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LMC weekly update - 28 August, 2020

GMS and PMS regulations changes from October 2020 (England)

The amendments to GMS and PMS regulations in England to commence from October have now been laid before Parliament and published. These mainly bring into force elements of the GP contract agreement from earlier this year. The amendments include:

·         Requirement for monthly data submissions to the NHS Digital Workforce Collection

·         Requirement to participate in the existing GP appointments data collection

·         Requirement for practices to ensure patient registration data is regularly updated

·         Removal of patients who move outside of the practice catchment area: the practice is responsible for the patient’s care for up to 30 days (unless and until the patient registers at another practice) but is not responsible for home visits or out of hours services during that period.

·         A modification to make sure that patients who have previously been removed from a practice list and been put onto a violent patient scheme cannot be permanently refused readmission to a practice list if they have been correctly discharged from that scheme.

·         Patient assignment to any practice within the patient’s local CCG, rather than within the practice area.

·         Patient assignment as part of a list dispersal

·         An exemption to the ban on subcontracting a subcontract in order to allow PCNs greater flexibility to deliver the DES

·         Final cancellation of CQC registration is a ground for termination of a GMS contract

·         Other minor amendments to wording without significant change to the meaning

Impact of delays for cancer patients

I wrote a letter to the Sunday Times (log-in required) highlighting the impact of the pandemic on cancer referrals and treatment, following a Times article (15 August) which reported that cancer survival rates were expected to fall due to delays in getting urgent referrals or treatment during the pandemic. The letter reads:

“The Institute for Public Policy Research is right to highlight the impact of the Covid-19 pandemic on cancer referrals and treatment. Its warnings echo the concerns doctors have been raising for months. In the latest survey for the British Medical Association (BMA), more than half of GPs said they had seen more patients presenting later with conditions than they would normally expect, with cancer symptoms causing them most concern. Yes, the government and NHS must urgently address the huge backlog in nonCovid care. Equally, patients should not be put off seeking help when they need it.”

Registering patients prior to their release from the secure residential estate (England)

As we reported last week, practices have a contractual obligation to support patients prior to their release from the secure residential estate, as set out in the NHS England Standard General Medical Services (GMS) Contract 2017/18. Practices are therefore asked to ensure that processes are in place to support this and information on how to do this here.

Our guidance page on patient registration has now been updated to reflect this clarification.

Redacting GP records

In June, GPC wrote to NHSE/I to raise concerns over the redaction of records and unintended consequences of any processes put in place to facilitate patient access to records. The letter sought reassurances that a) patients would not be able to view incoming correspondence before a GP has had the opportunity to review it and b) that the workload of GPs should not increase as a result of needing to review individual records and mark consultation notes for redaction. We have now received a response outlining what measures have been put in place to mitigate these concerns. We also received reassurances that where practices feel granting access to patients’ records during the pandemic would have an adverse impact on provision of essential services, they are not required to do so. NHSE/I is now reviewing their patient-facing guidance on access to records to reflect these points.

GP workforce data (England)

The latest GP workforce data has been published. In response to this I said: “The prolonged and continued decline in the number of FTE GPs in England is a matter of serious concern, but this data is hardly surprising when we consider the immense pressures family doctors are under across the country – both now and long before the pandemic hit. Before Covid-19, GPs were contending with chronic underfunding, rising patient demand, and toppling workloads, all of which has been exacerbated by the virus, with many surgeries going above the call of duty to keep patients safe.

This further drop of 1.4% FTE GPs since March speaks for itself, and yet despite the clear need to do more to attract and retain more GPs, the government have just undermined morale further by failing to use the DDRB recommendations to recognise the incredible work GPs and their teams have done during the pandemic.

Whilst the schemes that we have recently succeeded in introducing, such as the partnership premium, the GP fellowship scheme and the expansion of GP training places may help in the longer term, much more needs to be done to turn these figures around.  That's why, as we prepare for a potential second wave, it’s therefore never been more important that the Government does far more to value GPs and to ensure general practice has the resources it needs for GPs to keep their patients safe and well”. This was reported by Pulse

GP appointment data

The GP appointment data for July was released yesterday, which show that the number of appointments delivered by practices are continuing to rise towards pre-pandemic levels.  Although total figures still remain around 6% down on those for March, the number of same or next day appointments has risen to the highest in the 18 months covered by the dataset, supported by the continued pragmatism and flexibility of practices utilising triage arrangements and remote consultation methods. 

NIGPC media (Northern Ireland)

NIGPC chair Alan Stout was interviewed on the BBC Good Morning Ulster programme  (starting at 35:43) about the latest quarterly waiting list statistics and what needs to happen to address the waiting list crisis in terms of HSC transformation.  Dr Stout was also on the Nolan Show (from 31:24) talking about the winter flu jab programme during the ongoing pandemic. 

Influenza and Pneumococcal Vaccination (Coronavirus Outbreak) Directions 2020 (Scotland)

The directions will have the effect of directing Health Boards to deliver those parts of the Influenza and Pneumococcal Immunisation Scheme which GP contractors cannot reasonably deliver under the Influenza and Pneumococcal DES in Scotland.

Annual Representative Meeting 2020

The BMA’s Annual Representative Meeting will be held virtually on Tuesday, 15 September. Find out more about the ARM and why it matters for BMA members in this short video and read more about how to take part and make a difference, in this blog by Helena McKeown, Chair of the BMA’s representative body.

BMA photography competition

Do you have a photograph that captures COVID and what the pandemic has meant to you? There's still time to enter the BMA photography competition – the deadline is 31 August. The winner will be announced at the ARM meeting. Enter the competition here

Social Prescribing Link Worker Day Conference

The National Association of Link Workers will be hosting a virtual Social Prescribing Link Worker Day Conference on 9 October 2020, with the theme of ‘The Social Innovators Powering up wellbeing’. This event is open to GPs, social prescribing link workers, community health and social care industry leaders, Primary Care Networks and clinical directors across the UK.  It will provide updates and examples of local arrangements benefitting practices and patients through social prescribing – find out more here. There are 50 free tickets available for BMA members via this link

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BMA COVID-19 guidance

We continue to regularly update our toolkit for GPs and practices, which includes a large range of topics relating to COVID-19. There is also guidance on the following topics:

·         Guidance on risk assessments which includes specific information for practices.

Mental health and wellbeing

The BMA continues to offer wellbeing services and confidential 24/7 counselling and peer support for all doctors and medical students, as well as their partners and dependents, on 0330 123 1245. For hard copies of our Wellbeing poster, please email wellbeingsupport@bma.org.uk

Access the BMA’s COVID-19 wellbeing pages here

See this week’s GP bulletin here.

See the latest sessional GPs newsletter here

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