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LMC update - 11 August, 2022

GP Wellbeing

Last week we wrote to BMA members regarding the distressing news that Dr Gail Milligan, a GP at Camberley Health Centre in Surrey, took her own life, and to inform that on behalf of the BMA and the General Practitioners Committee, we have expressed our condolences to Dr Milligan’s family and her Practice.

We know Dr Milligan was, like so many of us, under intense pressure at work, as we struggle to meet what often feel like the impossible demands of the job. It’s clear that action by Government is the only way in which these systemic pressures can be relieved on a long-term basis. On behalf of the profession, we have long been urging government to tackle these issues that contribute to burnout and worsening wellbeing among doctors, be they GPs or otherwise, and we will continue to raise these issues. Last week we wrote to James Morris MP, the minister for primary care, urging him to take action, and we will continue to impress upon the government the need to support the workforce.

Here at the BMA, we want you all to know you have the support of your colleagues and your union. A range of wellbeing and support services are available to doctors, and we encourage anybody who is feeling under strain to seek support.  Please take a moment to check in on your colleagues’ wellbeing and look out for each other.

Support comes in various forms, from confidential counselling services to networking groups and wellbeing hubs with peers as well as the NHS’s Practitioner Health service and non-medical support services such as Samaritans.

Specialist services are also available, helping doctors with specific issues ranging from Covid and addiction to financial and legal assistance. Most services are free of charge and available to all doctors and medical students, not just BMA members. Please do not hesitate to reach out.

Please visit the BMA’s dedicated wellbeing support services page, speak to a BMA adviser on 0330 123 1245 or email and for further information see our extended directory. We encourage you to access any, or all, of the forms support mentioned above, or encourage colleagues to do so, if you believe your or colleagues’ wellbeing is at risk.

Polio vaccine – London

As you will be aware, it was announced yesterday that all children between the ages of 1 and 9 in all London boroughs will be offered a polio vaccine booster. This has been recommended by the JCVI, following the discovering of polio in sewage in north and east London.

Prior to this announcement, the details regarding how this vaccine programme would be delivered had not been agreed.  The involvement of GP practices in this programme was not discussed or agreed with either GPC England, Londonwide LMCs or Surrey and Sussex LMCs.  We are currently having urgent conversations with NHSE/I to reach agreement on whether or not practices will be involved in the programme.  As part of these discussions we have raised our concerns regarding capacity to deliver any part of the programme, and funding available for the work involved.   

We have made clear our discontent with how this announcement was made prior to agreeing how this programme would be rolled out, especially as practices are already overburdened and do not have spare capacity. We will ensure you are updated when progress is made.

Pay Transparency update

In April 2022, amendments to the GP contract regulations were made that removed the requirement for individuals within scope of the general practice pay transparency provisions to make a self-declaration of their 2020/21 NHS earnings by 30 April 2022.  Individuals within scope of the pay transparency provisions are not required to take any action in relation to their 2020/21 NHS earnings at this stage.

Pay transparency remains part of the current regulations, however DHSC has confirmed that commissioners should not enforce the requirement at this time.

Currently the individuals in scope of the regulations introduced in October 2021 will need to make a declaration of their 2021/2022 earnings in April 2023 as the provision remains in the GP contract. The latest position on Pay Transparency is available on the NHSE website:  NHS England » General practice pay transparency

We continue to request further suspension of the requirement to declare earnings as we believe this is harmful to morale of the profession and could lead colleagues to reduce their working commitments or to retire.  We also believe that it is inequitable to single out general practice for this requirement.

Changes to COVID-19 Vaccination ES (Phase 5)

Many of you raised significant concerns about recent amendments to the Enhanced Service for the COVID-19 vaccination programme, particularly in relation to the reduction of the item of service charge from £12.56 to £10.06, the removal of the care home administrative payment, and the decision to pass the cost of consumables (needles and needle disposal, cotton swabs etc) on to practices.

We wrote to Nikki Kanani (Medical Director of Primary Care, NHSE/I) and Amanda Doyle (Director of Primary and Community Care, NHSE/I) on 18 July to raise these concerns. We underlined the key role of, and enormous efforts made by, general practice in the rollout of the COVID-19 vaccination programme and highlighted that this amendment will effectively disincentivise practices from taking part – with severe risks to vaccine uptake and public health. We strongly urged NHSE to reverse its decision, and to extend the opt-in window to reflect these late changes. Finally, we emplored NHSE/I to adopt a collaborative approach on these crucial issues, noting that GPCE was not afforded a meaningful opportunity to negotiate these amendments.

On 3 August we heard back from Nikki Kanani and Caroline Temmink (Director of Operations and Delivery, CVP, NHSE/I). Whilst it included recognition that general practice has helped to save ‘an estimated 200,000 lives and 186,600 hospital admissions’ throughout the pandemic, the response also made it clear that NHSE was not willing to make any of the concessions we had requested to ensure that the Enhanced Service remains sustainable. Whilst this is a frustrating outcome, we will continue to make representations on this issue to NHSE/I. Despite NHSE/I’s assertions, the pandemic remains a public health an emergency and therefore requires us to operate on an emergency footing; decisions taken to reduce the strength of our COVID-19 vaccination programme must be vehemently challenged.

Patient Lists

NHSE/I has asked PCSE to recommence data quality checks on GP practice patients lists, this includes a reconciliation of practice patients lists. This work was paused during the COVID-19 pandemic but started again on Monday 1 August 2022. Copies of the communication circulated to practices can be found here: Patient list reconciliation and Patient list maintenance.

Although some targeted list reconciliation activity continue during the pandemic as essential groundwork for the decommissioning NHAIS, it was now been un-paused as a 3-year rolling cycle for all GP practices.  The reconciliation checks the practice-held list with the NHAIS list held by PCSE. PCSE plan to start a new 12-month cycle, meaning a third of practice will be contacted over the next 12 months that have not previously had a reconciliation request.

We have raised our concern with NHSE/I that this is a bureaucratic burden for practices which will detract from practices’ capacity to provide patient care. We asked that the process be delayed until practices had their full complement of clinical and administrative workforce.

Whilst NHSE/I have acknowledged and considered the points raised, they have declined our request, stating that the process will only affect a small proportion of practices nationally and that there will never be an ideal time to restart the process. 

GPC England Officer Team election

Following a recent decision at GPC England, the GPCE Executive Team (made up of a chair, a deputy and two executive team members) has become the GPC England Officer Team (made up of a chair and three deputies). This brings the leadership structure of GPC England further in line with what is standard practice at the BMA and ensures parity of esteem between the Officer Team. It will not impact the function of the Team.

There is a vacant position on the GPC England Officer Team. Following a recent decision at GPC England, this position shall be elected to ensure democratic accountability.

GPs who were members of the BMA were eligible to stand, and four candidates put themselves forward for the position. A husting between the candidates and the electorate, voting members of GPC England, was held on Tuesday, 9th August. Voting opened on Wednesday, 10th August and closes on Wednesday, 17th August. The result of the election will be announced following this.

If you have any questions about the election process, please email

Best Practice Show, 12-13 October 2022, NEC Birmingham

This year the BMA and GPC England will be at Best Practice Show, UK’s number one event for the primary care and general practice community, at the NEC Birmingham on 12-13 October 2022.

Free for healthcare professionals, the conference programme will provide up to 12 hours of CPD certified training, expertly tailored to meet the training requirements of healthcare professionals, with clinical content closely following the GP curriculum spearheaded by the Royal College of General Practitioners.

The BMA and GPC England will have a dedicated theatre at the conference, with a programme focussed on the most pressing issues facing general practice, including the future of general practice, working within ICSs, workload management, workforce management (ARRS roles and multidisciplinary teams), primary care estates, and more.

The conference programme as a whole will address major policy topics impacting general practice, such as around access, health inequalities, digital innovation, and the GP contract. It was also cover range of clinical issues around areas such as cancer, dermatology, diabetes, gastroenterology, neurology, mental health, and cardiovascular disease. This year we’ll also have a renewed focus on women’s health and pain management as well as more content on immunisations.

If you are interested in attending, you can register here.

GPC England committee pages and guidance for practices

Read more about the work of the GP Committee

Read practical guidance for GP practices

See the latest update on Twitter: @TheBMA / Twitter,   @BMA_GP / Twitter @DrFJameel / Twitter

Read about BMA in the media: BMA media centre | British Medical Association

  Read the latest GP bulletin (England) here  
Last updated on: 
August 15, 2022
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