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Wessex LMCs Email update July 2018

Date sent: Monday 2 July 2018

'We live in interesting times' is a famous quote which has been translated from a Chinese saying and certainly reflects what is happening in the NHS generally and general practice specifically at the present time.

This week the NHS celebrates its 70th Birthday and there is much to be proud of. The NHS is one of our nations most treasured institutions and it is fitting that much of the Media coverage over the last couple of weeks has been positive and has been looking at the services provided  but also about the individuals and professionals who work in the NHS.  One thing that I was finding slightly irritating was most of the coverage did seem to be about hospital based care and you could be forgiven in thinking that the Media were not aware that most of the patient contacts occur out of hospital in general practice.

I was then approached on Thursday to record a piece for ITV Meridian on the 70th Anniversary looking at the key role general practice has played in the NHS and then on Friday I was invited to be one of the guests on BBC Solent's Morning radio show hosted by Julian Clegg, the other guest was Steve Brine, MP for Winchester and Health Minister with responsibility for Primary Care - so we had an hour this morning talking about general practice and some wider NHS issues.  So some general practice coverage but not enough!


1. The Future of the Partnership Model of General Practice

The GP Partnership Review is now in full flow, read Blog 2 and see attached document which gives you more information and explains how you can get involved.

2. Long-term NHS funding boost announced

But what does that mean for general practice.

3. Younger GPs - information and update

Three GP Fellows appointed by the LMC.

4. Carrying medicines abroad

The implications for practices.

5. About 40 per cent of GP visits for mental health problems

Results of a survey by MIND - increasing demand in general practice.

6. Babylon

Use of technology an opportunity or a threat?

7. Workload - how you and your practice can help

How you can help us to help you


1. The Future of the Partnership Model of General Practice

We are now 1 month into the review with only 6 months left to complete the work. We are still in the phase of information gathering and then checking this with front line services to ensure we have not only engage with a broad range of GPs and other but also ensure we are trying to address the real problems that we all face.

To read my second Blog click here .

How can you have your say?  Please read the the document attached which aims to frame the work that I am leading in terms of the review of the GP Partnership model. The contact details are at the end of the document and I would be happy to receive your comments as individuals, from your practice or group you work with (I know some practice manager groups have asked me for this so that they can discuss the details to feed back as a group).


2. Long-term NHS funding boost announced

This week the  Prime Minister Theresa May that the NHS will get an additional £20bn a year in real-terms funding by 2024.

This increase is clearly welcomed but will only represent a 3.4% increase year on year which is lower than the average increase of 3.7% increase the NHS has received over the last 70 years and follows a period of 6-7 years of less than inflation growth in funding.

The key question now is what will the additional funding be used for. If it is simply used to fix hospital deficits and expand hospital based services without significant additional investment in general practice, community services and community based mental health there will be little possibility of the NHS undergoing the transformation that is required and the situation for general practice and other community based services will have inevitable results.

General practices needs recurrent investment to expand the workforce and address the problems of workload and this will then help with recruitment and retention.


3. Younger GPs - information and update

Next Generation GP - I have included this in previous emails. This was an initiative to give younger GPs the opportunity, experience and exposure to leadership by bringing together 40-50 GPs  who are in the early stages of their career and are within 7 years of becoming GPs. This started in London and Wessex had the second group which proved to be hugely popular.

The LMC bid for funds to have a GP Fellow working with us part time for a year focusing on leadership and system development.  I am please to report not only were we successful in our bid but we have recruited 3 GPs from the Next Generation GP group who will be starting in September and will be working with the LMC for 2 days a week for 1 year.

Last week I spoke at a national conference for the Next Generation GPs - over 300 delegates from all parts of the country. This was hugely positive and reassuring that we have suture leaders ready, willing and able.

Read the latest GP Trainee newsletter - click here


4. Carrying medicines abroad

Last week the BBC reported that the Foreign and Commonwealth Office (FCO) is advising holidaymakers to see their GPs to check if any of their prescribed medication contained controlled drugs, to avoid falling foul of local laws when travelling abroad.  

It is estimated that there are over 70 million trips made by UK residents abroad every year. It is also estimated that 50% of the population are prescribed one or more medications.  So the potential for surgeries being filled with patients asking about their medication, checking that it is ok for various countries and then asking for a letter confirming that these medicines are prescribed is enormous.

If patients are concerned about taking medication abroad they should visit their local community pharmacy who are well placed to provide the information that is needed, and can also advise on a wide range of travel-related health issues.  The GPC have raised their concerns directly with the FCO and were informed that they will be amending their website accordingly.


5. About 40 per cent of GP visits for mental health problems

A survey by Mind, the mental health charity, of more than 1,000 GPs has revealed rising demand for mental health support in primary care with doctors saying two in five of their appointments now involve mental health, which two in three GPs say the proportion of patients needing help with their mental health has increased in the last 12 months. 

This certainly reflects what I see in my practice. The rising demand with children who cannot access CAMS services, adults with personality disorders and people with ongoing mental health problems that are too severe for IAPT but do not reach the criteria for the adult Mental Health Service.

 In response to this, Richard Vautrey Chair of GPC said “GPs want to offer the best possible care to their patients and are working hard to do so, despite the challenges created by a decade of underfunding. At the same time, the number of patients needing help with mental health problems is increasing.  We not only need greater investment in community-based training to give GPs more opportunity to develop their skills but also a significant increase in mental health therapists directly linked to practices. This would reduce the unacceptable delays many patients currently face getting access to the care they need.”


6. Babylon

We need to separate out the use of the technology developed by Babylon and the impact of a rapidly expanding practice who have the ability to register patients from all over the country and potentially destabilise local practices.

At our recent LMC IT Conference we had an excellent presentation from a group of sixth formers from Poole Grammar School (see below) who described how they and their friends used social media and how they would want to engage with GPs in the future would be by using the sort of technology that Babylon have developed.

As practices we are funded on a capitation basis and the sum we are paid reflects the fact that some patients will be seen less often and some more often. The frequency of attendance has two major determinants which are age and existing medical conditions. Practices also have the ability to organise care based on the population they serve and the register list they hold.  We are increasingly moving away from commissioning by activity to commissioning services based on a defined population that is geographically contiguous and based on outcomes.

The LMC would like to see this technology made available to all practices. Our concerns are not about the technology but relate to the potential impact the model of care being developed could have if held by a small number of practices.



7. Workload - how you and your practice help?

I attend many meetings and find myself repeatedly arguing the case for general practice. I am frequently challenges about the lack of evidence that we have in terms of workload and demand. Hospitals can present lots of data about 4 hour trolley waits, waiting times for out patients, the number of patients seen for a new appointments and follow ups, emergency admissions, cancer waiting times etc. This then makes it more difficult for us to make the case for additional resource.

For some time LMCs have been discussing the need for us to have a similar dataset. We need to collect this as part of our working days and not as additional work for clinicians working in general practice.

The RCGP has run the Research and Surveillance Centre (RSC) for many years, with over 250 practices as members of this network. The RSC extracts data twice a week and generates weekly reports on disease levels.

These reports focus on disease surveillance currently, for example the best known is probably the flu surveillance.

The RCS has a GP who is the Director, Professor Simon de Lusignan, who is a GP in Guildford and I have known for over 35 years as we were SHOs in Accident and Emergency at UCH in 1983!

Simon is trying to develop a workforce observatory to properly answer the question about workforce / practice configuration and health outcomes.

To do this he needs far more practices to become members of the Observatory.

Please read more about this and consider the benefits of your practice becoming a member not only for you but for the future of our profession -

click here to learn more.

Sign up details are on the RCGP RSC web page: or by contact Simon directly – via his Medical Director email:

Best wishes


Dr Nigel Watson

Chief Executive

Wessex LMCs

Churchill House, 122-124 Hursley Rd

Chandler's Ford, Eastleigh

Hants. SO53 1JB (Registered Office)

Tel: 02380253874

Mobile: 07825173326


Attached file: PGD for HiB-MenC.docx

Attached file: GPPR key lines doc. FINAL1.pdf

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Updated on 02 July 2018 917 views