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LMC Weekly Update 24.1.2020

GPC England contract negotiations
Following the vote not to accept the contract package on 16 January, GPC England have been in further negotiations with NHS England and NHS Improvement.  There will now be a further meeting of GPC England on Thursday 6 February to discuss the outcome of negotiations.

This week the Guardian also reported on the wide concerns of NHSE/I’s proposals, and I commented that the previous draft service specifications were “unreasonable and completely unachievable”.

PCN conference 2020
The PCN Conference will be held on Saturday 8 February, at the ICC Birmingham. At this crucial time, not least following NHSE/I's consultation on draft service specifications, this is an important opportunity to share your views, raise concerns and highlight challenges directly with national policy makers, exchange experiences with peers, meet a career coach, and find answers to all your questions on legal, insurance and HR issues relating to PCNs. Find out more 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.

Scottish GPC meeting update
The Scottish GP Committee met yesterday in Edinburgh where they received updates on contract implementation and negotiations including: premises sustainability loans FAQ and letter of comfort, the remote and rural working group report and rural flexibility options appraisal, data collection for phase 2, the MDT survey results, various letters from the Scottish Government relating the GMS National Oversight Group, and an update on the SLMC Conference motions.

There were general updates on information management and technology, sessional GP issues, GP training and various reports from external groups such as the Primary Care Prescribing/Dispensing Pathway. An update was also provided on pensions, a GP IT presentation by Jonathan Cameron as the deputy director for digital health and care at the Scottish Government, and the Daphne Romney Report into allegations of sexism and sexual harassment at the BMA was discussed.

Northern Ireland GPC meeting update
The first meeting of NIGPC came on the heels of the restoration of the Northern Ireland Assembly and appointment of a new health minister, Robin Swann, the first minister there has been in post for three years. There is no doubt about the extent of the challenge he will face with over 300,000 people in Northern Ireland waiting for a first appointment with a consultant and significant pressures facing practices.

The meeting considered a number of issues that need to be brought to the minister’s attention as a matter of urgency including indemnity, pensions and the roll out of MDTs. The meeting reviewed a paper on out of hours provision across Northern Ireland and discussed the best way to address the gaps in the service and ensure its stability. The meeting also had a presentation from Dr John Maxwell, an ED consultant in Belfast Trust and clinical lead and Alastair Campbell, Director of hospital services reform, DH who have been leading a review of urgent and emergency care in Northern Ireland; their full report will be available in March 2020. 

BMA briefing – Impact of pension taxation on the NHS 
As part of the BMA’s ongoing campaign to address the current pension taxation crisis impacting doctors across the country, we have produced a briefing paper which highlights the current situation, background to the issue and consideration of possible solutions. This includes an overview of the BMA’s preferred solution removing the annual allowance in defined benefit schemes, such as the NHS pension scheme. Read the briefing here

NHS pensions records
I have written to Sir Simon Stevens, chief executive of NHSE/I, about the need for urgent action to resolve pensions issues impacting GPs. This was illustrated well by a detailed article in The Times which reported on how three-quarters of GPs haven't been given up-to-date NHS pension statements and could get shock tax bills because they have not been given up-to-date pension statements from the NHS. In response to this, I said: “It is a disgrace that bureaucratic delays are preventing so many GPs from accessing vital pension statements. Quite simply, the body tasked with issuing these statements, the NHS Business Services Authority, is woefully under-resourced and unable to cope, while the involvement of Capita's Primary Care Services England, which has a history of failure, just makes matters worse.”

I am also seeking from NHSE/I full details of how GPs can benefit from the commitment made at the end of last year to cover annual allowance tax charges incurred in this financial year.

Coronavirus guidance for primary care
Public Health England has now published guidance for primary care to reduce the risk of spread of infection during and following consultation with a suspected case of the Coronavirus (WN-CoV). The main principles are:

  • identify potential cases as soon as possible
  • prevent potential transmission of infection to other patients and staff
  • avoid direct physical contact, including physical examination, and exposures to respiratory secretions
  • isolate the patient, obtain specialist advice and determine if the patient is at risk of WN-CoV infection, and inform the local Health Protection Team (HPT)

If WN-CoV infection is seen in the UK, it is most likely to occur in travellers that have recently returned from Wuhan city in China. All PHE’s coronavirus guidance is available here, information for travellers and HCPs on the NaTHNaC website and information for patients on the Patient website.

Peter Holden, GPC member, was interviewed on Sky News yesterday on the coronavirus outbreak in China. He was also quoted in London’s Evening Standard.

NHS England campaign materials
Practices in England should now have received the materials to support the NHS ‘Measles, Mumps and Rubella (MMR) – Help Us Help You, Get Protected’ campaign (also available on the PHE Campaign Resource Centre). This is final one of the six campaigns that practices are required to take part in as agreed in contract negotiations last year.

The other campaigns, materials for which practices have also been sent already, are:

  • NHS 111 (Help Us Help You - Know what to do)
  • Keep Antibiotics Working
  • GP Access (Help Us Help You – When you need it)
  • Pharmacy Advice (Help Us Help You – Before it gets worse)
  • NHS App

If you have not received materials for any of the above, please contact your local NHS England team

 
QOF Personalised Care Adjustments
Following the concerns raised by practices about the loss of opportunistic prompts following the roll out of the QOF changes in 2019, TPP have confirmed to NHS Digital that they will add a status flag to the patient record which will alert practices to the fact these patients may be missing QOF care as part of their roll out of v44 of the QOF business rules. This will be implemented in the next two weeks.

NHS Digital will explore whether additional functionality can be added to v45 of the QOF business rules to ensure that the two invitation PCA will only come into force at the end of the reporting period i.e. 31st March. 
 
New FP10 and prescriber endorsement
NHSE/I have published a new FP10 NHS prescription form with the new prescriber endorsement ‘FS’ for free supply of sexual health treatment – please see attached the guidance and toolkit. The new FP10 form is being rolled out at the end of January. Existing stocks of the old form already in the system, such as in GP practices and pharmacies, should be used up prior to use of the new form. Both forms will be accepted for processing during the transition to the new form.

The new prescriber endorsement will become live from 1 February 2020. Until the necessary changes have been made to prescribing systems, prescribers should revert to issuing paper prescriptions with 'FS' manually endorsed next to each item intended for the treatment of an STI. Where ‘FS’ has been added as a handwritten endorsement, for example, on a computer-generated form, this should be counter-signed in the usual way. Dispensing doctors will continue to use paper prescriptions with a handwritten endorsement. More information is available here.

Changes to gun licensing rules putting more pressure on GPs
Tom Yerburgh, deputy policy lead of the GPC clinical and prescribing group, was interviewed by BBC Radio Gloucestershire over changes to gun licensing rules in the area. The BBC reported how at the start of the year Gloucestershire police made it a requirement for anyone applying for a firearms certificate to first of all have a letter from their GP. Previously only people with a listed condition, such as depression, drug and alcohol abuse or dementia needed to apply. He said that the changes were putting an unfair burden on GPs, and "The question asks if there's any mental health issues that the patient has ever had which is an immense amount of work, going back volumes of records. There's confusion because the process has changed without us being able to advise or offer help to practices on what to do, the other thing is that every police force seems to do this process differently which is really confusing for practices on the edge of the county."
Listen to the full news item on here (from 2hours 10minutes).

Physician-assisted dying briefing
In February, for the first time, the BMA will be surveying our members to inform a debate at the annual representative meeting (ARM) on physician-assisted dying. To make sure you don’t miss out, please check that your contact details are up to date (including your preferred e-mail address) and that you have ‘opted-in’ to receive membership updates from the BMA. To find out more about what we’re doing and why, and to download the briefing pack before you take part, visit www.bma.org.uk/PAD.

DWP end of life survey (UK)
The Department of Work and Pension is undertaking an evaluation looking at how the benefits system supports those nearing the end of their lives, as part of this they have published a survey to collect information from clinicians on this issue. A similar change has already occurred in Scotland – this impacts on GPs and any hospital doctors involved in terminally ill patients.

The results from this survey will help support DWP in making decisions around how best to support claimants nearing the end of their life and provide valuable insight into how clinicians across the UK feel about the current system and where they think it can be improved. Take the survey here

Medicine supply update 
Please see attached the latest medicine supply update from the Department of Health and Social Care.

BMA MAPs (Medical associate professions) publications
The following two new papers relating to MAPs have been published on the BMA website:
Principles for effective working with medical associate professions outlines a range of principles that can help to improve the ways that doctors and MAPs (medical associate professions) work together and identifies possible solutions to some of the common problems that have arisen with the introduction of MAPs.

Medical associate professions in the UK provides key information about MAPs, including roles, regulation, and prescribing.
 
GPC UK Regional elections
Nominations for GPC UK regional representative are open until 12pm Monday 3 February. 

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. This may mean that the term of office that a representative is elected to may be less than the usual three years. Such a decision could be made part way through a representative’s term of office.

For further information and to nominate yourself for a seat click here (elections section). If you have any queries, please contact elections@bma.org.uk 

Public Health Conference 2020
Public Health Medicine Committee will be holding their Public Health conference on 26 February 2020 at the BMA House London. The underpinning theme of the conference will be ‘21st century public health’ and what that might mean for public health professionals. The conference will include keynote speakers on the issues of climate change and economic inequality. If you are interested in attending or for further information, please contact info.phmc@bma.org.uk   

See the last GPC bulletin here

See the last Sessional GP bulletin here

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