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LMC Weekly Update 22.11.2019

LMC England Conference

It was good to see many of you at the 2019 Conference of England LMCs which was held today in London. Thanks to Rachel McMahon, chair of conference, and all those who organised this. The webcast will be available next week and we will share it with LMCs as soon as it has been added. You can read my full speech here

Legal action against NHS Property Services 
It was announced today that the BMA is launching legal action against NHS Property Services (NHSPS) over “unjustifiable” rises in service charges faced by GP practices. Practices leasing their buildings from NHSPS have seen their charges rise over the last three years, with no agreement, and sometimes being billed for services they are not receiving. Earlier this year we wrote to NHSPS setting out why we believe they are acting unlawfully, but received no acceptable response. Therefore, the BMA is now taking NHSPS to court. 

At the LMC England Conference today, in response to this, I said: “It’s not acceptable that practices in NHS Property Services premises are left to pick up the cost of an unjustifiable hike in charges. As such, we will very shortly be lodging a legal test claim in court which, if successful, would provide a template for GP practices to defend unlawful claims for service charges by NHSPS. We must and we will stand up for GPs and take legal action when it’s necessary to defend our profession.”  Read my full statement here. It was reported by the HSJPulse and GP Online, and again in another GP Online piece.
 
Pensions tax payment for 2019/20
Simon Stevens, chief executive of NHS England and NHS Improvement, has today announced plans for covering the costs of tax on the annual allowance for 2019/20. He has stated that the annual allowance tax charge for this financial year (for anyone that incurs it) will be covered via the scheme pays route and that when the individual retires and claims their pension, the NHS will pay to them the value of the tax charge for 2019/20 (including interest accrued), so covering the cost.

The BMA has responded to this proposal which can be found here.  The BMA is continuing to liaise on the details of how this will operate, as well as continuing to lobby for longer-term solutions, including proposals to get rid of the annual allowance altogether.

NHS England’s letter and FAQs are available here
This was reported by GuardianPulseGP Online, Mail OnlineHSJPersonnel TodayThis is Money, and Practice Business.

Medicine shortages
A motion demanding urgent action with regard to medicine shortages was passed at the LMC England Conference today. In response to this, Krishna Kasaraneni, GPC England executive team member, said: “Drug shortages can happen for lots of different reasons, but they are undoubtedly getting worse and becoming a daily frustration for both GPs and our patients.  GPs often only know about shortages once a patient returns from the pharmacy needing an alternative prescription, which can not only add to our already crippling workload, but also, and most worryingly, delay patients’ treatment. Conference has therefore, acknowledged the benefits of giving pharmacists more control in prescribing safe and considered alternatives, and going forward, there must be systems in place to support pharmacists to ensure they have the necessary patient information to make informed decisions.” This motion was reported on by thePharmaceutical Journal.
 
The Daily Mail has also reported on shortages on a number of prescription medications, including further comments from Krishna Kasaraneni.  Read the full article here.

Amendment of fluoxetine 30mg capsules Serious Shortage Protocol (SSP)
The Department of Health and Social Care has advised that the Serious Shortage Protocol for fluoxetine 30mg capsules (SSP02) is being extended to 18 December 2019. Please also note that this SSP has been changed, so pharmacists now supply fluoxetine 10mg capsules instead of tablets i.e. 1 x 10mg fluoxetine capsule, plus 1 x 20mg fluoxetine capsule. The SSP for fluoxetine 40mg capsules (SSP03) expired yesterday, 21 November, as scheduled.
 

GPC England meeting

GPC England met yesterday. The GPCE executive and policy leads report, which was received by the committee, is attached. 

We received a progress report of the BMA’s Gender Task and Finish Group, and an update from Tom Grinyer, chief executive of the BMA, on the BMA's overall strategy for implementing the important recommendations of the Romney report. The committee also discussed how it could bring the committee specific recommendations of the Romney report into the implementation of the GPC Gender Task and Finish Group which has already been looking at many of the issues which the Romney report addressed.

We were pleased to welcome colleagues from the Pharmaceutical Services Negotiating Committee to give us an update on their recently agreed pharmacy contract.  They have produced a PSNC web page outlining how these changes are relevant to GPs, including a briefing document which summarises the changes that would be of particular interest to practices.

The next GPC England meeting will take place on 16 January 2020 and the next GPC UK meeting will take place on Thursday 19 March 2020 in Cardiff, Wales.
 
General election campaign health pledges – Lib Dems
Following last week’s health pledges from the Conservative Party and Labour Party, the Liberal Democrats published their manifesto this week which include plans to protect the NHS by investing an extra £35 billion in the health service and social care over the next five years. They pledge to end the GP shortfall within five years (2024-25) by both training more GPs and also making better use of nurses, physiotherapists, pharmacists and other health professionals, and also phone or video appointments, where clinically suitable. Of the £35 billion, £32.2 billion would be spent in England, £1.8 billion in Wales and £1 billion in Northern Ireland, with the funding focused on relieving the crisis in social care, tackling urgent workforce shortages, and investing in mental health and prevention services, without any specific reference to general practice. They would also spend £10 billion of capital funding to make the necessary investments in equipment, hospitals, community, ambulance and mental health services buildings, again without any specific information about what would be available for general practice premises.
 
More doctors needed to fulfil election pledges
The Sunday Times published a letter from me about the GP workforce crisis, where I said: “While election pledges to deliver more family doctors are encouraging, we must not forget that previous promises have fallen far short and GP numbers have continued to decline. We need meaningful action to keep experienced GPs in the NHS, not least the scrapping of absurd pension regulations that punish doctors for staying in work. Both main parties say extra GPs will provide millions more appointments, but thousands more doctors are needed just to meet present demands. Politicians owe it to patients to be realistic about what can be delivered”. Read the letter here (pay wall)

Write to your MP to ensure the next government hears doctors’ voices
Ahead of the General Election on 12 December 2019, you can help ensure the next government hears doctors’ voices by emailing your prospective parliamentary candidates (PPCs) today. The BMA has set up a template to help emailing your PPCs - by filling in your details using our online tool, you can email each of the candidates standing in your constituency. 
 
Social prescriber costs
Following calls from GPC England, LMCs, and PCNs, NHS England has today agreed to extend the purpose of the ARRS (Additional Roles Reimbursement Scheme) funding for Social Prescribers.

We are aware that nearly all organisations supplying a Social Prescriber Link Worker Service (SPLW) are passing on additional cost over and above the equivalent of the actual salary and the on costs, for example in administration fees. The ARRS scheme will be updated so that, where a PCN engages an SPLW service through a supplier, a PCN will be able to claim an additional flat rate sum of £2400 per SPLW (on an annual WTE basis; to be pro-rated by the WTE and duration of the roles providing the service as appropriate) as a contribution toward those additional costs. This must be affordable within the existing maximum annual reimbursable amount for social prescribing link workers.This will apply to any existing supply arrangements for SLPWs and any new supply arrangements for SPLWs agreed from this point forward.

Enhancing shared parental leave (England)
The SPL (shared parental leave) scheme allows parents and adopters more flexibility in how they care for their child during the first year after birth/adoption. Currently the salaried GP contract only allows for enhanced maternity and paternity leave and statutory SPL. Maternity leave and pay in the salaried GP model contract is linked to the provisions of section six of the GWC handbook, rather than the NHS terms and conditions handbook. As such, salaried GPs employed under the model contract are still only entitled to the statutory SPL provisions. The provision for GP contractors will be whatever is set out in their partnership agreements.

GPC England is looking at how enhanced SPL could be provided under the contract. We need to understand the financial impact it will have on practices, if any, in moving from statutory to enhanced SPL, as well as from enhanced maternity/paternity to enhanced SPL. Email info.gpc@bma.org.uk with examples of practices that have introduced enhanced SPL/pay and its impact. All information shared is confidential and will help us make the case for enhancement to NHS England. Read more in a blog by Sarah Westerbeek, of the Sessional GPs committee.

Patient access to records online guidance
GPC England and NHS England have published joint guidance on patient access to records online: prospective record access. This guidance aims to support practices in meeting the commitment to give new registering patients online access to prospective data, subject to existing safeguards for vulnerable groups and third party and system functionality.

GP pressures
Gaurav Gupta, GPC member and premises lead, spoke to BBC's Sunday Politics (South East branch; no recording available) about GP pressures, where he said: "The main strength of the NHS is its people. Unfortunately, in general practice we find GPs are struggling with an unsustainable workload. What we would like from the government is an urgent investment in IT and premises as well as policies to make sure we recruit and retain enough GPs for the population."

Scottish LMC conference  
The Scottish LMC conference will be held on Friday 29 November 2019 at the Golden Jubilee Conference Hotel, Clydebank. Read the agenda here 

Self care week
It is the annual self care week this week, organised by the Self Care Forum to help people understand the benefits of self care and how they can better look after their own health.  Read more in a blog by Dr Andrew Tresidder and on the Patient Liaison Group resources and self-care page

Read the latest GPC newsletter here.

Read about the GP contract changes in Wales here.

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