a maximum figure which is below the salary range locally.
Our GPs feel that it is critical that PCNs are not set up to fail by taking on too many tasks too quickly. Many PCNs are still being supported to deal with issues such as resource, funding, data-sharing and organisational development. The risk in driving through new service specifications is that disillusionment following over-inflated expectations, as well as time-limited funding and support, leaves general practice in a worse position. It is also impacting on GPs nearing retirement seeing this as a catalyst that precipitates them leaving practice, so further increasing the resource problem.
The LMC are concerned that by negotiating these DES specifications as a component of the overall GMS contract negotiations, it presents a risk that other components of the main negotiations will be significantly detrimentally influenced. More specifically our constituents have called for:
- Time to develop more capacity to address the workforce legacy before committing to additional specifications.
- Specifications which have new supporting funding and can be delivered with the resources available in the PCN’s locality.
- A phased implementation of specifications which is achievable and commensurate with the development of supporting resources, and PCN maturity
- Meaningful and detailed consultation on any future specification proposals with a wider representative GP group and the negotiated specifications subject to a vote by the profession; the questions in the current consultation are unhelpful as a feedback mechanism
- PCNs to remain focused on the wider workforce and their original ethos to move work away from GPs; GPs should not be asked to do any additional work without dedicated funding being included for this
- Future PCN DES changes to include a cost: benefit analysis for each specification, to ensure they are financially viable for practices to take up
In summary, the draft specifications were described by our LMC committee as “The single most depressing document for a decade…didactic, central command and control that does nothing to alleviate workforce pressure…it feels like NHSE just don’t care.”'
The response was submitted as part of the consultation on the proposals which closed on 15 January 2020.
PCNs - Network Contract DES National Service Specifications 2020/21
Date published: Thursday 2 January 2020
NHS England is seeking feedback on the five national service specifications, of the GP contract framework, which will be delivered by primary care networks (PCNs) - in collaboration with community services and other providers - from April 2020.
The GP contract framework set out seven national service specifications that will be added to the Network Contract DES: five starting from April 2020, and a further two from April 2021. The five services are:
• Structured Medication Reviews and Optimisation
• Enhanced Health in Care Homes (jointly with community services providers)
• Anticipatory Care (jointly with community services providers)
• Personalised Care; and
• Supporting Early Cancer Diagnosis.
The LMC's position on the specifications is set our in our advice update which can be downloaded here.
There are a number of opportunities to share your thoughts on the outline draft of the service specifications. Please note there is a tight timescale to submit responses.
• The document is available online here, with a number of questions to be answered to help shape the final service specifications. This will be live until 1pm on 15 January 2020.
• A series of facilitated interactive webinars will be taking place as follows:
• Wednesday 8 January 2020 – 12 noon-1.30pm
• Thursday 9 January 2020 - 10am-11.30am
• Tuesday 14 January 2020 – 3pm-4.30pm (focusing on the community services elements of the Enhanced Health in Care Homes and Anticipatory Care service specifications, aimed at directors and chief executives of community health providers).
Nikki Kanani will be hosting a Twitter chat on 7 January 2019 specifically about the service specifications. Follow #primarycarenetworks from 8pm and join in the conversation and share your views.
Should you have any questions, please contact england.networkscontract@nhs.net.
LMC Newsletter December 2019
Date published: Thursday 19 December 2019
The December issue of the LMC newsletter is out now and available to download. In this final edition of 2019 you will find all the latest news, events and opportunities including:
- New LMC events in 2020 including a premises seminar with Capsticks solicitors
- News regarding GP direct access to diagnostic services - managing patient care and investigations
- Registration of individuals leaving the secure residential estate - guidance for practices.
LMC Manifesto for General Practice
Date published: Monday 9 December 2019
Humberside LMCs today publishes its manifesto for general practice.
Workforce and wellbeing
• We need to retain the excellent workforce we have and recruit new GPs by widening the bursary funding to attract doctors to parts of our region where there have been consistent shortages of trainees. The LMC welcome work force investment benefitting every practice to support the training of current reception and clerical staff to play a greater role in navigation of patients and handling clinical paperwork to free up GP time.
• In our August survey GPs told us that high workload, fear of complaints and low staffing levels are leading to low morale & burnout across the profession. The LMC would believe we need continuous funding for resilience support for GPs and the wider medical and support workforce in primary care.
Primary/Secondary Interface
• The LMC believe that primary and secondary healthcare providers in our region could work better together. We know there is a willingness from practitioners across our system to communicate, integrate and evolve to provide a better patient care experience. The LMC want to work with commissioners and providers to improve this integration and invite all stakeholders to embrace this opportunity.
Pensions
• The pensions taxation crisis means that doctors are being forced to turn down vital extra shifts caring for patients in our under-pressure GP surgeries because they would be literally paying to go to work. Doctors are trapped in a dilemma between wanting to care for patients and not wanting to end up financially worse off. The LMC support the work of the BMA to lobby Government to deliver pension taxation reform and for pensions administration to change to offer a responsive, timely and accurate service to GPs.
Premises
• An historical underinvestment in premises and increasing demand for accommodation for new PCN roles is placing an unsustainable demand on our primary care estate. The charges levied on premises are frequently difficult to understand and non-negotiable. The LMC would like long term realistic capital funding to meet the needs of patient care and a premises charging administration which is responsive, transparent and fair.
IT and Infrastructure
• The LMC is concerned about the impact of digital health providers on our local system. Continuity of care lies at the centre of traditional general practice, with local surgeries providing person-centred care from the heart of communities. We would highlight the risk that digital only practices poses to this and want to see a well-integrated and mixed provision which serves the need of all of our patient population.
• Effective primary care should be built on a stable and integrated IT platform. The LMC supports a case for fast and reliable infrastructure integrated across the whole healthcare system with controlled access to patient records by all practitioners.
LMC Newsletter November 2019
Date published: Thursday 28 November 2019
The November issue of the LMC newsletter is now available. Included in the latest news, updates and events:
- Invitation to complete our 2019 LMC survey
- A number of medication supply alerts practices need to be aware of
- Changes to the the community pharmacy contract and patients with diabetes
LMC Survey 2019
Date published: Tuesday 19 November 2019
GPs and practice managers in the Humber region are invited to take part in our annual survey to shape the work of the LMC.
The survey is a key method we use to assess our services to general practitioners and identify how we can improve. We study all the feedback we receive and use the results to help set the LMC’s priorities for the coming year.
Last year’s survey helped identify a number of key areas which we have been working hard to deliver since then:
- Supporting practices with the major changes underway in general practice through the new GP contract and formation of PCNs
- New resilience programme of training and support for GPs and practice managers
- New ways to engage with our constituent GPs and practices, including an improved website with access to a greater range of content
The closing date for responses is Friday 13th December 2019.
Click on the link below to take the survey. You can complete the survey on phones and tablets as well as your desktop.
LMC Newsletter October 2019
Date published: Wednesday 30 October 2019
The October issue of the LMC newsletter is now available. Included in the latest issue:
- New LMC events and training, including Better Conversations training
- Opportunity to become a GP mentor and receive training
- News on flu vaccinations for GP practice staff
Humberside LMC Resilience Support – Appeal for GP Mentors/Coaches
Date published: Monday 28 October 2019
Humberside LMCs invites you to apply to attend a two day Mentor Training course with a view to becoming a self-employed paid mentor for GP-S. GP-S is a free peer mentoring and coaching service for GPs due to launch in Humberside in early 2020.
The service will give all GPs in the area access to a free trained peer mentor/coach for four sessions of face to face support lasting two hours at a time.
Sessions can be used for any problem or opportunity an individual feels they may have, from career or personal development to stress and work/life balance. Everything discussed within GP-S is kept confidential.
To help set up this service, GP-S and Humberside LMC are looking to recruit a number of local GPs to become self-employed paid mentors for the scheme. All Humberside GPs are eligible to apply for the positions. Mentors will need enough time to complete two-hour mentoring sessions away from practice and will be able to determine the distance they feel able to travel.
Once GPs have applied for a position they may be invited to attend a two day training and assessment course. The GP-S potential mentor training and assessment course takes place over two full days on 16th and 17th January 2020. Delegates will need to attend both dates to have the opportunity to progress.
The course will cover mentoring and coaching techniques and focus on the Egan model. On the first day delegates will learn key skills and cement the knowledge already gathered through the pre-course learning materials. The second day will give everyone a chance to practice the model as a client, mentor and observer. Through this, delegates will be assessed to determine if they would be suitable for the role of mentor with GP-S locally.
The course is intensive but highly rewarding and previous delegate feedback has praised the safe and informal learning space created by GP-S trainers.
The training is due to take place on Thursday 16th and Friday 17th January 2020 at the LMCs Boardroom, Albion House, Albion Lane, Willerby, HU10 6TS.
If you’d be interested in attending the course to potentially become a GP-S mentor for Humberside GPs, please email contact@gp-s.org by Friday 29th November 2019 to receive an expression of interest form.
LMC Newsletter September 2019
Date published: Monday 30 September 2019
The September 2019 issue of our regular newsletter is now available. Included in this month's issue with all the latest news, events and updates:
- Premises issues update from the GPC
- Additional roles reimbursement guidance
- Latest training and events including HYMS courses
Download the September 2019 newsletter (pdf).
Premises Issues Update
Date published: Wednesday 25 September 2019
Practices affected by issues with CHP and NHSPS will be interested in the latest update regarding work being done at national level to address these matters.
In summary, the BMA has asked NHS Property Services for an urgent response to concerns over the worrying rise in service charges faced by GP practices. Failing this, legal action will be considered. BMA lawyers have set out in detail the reasons why it believes NHSPS is acting unlawfully in a letter of claim. If no satisfactory response is received, the BMA says it intends to take NHSPS to court. The BMA are currently engaging in the ‘alternative dispute resolution’ process proposed by NHSPS’s lawyers.
Further background to the issue can be found in a recent GPC policy leads update (see the Premises and practice finances update by Gaurav Gupta, pages 8-9).
The BMA has a dedicated area on their website Support with Community Health Partnership (CHP) and NHS Property Service issues (NHS PS) which practices may find useful.
BMA guidance is clear that practices should engage with NHSPS, identify areas where there is a dispute and pay undisputed amounts. Practices should not be forced into any agreement which places the viability of the practice at risk and solutions must be sustainable. Practices should be mindful that the BMA are proceeding with legal action to address historical charges and should ensure that in reaching any agreement independently of this they do not put themselves at risk of any future liability or compromise their future position.
We are happy to provide advice and support to practices facing issues with premises. Contact details here .
LMC Newsletter August 2019
Date published: Thursday 29 August 2019
The August 2019 issue of our regular newsletter is now available to download.
Included on this issue are all the regular updates, events and opportunities including:
- Primary Care Network Data Templates
- New local resource - GP Signposts for Yorkshire and the Humber
- Resilience Resources
Download the August 2019 newsletter (pdf).
New Appointment at Humberside LMCs
Date published: Tuesday 16 July 2019
We are delighted to announce the appointment of Dr Zoe Norris who will be joining the LMC Secretariat team as Medical Director in August.
Zoe is a sessional GP and Hull Chambers lead for The Medical Chambers and has worked in the East Riding for the last nine years. She also has roles as a GP Appraiser and Clinical Lecturer.
We will be welcoming Zoe when she starts early next month, working with us for one day a week. She will have a key role in informing, supporting and representing GPs and practices, and in liaising with a range of bodies on primary care issues including workload, funding and workforce development.
Take Part in Our Annual Survey 2021
Date published: Monday 1 January 0001
We're inviting GPs and practice managers in the Humber region to complete our annual survey and shape the work of the LMC.
The survey is a key method we use to assess our services to general practice and identify how we can improve. We study all the feedback we receive and use the results to help set the LMC’s priorities for the coming year.
Our last survey helped identify a number of key areas which we have been working hard to deliver since then:
• Our expanded secretariat team has enabled us to develop new programmes to support GPs and practices
• Rollout of our new service to provide free mentoring to GPs to support personal development, build confidence, and create better work life balance
• Supporting the development of primary care networks
The closing date for responses is 5pm on Friday 26 March 2021.
You can complete the survey on your desktop, phone, or tablet.