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.
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
Download the LMC newsletter June 2020.
Date published: Wednesday 24 June 2020
In response to NHSE’s recent undertaking for staff and patients to have access to antibody testing, local CCGs will be inviting practices to an provide antibody testing for primary care staff including dental, pharmacy and opticians, as well as GP staff and their patients. This is not a core service and is therefore not mandatory for practices to deliver. A service specification together with clear funding will be issued to practices shortly. The LMC have provided comments with respect to the service specification and we would advise practices who may wish to deliver this service to consider the following:
• The specification does not limit the scope and frequency of testing and extends to practice patient population. Some practices may have difficulty providing resources to respond to this level of demand.
• Practices may also be invited to test staff and patients of other practices who decline to be commissioned for this service. It is also possible that CCGs may commission this service through another provider to deliver a local solution.
• NHS Resolution have confirmed that where you are appropriately trained and competent to undertake this activity, and you are not covered for this activity under your existing indemnity/insurance arrangements, you will be indemnified under the Clinical Negligence Scheme for Coronavirus (CNSC). More information is available here.
• There will be a significant component of practice time required for briefing and counselling post-test. This should be reflected in the funding rate you accept.
• There have been recent reports of actuarial impact of insurance and finance applications which should be made clear before consenting to a test. The BMA have provided this information.
• The communication and recording of results process requires further detail. It the LMCs understanding that a record of the tests will not be placed on the GP patient record but may be recorded on the occupational health record for staff members.
• The Daily Mail and Pulse have reported that NHS England has said that any patient can ask their GP for antibody test when having a blood test for another reason. In response to this GPC said there was no obligation to offer antibody testing and that this could increase inappropriate attendance at surgeries. GPs would use their clinical judgement to decide whether to offer patients COVID-19 antibody tests. The Pulse article can be found here (registration required).
The LMC will provide any further updates on our COVID web page.
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."
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.
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.
Date published: Wednesday 20 May 2020
NHS England have announced that GP practices will not be required to open, outside the normal bank holiday cover arrangements, for the upcoming Whitsun Bank Holiday (25 May).
Our colleagues at the LPC have published details of pharmacy opening in our region on the bank holiday which can be viewed here.
More »
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:
- Risk reduction framework
- Risk stratification tool
- NHS Employers advice for BAME
• 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)
Date published: Monday 4 May 2020
UPDATED.
GP opening on 8th May is not mandated by NHSE/I and will depend on local anticipated demand. NHSE/I have requested that practices agree locally with their CCGs if they need to be open. CCGs have confirmed that they will be providing specific advice on your local arrangements.
All community pharmacies in England are required to open 2-5pm with exceptions or a variation to those hours, based on the likely demand and local needs, agreed in advance with the NHSE/I regional team.
Our colleagues at Community Pharmacy Humber have shared local pharmacy bank holiday opening hours here.
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).
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.
Date published: Wednesday 8 April 2020
As part of regulatory changes to General Practice, Good Friday and Bank Holidays are designated as “core hours”. The LMC are working with CCGs to clarify the level of delivery required across these periods. Whilst not all CCGs have confirmed their plans, the LMC is recommending:
• Good Friday and Easter Monday – All patients to have access to a total triage service 0800 to 1830 by contacting their own practice number as normal, with the service delivered at PCN level, by phone diversion, as determined by PCN practices. For ERY practices the OOH service will commence at 18:00 as usual and for Hull at 18:30.
• Easter Saturday and Sunday – Some PCNs and localities have established “Hot clinics” which it is recommended are open on these days. Some CCGs have confirmed that Easter Saturday and Sunday will be covered by the GP Out of Hours service as usual.
• Where Out of Hours cover is available through practices or other contractors this can be used to support across the weekend, provided the use of this does not impact on available resources.
• Funding for staff who will be required in addition to normal staff to provide this cover should be funded through COVID-19 contingency CCG support.
• Pharmacies will also provide increased opening hours across the bank holiday to support general practice although their opening hours will not match practice opening hours.
• The LMC secretariat will be providing support services across the Easter bank holiday. Please contact us in the normal ways.
Update 09/04/2020
NHSE have released an update on reimbursement for additional staffing on these days:
Good Friday and Easter Monday reimbursement rates
Where it is determined that a practice must open on Good Friday or Easter Monday, practices can seek reimbursement for additional staffing costs incurred on these days, in line with the respective rates as set out below. That includes:
• Sessional GPs: up to a maximum of £250 a session or £500 per day;
• Overtime for salaried GPs in line with the individual’s contractual arrangements;
• Additional capacity from GP Partners to recognise up to two additional sessions on each of Good Friday and Easter Monday at a rate of £289 per session plus applicable employer National Insurance and pension costs;
• Overtime for non-GP practice staff in line with the individual’s contractual arrangements.
NHSE's advice is that practices should discuss with their local commissioner the level of service required on bank holidays and agree in advance what additional staffing costs will be reimbursed.
Details of the General Practice COVID support fund will soon be shared, and additional expenses will be considered within this.
Date published: Thursday 2 April 2020
As we find ourselves facing incredibly difficult times, please remember that the LMC is here to support you. Please visit our resilience page for information about support and resources.
Mentoring:
If you are a qualified GP, please use the following contact details to access our mentoring service or contact Humberside LMCs for more information:
www.gp-s.org - complete the online contact form
email contact@gp-s.org
We are working with GP-S and our mentors with a view to providing shorter, virtual sessions so that as many GPs as possible may benefit from the service over the coming months.
Mentoring can help by providing general support or specific support including the following areas:
- Emotional support
- Working through stressful situations
- 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.
Lighten the Load:
We are planning to hold this one day event in November, date to be confirmed, instead of 18th June as previously announced.
You will learn how to ‘lighten the load’ by skilling up with some of the must-know, fundamental and empowering coaching skills and techniques, along with the theories that underpin them. By the end of the day, you will feel lighter and be even better equipped to have some great conversations that will change things for the better going forwards, for you, your staff and patients.
The programme is free and aimed at medical practitioners and practice managers in the Humber area, provided through our GP resilience programme. Lunch will be provided. Online booking details to follow.
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
Download the March 2020 newsletter (pdf).
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.
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
Download the February 2020 newsletter (pdf).
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).
Date published: Tuesday 11 February 2020
Wellbeing Lead - 7.5 hours per week - 15 month contract
£22,138 per annum
Are you a GP looking for a stimulating new opportunity to use your skills and experience? Have you considered an LMC role, supporting and representing your fellow GPs?
The Humberside Group of Local Medical Committees Ltd (Humberside LMCs) is seeking to recruit a GP Wellbeing Lead. The Wellbeing Lead will complement Humberside LMCs’ existing team and will offer the right individual opportunities to:
• use their considerable experience to be a positive, passionate representative for General Practice, to make a difference at a local, regional and national level
• demonstrate clinical leadership, advising across a range of areas including workforce planning and developments, primary care management, system change and resilience of general practice to name but a few
• use and further develop their network of expert contacts across the local landscape
• provide practical support and interventions and signposting of other resources by visiting and working with individual GPs and practices across our region.
Humberside LMCs will be working in partnership with YORLMC to deliver GP resilience, recruitment and retention support across the Humber, Coast and Vale footprint.
The role is likely to suit a GP keen to pursue a new opportunity alongside clinical work.
Our contemporary offices in Willerby are easily commutable from South and West Yorkshire. The immediate locality offers great schools, beautiful countryside and competitively priced housing as well as interesting clinical opportunities. We offer an excellent working environment and a strong, supportive staff team.
To access full details on the role and how to apply download the application pack.
Closing date: Friday 28 February at 16:00
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.
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.
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.
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 on the primary secondary care interface in Hull and East Yorkshire
Download the January 2020 newsletter (pdf).
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.
Date published: Tuesday 28 January 2020
The UK has a national shortage of qualified GPs to meet the growing demands of the population. Typical recruitment efforts have not produced suitable candidates required to fill GP roles in our area. The impact of this is extended waiting times for patients and greater pressure on the current workforce to meet the needs of patients.
The role of a GP is requires many years of specialist training including: a full medical degree; two years of foundation medical training; and at least three years of specialist GP training. While there are concerted national efforts to increase the numbers of available GPs in the UK, this does not address the immediate pressure on services and we therefore anticipate a need to recruit from overseas.
The role of General Practitioner has been included on the UK Shortage Occupation list as of 6 October 2019 and the resident labour market test (RMLT) is no longer required for GPs who will be working over 30 hours. However if a GP wishes to work under 30 hours the RMLT will need to be conducted - see the guidance on creating and assigning certificates of sponsorship below for details.
Practices looking to recruit GPs from overseas will benefit from new guidance to help with the process of obtaining Tier 2 Visas.
Tier 2 is an immigration route for non-European Economic Area (EEA) migrants who wish to work in the UK. Initially the focus was on doctors from the EEA but has now been widened to include Australia and New Zealand.
In order to obtain a Tier 2 Visa, these migrants must be sponsored by an organisation or company that holds a Tier 2 licence. A licence is a permission given to an organisation by the Home Office to sponsor workers in its business. This licence lasts for 4 years and the organisation is then recognised as a sponsor.
NHS England is offering a package of funding to support any practice who wants to become Tier 2 Visa sponsors. Funding available includes: reimbursement of sponsor licence fee (even if unsuccessful), Certificate of Sponsorship fee, the first two years of Immigration Skills Charge and Visa fees for GP trainee and their family.
There are a number of resources to help practices with Tier 2 Visa Applications:
Tier 2 Visa Applications: Support Information from NHSE - an overview of the rules, and how to get help from NHS England (updated January 2020)
Becoming a Tier 2 Visa Sponsor - PowerPoint slides outlining the process (updated December 2019)
Creating and Assigning Certificates of Sponsorship - PowerPoint slides explaining how to create the required certificates (updated December 2019)
NHSE have extended the deadline for Tier 2 visa reimbursements to 31/03/2020 when the funding ends. However if you are looking to apply after this deadline it may still be worth approaching NHS England to discuss your situation.
Date published: Monday 20 January 2020
The BMA’s England GP committee has voted not to accept a contract agreement with NHS England and condemned the recently-published draft service specifications outlining what is expected of Primary Care Networks over the next four years.
Members of the committee, who met in London on Thursday 16 January, were presented with a package of changes but voted against accepting them. The GPC’s executive team will now return to negotiations with NHS England. Details of the package remain confidential.
A separate motion* condemned the draft service specifications, put forward by NHS England and NHS Improvement in December, and called for a Special Conference of English LMCs to allow GP reps from across the country to debate and consider the outcome of contract negotiations.
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.
BMA GP committee England chair Dr Richard Vautrey said:
“The message from GPs in recent weeks has been a clear one: proposals put forward by NHS England and NHS Improvement before Christmas were inappropriate, unreasonable, and completely unachievable.
“At a time when demand and workload for practices are unprecedented, GPs working on the front line felt these draft specifications piled on more pressure and risked destabilising general practice entirely.
“This overload would also put in jeopardy all of the good work and progress PCNs have already made for the good of both staff and patients.
“Even in the short time GPs were given to respond to the consultation, NHS E/I were overwhelmed with feedback, which was unanimous in its condemnation. Now GPC England – which is elected to represent GPs across England – has made its own position clear and demanded that policymakers engage properly with GPs working on the frontline.
“This is not the end of the process, and we will now go back, with a clear mandate from our colleagues, to negotiate a deal that truly benefits and safeguards general practice, family doctors and their patients.”
*You can read the full text of the motion at https://www.bma.org.uk/news/media-centre/press-releases/2020/january/bma-gp-committee-england-votes-down-contract-package-and-calls-special-conference.
We will keep you informed of further developments with this issue.
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.
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.
Date published: Thursday 2 January 2020
The Joint Committee on Vaccination and Immunisation (JCVI) published its advice on the use of influenza vaccines for the 2020/21 influenza season in September 2019. The guidance covers:
- adults who are 65 and over
- at-risk adults (including pregnant women) and children for whom there are contraindications for use of LAIV
The guidance can be downloaded here.
In December 2019 the JCVI published follow-up advice on the 2020/21 vaccination programme and reimbursement guidance for 2020/21. This latest guidance can be downloaded here.
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.
Download the December 2019 newsletter (pdf).
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.
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
Download the November newsletter (pdf).
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.
https://www.surveymonkey.co.uk/r/NTYYWMQ
Date published: Monday 11 November 2019
Humberside LMCs would like to provide advice on the impact of pre-election purdah on PCNs.
Purdah has implications for NHS organisations, including the arm's-length bodies such as NHS England, CQC and NHS Improvement over this period. During these periods, communications either in the form of announcements or activities by NHS organisations should be avoided if they could influence, or be regarded as influencing, the outcome of elections. Public authorities should avoid situations that may provide opportunities for party political benefit.
PCNs are not public sector bodies. A PCN is essentially a contractual joint venture between the member practices. The Cabinet Office guidance on purdah does not formally apply to PCNs since it is aimed at civil servants and the board members and staff of Non-Departmental Public Bodies (NDPBs) and other arms’ length bodies. However, the NHS cannot prevent GPs from political activity, and the RCGP has launched its own campaign for GPs to back candidates that will support investment in general practice. Ultimately, if GPs and PCNs decide that they do want to participate in political activity during the pre-election period they are free to do so.
Our advice is however that it would be prudent for PCNs to observe the key principles of the Cabinet Office guidance during the pre-election period.
Do
• Confine your communication activities and announcements to those necessary for the safety and quality of patient care.
• Consider whether you will allow visits from all your local prospective councillors/local political parties/campaign groups and what format they will take. It is your decision whether to invite them or not. If you do, remember to keep your policy around visits consistent and impartial.
• Keep any communications with local candidates/political parties/campaign groups to a factual and apolitical basis – apply the same approach to any communications with the media and in the public sphere.
• Continue to conduct normal business and adhere to good governance and regulation.
• Continue to plan campaigns post purdah.
• Familiarise yourself with the official guidance from the Cabinet Office.
Don't
• Undertake any activity that could be considered politically controversial or influential, or could give rise to criticism that public resources are being used for party political/campaigning purposes. For example, allowing certain public awareness activities that could be deemed party political, market research and public rallies, and producing election materials or canvassing.
• Be selective if you are inviting local prospective councillors/political parties/campaign groups to your premises – invitations should be sent to all or none.
• Allow party political meetings to take place on your organisation’s premises.
• Allow visits by local candidates/political parties, national and local politicians or campaign groups to your organisation to interrupt services or care for patients – make sure your staff are aware of any visits in advance.
• Launch large-scale PR campaigns during this period.
Please contact LMC if you have any questions.
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
Download the LMC newsletter October 2019 (pdf).
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.
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).
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 .
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).
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.
