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The Single Electronic Referral Form (SERF)

LMC members continued to express concerns that the SERF was not fit for purpose and generated administration for clinicians which reduced their time for clinical tasks. Discussions continue with the CCG, RCHT and CFT.

Committee Roles

After a request for expressions of interest the three Executive posts were elected by Committee unopposed in line with the current Executive’s proposals for the new three-year term. Commencing September 2021, the Executive will be re-structured as follows:

  • Chair – Dr Nick Rogers
  • Vice Chair – Dr Will Hynds
  • Treasurer – Dr Phil Trevail#

Chair’s Report

Dr Will Hynds reported on the following:

  • Secondary care are keen to establish community diagnostic hubs to bolster secondary care investigations outside the hospital.
  • The Executive Team are in consultation with partners around safeguarding reports and will continue to update you.  In the meantime, please ensure that any invoices for reports are emailed to adultsfinance@cornwall.gov.uk
  • Expect a further iteration of the White Paper in due course. Work continues on your behalf to ensure the voice of primary care will be heard within the Integrated Care System (ICS).

KCCG Report

Andrew Abbott and Kirsty Lewis report on:

  • The planned transfer back of various community services eg dental, pharmacy etc from NHS England to the ICS.
  • IAGP funding and CCG LES’s are to be paid at block contract rates to September 2021.
  • For the first quarter of this financial year, CDs will be funded at 1 full-time equivalent if their PCNs are signed up to provide C19 vaccinations.
  • An escalation framework for pressures in primary care is to be looked at by a joint KCCG/LMC working party.

KHCIC Training Hub update

Laura Wheeler from KHCIC gave an update on the various training courses available.  Please refer to their website for further information https://www.kernowhealthcic.org.uk/cornwall-training-hub/

Institute of General Practice Management (IGPM)

Nicola Davies from Roseland Surgeries gave a presentation on the newly formed Institute of General Practice Management (IGPM) which Kernow LMC is supporting. Further information can be found on our website here -  About the IGPR - Kernow LMC

Observer seat for KHCIC at our Committee

It was agreed by members for Kernow Health CIC to have an Observer seat at our Committee meetings as a reciprocal arrangement for our seat on their Board

Post Covid Service

Dr Robert Gardner gave an update on the Post Covid Service and reported that referral forms are now available to share with colleagues. 

VTE pre-assessment tool

A reminder was given that valid referrals to secondary care cannot be refused. The LMC are following up a recent refusal from fracture clinic to accept a referral without a VTE pre-referral assessment. The LMC continue to campaign for a reduction in administrative burden on practices – this is one practical example.

LMC Remuneration Survey

LMC salaries and Committee remuneration rates were found to represent good value to Cornwall when benchmarked with other areas.

ICS and system-wide influence

Various LMC members already sit on the ICA Boards in Cornwall but anyone with ideas/views/comments on how GPs/the LMC can influence the ICS (Integrated Care System) further please email emma@kernowlmc.co.uk

COVID alert levels and advice for practices and patients at risk 

Following the announcement of a three-tier lockdown approach for England last week, Greater Manchester and South Yorkshire have now joined Liverpool City and Lancashire in the Tier 3 (very high) alert level.  Warrington will be added next week. Read the full list of COVID alert levels in England by area here. A 17-day national "firebreak" will begin in Wales at 6pm today and a 5 tier system will be introduced in Scotland from 2 November. 

We recognise that few will welcome these restrictions, but unless rising rates of transmission are curbed urgently, we will soon see an increase in patients needing care, and sadly a rise in deaths.  Some hospitals have already announced that they will have to once again reduce some elective procedures, with all the implications that then brings both for patients and practices. More stringent lockdown measures are therefore necessary, and we urge everyone to take the new rules seriously.  People need to have confidence that the sacrifices they are now required to make are understood by those in power and these new restrictions must be backed with more support for GP practices in those areas who will be impacted significantly. 

As we reported previously, NHSE/I has confirmed that local flexibilities should be made available,  to support practices to clinically prioritise capacity in these challenging  times. We are in discussion with NHSEI about how they can provide clearer support to practices struggling with workload pressures as the prevalence of patients with COVID-19 increases. We are also making it clear in our public messaging that despite some media reports, whatever the current local COVID alert levels are, GP practices continue to remain open as they have done throughout the pandemic. Whilst remote consultations should be the main way in which patient care is delivered, when it is clinically necessary to see high risk patients face to face, they should be able to attend the.  

Ordering additional adult flu vaccine stock (England)

As we reported last week, DHSC has written to practices to confirm the process by which they will be able to access the additional adult flu vaccine stock secured to support the expanded vaccination programme this season.  

GP practices are now invited to begin ordering or pre-ordering the following vaccines: 

  • Flucelvax® Tetra (Seqirus) for 18-64 years 
  • Adjuvanted Trivalent Influenza Vaccine (Seqirus) for over 65s 
  • Quadrivalent Influvac® sub-unit Tetra (Mylan) for 18-64 year olds 

If a GP practice has a provisional order with Sanofi for QIVe, please contact them to confirm this, before placing another order for QIVe for this cohort.  


On placing an order, practices will be asked by manufacturers to verify that stock is being ordered for NHS eligible patients or frontline social care workers, where there is a genuine shortage for this cohort. Orders should only be placed where you have a shortfall in supply for existing eligible patients at this stage.   

Further instruction on timing of extension of eligibility to all 50 to 64 year olds will follow and stock should not be ordered for this cohort at this stage.  

Influenza immunisation FAQs (England)

NHSE/I have now produced a set of FAQs relating to the influenza immunisation programme and can be found here. They have also issued guidance on how practices and CCGs can make use of the additional £15.4m made available to local systems and primary care providers to cover reasonable additional costs (over and above the usual fee structures) associated with this year’s extended flu programme. 

Pensions newsletter 

The BMA’s pension committee has been at the forefront of fighting to maximise your pension benefits. Please see the first quarterly newsletter here.  The newsletter provides an update you on what actions the committee is taking on a range of issues, and also provides access to educational resources, blogs and information on how to access BMA support regarding your pension. 

DDRB pay award and template letter 

The Sessional GPs Committee has received reports that some salaried GPs are struggling to get their 2.8% paylift, as recommended by DDRB and approved by the government, despite being entitled to it. We believe it is only fair that this uplift is awarded to all doctors, and this includes all practice-based salaried GPs. Practices are encouraged to apply this uplift across all of their employed GPs, regardless of individual contractual requirements. However, it is worth noting that there is a contractual requirement to implement this pay increase for salaried GPs employed on the model contract. 

If you are a salaried GP struggling to obtain the pay increase, even after having a conversation about the matter with your practice manager, you may wish to send a formal letter. The BMA DDRB template letter can be adapted to reflect your individual circumstances. Please get in touch with the BMA if you need further assistance in this area. Read more in the Sessional GPs newsletter

GPC Wales meeting 

GPC Wales met for the first meeting of the 20/21 session yesterday, 22 October 2020 and I was pleased to be able to join them in the morning. A major focus of the meeting was a discussion about the second wave of COVID-19 and what it meant for GP practices already facing the challenges of winter pressures and flu campaign delivery. The committee unanimously supported GPC Wales’ proposals for contractual relaxation and support measures, while also unanimously voting that Welsh Government’s efforts to date were insufficient. Other items discussed included the NHS Wales flu campaign for 20/21, COVID vaccination plans, the committee’s workplan and taking forward future contractual agreements.  

Circuit breaker lockdown in Wales 

BMA Wales issued a press release welcoming plans for a circuit breaker lockdown in Wales, which means that a series of restrictive measures will be in place from 6pm Friday 23 October until the start of Monday 9 November 2020. Dr David Bailey, Chair BMA Cymru Wales, said: "Cases are climbing fast across Wales… It's clear that the current restrictions are not strong enough to suppress the spread of the virus. Doctors in Wales support, and are calling for as a matter of urgency, a circuit-breaker lockdown for a number of weeks. It is imperative that robust action is taken now without delay, to protect the citizens of Wales, and the Welsh NHS." Read more in the Welsh Government’s’ coronavirus firebreak FAQs here 

This was reported by the BBCBBC Radio Five and BBC Radio Wales breakfast show (at 08:37). 

Dr Phil White, Chair GPC Wales, was a guest on Y Post Cyntaf on BBC Radio Wales (from 19m30s) to discuss the new ‘fire break’ lockdown for Wales.  

GPC Scotland meeting 

SGPC held its first meeting of session yesterday, 22 October 2020 and I was pleased to be able to join in the afternoon. Progress on delivery of the 2018 GMS contract was discussed along with work to negotiate transitionary arrangements following the end of the implementation period. The committee discussed recovery and remobilisation with a focus on general practice priorities, urgent care and enhanced COVID-19 pathway proposals, and GP IT issues, and received reports from various GPC meetings, external groups, and the GP Sessional Committee. 

SGPC also heard updates on letters produced by Scottish Government including the Primary Care Improvement Fund letter, and an update on NHS Scotland Primary Care National Premises meeting, GP Wellbeing, and the SLMC Conference on 4 December. A pensions update was provided by Alan Robertson, a member of the BMA Pensions Committee who was leading on a lot of the work.  

Congratulations to Andrew Cowie and Patricia Moultrie who were elected uncontested as joint deputy chairs of SGPC and to Chris Black, Iain Kennedy, John Ip, Denise Mcfarlane and Tyra Smyth were elected to the SGPC Executive for the 2020-21 session. 

CQRS system supplier change (England)

NHSE/I is overseeing a programme to ensure the CQRS system supports efficient GP incentive-based payments. As part of this work NHSE/I is working with NHS CSUs to bring the running and development of the CQRS system in-house from 1 November 2020 and to introduce a new centrally funded system (CQRS Local) to support locally commissioned schemes by April 2021. These changes aim to streamline processes and reduce the administrative errors in GP payments as called for in GPCE’s Saving General Practice.  

A structured transition from the existing supplier is in place to ensure the continued provision of the CQRS system from November with minimal interruption for end users. How users access and use the CQRS system is not changing and no action is required from practices or commissioners.  

From 1 November the new number for the CQRS service desk will be 0330 124 4039, although the email address remains support@cqrs.co.uk  

While the system itself will look and feel the same a new CQRS welcome page is now live providing direct links to the CQRS system and online training modules, guidance and news updates. 

Tackling health inequality webinar 

The BMA committee for medical managers is hosting a free, online panel event on Tackling health inequality, with speakers Tracie Jolliff (head of inclusive system development at NHSEI) and Roger Kline (author of The Snowy White Peaks of the NHS) on Wednesday 4 November 5.30-7pm. The event will explore why diverse leadership is essential to create an NHS that truly serves the whole country and, crucially, what steps medical managers can take to achieve this. Find out more and to book your place here 

Mental health and wellbeing 

The BMA continues to offer wellbeing services and confidential 24/7 counselling and peer support for all doctors and medical students, as well as their partners and dependents, on 0330 123 1245. Access the BMA’s COVID-19 wellbeing pages here.  

The BMA has welcomed the NHSE/I announcement of further funding for the expanded and rapid access provision of mental health services for NHS staff in England over the winter. This is urgently required and something the BMA has been calling for to support the major challenges NHS staff are facing. At the ARM, a motion was passed expressing concern at the potential long-term impact of the pandemic and called for resources to support the profession. As we head into a second wave of the virus it is vital that staff are protected. Find out more here 

BMA COVID-19 guidance 

Read our COVID-19 toolkit for GPs and practices, to help answer questions on a large range of topics relating to COVID-19. There is also guidance on the following topics: 

COVID-19 media 

On Monday I did an interview for BBC Radio York following the news that Test and Trace information could be shared with the police. GPC member Gaurav Gupta spoke to BBC Radio Kent (8.45am) on Wednesday discussing the issue of face covering exemptions.  

There was extensive media coverage on NIGPC’s concerns over the flu vaccination programme shortages. NIGPC chair Alan Stout was interviewed by BBC News NIThe Nolan ShowUTV LiveBBC NewslineNews Letter. NIGPC deputy chair Frances O’Hagan appeared on BBC Talk Back (48:47). 

Pulse reported on future Covid-19 vaccination campaign, and I was quoted: “While we don’t have a specific date when the vaccines will be ready, the BMA fully expects general practice to play a significant part in administering them, and practices will require significant support for what is set to be a huge immunisation campaign."’ 

See this week’s GP bulletin here.  

Read the latest Sessional GPs newsletter here

The LMC's monthly newsletter for the Duchy’s GPs and practice managers includes:

  • A savage blow
  • CAMHS waiting time recovery plan update
  • SERF update 
  • Evolution of PCNs
  • Flu latest
  • Gender reassignment
  • The role and work of the LMC
  • Child Health Information Service (CHIS) latest
  • Practice Managers Learning Event cancelled/PM Conference update
  • Latest NHS Kernow Highlight Report
  • Guidance note for patients requesting exemption letters for wearing face masks
  • Covid-19 certification for travelling abroad
  • NHSEI third phase of NHS response to Covid-19
  • Covid-19 – new infection control recommendations for primary health care providers
  • Self-isolation of health and care workers from high-risk countries
  • Shielding guidance for staff on returning to work
  • Regional Covid-19 cases and triage figures published in new interactive dashboard
  • New system alerts GPs to Covid-19 test results
  • Update on GP services for 2020/21
  • Workflow and workload issues
  • Intimate clinical assessments undertaken remotely
  • RCGP calls for less arduous regulation and more trust in general practice
  • NHS Health Check: Restart Preparation
  • National Data opt out – deadline reminder
  • Transition between Covid-19 care home support and the Care Homes service in the PCN DES
  • NHS Confederation report on PCNs
  • New report on ‘Mental health and PCNs – Understanding the opportunities’
  • Workforce Minimum Data Set
  • SystmOne practices: new electronic notifications for the urgent supply of medicines
  • Feedback on your interactions with CQC
  • Childcare costs for doctors to be covered in drive to boost GP numbers
  • New video gives advice on reducing administrative errors
  • GP recruitment
  • Third record-breaking year for GP trainee recruitment
  • Apprenticeship funding
  • Health and care video library available free to NHS
  • Could you save money with the LMC Buying Group? 
  • Fraudulent curriculum vitae
  • Latest jobs in local general practice
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