Tackling the challenges GPs face

Tackling the challenges GPs face

 The unique strength of GPC as your representative body comes from its infrastructure of LMCs — it democratically represents the interests of general practice across the UK. It is vital GPC connects with and understands everyday GPs on the ground, which is why we go out and speak at your local and regional meetings throughout the year. We run a series of national GPC roadshows twice yearly, which are open to all GPs and hosted by LMCs (local medical committees). These have been running this month in more than 10 areas across England. Last week I spoke at Beds and Herts, Kent, and West Midlands LMCs, which gave me an invaluable opportunity to report on the work and priorities of GPC, and most importantly to hear directly from grassroots colleagues about their issues and concerns, coupled with lively debate on how to move forward together to address the challenges ahead. These meetings cover issues including: Forthcoming changes to the GP contract Managing workload Co-commissioning New models of care Workforce GP premises. You may still have time to attend a roadshow in your area.   Workload A constant theme in the roadshows has been our excessive and unmanageable workload. I was pleased that so many practices are finding our guidance on managing workload, Quality First, useful. One GP who has a partnership vacancy, and was fortunate enough to have applicants, told me that as part of the interview process prospective partners were asked to use our guidance to present a practice-workload management strategy. Another GP recounted that in a recent CCG (clinical commissioning group) practice visit, he used our guidance to...
Your Chairman Writes …

Your Chairman Writes …

Medico-politically this should be a quiet time of the year. We are approaching a General Election and although the political parties are setting out their policies ahead of their manifestos, no one wants to upset the NHS applecart especially in the light of the Five Year Forward View. Cornwall, however, is quietly undergoing a small medical revolution. The major news of course is that a GP owned company has won the GP OOH contract. How did we get here ? Let’s recap the events that have brought us to this point. A year ago the LMC led a series of countywide events entitled ‘The Future of General Practice’. The overwhelming majority of attendees expressed support for the development of a Cornwall GP provider company with the intent to protect and develop Cornish General Practice and to bid for the GP OOH service. Very rapidly Kernow Health CIC was born and a further company Cornwall Health has evolved from Kernow Health and Devon Doc. It is this company that will run our OOH service. The work with Devon Doc and the formation of Cornwall Health is the culmination of the decisions taken at those Future of General Practice meetings. I think this fact highlights a number of issues. Firstly, when GPs act together they can effect large and seismic change in the healthcare environment. Secondly the future is in our hands. It is my strong belief that standing still will create a vacuum that others will fill. We must continue to innovate and make bold decisions about our futures. However, this aspect of our future will require continued hard work...
New BMA Guidance

New BMA Guidance

The BMA has produced some new guidelines on delivering safe patentee care (the complete documents can be downloaded from our “Latest Guidance” page. It is in response to GP workload having now reached unmanageable proportions, against a backdrop of escalating demand, which has far outstripped our impoverished capacity, and which is seriously impairing our ability to deliver the care our patients need. GPs are trying to square an impossible circle; many working 12- to 14-hour days, seeing up to 50 patients — including those with complex needs — on a conveyor belt of 10-minute slots, added to by numerous telephone consultations, daily home visits, ploughing through a mountain of hospital correspondence, test results and repeat prescriptions, writing reports, making referrals, attending meetings, as well as the rigours of running a GP practice. No wonder the recent BMA quarterly tracker survey showed that the percentage of GPs describing their workload as ‘unsustainable’ was 74 per cent — higher than for any other category of doctor. Funding cuts to individual practices via imposed changes to the MPIG (minimum income practice guarantee) and PMS (personal medical services) reviews are exacerbating the problem, while other practices are struggling to provide services with unfilled GP vacancies. In this intense, pressured climate, it is crucial that the safe provision of care to patients remains GPs’ overriding priority, at a time when practices are undermined from doing so by excessive, inappropriate or unresourced work. Quality First: Managing Workload to Provide Safe Patient Care is a handbook to empower practices with practical tools, including model templates, to manage workload and to shape demand, in order to fulfil...
CQC: Important changes

CQC: Important changes

Dear colleague, I am writing to update you on important changes coming into effect on 1 April 2015 and to tell you about guidance we are developing to help you to prepare for those changes. Today we have published: Guidance for providers on meeting the regulations (the Fundamental Standards) Bar guidance for a small number of regulations we are still consulting on Enforcement Policy Enforcement Decision tree Memorandum of Understanding with the Health and Safety Executive Early next month we will publish: Guidance on the new Fit and Proper Person Requirement for Directors and Duty of Candour regulations (except for NHS bodies – their guidance and approach came into effect in November 2014) Guidance on the requirement to display ratings Later in March we will publish: Enforcement Handbook The final Guidance for provider on regulations (the Fundamental Standards) Including guidance on all the regulations More information on each of these pieces of guidance can be found below. Guidance for providers on meeting the regulations (the Fundamental Standards), and Enforcement Policy and decision tree From 1 April 2015, new regulations (the Fundamental Standards) will come into effect. They will set the standards below which care must not fall, and which providers must demonstrate how they will meet as part of registration. The standards sit alongside the five questions we ask and rate against when we inspect; are services safe, caring, effective, responsive to people’s needs, and well-led? These questions help our inspectors identify good care. When our inspection teams identify poor care, they will determine whether there is a breach in the new regulations and if so, what action to take. Following a public...
Your Chairman Writes …

Your Chairman Writes …

2015 will, I think, be a pivotal year for GPs and then NHS as a whole. Soon we will have a General Election. All the major parties are agreed on the predicted shortfall in NHS funding but each has a different view on how this gap can be bridged – of course this is all predicated on a huge saving first, something that I am yet to be convinced about. One thing is for sure is that all are agreed that the Five Year Forward view represents an acceptable blue-print. I commend it to all of you as essential reading. Essentially the choice is between Multispecialty Community Provider (MCP) setup or an integrated hospi-tal and primary care provider (Primary and Acute Care Systems). The former would give us more control and could be delivered through KernowHealth CIC. This organisation which belongs to all of us is matur-ing and expanding and you will have heard about some of the latest developments from Mike Ellis. I be-lieve that if we are to thrive then KernowHealth has to deliver most of the solutions. I am confident that given time this may be possible. Hopefully there will be enough of us to deliver the necessary care that is needed. 10 million pounds has apparently been set aside by NHS England to encourage newly qualified doctors to become GPs in hard to doctor areas (that unfortunately does not mean us). At last there will be a returners policy and some incentives to encourage GPs to continue working rather than retiring (it will have to be good!). There is a realisation that General Practice is...
Update on Occupational Health

Update on Occupational Health

The New Year arrives with the icy blasts of disinvestment in occupational health (OH) that we have struggled for so long to avoid. I have been working for roughly a year outside of my LMC capacity to try and streamline OH structures and position us to be able to compete in whatever procurement was likely to come our way in the wake of OH reorganisation from NHS England. Sadly, their final word on the matter came just before Christmas and was devastating, and it is my sad duty to report this to you. In December I was informed that NHS England will continue to finance all of our current OH ar-rangements until 31st March 2015. After that date the only services that will receive funding are the needlestick injury service, and a one-off assessment for practitioners who are struggling. At a meeting that involved the two LMCs it was agreed by the Area Team that there would be run-off funding arrangements for those practitioners already in treatment but it was made clear that NHS England will henceforth not fund any treatment required by sick doctors. The rationale from NHS England is that all treatments should be commissioned by CCGs and therefore a sick doctor should be directed to standard psychology services in the usual way. The argument has been made strenuously that this is completely inappropriate, but to no avail. I have also written to the Clinical Chairs of both CCGs inviting them to commission specialist OH ser-vices for sick doctors. Understandably, their response has been cool, leaving us in a situation where the most likely outcome will be...