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LMC Weekly Update 20.12.2019

General election: Government pledges on NHS investment
I spoke to LBC on Sunday (just after 5pm) about the new Government's pledge to invest more into the NHS, where I said that the money promised is not enough, and that the Government must recognise that we have a growing, ageing population, which needs a stable health service to keep up with demand. I also mentioned the pensions issue and explained why this is deterring doctors from doing extra shifts in the NHS, or wanting to stay altogether. I also spoke to BBC York on Monday morning (interview starts about 2 hours in).

Dr Helena McKeown, chair of the BMA representative body, also spoke to BBC Wiltshire (7am) and BBC Humberside (9.15) on Monday, and said that now is the time for the Government to make a real difference on the frontline of the health service - something which was reiterated in our letter to Boris Johnson last Friday. She said the Conservative manifesto is 'promising, but not enough', and that she has concerns about attracting more healthcare professionals to the NHS.

BMA council chair Chaand Nagpaul has written to the prime minister calling for decisive action from the new Government to tackle NHS pressures and deliver real change for staff, patients and services. Read the letter 
 
BMA Legal action against NHS Property Services – Service and Facilities Management Charges
As you know, over the last three years many practices have seen significant increases in service charges and facilities management costs without prior agreement while some report being billed for services they are not receiving. This situation is placing unsustainable pressure on practices and is essentially diverting precious resources away from patient care. Furthermore, we know that this it is destabilising the future of practices as many young doctors are discouraged from becoming GP partners where this issue remains unresolved. The overall impact of this ongoing dispute is having a devastating effect on the profession.

The BMA has repeatedly pressed NHSPS to cease its inflated demands and to provide a proper explanation for the charges. Unfortunately, discussions and negotiations have reached a standstill. Consequently, the BMA wrote to NHSPS earlier this year, setting out why it believes NHSPS is acting unlawfully but received no acceptable response. Therefore, as you know I announced at the Annual Representative Meeting in Belfast in June this year that the BMA is now taking NHSPS to court. 

I attach a letter to you from Gaurav Gupta, GPC premises and practice finance lead, updating you further on progress.

CCG mergers guidance
Following the recent debate at LMC England Conference we are developing a “Focus on CCG mergers” guidance document outlining our work on CCG mergers which we will publish shortly. As outlined both by LMCs and in our letters to NHS England, mergers present a number of issues for practices, including the potential loss of local influence, continuity of funding and support, and understanding of the local population’s needs. We have also received a number of examples of mergers being carried out with poor quality and limited engagement with member practices.

We have raised each of these issues with NHS England and their most response  sets out their position on each. The response also includes a request for any examples of issues with mergers locally, which we may wish to highlight. Therefore please share with us any further examples and in doing tell us whether there been consultation with the LMC or BMA regional council and if so, is there support for the merger plans, whether you are aware of any support from local public (Healthwatch, patient groups, etc), and whether the relevant information including financial and service implication been provided with enough time to properly consider documentation ahead of votes? Please send any examples or feedback to tbramwell@bma.org.uk

Performers List Online Service
The new online Performers List service has now been launched by NHS England and is being managed by Capita (PCSE). Over the next few weeks GPs will be automatically registered on PCSE Online. You may have recently received an email from PCSE, with a link for you to verify your account. This is a legitimate email and we are recommending that you follow the link and verify your account – you will need to do this within 72 hours of receiving the link. If the link has expired you can use the ‘forgotten your login details’ button on the PCSE Online homepage.

If you have not received this email you will need to check that you have an email address registered with the GMC and/or that this is up to date. You can do this by logging into your GMC Online account and updating the ‘My details’ section, by emailing gmc@gmc-uk.org or by calling the GMC on 0161 923 6602.

The new online Performers List essentially is a move from a paper application to an online application and we have been involved in the development of the system.

There has been some concern regarding a tick box which asks for your permission for your details to be shared with your Local representative committee; this is your LMC.  Please do share your details as this will allow your LMC to contact you. Capita (PCSE) cannot share your details with anyone else.  

We would strongly recommend signing up to the new Performer’s list.

Practice e-declaration 
Following concerns raised by practices completing the e-declaration about including an email address, we raised this issue with NHSEI.  They have now modified the declaration so that practices can leave the data field relating to the email address blank. However, this only applies to those practices who have not yet submitted their form, it cannot be changed retrospectively.  Email addresses already submitted will not be published on NHS Choices. 

Influenza Season 2019-2020
A delay in the delivery of some influenza vaccines this year meant that the flu vaccination programme started later than usual; further supply constraints then occurred with the children’s nasal vaccine.  Although these issues are now resolved, vaccine uptake rates are around 5% lower than expected for this time of year for those in clinical risk groups under 65 years. Of particular concern is uptake for two and three year old children, which is around 8% lower than the same time point last year. The data suggests that practices are working hard to catch-up and we would like to thank all the GPs, practice nurses and other practice staff who support the programme. Unfortunately, however, we have already started to see early influenza activity in the community, particularly in the northern part of England.  School children have been particularly affected and several paediatric deaths have already been reported, as well ICU admissions.  The predominant strain causing cases this year appears to be well matched to this season’s influenza vaccine, and so we hope that practices will be able to continue these efforts to ensure as many children and younger adults are protected as possible.
 
Updated BMA handbook for salaried GPs
The sessional GP committee has just updated our salaried GP handbook which is written for salaried GPs and GP employers. It will also be of interest to those who are intending or about to become salaried GPs. It explains the legal entitlements of salaried GPs as employees and helps to ensure that salaried GPs are aware of their statutory and contractual rights. It also helps to prevent GP employers contravening the law unwittingly. In addition, it explains the national and local representation of salaried GPs, how to become a salaried GP and the work involved.

One of the aims of this handbook is to help ensure that all salaried GP members receive appropriate employment terms and conditions. It does this by setting out the legal entitlements that salaried GPs receive as employees, as well as the additional contractual benefits that are, or may be, available. It provides a comprehensive overview of the employment contracts available to salaried GPs and the effect of the various provisions of the model salaried GP contract. The handbook also provides guidance on negotiating improvements to salary and other
contractual provisions.

The handbook provides detailed guidance for salaried GPs. However, this cannot replace the expert and confidential advice on individual employment issues that salaried GPs should and can obtain. This is available as part of BMA membership by contacting the BMA.

Also, a specialised and invaluable benefit of BMA membership is the employment contract checking service that is offered. The BMA will review the employment offer letter and terms and conditions, and advise on any necessary improvements.

The handbook is a valuable tool for GP employers. It explains the statutory entitlements that a GP employer must provide to its salaried GPs in order not to fall foul of the law. It also highlights various contractual obligations, including those under the model salaried GP contract.

You can access the updated handbook here.
 
Pensions 
A special edition of the PCSE GP Bulletin had been published, which covers the End of Year Pension administration processes for 2020 and an update about Annual Benefit Statements (ABS). NHS Pensions has released the Type 1 Annual Certificate of Pensionable Profits and the Type 2 medical practitioner self-assessment form will be available very soon. In this bulletin we will help you understand what you need to do in order to prepare End of Year Pension administration in 2020.

NHS Pensions has confirmed that the following pension forms and associated guidance notes have now been published and are available to download from the NHS Pensions website here.

The following pension forms and associated guidance notes have now been published:

  • Type 1 GP and non-GP providers annual certificate of pensionable profits (partnership / single-hander) 2018/19
  • Type 2 medical practitioner amnesty form - for use when forms not already submitted from years 2009/10 to 2016/17

    Also available is: GP and non-GP providers annual certificate of pensionable profits (limited company) 2018/19

    Available very soon: 
  • Estimate of NHS pensionable profits / pay form 2020/2021

Type 2 medical practitioner self-assessment forms 2015/16, 2016/17, 2017/18 and 2018/2019

To read the full bulletin click here

GMC’s State of Medical Education and Practice annual report 
The GMC has published its State of Medical Education and Practice annual report. It notes that 45% of GPs reported working less than full time (61% female GPs compared with 26% male GPs), 36% have reduced their hours in the past year, and many are considering leaving the profession altogether (18% in the next year). Increasing workloads has resulted in two thirds of GPs working over their rostered daily hours with 19% taking stress related absence over the last year. 92% of GPs reported that they felt unable to provide sufficient levels of care at times while a quarter reported witnessing patient care being compromised. Despite this, the report also notes that around half of GPs are satisfied in their work, largely driven by a sense of fulfilment.

PCN conference
Join other PCN leaders and gain insight into what’s happening across England, share best practice and build supportive relationships at the PCN Conference on Saturday 8 February, at the ICC Birmingham. Learn more and get your early bird discount at www.bma.org.uk/pcn-whats-next

Social Prescribing webinar
The National Association of Link Workers is running a short webinar on 30 January for anyone interested in getting a bit more information about Social Prescriber Link Workers and their involvement in PCNs. LMCs and PCNs can register here.

Read the latest GPC newsletter here.

Read the latest Sessional GPs newsletter here.

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