You will all be aware that, on Monday, the Prime Minister issued a statement introducing even tougher measures on social distancing and said that people “must stay at home” in order to protect the NHS and save lives, by reducing the spread of the infection. As both the Prime Minister and the Secretary of State for Health and Social Care have now both tested positive, and with England’s CMO Prof Chris Whitty also showing symptoms, the spread of infection is clear. It’s all the more important to use remote methods for consultations to the maximum, to limit face to face contact with patients to the absolute minimum and when only absolutely clinically necessary, and then to use PPE at all times.
Vulnerable patients and social distancing
Following the announcement last week introducing new measures on social distancing, advising those at increased risk of severe illness to be particularly stringent, the CMO has published a letter defining those at high risk which are:
We have published joint guidance with the Royal College of GPs on Vulnerable Patients – Role of General Practice during COVID19, which can be accessed on the RCGP COVID-19 hubpage. This document may be updated over time and we will let you know should that happen.
There are two specific groups of very high risk patients - those in category B (Groups 1-3) will automatically be sent a letter by NHSBS. The CMO letter communicated a need for General Practice to identify and write to group 4 patients. We are awaiting further formal guidance in terms of next steps for identification of group 4 patients. You will have received a similar message through your system suppliers.
We know there has been some confusion about the definition of the very high risk groups. These groups were categorised by the NHS England Clinical Reference Group and other specialist clinicians, into the very high risk patients that could be identified by extracting relevant groups from national datasets using HES data as this was readily available. Those doing this acknowledge the potential flaws in this process but it was the best that could be done in a short space of time. NHS Digital are currently working with system suppliers to try and reconcile any inaccurate codes applied.
These patients will have received different texts to the ones going to the general public, and they should receive letters directly. Practices should have received lists of their patients in this group and codes will be added to patients’ electronic record.
PPE update
We have been very concerned about the lack of appropriate PPE for primary care providers and the problems practices are having in obtaining additional supplies. We are working to resolve this with NHSE and the DHSC as urgently as possible and I spoke to the Health Minister, Jo Churchill MP, about this again today. The BMA wrote to the PM last week calling for this to be urgently resolved, as well as demanding that testing be made available for HCWs. This week BMA demanded answers about PPE from the Government, and Chaand Nagpaul, BMA chair of council, made this statement
It is imperative that practices and other primary and community care organisations get regular supplies of PPE and that practitioners are given confidence that the PPE they receive and use is appropriate. Practices should not need to purchase this themselves.
As a result of our pressure we have finally secured some action in delivering PPE to practices. The messaging on the helpline has now changed. The National Supply Disruption Response was designed to deal with supply disruption in the event of no-deal Brexit and is now focussed around the distribution of PPE. Additional stock, following the initial delivery a few weeks ago, has been placed with distributors and wholesalers (such as Phoenix/ DCC Vital/ Williams) to enable GP practices to order through their BAU routes.
NHSEI and DHSC are working with the military to enable swift movement from pandemic stockpiles into distribution centres to fulfil demand.
For more immediate short term issues NSDR are able to issue ‘pre-packed kits’ with a minimum of (100 Type IIR facemasks; 100 aprons and 100 pairs of gloves) within 72 hours. Primary care providers who raise requests for kits through NSDR must to be able to make arrangements to receive emergency delivery of these ‘pre-packed kits’ outside of business hours. They are focussed on providing swift responses to meet gaps until scheduled deliveries arrive; and until orders with wholesalers through BAU are back up and running. The National Supply Disruption Response 24/7 telephone helpline is 0800 915 9964.
We are also expecting an NHS-wide statement on PPE from the CMO to be published imminently.
Media
I was quoted in the Yorkshire Post on Monday, highlighting concerns about PPE and the pressure of NHS staff being in self-isolation and reiterated these points on LBC on Sunday evening and later in the week to TalkRadio, and again today, to talk about the importance of testing. The BMA letter to the PM was reported on by the Telegraph, Channel 4 News, and Daily Mirror. The BMA call for better PPE led the new bulletins and was reported by the Times, BBC news online, BBC News at Six, Guardian, Mail, ITV online, Metro, Buzzfeed, Sun, Evening Standard, Asian Image, Pulse, GP online, BBC Radio 4 and a large number of regional publications. Chaand Nagpaul, was interviewed on BBC Radio 5Live (1hr10mins in) for an immediate reaction following a press conference featuring the Health Secretary. Phil White, GPC Wales chair, spoke to BBC Radio Wales as part of a Covid-19 phone-in.
Workload prioritisation
We have published joint guidance with the RCGP on workload prioritisation for clinicians in general practice during COVID-19. This should be read alongside our own guidance on prioritisation published last week, where we advise practices to prioritise the urgent needs of their patients and do so in a safe way that protects the workforce. As this is a rapidly developing situation it is possible that this guidance will need to be updated and we will inform you if that is necessary. Read the guidance on the RCGP COVID-19 hubpage
Retired doctors and returning on performers list
Last week, the GMC wrote to the doctors who have retired in the last three years to ask if they would be willing to return to practice to provide support during the pandemic. This week we have written a joint letter with NHSE/I and the Royal College of GPs, to GPs specifically to let them know how they can help if they would like to, including letting people know how they can ask to be temporarily registered on the Performers List.
The MDOs have waived their fees for retired doctors returning to work – read more on their websites:
Medical Protection
Medical Defence Union
MDDUS
Remote consultations and homeworking
The BMA has published guidance to support doctors in any healthcare setting to conduct remote consultations during the pandemic
A new BMJ article on remote consultations provides a very helpful summary on how to do these as effectively as possible and also underlines the importance of reducing face-to-face physical consultations to an absolute minimum.
Digital isolation note
A digital isolation note created by the NHS and DWP is now available to provide patients with evidence for their employers that they have been advised to self-isolate due to coronavirus, either because they have symptoms or they live with someone who has symptoms, and so cannot work. The notes can be accessed through the NHS website and NHS 111 online. After answering a few questions, an isolation note will be emailed to the user.
Emergency access to GP Connect capabilities
Arrangements have now been made for practices to request emergency access to GP Connect capabilities, that can be used if a practice has to close due to the Coronavirus outbreak and patients are being treated at another practice which uses a different IT system. Read the NHSD guidance here
NHS regulations – amendments relating to primary care during a pandemic (England)
The NHS Regulations amendments relating to the provision of Primary Care Services during a Pandemic 2020 have now been published. The amendments include:
- provision to allow for opening on bank holidays and Easter weekend
- provision to prevent remedial action in the event of a breach
- provision to allow an increased number of bookings from NHS111
- provision for dispensing doctors and pharmacies to delivery medicines to patients
Emergency COVID-19 bill and Easter opening hours
The Emergency COVID-19 Act has now become law. In addition emergency changes to GMS contract regulations published yesterday, require practices to be open on Good Friday and Easter Monday, as it is expected that this bank holiday period will coincide with a peak in activity. We are working with NHSE/I about the details of this and will provide more information as soon as possible.
Death certification and cremation- UK
We are liaising with the DHSC to clarify as quickly as possible what the new procedures will be following yesterday’s passing of the Coronavirus Act 2020 for certifying death and cremations. NHS England and MOJ guidance is imminent and will be linked to on our website. As soon as this is available we will circulate to members and LMCs. In lieu of this the General Register Officer has issued a letter with guidance on the measures which is attached.
Scottish guidance on death certification
The Scottish Government has published the attached letter with guidance on death certification, which includes nomenclature for the disease/infection; procedures to speed up certification in anticipation of significant increases of deaths; and removal of requirement to notify Crown Office and Procurator Fiscal Service (as a notifiable disease).
COVID-19 community hub arrangements – Scotland
Plans by the Scottish Government (co-signed by SGPC and RCGP Scotland) on COVID-19 community hub arrangements are outlined in the attached letter, which describes changes in the triage and assessment of COVID-19 in Scotland. From Monday, NHS24/111 will be the single point of contact for people (previously GP practices were involved during day time). More detailed information is available here
RCOG advice pregnant women working in the NHS
The Royal College of Obstetricians and Gynaecologist has published updated advice for pregnant women who are working in the NHS during the coronavirus outbreak. The updated guidance emphasises that pregnant women of any gestation should be offered the choice of whether to work in direct patient-facing roles during the pandemic.
Engagement of locum GPs
As general practice continues to adapt and prioritise the delivery of services in relation to coronavirus, we are aware that many practices with existing engagements with locum GPs are continuing as best as possible to honour these commitments and to find equitable arrangements for the division of work. During this stressful time it is important that the workforce continues to pull together and support each other. Where there is uncertainty over the ability to honour existing commitments, please continue to engage at the earliest possibility to find collaborative solutions.
Guidance for employers on COVID-19 Job Retention Scheme
Guidance for employers on the Coronavirus Job Retention Scheme has now been published. It is designed to support employers whose operations have been severely affected by COVID-19, however it states that public sector and publicly-funded will generally not be eligible for the scheme.
QOF calculations in England 2019/20 and 2020/21
NHSE/I has published a letter confirming that calculations for QOF 2019/20 will be made as usual, and will be analysed to understand the impact of Covid-19. This letter also committed that NHSE/I will ensure that all GP practices in 2020/21 continue to be paid at the same rates.
Social Prescribing Link Workers COVID-19 guidance
The National Association of Link Workers about Social Prescribers and General Practice, has published guidance regarding what social prescribing link workers should be doing at this time and the support that could be available from them. Read more here
Preparedness letter for pharmacy
The NHSE/I preparedness letter for community pharmacists, was published last week. This has references to general practice within it, particularly relating to prescription length. We would again encourage practices to limit prescription length and where possible use repeat dispensing to help support our pharmacy colleagues.
Medication and specialist advice during the COVID-19 pandemic
UCL Hospital’s Medicines Information Service have put together a list of useful links that outline the significant number of guidelines produced to support medication advice for patients. The document is attached.
BMA ethical guidance on COVID-19
The BMA has now published ethical guidance on COVID-19– access it here. The RCGP will be bringing out further, primary care specific guidance shortly and the BMA will be bringing out more detailed guidance once the CMO has issued its guidance on prioritisation and triage.
BMA COVID-19 webpage and guidance
The BMA COVID-19 webpage is updated daily with guidance and links to official information:
The BMA has published FAQs on your contract terms and conditions which will be updated regularly. See also the COVID-19 ‘update page’ with links to BMA priorities, guidance and news.
If BMA members have any specific concerns or issues related to COVID-19 please contact the BMA’s advisers on 0300 123 1233 and support@bma.org.uk.
Wellbeing
At times of crisis it is also vital that we all look after our emotional as well as physical health and the BMA has a range of wellbeing services including 24/7 counselling, available to ALL doctors and medical students (not just BMA members).
The BMA has set up a ‘wall of thanks’ webpage where the public can send message of gratitude or donate funds to doctors working tirelessly in response to COVID-19
Letter of thanks for supermarkets
The BMA is rolling out care pages and have also written a letter of thanks to the supermarkets across the country for taking steps to ensure NHS staff remain able to access essential goods.
ARM 2020 has been adjourned until September 2020
As the NHS works to contain the spread of coronavirus, BMA Council has adjourned this year’s Annual Representative Meeting, due to be held in June 2020, until at least September 2020. More information here
NHSE/I daily primary care bulletin
NHSE/I will publish daily primary care bulletins on COVID-19 – sign up here
See this week’s GP bulletin here
Read the latest Sessional GPs newsletter here
I normally wish you a good weekend, and I still do so, but I've no doubt that for many of you the pressures you've faced over recent days will continue over the weekend. I want to thank you to all those that took part and applauded NHS staff in #ClapForOurCarers last night. I know it has been appreciated by very many working in general practice. It is though equally important that we look after our own wellbeing and that of our family and friends. Colleagues in Leeds have produced resources that may be helpful. If you have children here’s some ways to keep them entertained and if you don’t here’s some other ideas to help you focus on something different.
Coronavirus (COVID-19) update
On Monday, the Prime Minister and CMO announced that the UK has entered the ‘rapid spread’ stage, and has introduced a number of new measures on social distancing:
This has led to an extraordinarily busy and challenging week for everyone as we do our best to respond to this unprecedented situation.
NHSE/I published its latest letter of preparedness yesterday, which outlines the actions that are being taken related to general practice. It includes important areas outlining what routine work can be stopped. We have however a number of concerns which we have raised directly with NHSE/I and government, including with the Health Minister, Jo Churchill, today.
We have produced guidance to help support practices on deciding what they should be doing now. Our advice is that practices should prioritise the urgent needs of their patients and do so in a safe way that protects the workforce. The NHSE/I letter provides guarantees of payments for 2019/20 QOF which will be based on either 18/19 or 19/20, whichever is greater, and provides similar guarantees for 2020/21. It also highlights a range of areas of routine work that can be stopped. This is just the first step and it is likely that this will need to be extended once it becomes clear how long the current crisis lasts for, including the need for a recovery period.
PPE and GP pressures
We remain particularly concerned about lack of appropriate PPE for primary care providers and are working with NHS England and other stakeholders to get this sorted urgently. Today I raised this directly with the health minister, Jo Churchill MP, and stressed the urgency of getting adequate PPE to practices and giving practitioners confidence that the PPE they receive and use is appropriate. The Minister responded that this was a government priority, that they understood the concerns of healthcare workers and were trying to respond as quickly as possible. This is an issue the BMA will continue to push for a resolution to as a matter of urgency.
In relation to the need for increased COVID-19 testing and prioritisation for healthcare workers, there was also agreement with DHSC outlining their commitment to significantly increasing the number of tests being carried out in order to help healthcare workers and patients to have the reassurance they need.
Read the BMA statement calling for reliable supply of proper PPE for HCWs here.
Read the updated NHSEI Standard Operating Procedure for General Practice here
NHSE/I has also published a letter to NHS about next steps on NHS response to COVID-19 this week in which they stated that they would ensure that all GP practices in 2020/21 continue to be paid at rates that assume they would have continued to perform at the same levels from the beginning of the outbreak as they had done previously, including for the purposes of QOF, DES and LES payments.
Following our request last week, the CQC has written to all providers in England informing them that as of 16 March they are stopping routine CQC inspections. Read the full letter here
The Welsh Government released a statement last week suspending non-urgent work and relaxation of GP contract. Read the BMA response to the statement here.
The attached letter from Welsh Government has guidance to practices regarding PPE and the appropriateness of the stock currently distributed. Phil White, GPC Wales Chair, was quoted in Wales online about the concerns about some GPs note having received any PPE.
The Scottish Government has published the attached supporting guidance for general practice.
COVID-19 prescribing and supply issues
As set out the NHSE/I letter of preparedness (5 March), practices are reminded not to increase the quantities they prescribe but to put patients on electronic repeat dispensing 13x23 day supplies to manage supply issues.
Appraisal and revalidation
NHS England has sent out the attached letter, which confirms that any doctors who are due to revalidate before the end of September will have their revalidation date deferred for one year. Appraisals have been suspended until further notice.
Online isolation notes - providing proof of coronavirus absence from work
Online isolation notes via NHS111 online, for patients that are self isolating, have now been launched. An isolation note can be obtained without contacting a doctor, this will reduce the pressure on GP surgeries and prevent people needing to leave their homes. The notes can be accessed through the NHS website and NHS 111 online.
COVID-19: retired doctors returning to work
The Government is calling upon health professionals who have recently left clinical practice to help tackle the coronavirus outbreak in the UK. This BMA guidance aimed at doctors who choose to return to work. The GMC is contacting around 15,000 fully qualified and experienced doctors of good standing with a UK address, who left the register or gave up their licence to practise in the last three years.
Serological testing letter (England)
PHE has sent out the attached letter to a small number of practices whose patients have tested negative for the COVID-19, asking for their assistance in obtaining a further blood sample from patients for serological testing. This is a specific and very limited project in this unprecedented situation and will enable PHE and those they work with to use those who have now recovered to help understand the condition better, develop a vaccine and help us all fight this infection better.
The BMA COVID-19 webpage is updated daily with guidance and links to official information:
The BMA has published
FAQs on your contract terms and conditions which will be updated regularly. See also the
COVID-19 ‘update page’ with links to BMA priorities, guidance and news.
We continue to raise issues that need to be addressed with the relevant organisations, and will continue to disseminate information as it becomes available.
If BMA members have any specific concerns or issues related to COVID-19 please contact the BMA’s advisers on 0300 123 1233 and support@bma.org.uk.
Wellbeing
At times of crisis it is also vital that we all look after our emotional as well as physical health and the BMA has a range of wellbeing services including 24/7 counselling, available to ALL doctors and medical students (not just BMA members).free of charge.
The World Health Organisation has also published guidance on
Mental Health and Psychosocial Considerations During COVID-19 Outbreak
Media
Chaand Nagpaul, BMA Chair of Council, appeared on Sky’s Sophy Ridge programme, BBC Newsnight and BBC Radio four where he raised concerns about lack of supplies of PPE and priority testing for HCP staff. This was also reported by The Telegraph, The i, The Mirror, Financial Times (subscription required) and Medscape. He was also interviewed on. David Wrigley, GP and Deputy Chair of BMA Council, was quoted in the Guardian about PPE and in GP online about testing for frontline staff.
PCN DES
As highlighted above, NHS England released a letter yesterday relating to contract changes in England due to the escalating crisis we are facing. GPC England has produced guidance about what practices can stop and other measures that practices and PCNs can take to focus on managing the current situation.
The PCN DES has been changed considerably in response to this emergency. It still supports practices to work in PCNs, and this is now more important than ever. The funding streams remain guaranteed, crucially to support workforce expansion and support for CDs who will be taking a key leadership role during this current crisis. The service specifications have been delayed or can be delayed due to COVID-19 taking priority. The IIF has been abandoned for at least 6 months, if not for longer, in favour of providing the equivalent funding for PCNs to use to support their COVID-19 related activity. We will be engaged with NHS England over the coming days as the situation develops to ensure any further changes required are implemented.
Practices still have until the end of May to confirm their sign up to the DES. As the situation is so different from last week when the special conference of English LMCs was held we would now encourage practices to do this as early as possible to ensure funding flows and collaborative working arrangements are in place during this extremely challenging period. We are aware that some CCGs have asked for earlier confirmation, and where possible we would encourage practices to respond, but the final deadline will be 31 May. However the DES does remain voluntary.
With the recent changes the PCN DES Specification is still being finalised but will be released very soon so you will be able to then see the detail of what has changed.
In view of the dramatic changes since last week, after careful thought and checking with GPC England, we believe that postponing, for the moment, the survey we were planning to do on asking practices about signing up to the PCN DES is the right thing to do for the profession at this time. We will revisit this decision when the situation becomes clearer and ascertain the most appropriate time to circulate the detailed survey that we were planning to do.
National data opt-out
Given that the health and social care system will face significant pressures in the coming month due to the Covid-19 outbreak, NHSX and NHS Digital have made the decision to extend the compliance deadline for the national data opt-out and the final date for submission of the Data Security and Protection Toolkit (DSPT) to 30 September 2020. In addition NHSX has produced some Covid-19 IG guidance
Pensions tax annual allowance
As mentioned last week, NHSE/I have written to all GP contract holders and performers (including Locums) in England. The letter gives eligible clinicians assurance that they can undertake any combination of clinical roles for the NHS during the 2019/20 tax year without suffering any financial loss as a result of the annual allowance pensions tax, subject to using the Scheme Pays mechanism. This includes any additional work related to the response to coronavirus. Read the letter here and BMA guidance here
GP pressures
The latest general practice data from NHS England shows that before the COVID-19 outbreak, the monthly appointment count continued to climb this January (15% higher than December 2019) despite no increase in the number of fully qualified FTE GPs. 30,000 more GP appointments occurred in January 2020 than the same month last year. This scale-up in appointments, without corresponding increases in workforce means that GPs in 2020 are working under more pressure than ever – this is likely to only be exacerbated by the worrying onset of COVID-19. Read more about what the data shows about the changing nature of general practice on the general practice pressures page
GP contract Roadshows (England)
The GPC England executive team have now presented GP contract details for 20-21 at a number of contract roadshow events across England. All of the other planned events have now been cancelled due to the developing Covid-19 situation, but you can now access the roadshow presentation, with a commentary from me, on the contract page of our website.
LMC UK Conference 2020 – message from LMC UK Conference Chair, Mark Corcoran
After consulting with the GPDF and the BMA I have today taken the unfortunate but necessary decision formally to cancel this year's UK Conference of LMCs. I am sure you all understand why. Given current circumstances and the uncertainty going forward, it is unlikely that we will able to reschedule for any time later this year, so the next conference is likely to be May 2021. We will announce that date as soon as we possibly can.
On behalf of the UK conference agenda committee I would like to thank you all for the time and effort which went into crafting the motions you submitted. I will liaise with the chair of GPC UK in relation to how some of the key themes from those motions can be taken forward by GPC.
I know that many of you will also have questions in relation to the elections, which would have been held at conference, and I am working closely with the GPC Representation Policy Lead and the GPC secretariat on a solution. We will update you in due course.
I would also like to take this opportunity to thank you for your exceptional work on behalf of the profession and our patients during this national health emergency.
Finally, I refer you to the below message from the GPDF/BMA regarding expenses:
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Where there are unrefundable costs, or cancellation fees, we will reimburse these.
See this week’s GP bulletin here
See the sessional GPs bulletin here
See this week’s BMA COVID-19 bulletin here.
Coronavirus (Covid-19) update
The Prime Minister made an announcement yesterday regarding Covid-19 confirming that the UK has officially moved from containment into delay phase. The case definition has changed as of today:
However, we know people will likely contact NHS 111 and/or their practice. NHS 111 will increase capacity to deal with the inevitable increase in demand over the next few days until the new advice has bedded in. If patients call the practice concerned they might have Covid-19, they should be provided with the latest advice, which is to self-isolate for 7 days and if their symptoms worsen, they should contact NHS 111. If a patient presents with symptoms they should be advised to self-isolate for 7 days. The advice from Government is to go to NHS 111 online first and not to call.
The BMA COVID-19 webpage is updated daily with guidance and links to official information:
Read a joint statement from the Chief Medical Officers, GMC, and NHSE/about Supporting doctors in the event of a Covid-19 epidemic in the UK, here
Read guidance on data protection and coronavirus, from the Information Commission Office.
NHSE/I have written to CCGs asking them to extend the out-of-hours provider contracts in England to cover 24 hours, to support patients who have tested positive but who do not require immediate admission and are self-isolating.
I have written to the CQC requesting that all routine CQC inspections within primary care be halted. The CQC has responded to say that they are now making telephone contact with practices rated good and outstanding before an inspection to give the practice the opportunity to decide whether they want the inspection to take place or not, as some practices have expressed a preference for the inspection they have prepared for to go ahead. They have also stopped the provider information collection for all annual regulatory telephone reviews and postponed new registration inspections unless there is an indication of a safety concern. See the latest CQC web page and guidance.
We continue to raise issues that need to be addressed with the relevant organisations, and will continue to disseminate information as it becomes available.
If BMA members have any specific concerns or issues related to COVID-19 please contact the BMA’s advisers on 0300 123 1233 and support@bma.org.uk. If you have any concerns about employees who may be at risk, contact the BMA’s Employment Advisory Service
I have been interviewed by the BBC, ITV and a number of radio stations including BBC Five Live, TalkRadio and LBC. On Wednesday, I said: "We do expect cases to rise rapidly and over the coming weeks. We will need to stop doing much of the routine work that we do week-by-week to enable us to focus on the sickest patients and prioritise those who most need us…. Routine checks will need to stop." This was also reported by the BBC, ITV, Daily Mail, Mirror, and Express.
The BMA Chair of Council, Chaand Nagpaul, was interviewed by Channel 4 News where he said, ”We have to be rational and being rational is rightly to be concerned and vigilant”. He was also quoted in the Guardian. Helena McKeown, BMA chair of RB spoke to LBC, and said that medics, like everyone else, need reassurance at the moment, and that NHS staff need to know they are going to be supplied with the proper equipment over the coming weeks. She also appeared on Newsnight.
Pensions
For over 18 months the BMA has been raising significant concerns over the impact of punitive annual allowance tax charges facing senior doctors across the NHS. The announcement from the Chancellor in the Budget Statement of an increase in the threshold income of all workers to £200,000 (or £240,000 adjusted income) demonstrates that the Government has listened to our compelling evidence. However, it is not everything that we have asked for. We fundamentally believe that the annual allowance is unsuited to defined benefit schemes such as the NHS and many doctors with incomes far below the new threshold income will face tax bills as a result of exceeding the standard annual allowance, which remains set at £40,000. However, the fact that Government has committed to significant taxation reform demonstrates that our campaigning on behalf of members has been effective and delivered an outcome that will help the majority of doctors.
Separately NHSE/I have, after persistent pressure from GPC England, written to all GP contract holders and performers of primary medical services under GMS, PMS and APMS contracts (including Type 1 and Type 2 Medical Practitioners and Freelance GP Locums). The letter gives eligible clinicians assurance that they can undertake any combination of clinical roles for the NHS during the 2019/20 tax year without suffering any financial loss as a result of the annual allowance pensions tax, subject to using the Scheme Pays mechanism. This includes any additional work related to the response to coronavirus. It is important that you understand how pension taxation affects you. You can find information and guidance on the BMA website and the letter to GPs is attached and please circulate this widely.
In the coming days we will be considering our full response to the Government’s announcement and raising those issues on your behalf that remain unresolved. For GPs it is essential that information about their pension is provided in a much timelier manner so they have the confidence that they will not be penalised for doing more work.
Submission of estimates of pensionable earnings
NHS England have advised that a proportion of practices have still to submit the mandatory ‘NHS Pensions - Estimate of GP and non-GP Provider NHS Pensionable Profits/Pay: 2020/21’ forms. As the 1 March 2020 deadline for submission has passed, practices are advised to complete this as soon as possible. PCSE have been advised by NHS Pensions from April 2020 to deduct the contributions at the 14.5% maximum tiered rate regardless of previous contribution rates if they do not have the estimate. This will impact on practices resulting in the higher deductions being made. Forms are available from the NHSBSA website and via PCSE online
PCN guidance (England)
An updated version of the PCN handbook, taking into account the 2020/21 contract agreement, has now been published, as has the first PCN scenario, based on a four practice PCN in the South West, here (in the PCN section). Further real-life PCN scenarios will be published in the coming weeks.
GP contract Roadshows (England)
The GPC England executive team have now presented GP contract details for 20-21 at a number of contract roadshow events across England. Most of the others that were planned have beencancelled due to the developing Covid-19 situation. As an alternative to attending an event you can now access the roadshow presentation, with a commentary from me, on the contract page of our website.
Special Conference of English LMCs
The special conference of English LMCs was held this week to discuss the outcome of negotiations and the contract agreement. The motions at the special conference focused on a wide range of contract related issues, including pay transparency, partnership incentives, fellowships, premises, vaccination payments, continuity of care, out of hours care, care home premiums and the future development of PCNs. There was also an important themed debate on the ARRS with motions being passed by the special conference on this area. An emergency motion was also agreed on the response required to support practices during the developing covid-19 pandemic. GPC England will consider how to take the resolutions forward. The conference resolved that a survey of the profession should be done to get feedback on whether practices intended to sign the PCN DES, and this is something GPCE will be trying to do as soon as practical. Read the resolutions here, and access the agenda here (in ‘Conference’ tab). A recording of the event is available using this link.
NHSmail for locums in England
We are pleased to announce that NHSmail for locums in England was launched on Monday after lengthy lobbying by the GPs committee and Sessional GPs committee. Benefits of having an NHSmail include being able to share patient data with NHS colleagues and allowing locum GPs to be added to local distribution lists such as those run by CCGs. This will enable locum GPs to keep up to date on local, regional and national issues. If you are a GP locum in England, you can now apply for an NHSmail account by completing this form.
Serious Shortage Protocol for fluoxetine 10mg tablet
A Serious Shortage Protocol (SSP) for fluoxetine 10mg tablets came into effect today, with an expiry date of Friday 12 June 2020. The SSP will enable community pharmacists in England, Wales and Northern Ireland to supply patients with fluoxetine 10mg capsules. Read more here
BMA meetings and conferences
Please be aware that BMA council has agreed that from Monday, 16 March, all face-to-face BMA meetings and conferences of 20 members or more will be rearranged as virtual (or part-virtual) meetings where possible, or cancelled for a period of six weeks initially (and potentially until the annual representative meeting in June) as the NHS works to contain the spread of COVID-19. Importantly this means our members can be where they need and want to be: on the front line supporting their colleagues and patients, and prioritising what spare time they have to rest or spend as they wish, as the spread of the virus continues to escalate. This is not a decision that has been taken lightly and comes following extensive discussion at BMA council.
LMC UK Conference 2020
As of today we have no indication that the LMC UK Conference will be cancelled and can only proceed on the basis that it is going ahead. Of course, this situation is very fluid at the moment and may change within days. Can we remind you that currently, the deadline to register to attend the conference and dinner, is Friday 27 March, using this link: https://events.bma.org.uk/uk-lmc-conference-2020/registration
GPC UK Regional elections
Please be reminded that elections for the following regions will close at noon, 16 March:
To submit your vote please go to: https://elections.bma.org.uk/. If you have any queries, please contact elections@bma.org.uk
Patient Liaison Group vacancy
The BMA’s Patient Liaison Group (PLG) is looking to recruit one new doctor member on a voluntary basis for a 3-year term commencing in July 2020 and would welcome applications from a diverse range of backgrounds. The individual will have an active interest in influencing health policy and working to improve patient care. Please note, the new doctor member can’t be an existing member of a BMA committee. If you are interested in applying, read more on the BMA website
See the last GPC bulletin here
GP contract Roadshows (England)
The GPC England executive team have been presenting GP contract details for 2020-21 to GPs and LMCs, at a series of contract roadshow events across England. Thanks to those of you who have hosted us in the last few days. The list of upcoming events is available here. A number of LMCs have also arranged some local events. However it may be necessary to cancel events because of the developing COVID-19 situation and we will be guided by local organisers about that, so please do check with them when booking. The roadshow presentation, with a commentary from me, is now available on the contract page of our website.
PCN scenarios (England)
Over the next few days we’ll be releasing some real-life PCN scenarios, covering income, workforce, services and workload impact showing how PCNs are/can operate with the contract changes. The first of these can be found on the GP Contract page (PCN section)
Letter to CCGs on financial impact of GP contract and ARRS funding (England)
NHS England has published a letter to CCGs which sets out the financial implications of the GP contract, which includes details about how the ARRS funding will work.
LES/LIS investment (England)
Concerns were raised with us regarding a letter (predating the GP contract agreement) which states that local LES funding will be used to assist with CCG deficits, conflicting with the new contract agreement in England that local investment must be reinvested by the CCG into primary medical care. NHS England has confirmed that ‘where the Network Contract DES delivers services that were previously funded through LIS/LES arrangements, the deal describes how funding must be reinvested by the CCG into primary medical care’, as stated in their contract update letter
Special Conference of English LMCs
The agenda for the special conference of English LMCs in London on 11 March, to discuss the outcome of negotiations and the contract agreement, has now been published and is available here (under the ‘Conference’ tab). The event will be webcast and available on the day via this link
GPC UK meeting 19 March cancelled
Please note that we have decided to cancel the next GPC UK meeting on 19th March in Cardiff, after careful consideration due to the developing situation with Covid-19 and now that NHSE/I have upgraded to emergency level 4. We will though continue to hold the planned policy group meetings but these will now be done through video conference.
Coronavirus (COVID-19) update
The containment of COVID-19 remains of major concern and we are monitoring the situation and will continue to disseminate information as it becomes available.
Our webpage is regularly updated with guidance and links to information from official UK agencies, including a link to the PHE guidance for primary care and the Standard Operating Procedures for primary care. Other updates include a GMC statement on regulation in light of Covid-19, clarification of what cleaning equipment to use, and updated guidance to include 111 online tool.
NHS England sent a letter on preparedness to all practices in England yesterday, which confirms that practices will be sent an initial stock of PPE, including aprons, examination gloves and face masks next week. In addition, practices are being advised to change face-to-face appointments booked online to triage appointments via telephone or video, and have published commissioning guidance on the process for managing GP practice requests to suspend online bookings of appointments which has been identified as a possible mitigating action to manage infection risk of COVID-19. More information is available here.
The Government COVID 19 action plan was published this week. The action plan features, in the event of a major outbreak, the possibility of cancelling non-urgent operations and asking retired doctors to return to work. Read the BMA statement in response to the action plan here.
CQC has emailed all providers with a statement that they will be reviewing inspection plans on an ongoing basis during the outbreak. Whilst this was a general letter to all providers we understand that for general practice CQC are likely to be significantly reducing inspections and will be working closely with practices to identify the most appropriate approach based on a risk assessment on a case by case basis.
On 5 March 2020, a statutory instrument was made into law that adds COVID-19 to the list of notifiable diseases and SARS-COV-2 to the list of notifiable causative agents. This change in law requires practices in England to report all cases of COVID-19 to Public Health England. Read more here.
If BMA members have any specific concerns or issues about COVID-19 we advised them to contact our First Point of Contact advisors on 0300 123 1233 and support@bma.org.uk.
BMA council chair, Chaand Nagpaul, was interviewed by Sky News (49mins in), and LBC, as well as several BBC regional interviews (BBC Radio Berkshire from 1hr10). Helena McKeown, Chair of BMA’s Representative Body, was interviewed by ITV GMB (from 1h49), BBC Newsnight, Channel 4 News, BBC News (from 3mins50). I have done interviews for ITV news, BBC Look North and BBC Radio York and thanks to the many other GPs who have helped do a large number of TV and radio interviews over the last few days.
International Women’s Day – 8 March
Sunday 8 March marks International Women's Day, when people around the world will celebrate female empowerment and women's rights. The 2020 campaign theme is #EachforEqual (see some examples here). Read the blog by the BMA’s Chair of the Representative body, Helena McKeown.
NHSmail for locums in England
We are pleased to announce that NHSmail for locums in England will be launched after lengthy lobbying by the GPs Committee. GP locums will be able to apply via a link that will be released on Monday 9 March 2020.
Practice registration – PCSE Online
Please be reminded that practices are required to register a nominated administrator to be able to action performers’ list requests that require practice validation. While practices will already have administrators registered with PCSE Online for purposes such as supplies and medical records, additional registration is required for the performers’ list role. PCSE have sent letters with registration codes and details via recorded delivery to all CQC registered practice managers. Practices that have not yet registered are encouraged to check with the relevant practice manager to obtain the details and if needed can request a new registration letter by contacting PCSE.
DDRB submission
The BMA’s submission to the DDRB is now available on the BMA website. The DDRB process is again delayed this year, with oral evidence being given in the coming week. This means that they are unlikely to produce a recommendation until the summer.
Commonwealth Fund Survey of primary care physicians
The Health Foundation has published their Commonwealth Fund Survey of primary care physicians today, which showed that UK GPs were the least satisfied with amount of time they have with patients. Read more here
BMA’s Physician assisted dying survey
The BMA’s survey on physician-assisted dying closed on 27 February. We received over 29,000 responses, working out at a response rate of 20.1% - making this one of the largest ever surveys of medical opinion on this issue. Thank you to everybody who took part. The results will be produced for the ARM in June. You can find out more at www.bma.org.uk/PAD.
Medicine supply update - Emerade 150mcg patient level recall
The Department of Health and Social Care has issued a patient level recall for all unexpired batches of Emerade 150 microgram auto-injectors from patients due to an error in one component of the auto-injector believed to cause some pens to fail to activate and deliver adrenaline. Read more here
NHS England webinar: delivering digital transformation in primary care
The NHS has made a commitment that every patient in England will have access to digital GP services and the right to digital first primary care by March 2024, giving patients the choice to access virtual services. NHSE/I is hosting a free interactive webinar on Wednesday 8 April from 3-4pm which will include a brief introduction to digital first and online consultations, with a focus on the funding and support available to PCNs and commissioners. Register for the webinar here. If you have any queries please email england.digitalfirstprimarycare@nhs.net
UK Annual Social Prescribing Link Worker Success Conference
The National Association of Link Workers are holding their 2nd UK Annual Social Prescribing Link Worker Success Conference at ExCel London on 20h April 2020. It coincides with Link Worker Day, a day to showcase and celebrate the impact of Social Prescribing Link Workers. Speakers include Baroness Barran MBE and Dr Nikki Kanani (Medical Director of Primary Care NHS E/I)
GPC UK Regional elections
Please be reminded that elections for the following regions will close at noon, 16 March:
To submit your vote please go to: https://elections.bma.org.uk/. If you have any queries, please contact elections@bma.org.uk
LMC UK Conference 2020
The deadline to register to attend the conference and dinner, should be done by no later than Friday 27 March, using this link: https://events.bma.org.uk/uk-lmc-conference-2020/registration
See the last GPC bulletin here
GP contract Roadshows (England)
The GPC England executive team we will be presenting the GP contract details for 2020-21 to GPs and LMCs, at a series of contract roadshow events across England over the coming month. Thanks to those of you who have hosted us in the last few days. The current list of events is available here. A number of LMCs have also arranged some local events. We are in the process of drafting guidance about the contract changes which will be available shortly.
GMS ready reckoner
NHS England has updated their GMS ready reckoner. This should help individual practices see what happens to their baseline. This is an update to the one from last year.
Special Conference of English LMCs
The Agenda for the special conference of English LMCs in London on 11 March, to discuss the outcome of negotiations and the contract agreement, will be published next week.
LMC UK Conference 2020
The deadline to submit motions for this year’s annual LMC UK conference (held on 6-7 May 2020 at York Barbican) has now passed. The Conference Agenda Committee will now start working on the Agenda. The deadline to register to attend the conference and dinner, should be done by no later than Friday 27 March, using this link: https://events.bma.org.uk/uk-lmc-conference-2020/registration
Coronavirus (COVID-19) update
The containment of COVID-19 remains of major concern and we are monitoring the situation and will continue to disseminate information as it becomes available.
Our webpage is regularly updated with guidance and links to information from Public Health England, Health Protection Scotland, Public Health Wales and Public Health Agency (Northern Ireland), and the Department of Health and Social Care. Our webpage includes a link to the PHE guidance for primary care which was updated last week.
NHS England has published four Standard Operating Procedures for primary care: general practice, optical practice, community pharmacy, primary dental care.
Primary dental care settings (including community dental services)
We are aware that there are several issues that are not dealt with in the document (for general practice) and are liaising with NHSE/I to ensure they are resolved.
The standard operating procedure, other documents and guidance are also available on the NHS England Emergency Preparedness COVID-19 webpage.
The Telegraph reported on travel insurers asking for GP notes to pay out for cancelled trips, to which I commented: "It is completely inappropriate for insurers and travel agents to be asking their customers to approach family doctors with such requests. GPs are not in a position to advise whether patients are fit to travel in this situation and it is not their responsibility to do this.” This was also reported (again) by the Telegraph and Express Informer
Peter Holden was interviewed by BBC Derby (listen herefrom around 36 mins). Pulse reported about our concerns over lack of PPE for practices, and about the updated PHE guidance advising GPs to wear PPE if in contact with a suspected case (read Pulse article here). The Telegraph andPulse reported about PHE guidance calling patients who have recently travelled from Italy to self-isolate.
COVID-19 – attending BMA Conferences (message from BMA’s acting directors of policy)
At the time of increasing concern about the outbreak of COVID-19, we would advise that if you meet the case definition (current case definition can be found here) you should follow Public Health England’s advice and not attend meetings or conferences at BMA House, no matter if your symptoms are mild (or if you are asymptomatic and fall under category 1). The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea. These symptoms are usually mild and begin gradually.
VC facilities should be available for meetings and generally conferences will be live streamed. Expenses will be reimbursed for cancelled travel and accommodation.
As you will all be very well aware, all respiratory viruses are spread by coughs, sneezes and on your hands; as such, you should aim to catch coughs or sneezes in a clean tissue and place it in the bin immediately after use (catch it, bin it, kill it) and regularly wash or decontaminate your hands. The BMA will be increasing the provision of alcohol hand gel, tissues and bins for people to use if needed.
Please do let the relevant committee secretariat know if you are unable to attend a meeting or conference as soon as possible.
Joint letter calling for pension tax changes
The BMA continues to lobby for pension tax reform ahead of an anticipated announcement in the forthcoming Budget 2020, and has written a joint letter together with several other health bodies to the new Chancellor, Rishi Sunak MP, calling for a solution to the pension taxation crisis.
The letter states that “It is essential that such a reform of pension taxation policies is implemented as soon as possible. This change is supported by the signatories of this letter and the tens of thousands of doctors our organisations represent.”
You can read more in our press release here and in our tweet. This was reported on by GPonline
Friends and Family Test – April 2020 (England)
In advance of the revisions to the Friends and Family Test guidance effective from April 2020 which apply across the NHS, NHSE/I have published additional guidance on the submission of data in General Practice along with the submission dates for 2020/21. FAQsare also available setting out the changes made to the standard questions and advice for implementation.
Medicine supply updates
Please see attached the medicine supply update from the Department of Health and Social Care, for February. In addition, a diamorphine injection supply disruption alert (SDA) has been issued via CAS.
GPC UK Regional elections
Please be reminded that elections for
the following regions are open and will close at noon, 16 March:
Gloucestershire and Avon
Leicestershire, Rutland and Northamptonshire
To submit your vote please go to: https://elections.bma.org.uk/. If you have any queries, please contact elections@bma.org.uk
See the last GPC bulletin here
GP contract in England
Following the vote to accept the changes to the GP contract in England for 2020-21, we will be presenting the contract details to GPs and LMCs at a series of contract roadshow events across England over the coming month. The current list of events is available here. In addition a number of LMCs have also arranged some local events.
The King’s Fund have produced a summary of the contract changes which can be read here.
As a result of further discussions we have had with NHSEI, they have sent a letter to commissioners about the PCN Additional Roles Reimbursement Scheme, which states "NHS England encourages commissioners to use unspent entitlement to enable PCNs to recruit now to any of the ten roles which will be included in the Additional Roles Reimbursement Scheme from 1 April 2020" and "commissioners are encouraged to reimburse any new appointments from 17 February at 100% of salary and employer ‘on-costs’, up to the maximum reimbursable amounts for each role, as set out in Table 1 of the GP contract update, with a view to these workforce roles then becoming eligible for reimbursement under the Additional Roles Reimbursement Scheme from 1 April 2020 without any change to their terms and conditions. Commissioners may also use this unspent funding to support PCN recruitment exercises. "
Special Conference of English LMCs
The deadline to register and submit motions for the special conference of English LMCs in London on 11 March, to discuss the outcome of negotiations and the contract agreement, has now passed. The Agenda Committee will now work on preparing an agenda for the conference and publish it shortly.
LMC UK Conference 2020
A reminder that the deadline to submit motions for this year’s annual LMC UK conference (held on 6-7 May 2020 at York Barbican). Is noon, 24 February 2020. Please submit motions via this link
The deadline to register for the conference and dinner, should be done by no later than Friday 27 March, using this link: https://events.bma.org.uk/uk-lmc-conference-2020/registration
Coronavirus (COVID-19) update
The containment of COVID-19 remains of major concern and we are monitoring the situation and will continue to disseminate information as it becomes available.
Our webpage is regularly updated with guidance and links to information from Public Health England, Health Protection Scotland, Public Health Wales and Public Health Agency (Northern Ireland), and the Department of Health and Social Care. Our webpage includes a link to the PHE guidance for primary care which was updated today, posters for practices and guidance by the RCGP (including practice action cards). The updated PHE guidance advises that the patient should be isolated and to call 111 directly, rather than there being an expectation that the GP does this. NHS England also distributed the attached briefing for primary care providers earlier this week.
I also wrote to the NHS England about coronavirus emergency planning, including the feasibility of an online booking suspension and procurement challenges such as the cost of supplies and equipment. We would encourage all practices to continue to follow current advice from PHE, and for anyone who suspects they might be at risk of having the virus, or has developed symptoms, to call NHS 111.
IR35 guidance for locum GPs
We have updated all our employment status (IR35) guidance into one easy-to-read document so that locum GPs have all the information they need to be confident in determining their employment status. Read more in a blog by Matt Mayer, deputy chair of the GP Sessional GP committee
Patients encouraged to get MMR vaccine after UK mumps outbreak
I was interviewed by LBC last Friday about the importance of MMR vaccines, following the news reports about a surge in mumps cases in the UK. I said that while the BMA is against mandatory vaccination, it’s essential that people are encouraged to get their jabs.
NHS 111 Data Sharing Agreements
We understand practices are still being approached by NHS111 providers to sign Data Sharing Agreements in order for NHS 111 staff to book GP appointments directly. Our advice stands that a DSA is not necessary for the purposes of assigning an appointment only as it does not require access to the patient’s medical record.
NHS Digital and the Private Healthcare Information Network (PHIN) consultation
NHS Digital and the Private Healthcare Information Network (PHIN) have launched a consultation as part of the next phase of a programme to align private healthcare data with NHS recorded activity. The consultation sets out a series of changes to how data is recorded and managed across private and NHS care, along with a series of pilot projects, based upon feedback from a variety of stakeholders. The consultation, which has been launched following the publication of the Paterson Inquiry, is hosted on the NHS Digital Consultation Hub.
Pensions
The deadline to submit the NHS Pension Scheme end of year Type 1 medical practitioner (GP Provider) certificate or the Type 2 medical practitioner (salaried GP) self-assessment form for year 2018/19 is Saturday 29th February 2020. These need to be submitted to Primary Care Support England in accordance with the statutory NHS Pension Scheme Regulations. You can access all GP pension forms using this link
GP Online and Pensions Age reported that there are still concerns over the ongoing pensions crisis, in particular about how a stop-gap offer from NHS England to pay off pension tax bills for 2019/20 will apply to general practice. I responded that "the situation needs urgently addressing as it greatly impacts on GPs being able to manage not just their pension but their wider finances. It’s therefore understandable that, without this clarity, GPs will be hesitant to commit to extra work this year that could risk triggering significant annual allowance charges…we are therefore continuing to push NHS England and NHS Improvement to take the necessary urgent action to resolve this important issue."
GP streaming service in A&E
Pulse reported that the government in England is planning to expand GP streaming services in A&E departments after claiming that it reduced pressure on urgent care services. Krishna Kasaraneni, GPC England executive lead for workforce, said: “One of the key solutions to addressing the pressures on access to services in the NHS is to invest in expanding the primary care teams in GP practices. With investment to increase the number of GPs and allied health care professionals, the care provided to patients in general practice will continue to improve. This, in turn, should then address some of the pressures on the NHS as a whole. There is no substitute for continuity of care and spreading the already stretched GP workforce even more thinly is likely to further fragment care.”
Paperwork and bureaucracy
GP online reported that that the government in England are planning to consult GPs in a review to ‘reduce the bureaucratic burden’ on practices, announced as part of the 2020 GP contract deal in England. In response to this I said: “Increased bureaucracy is a daily headache for GPs and practices, taking valuable time away from what family doctors and their teams do best – providing care to patients….we know GP workload is at an unsustainable level, and the BMA has long been campaigning against unnecessary admin in general practice, much of which centres around doctors being requested to produce reports or sign letters that shouldn’t need GP input or indeed the input from any healthcare professional…the pledge of a government review comes as a direct result of BMA pressure on this issue, and we will be informed by the profession as to what they want to see change so that doctors and practice teams are able to focus on treating patients.”
Childhood health briefing
The BMA has published the report Supporting a healthy childhood - The need for greater investment in services in England, which highlights a serious lack of investment across a range of child services, leaving doctors concerned about the adverse impact on child health in England. The BMA is urging the Government to increase investment across the entirety of children’s health and social care services, and reverse local authority cuts to ensure children have a healthy start in life.
Have your say - DWP survey for doctors involved in benefits process for the terminally ill (UK)
The Department for Work and Pensions is evaluating how the benefits system, including the DS1500 process, supports those nearing the end of their lives and desperately needs views from those doctors involved. To have your say please complete this short survey.
GPC UK Regional elections
Elections for the following regions are now open and will close at noon, 16 March:
To submit your vote please go to: https://elections.bma.org.uk/
If you have any queries, please contact elections@bma.org.uk
See the last GPC bulletin here
See the last Sessional GPs bulletin here
GPC England contract update
As you will be aware, last week, GPC England voted to accept the changes to the GP contract for 2020-21. Read more about the contract changes, including an update from me, here. We are now in the process of planning a number of GPCE roadshows to outline the agreement - more details will be announced shortly.
GP Online, Pulse and HSJ have covered the contract changes in detail. In addition P3 Pharmacy and Independent Community Pharmacist also reported on the contract changes. Practice business reported on the RCGP’s take on the new contract.
PCN conference 2020
Last Saturday, we held our second annual Primary Care Networks (PCN) 2020 Conference , this time in at the ICC in Birmingham. The event was very successful and provided a good opportunity for the almost 400 attendees to hear and talk about the new GP contract agreement and its impact on the future of PCNs for the years ahead. Read a summary here and my blog about it here
At the conference, I also called for a rapid solution to the pension annual allowance tax issue, more work to address the gender pay gap in general practice and urgent funding to support practice premises and IT developments. This was reported in GPonline
The BMA is continuing to provide a programme of support for the development of PCNs to ensure that this takes place in a way that supports GP practices and everyday GPs in their workload and provision of patient care.
Special Conference of English LMCs – 11 March
There will be a special conference of English LMCs on 11 March to discuss the outcome of negotiations and the contract agreement. The conference will take place at the Mermaid Theatre, London. The deadline to register to attend is Thursday 20 February, via this link
The deadline to submit motions is noon, Friday 21 February, via this link. Before you submit motions, please ensure you have read the 2020/21 contract agreement and that you submit motions using the suggested headings.
LMC UK Conference 2020
This year’s annual LMC UK conference will be held on Wednesday 6 and Thursday 7 May 2020 at York Barbican. UK LMCs have been sent an email earlier this week about registering for the conference and dinner, which should be done by no later than Friday 27 March, using this link.
The deadline to submit motions for the LMC UK conference is noon, 24 February 2020, via this link [Please do not submit motions for the special conference of English LMCs using this link]
Coronavirus update
An email was sent out by the BMA yesterday to update members about COVID-19 (Wuhan novel coronavirus). The BMA has also updated its guidance to reflect the latest Government guidance for health professionals. We are expecting further information for clinicians to be published shortly and will ensure our own guidance on the website reflects this. The main principle remains - to avoid pressures on primary care, ambulance services and emergency departments, and to direct patients to NHS111. Read the Public Health England guidance here
Following concerns raised by practices and LMCs about patients accessing appointments via online system, without being triaged about the risk for having been infected, we have discussed with NHS England about practices being able to suspend online booking systems for appointments. They have advised that currently, this would be local decision based on specific risks in the area e.g. in relation to confirmed cases and the adequacy of online booking messaging. In such situations practices should raise their concerns with the local commissioner through their LMC so that a risk assessment can be carried out and decision made. This issue was reported in the BMJ with comments by Peter Holden, BMA’s emergency preparedness lead.
Peter Holden was interviewed on Monday morning on Talk Radio (7.10am) and also by BBC News on Wednesday evening. He also spoke to Sky News this morning, saying that it is crucial for the public to practice good personal hygiene, such as regular hand-washing. Pulse and Daily Mail reported on the issue of some NHS 111 call handlers failing to ask patient if they have travelled to the affected countries, and advising patient to see their GP. I spoke to BBC Radio York on Monday evening (about 5.45pm) and said that good personal hygiene is essential to stopping the spread of infection. BBC and Pulse reported on the GP practice in Brighton having closed after a staff member had been confirmed as infected by Covid-19.
We remain in regular contact with Public Health England, RCGP and other relevant stakeholders to highlight members’ concerns on a range of issues.
Regulations on Coronavirus (England)
The Secretary of State for Health and Social Care (England), Matt Hancock, has published new regulations declaring that the incidence or transmission of novel Coronavirus constitutes a serious and imminent threat to public health. The measures outlined in these regulations are considered as an effective means of delaying or preventing further transmission of the virus. Read their statement.
Mumps cases rising
BBC News and other media have reported today on the rise in the number of cases of mumps, reaching the highest level in England for a decade. I will be interviewed on LBC this evening about the importance of MMR vaccination.
Medicine supply notification: Salbutamol
Salbutamol 2mg/5mg syrup is out of stock until the end of February 2020. For patients with insufficient supplies, clinicians should consider prescribing an unlicensed import of salbutamol 2mg/5ml syrup or salbutamol 2mg or 4mg tablets.
GP pressures
In December 2019, 1.42 million more appointments occurred in general practice than in December 2018. This echoes the overall monthly trend towards increased appointments in general practice across England – over the entirety of the 2019 calendar year, 3.77 million more appointments occurred across England than in 2018. Whilst recognising the workload pressures the rise in the number of appointments reflects, this is a simplistic way of measuring activity in general practice and we believe practices should be supported to offer fewer but longer appointments to enable better quality consultations. Read more in our latest analysis of general practice data.
Reform report on practice premises
The think tank Reform has launched the report A primary care estate fit for the future, arguing for the need of greater focus and prioritisation of the primary care estate in the Government’s plans, calling for further investment into these services, better streamlining of existing funding and a new approach to funding digital initiatives in primary care. This reflects our position about the need for premises funding in our letter to the Chancellor calling for premises funding. We are continuing to lobby for urgent action on premises ahead of the UK Government’s Budget on 11 March.
IPPR report on new deal for primary care in England
The Institute for Public Policy Research has published a report entitled Realising the neighbourhood NHS: A new deal for primary care in England warning that scrapping the GP partnership model could be the key to delivering the extra 50m appointments and 6,000 GPs promised by the government. In response to this I said: “The partnership model is the ‘backbone of general practice’, allowing the practices the autonomy and independence to innovate. The changes brought in through primary care networks should, in time, improve the provision of care to patients – as this report highlights – without the need to change the entire model of general practice.” This was reported in GPonline.
GPC UK Regional elections
Nominations have reopened for Dyfed Powys and North Wales – and Hillingdon, Brent, Harrow, Ealing, Hammersmith and Hounslow regions. To submit a nomination please go to: https://elections.bma.org.uk/ by noon, 21 February.
Elections for the following regions will open at noon on Monday 17 February:
For more information, go to the ‘elections’ section on this page.
See the last GPC bulletin here
GPC England contract negotiations
GPC England met again yesterday following further contract negotiations with NHS England and NHS Improvement. The committee voted on and agreed to accept the changes to the GP contract for 2020-21, including funding to attract more doctors to take up partnership roles and expand the practice team seeing patients in surgeries. The main changes are:
CCGs will be expected to provide LMCs with an annual report to enable them to monitor local investment in general practice. There is also reference to the important role of LMCs throughout the agreement document.
We will be planning a number of GPCE roadshows to outline the agreement, and the details of the contract agreement will also be discussed at the PCN conference tomorrow.
Following the announcement, I said "After months of challenging and tough negotiations we’re pleased to have secured this package of changes that have the potential to make a real difference to GPs, the practices they work in and the patients they treat. The significant investment in and focus on recruitment and retention, including payments to incentivise doctors to take up partnership roles and work in under-doctored areas, is a vote of confidence in the partnership model and a much-needed first step if we are to reverse the worrying trend of falling GP numbers that we have seen in recent years." Read my full statement here
Read more about the contract agreement on the BMA website. Read NHS England’s press release here. It was reported by The Times, Pulse, HSJ and GP Online.
There will now be a special conference of English LMCs to discuss the outcome of negotiations and the contract agreement. The date will be confirmed shortly.
PCN conference 2020
The PCN conference will be held in tomorrow, 8 February, in Birmingham. It will provide an opportunity to hear from experts – including the HMRC – network with peers and seek professional advice on HR, insurance and the law. Those attending will also hear about the full details of the agreed contract changes. There are now limited places available. Find out more here
NHSEI operational guidance 2020/21
The annual NHSEI operation guidance has now been published. There's a helpful mention of "funding invested by CCGs during 2019/20 in local service provision which will be duplicated through delivery of the new service requirements in the Primary Care Network Contract DES in 2020/21 should be reinvested within primary medical care."
MDDUS member vote on arrangements for historic liabilities
In September 2019, MDDUS entered into a transaction with DHSC in relation to its GP liabilities in England. It is important that arrangements for the management of existing liabilities remain clear – this was recognised during the contractual negotiations which set up the clinical negligence scheme for GPs (CNSGP). There is therefore acknowledgement from the GPC England that such arrangements are necessary as responsibilities for existing liabilities transfer. Information for MDDUS members is available here
Physician-assisted dying
The BMA has launched a survey of members on physician-assisted dying, following a vote at last year’s ARM to do so. Members will be asked whether they believe the BMA should support, oppose, or take a neutral stance on a change in the law to permit doctors to prescribe drugs for eligible patients to end their own life. They will also be asked about a stance to a change in the law to permit doctors to administer drugs with the intention of ending an eligible patient’s life. All BMA members will receive an email (BMAsurvey@kantar.com) from Kantar, the independent research agency, with a link to participate. Find out more at www.bma.org.uk/pad and read the BMA statement here.
Coronavirus guidance
The BMA has published a web page highlighting key information and links to official guidance from government agencies on coronavirus, including how to handle queries from patients and how to manage patients who contact or attend GP practices.
We are aware that GP practices in England are being contacted by their CCGs, on behalf of NHSEI requesting information regarding practice preparation for coronavirus. Our advice remains that while there is no obligation to provide this information, unless the Secretary of State issues a direction, we would encourage practices to respond so that NHSEI and Public Health England are aware the national picture for preparations.
We remain in close contact with NHSEI and other stakeholder to ensure that any measures they put in place are supportive and do not place any overly onerous burden on GPs and their patients. Practice should continue to review your business continuity plans, infection prevention and control measures in addition to any
national guidance issued by UK health or public health agencies.
Following the reports of the two confirmed cases in York last week, Peter Holden, BMA's emergency preparedness lead for primary care, was interviewed by BBC Radio Derby (from 1hr20) and BBC Radio York, and I was interviewed on BBC Look North, BBC Radio Leeds and BBC Radio York. Peter was also interviewed on LBC on Wednesday 5 February (just after 11.30pm).
GPC Wales update
GPC Wales met last week and discussed the Romney report with small breakout sessions to facilitate a more open and inclusive discussion. All feedback is to be discussed at the Welsh Council sub-group who will take forward as recommendations to UK Council.
Health Inspectorate Wales attended GPCW to present on their draft programme of work and strategic plan for 20/21 with national reviews being carried out on Mental Health Crisis care and Unscheduled care services.
The performance of the unscheduled and urgent care system in Wales was discussed in length. The committee were advised that the Health Minister has established an ambulance ministerial taskforce which will look
at revising measures within the system with proposals for incentives/sanctions moving forward.
GPC UK Regional elections
The following regional reps have been successfully elected uncontested to the GPC UK committee:
Nominations have reopened for the following regions, and will remain open until noon, 21 February.
To submit a nomination please go to: https://elections.bma.org.uk/
Elections will be held for the following regions:
Voting is due to open on 17/02/2020 at noon, reminder emails will be sent nearer the time. To take part in elections you must have a BMA website account. You do not need to be a BMA member to create a BMA website account click here.
If you have any questions about elections please email elections@bma.org.uk
COMAR 2020
The BMA’s annual conference for medical academics will be held at BMA House on Friday 15 May 2020. The main theme will be doctors’ well-being. Save the date, express your interest in attending to confunit@bma.org.uk and look out for further information on the BMA website.
Sandy Macara Memorial lecture
The BMA’s Public Health Medicine Committee (PHMC) has held a memorial address to honour the life and work of the former BMA Council Chair Sir Alexander Macara. In the commemoration address in 2013, the PHMC noted that ‘Sir Alexander was an absolutely extraordinary person’ who was deeply committed to the BMA and to Public Health. The event was hosted by Professor Kevin Fenton, PHMC chair, and there were also speeches from the CMO for Wales, Dr Frank Atherton and Professor Ronan Lyons from the Department of Public Health at Swansea University.
The forthcoming Public Health Medicine Conference on 26 February will focus on climate change and inequalities. For further information email info.phmc@bma.org.uk
See the last GPC bulletin here
Brexit
As Britain prepares to leave the EU today, 31 January 2020, the BMA has released a statement saying that European doctors must continue to be welcome in the UK. Chaand Nagpaul, BMA council chair, said: “Freedom of movement has allowed talented doctors and other healthcare staff to travel, work and teach across Europe, letting those from the EU to both contribute to and learn from the NHS, while UK-trained clinicians have been able to share their skills in other European nations. Our message to our European colleagues – and indeed those around the world – is a clear one: you are welcome here.” Read the full statement here and the BMA work on Brexit here. This was reported on by GPonline,
The European Medicine’s Agency
(EMA) has also published information about what this will mean for medicines
during the transition period, including how to prevent shortages. Read more here.
Coronavirus
BMA emergency preparedness lead, Peter Holden, spoke to LBC on Saturday (just before 11am) about the coronavirus. He said that it’s understandable that people are worried, but that it’s important to have some perspective on the outbreak and that, compared to flu, general risk and fatalities remain low. He also spoke to talkRADIO on Tuesday morning (7.15am) about the latest developments in the spreading of the infection. Asked if the UK is prepared for its own outbreak, he said: "Yes, we're prepared, without in any way being complacent. We're as prepared as we can be because we don't know the precise size and shape of this beast yet.”
We are in regular dialogue with
PHE and NHSEI on this developing situation, particularly following the news of two confirmed cases in
York. We will keep practices informed as we can. Read the PHE guidance
for primary care here and further information, including to the public, is
available here.
GPC England contract negotiations
Following the vote not to accept the contract package on Thursday 16 January,
GPC England have been in further negotiations with NHS England and NHS
Improvement. There will a further meeting of GPC England on Thursday February 6
to discuss the outcome of negotiations. The content and agenda of the meeting
is confidential. This was reported in GP
Online and Pulse
Earlier this week, the GP contract negotiations and the concerns about the
draft PCN DES specifications, were discussed in Parliament’s
health questions with the Secretary of State for Health and Social Care,
Matt Hancock MP. He replied to a question from Jonathan Ashworth, shadow health
minister, about GPC England’s rejection of the contract package, and said “Of
course, the negotiations with the BMA over the GP contract are always tough:
they have been in every year in which they have taken place. The hon. Gentleman
will understand why I want to get the best possible value for the money that
the NHS spends, but I also want to see a successful conclusion to this
negotiation, and we are working with the BMA to that end”. Read the full
transcript here
The story was covered by Pulse,
GP
Online and Healthcare
Leader.
PCN Service specifications report
NHS England has released its response to the feedback from the PCN service
specifications engagement exercise, which is published here.
The revised service specifications are currently being negotiated as part of
the GP contract negotiations.
PCN conference 2020
There are just a few days left to be able to book for the PCN conference on 8 February, as spaces are now limited. It will provide an opportunity to hear from experts – including the HMRC who are now confirmed to attend the event – network with your peers and seek professional advice on HR, insurance and the law. Those attending will also hear about the outcome of the GPC England meeting. Find out more here and the updated agenda is available here
The GPDF has funded one seat for each LMC, which can be booked here; for any additional LMC seats please go through the standard booking form above.
Pensions tax charges
GPC England has written to NHS England about delays in GPs knowing whether they
will face pension tax charges for 2017/18. The letter comes after it was
revealed that more than 30,000 GPs had not been provided with a record of their
pension contributions. I wrote: "If the delays alone were not enough
cause for concern, the situation is being further exacerbated by current
pension taxation policies and their management. As you know the BMA, is more
widely calling for tax reform to address the punitive annual allowance and
taper policies." This was covered by GPOnline
and Pulse.
BMA pensions committee chair, Dr Vishal Sharma, was also quoted in People
Management and Pensions
Age.
GP appointments data
NHS Digital has published their latest GP
appointments data, in response to which I said: “These figures show the
intense strain practices up and down the country are under, managing increased
demand with a dwindling workforce. While the number of appointments delivered
in practices has increased by more than 3 million in 2019, the latest figures
show a drop of more than 300 full-time equivalent GPs in a year. So while the
largest proportion of appointments are delivered on the day of booking, GPs are
spreading themselves more thinly, not only risking their own health and
wellbeing, but also meaning there are often long waits for patients to see
their doctor.”
This was reported by GPonline
and Pulse
NHS 'rapid response'
teams (England)
Urgent community response teams will be rolled out at seven sites from April
under a £14m joint NHS and local authority initiative that aims to provide
support within two hours to help older people remain well at home and stay out
of hospital. In response to this I said: “'Providing more support and treatment
for patients at home by dedicated specialist teams visiting them rather than
having to travel to hospital could help many patients and also reduce the
pressure on currently overstretched services, both in hospitals and the
community”. This was reported by GPonline,
OnMedica
and Pulse
Online booking forms (Scotland)
Andrew Cowie, deputy chair of Scottish GPC, was quoted in the Scotsman
about patients using online forms to book GP appointments rather than calling
the surgery. The story comes after a GP surgery in Scotland decided to stop
patients phoning in for bookings with their doctor. He said: “GP practices need
to design and implement systems for appointments and access based on their own
local circumstances and the specific challenges faced by their patients.
Clearly innovation and digital solutions have a role to play here, though that
does need to be balanced against the need to ensure no-one – including those
who are either less technologically literate, or aren’t able to access technology
– is disadvantaged and unable to access services." This was also reported
in Practice
Business
LMC UK Conference 2020
As you are aware, the 2020 UK LMC Conference will be held on Wednesday 6 May and Thursday 7 May 2020 at the York Barbican, Paragon St, York YO10 4AH.
We emailed LMCs earlier this week
that the database to submit motions is now open, and to
use the suggested headings whenever possible. The final deadline for receipt of
motions for the LMC Conference is noon 24 February 2020 and motions received
after the deadline cannot be accepted.
Please confirm that all motions have been approved by the LMC members, and also
please check that the motions are new, and are not already covered by existing
conference policy (which can be checked on the policy database).
Please also note that the BMA provides a motions
advisory service, where members can email for advice on facts/figures,
information on existing policy, or for help with submitting motions correctly.
Information about registering for the conference and dinner will be sent out
shortly.
GPC UK Regional elections
A reminder that nominations for GPC UK regional representative close at 12pm Monday 3 February.
Nominees should be aware that the BMA is currently in the early stages of reviewing its governance structures, which may have some potential to impact on the length of terms of office and regional remits during a term of office. This may mean that the term of office that a representative is elected to may be less than the usual three years. Such a decision could be made part way through a representative’s term of office.
Please note that alongside each nomination, confirmation must be received from a representative of the candidate’s LMC that the candidate contributes to the voluntary levy. This confirmation is part of the candidate’s nomination and must be received by the nomination deadline for the completed nomination to be accepted.
It is the candidates
responsibility to ask their LMC to do this on their behalf, confirmation emails
can should be sent to elections@bma.org.uk.
For further information and to nominate yourself for a seat click here (elections section).
See the last GPC bulletin here
GPC England contract negotiations
Following the vote not to accept the contract package on 16 January, GPC England have been in further negotiations with NHS England and NHS Improvement. There will now be a further meeting of GPC England on Thursday 6 February to discuss the outcome of negotiations.
This week the Guardian also reported on the wide concerns of NHSE/I’s proposals, and I commented that the previous draft service specifications were “unreasonable and completely unachievable”.
PCN conference 2020
The PCN Conference will be held on Saturday 8 February, at the ICC Birmingham. At this crucial time, not least following NHSE/I's consultation on draft service specifications, this is an important opportunity to share your views, raise concerns and highlight challenges directly with national policy makers, exchange experiences with peers, meet a career coach, and find answers to all your questions on legal, insurance and HR issues relating to PCNs. Find out more here
The GPDF has funded one seat for each LMC, which can be booked here; for any additional LMC seats please go through the standard booking form above.
Scottish GPC meeting update
The Scottish GP Committee met yesterday in Edinburgh where they received updates on contract implementation and negotiations including: premises sustainability loans FAQ and letter of comfort, the remote and rural working group report and rural flexibility options appraisal, data collection for phase 2, the MDT survey results, various letters from the Scottish Government relating the GMS National Oversight Group, and an update on the SLMC Conference motions.
There were general updates on information management and technology, sessional GP issues, GP training and various reports from external groups such as the Primary Care Prescribing/Dispensing Pathway. An update was also provided on pensions, a GP IT presentation by Jonathan Cameron as the deputy director for digital health and care at the Scottish Government, and the Daphne Romney Report into allegations of sexism and sexual harassment at the BMA was discussed.
Northern Ireland GPC meeting update
The first meeting of NIGPC came on the heels of the restoration of the Northern Ireland Assembly and appointment of a new health minister, Robin Swann, the first minister there has been in post for three years. There is no doubt about the extent of the challenge he will face with over 300,000 people in Northern Ireland waiting for a first appointment with a consultant and significant pressures facing practices.
The meeting considered a number of issues that need to be brought to the minister’s attention as a matter of urgency including indemnity, pensions and the roll out of MDTs. The meeting reviewed a paper on out of hours provision across Northern Ireland and discussed the best way to address the gaps in the service and ensure its stability. The meeting also had a presentation from Dr John Maxwell, an ED consultant in Belfast Trust and clinical lead and Alastair Campbell, Director of hospital services reform, DH who have been leading a review of urgent and emergency care in Northern Ireland; their full report will be available in March 2020.
BMA briefing – Impact of pension taxation on the NHS
As part of the BMA’s ongoing campaign to address the current pension taxation crisis impacting doctors across the country, we have produced a briefing paper which highlights the current situation, background to the issue and consideration of possible solutions. This includes an overview of the BMA’s preferred solution removing the annual allowance in defined benefit schemes, such as the NHS pension scheme. Read the briefing here
NHS pensions records
I have written to Sir Simon Stevens, chief executive of NHSE/I, about the need for urgent action to resolve pensions issues impacting GPs. This was illustrated well by a detailed article in The Times which reported on how three-quarters of GPs haven't been given up-to-date NHS pension statements and could get shock tax bills because they have not been given up-to-date pension statements from the NHS. In response to this, I said: “It is a disgrace that bureaucratic delays are preventing so many GPs from accessing vital pension statements. Quite simply, the body tasked with issuing these statements, the NHS Business Services Authority, is woefully under-resourced and unable to cope, while the involvement of Capita's Primary Care Services England, which has a history of failure, just makes matters worse.”
I am also seeking from NHSE/I full details of how GPs can benefit from the commitment made at the end of last year to cover annual allowance tax charges incurred in this financial year.
Coronavirus guidance for primary care
Public Health England has now published guidance for primary care to reduce the risk of spread of infection during and following consultation with a suspected case of the Coronavirus (WN-CoV). The main principles are:
If WN-CoV infection is seen in the UK, it is most likely to occur in travellers that have recently returned from Wuhan city in China. All PHE’s coronavirus guidance is available here, information for travellers and HCPs on the NaTHNaC website and information for patients on the Patient website.
Peter Holden, GPC member, was interviewed on Sky News yesterday on the coronavirus outbreak in China. He was also quoted in London’s Evening Standard.
NHS England campaign materials
Practices in England should now have received the materials to support the NHS ‘Measles, Mumps and Rubella (MMR) – Help Us Help You, Get Protected’ campaign (also available on the PHE Campaign Resource Centre). This is final one of the six campaigns that practices are required to take part in as agreed in contract negotiations last year.
The other campaigns, materials for which practices have also been sent already, are:
If you have not received materials for any of the above, please contact your local NHS England team
QOF Personalised Care Adjustments
Following the concerns raised by practices about the loss of opportunistic prompts following the roll out of the QOF changes in 2019, TPP have confirmed to NHS Digital that they will add a status flag to the patient record which will alert practices to the fact these patients may be missing QOF care as part of their roll out of v44 of the QOF business rules. This will be implemented in the next two weeks.
NHS Digital will explore whether additional functionality can be added to v45 of the QOF business rules to ensure that the two invitation PCA will only come into force at the end of the reporting period i.e. 31st March.
New FP10 and prescriber endorsement
NHSE/I have published a new FP10 NHS prescription form with the new prescriber endorsement ‘FS’ for free supply of sexual health treatment – please see attached the guidance and toolkit. The new FP10 form is being rolled out at the end of January. Existing stocks of the old form already in the system, such as in GP practices and pharmacies, should be used up prior to use of the new form. Both forms will be accepted for processing during the transition to the new form.
The new prescriber endorsement will become live from 1 February 2020. Until the necessary changes have been made to prescribing systems, prescribers should revert to issuing paper prescriptions with 'FS' manually endorsed next to each item intended for the treatment of an STI. Where ‘FS’ has been added as a handwritten endorsement, for example, on a computer-generated form, this should be counter-signed in the usual way. Dispensing doctors will continue to use paper prescriptions with a handwritten endorsement. More information is available here.
Changes to gun licensing rules putting more pressure on GPs
Tom Yerburgh, deputy policy lead of the GPC clinical and prescribing group, was interviewed by BBC Radio Gloucestershire over changes to gun licensing rules in the area. The BBC reported how at the start of the year Gloucestershire police made it a requirement for anyone applying for a firearms certificate to first of all have a letter from their GP. Previously only people with a listed condition, such as depression, drug and alcohol abuse or dementia needed to apply. He said that the changes were putting an unfair burden on GPs, and "The question asks if there's any mental health issues that the patient has ever had which is an immense amount of work, going back volumes of records. There's confusion because the process has changed without us being able to advise or offer help to practices on what to do, the other thing is that every police force seems to do this process differently which is really confusing for practices on the edge of the county."
Listen to the full news item on here (from 2hours 10minutes).
Physician-assisted dying briefing
In February, for the first time, the BMA will be surveying our members to inform a debate at the annual representative meeting (ARM) on physician-assisted dying. To make sure you don’t miss out, please check that your contact details are up to date (including your preferred e-mail address) and that you have ‘opted-in’ to receive membership updates from the BMA. To find out more about what we’re doing and why, and to download the briefing pack before you take part, visit www.bma.org.uk/PAD.
DWP end of life survey (UK)
The Department of Work and Pension is undertaking an evaluation looking at how the benefits system supports those nearing the end of their lives, as part of this they have published a survey to collect information from clinicians on this issue. A similar change has already occurred in Scotland – this impacts on GPs and any hospital doctors involved in terminally ill patients.
The results from this survey will help support DWP in making decisions around how best to support claimants nearing the end of their life and provide valuable insight into how clinicians across the UK feel about the current system and where they think it can be improved. Take the survey here
Medicine supply update
Please see attached the latest medicine supply update from the Department of Health and Social Care.
BMA MAPs (Medical associate professions) publications
The following two new papers relating to MAPs have been published on the BMA website:
Principles for effective working with medical associate professions outlines a range of principles that can help to improve the ways that doctors and MAPs (medical associate professions) work together and identifies possible solutions to some of the common problems that have arisen with the introduction of MAPs.
Medical associate professions in the UK provides key information about MAPs, including roles, regulation, and prescribing.
GPC UK Regional elections
Nominations for GPC UK regional representative are open until 12pm Monday 3 February.
Nominees should be aware that the BMA is currently in the early stages of reviewing its governance structures, which may have some potential to impact on the length of terms of office and regional remits during a term of office. This may mean that the term of office that a representative is elected to may be less than the usual three years. Such a decision could be made part way through a representative’s term of office.
For further information and to nominate yourself for a seat click here (elections section). If you have any queries, please contact elections@bma.org.uk
Public Health Conference 2020
Public Health Medicine Committee will be holding their Public Health conference on 26 February 2020 at the BMA House London. The underpinning theme of the conference will be ‘21st century public health’ and what that might mean for public health professionals. The conference will include keynote speakers on the issues of climate change and economic inequality. If you are interested in attending or for further information, please contact info.phmc@bma.org.uk
See the last GPC bulletin here
See the last Sessional GP bulletin here
