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LMC Weekly Update 10.1.2020

PCN DES draft Service Specifications – summary for GPC and LMCs

The response to the NHS England and NHS Improvement draft PCN service specifications has been significant, with unprecedented numbers responding to this important survey. We are pleased that so many LMCs and PCNs have already submitted their responses to the service specification consultation. There is still time to send further feedback, including from the many LMCs and PCNs that have meetings in the next week.  We have produced the attached summary in table form which summarises what would be required, who from PCN workforce could deliver it, what the role of the community teams might be, and what the outcome measures are.

In response to these concerns I said: “General practice continues to be under a huge amount of pressure and we hear the concerns raised by the profession in recent weeks about these draft specifications, the workload implications and the need for a qualified workforce to deliver them, loud and clear.  While the content of negotiations is confidential, the profession should rest assured that we are listening to doctors on the ground, reviewing their feedback and this will form the basis of talks with NHS England to ensure that the specifications are fair and appropriate before they are agreed.” The BMA has reported it on this and commented on twitter, and it was also covered in PulseGP Online, and GP online

The HSJ (login required) have also commented today that “NHS England looks likely to row back quickly on its proposed requirements on GPs and primary care networks, after a deluge of strong opposition from GPs and others. Responding to criticism of the specifications which GPs would be asked to deliver as part of their PCN, NHSE director of primary care Nikita Kanani said: “The feedback is crucial and will absolutely be heard and reflected.”

Meeting with Health Minister

On Wednesday I met with Jo Churchill MP, the health minister with responsibility for primary care in England. We joined with Prof Martin Marshall, chair of RCGP, Nikki Kanani, Medical Director of Primary Care, NHSEI, Dr Rosie Benneyworth, CQC’s Chief Inspector of Primary Medical Services and a group of GPs from around the country.  It was a long and helpful meeting, providing a good opportunity to discuss with the health minister the key issues facing general practice and she was left in no doubt about the challenges we face and the support we needed from the new government. 

GP appointments wait

The Sunday Times (login required) reported that around 11 million patients waited more than three weeks for a GP appointment in England in the most recent four months for which statistics are available. The article referenced Boris Johnson's pledge, soon after becoming Prime Minister, in which he said that his "job is to make sure you don’t have to wait three weeks to see your GP". In response to this I said that these figures “come amid a backdrop of falling GP numbers because, despite their best efforts, many practices simply do not have the capacity to meet the ever-increasing demand” and that Boris Johnson’s promise to increase appointment numbers by recruiting more GPs “will require sustained investment and ensuring that it is easy to recruit overseas doctors”. The story was also reported by i NewsMailOnline and Pulse (log-in required).

NHS IT investment

The Department of Health and Social Care and NHSX have announced that they would be investing £40 million in updating NHS IT, beginning by focusing on speeding up login times by minimising multiple logins. In response to this, Chaand Nagpaul, BMA Council chair said that reducing multiple logins was a positive step, but that this would “not in itself address the overdue and urgent need to upgrade antiquated hardware and software in the NHS, and that we needed “to see an absolute commitment to interoperability so that different systems communicate with one another effectively, and we need to see a clear action plan of how this will be achieved”. This was reported by the BBC, the BMJ and the Times print edition.

GP earning figures

The Sun reported on figures which they said showed that over 160 GPs were paid more than £200,000 in 2017/18. In response to this I said that high earners are “more likely to be managing a business operation who are set up to manage multiple practices, rather than being on the front line of general practice seeing patients”. This was also reported by the Mail and Pulse.

Gender pay gap

The Institute for of Public Policy Research has published report which showed that women GPs earn an average of £40,000 a year less than their male colleagues. The IPPR argue that this is because of the existing GP partnership model and women being underrepresented amongst GP partners.  

In response to this, Farah Jameel, GPC England executive team member said: “The gender pay gap in this day and age is something that we as a society should be ashamed of, and we need to work harder to examine more closely and address the issues that lead to this in the medical profession. For many female doctors – many of whom will have family or caring responsibilities – working flexibly is the right thing for them, and salaried roles at present are able to provide a greater control over work-life balance. However, partnerships too can offer a great opportunity for flexible ways of working, which could be positive for the recruitment and retention of women, but action must first be taken to reduce the risks that put off GPs of all genders from currently taking on this role.”This was reported by the Independent

PCN conference 2020

At this crucial time for the future of PCNs, there is an important opportunity to join other PCN leaders and share best practice and build supportive relationships at the PCN Conference on Saturday 8 February, at the ICC Birmingham. It should be an interesting day and give people a flavour of how different PCNs, CCGs, LMCs across the country are doing things and giving PCNs ideas for the future and maybe how to do things differently for greater benefit. If you haven’t already signed up then you can do so 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.

CCG mergers guidance (England)

The BMA has produced new guidance on CCG mergers in England, to help GPs and LMCs get to grips with the changes taking place. This includes information on why, how, and when mergers are likely to take place, as well as advice on how to approach them, and examples of ways in which LMCs and grassroots GPs have influenced and shaped mergers in their areas. Read more here.

Online consultations toolkit

NHS England has published a toolkit to inform staff in practices and commissioning organisations who are implementing online consultation systems. There is a shortened version aimed at GPs and other practice staff, as well as a full version of the toolkit for those who are leading these projects. 

BMA mental health workforce report

The BMA published a mental health workforce report yesterday, which revealed that over half of respondents said they were too busy to provide the care they would like to be able to give, with 44% saying that they felt demoralised and the same number saying their workload was unmanageable. It also showed that around two in five GP appointments now involve mental health, while two in three GPs say the proportion of patients needing help with their mental health has increased in the last 12 months. Read more here. This was reported by  GP Online, and OnMedica.

RCGP (Royal College of GPs) Workforce Roadmap

The RCGP has launched a workforce roadmap, calling on the Government to take urgent action on the GP workforce with clear targets for expanding the entire general practice workforce, a commitment to increase GP training places to 4,000 in 2020/21 and to 5,000 soon after, and significant investment into initiatives to improve GP workload and retain existing GPs in the profession. This was reported by the BBC and I responded publicly in support of the RCGP’s recommendations.

Supply Disruption Alert for Phenytoin 100mg capsules

The Department of Health and Social Care has informed us that a supply disruption alert for phenytoin 100mg capsules has now been issued and can be found here.

GPC Regional elections

The nominations for the following GPC UK regional seats will open on Monday 13 January at 12pm:

  • Hillingdon/Brent & Harrow/Ealing, Hammersmith & Hounslow
  • Lewisham, Southwark & Lambeth/Bexley & Greenwich/Bromley
  • Cheshire/Mid Mersey
  • Northumberland/Newcastle & North Tyneside/Gateshead & South Tyneside/Sunderland
  • Glasgow & Clyde
  • Gloucestershire /Avon
  • Wiltshire/Dorset
  • Buckinghamshire/Oxfordshire 
  • Berkshire/North and East Hampshire
  • Barnsley/Doncaster/Rotherham/Sheffield 
  • Leicestershire & Rutland/Northamptonshire
  • North Yorkshire/Bradford
  • Dyfed Powys/North Wales
  • North Staffordshire/South Staffordshire/Shropshire
  • Sandwell/Walsall/Wolverhampton/Dudley

    Governance review

    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.

    The nominations close at 12pm Monday 3 February. For further information and to nominate yourself for a seat see here (in the elections tab). If you have any queries, please contact elections@bma.org.uk
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