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Wessex LMC Update 11th March 2019

Date sent: Tuesday 12 March 2019

Once again I would like to apologise for the number of emails I have sent you in recent days but there is quite a lot going on and all this information is important for you to be aware of.

I am sure as time goes by there will be more information coming out about the GP Contract and also the NHS Long Term Plan and I will update you as this information becomes available.

In a recent BMJ Open article, researchers from the University of Warwick reported the results of a survey of 929 GPs in Wessex (the LMC was not involved in this survey) which showed that over the next five years 40% of the respondents within the next 5 years - and increase of nearly a third since 2014. This has been widely reported in the media and clearly is a cause for concern.  These results were not unexpected and reflected the findings of the GP Partnership review and supports the need to address the reasons for this.

The Government and NHS England have demonstrated their commitment to support and invest in general practice, through the GP Partnership Review, the Primary Care commitments in the Long Term Plan and the significant investment in the GP Contract changes.  The GP Partnership Review and recommendations were only published 8 weeks ago and the Government and NHS England have not yet formally responded to the Review but already about 50% of the recommendations are in the process of being implemented via the GP Contract and the Long Term Plan.

Following our recent Roadshows I have had a number of GPs and Practice Managers contact me to say how, for the first time in many years they feel much more positive about the future . We need to build on this and ensure the opportunities are created make a real difference and it is important that commissioners deliver what is promised and more - the NHS is good at hitting the target and missing the point!



1. Funding for increased employer contributions

Clarification on how this will work and the benefits for GP Practices.

2. Indemnity settlement 18/19

Details of the funding for the growth in indemnity costs for 2018/9.

3. Britain’s opioid ‘epidemic’

Recently reported in the Media but how does your practice compare to others in terms of opiate prescribing?

4. Government launches cervical smear campaign

Cervical cancer is avoidable and it is great news that boys will be vaccinated against HPV starting in September but it is of concern that the cervical smear uptake has hit a 21 year low - what can you or your practice do to help increase the uptake.

5. Training hubs essential in workforce transformation

What do you get from your training hub?

6. Supply Issues Update for Primary and Secondary Care February 2019

See attached for more details.

7. Sessional GPs

Links to latest newsletter

8. CQC Update 

9. Firearms licensing process

Latest information from the GPC

10. BBC investigation into violence against GPs and practice staff

What is happening in your practice?


1. Funding for increased employer contributions

Following our recently concluded contract negotiations, the GPC agreed that additional funding would be provided to fund the expected rise in employers superannuation costs.

The DHSC (Department for Health and Social Care) has now published its response following recent public consultation. They have confirmed that for 2019/20 an employer rate of 20.6% (20.68% inclusive of the administration charge) will apply from 1 April 2019.

However, the NHS Business Service Authority will only collect 14.38% from employers such as practices. Central payments will be made by NHS England and the DHSC for their respective proportions of the outstanding 6.3%. This will also apply to locum GPs.

This information has changed from our LMC Roadshows where we had expected the additional funding to be distributed to practices on a weighted capitation basis.


2. Indemnity settlement 18/19

GPC England and NHS England have agreed the amount to cover the increased cost of indemnity for 2018/19. This will again be £60m and be paid on a per-patient basis equivalent to £1.005 per patient.

Practices and individual GPs will need to discuss how this funding is distributed, in line with previous years. This is the third year that the GPC have secured payment to cover the previous annual rise in indemnity costs. It now completes discussions related to the current indemnity scheme and represents a fair and final settlement. This is in addition to the state-backed indemnity scheme which begins next month


3. Britain’s opioid ‘epidemic’

The Sunday Times  reported on a major investigation into opioid use in England and Wales, which showed that 91,000 deaths have been linked to the drugs in the last two years alone.

In its analysis of NHS figures, the paper found that prescriptions had increased by 30 per cent in the last decades, and overdoses were up 89 per cent.

GPC clinical and prescribing lead Dr Andrew Green told the paper that there “is no doubt that we have an epidemic of opioid use”. This was also reported by  MailOnlinei News  and  BBC Online .

The opioid epidemic was first reported in the USA abut clearly is also happening in the UK.

The indications for the prescribing of opiates have changed in recent years with  and the NICE guidelines state:

According to the British Medical Association (BMA) briefing paper  chronic pain: supporting safer prescribing of analgesics the management of people with chronic pain can present significant challenges for clinicians. It is important that people receive appropriate treatment for their pain with careful consideration of the benefits and risks of their treatment options. When discussing such options, the law now requires health professionals to take reasonable care to ensure that the person is aware of any material risks involved in the recommended treatment and of any reasonable alternative or variant treatments.

How good is your practice in terms of opioid prescribing and does it matter?

You can easily find out how your practice or CCG are doing compared to the England average go to the Open Prescribing Website - click here .

If you look at this website you can drill down to CCG and practice and select different categories and one for example is opiates.

It is important because of increasing abuse of opiates and there is more notice being taken of GP prescribing of opiates.

This is a difficult problem for GPs especially with challenges with access to Pain Clinics but it is an issue you should all be aware of.  If your access to Pain Clinics is poor raise the issue with your CCG.


4. Government launches cervical smear campaign

The Government has launched a cervical cancer campaign after the number of women getting smear tests has dropped to 21-year low.

The GPC has recently wrote to NHS England expressing concern that so many women did not get letters because of an error on the part of Capita.  

What is your practices uptake for cervical smears, and what can you do to increase this?

From our LMC Roadshows you will have noted that HPV vaccination of boys will commence in September of this year which in the medium term will have a positive impact on these avoidable deaths in younger women.



5. Training hubs essential in workforce transformation

Training hubs, also known as advanced training practices (ATPs), enhanced training practices (ETPs) and community education provider networks (CEPNs), are an essential vehicle of workforce transformation due to their ability to engage multiple general practice organisations and provide consistent education and workforce planning support.

They are tasked with increasing capacity for future workforce training in the community and the development of the current and future workforce around the needs of a regionally defined population.

Practices are strongly encouraged to make the most of the education and training resources that these hubs offer to general practice and primary care staff, and to help develop them so that they attract more resource that local practices can access at no cost to themselves. 

Access the contact details for your local training hub leads - click here for BMA advice and information.

Email us if you have any feedback about your local training hub


6. Supply Issues Update for Primary and Secondary Care February 2019

The GPC have received the latest report produced by the Department of Health and Social Care (DHSC) Medicine Supply team. This report is produced monthly to provide an update on current primary and secondary care medicine supply issues that they are working on.  Please share the attached with all relevant colleagues and networks.


7. Sessional GPs

For the latest Newsletter - click here


8. CQC Update 

Recently  practices in England were sent an update on the new approach to regulation of general practice, being introduced from 1 April 2019. The updates outlined that practices rated good/outstanding will no longer be routinely inspected every two years, with their inspections changing to a maximum interval of five years. Instead these practices will have an annual regulatory review including the outcome of a  “provider information collection” (PIC) with an annual phone call to the practice, as a satisfactory IT solution for the PIC has yet to be developed.

That letter links through to updated guidance on CQC’s website:   How we monitor GP practices  and a new page on the questions that we’ll ask on the calls.

GPC England has worked closely with the CQC through various iterations of this in order to mitigate the impact on practices and our engagement has hopefully made the process considerably less burdensome and more fit for purpose that it otherwise would have been; it has also been piloted, though not in a huge number of practices. 


9. Firearms licensing process

The GPC  have updated their GP support guidance about the firearms licensing process .

Mark Sanford-Wood, GPC England executive team member, has also written a blog about medical involvement in firearms to explain the clarifications which you can access  here. 


10. BBC investigation into violence against GPs and practice staff

BBC Online  reported on an investigation into rising levels of violence against GPs and practice staff in England, with latest figures showing more than 3,000 patients have been barred from visiting their GP owing to violent incidents.

These figure are appalling and a sad reflection of society today.  Although the numbers are relatively small compared to the 1,000,000 consultations that occur in general practice every day, one event is too many. 

I am sure your practice will have a policy in place for those who are verbally abusive or physically violent.

If you report an event to the police please can you let the LMC know as it would be useful to keep a record across all our practices.

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: Supply issues update for primary and secondary care February 2019.docx

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Updated on Tuesday, 12 March 2019 903 views