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Humberside LMC Manifesto for General Practice in our Integrated Care System

Date published: Monday 13 June 2022


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.

• 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:

LMC Newsletter May 2022

LMC Events and Training

Hull Deaf Centre

Relay UK - system helping people with hearing and speech difficulties communicate with anyone over the phone.

Capsticks Diploma in Advanced Primary Care Management

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

Source: Scenario: Referral for suspected gastrointestinal tract (lower) cancer | Management | Gastrointestinal tract (lower) cancers - recognition and referral | CKS | NICE.

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

Newsletter decorative graphic

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 

Download the May 2022 LMC newsletter.  

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

Rebuild General Practice Open Letter to Patients

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The professional voice of general practice across East Yorkshire, Hull, North East Lincolnshire, and North Lincolnshire.