LMC Update Sept 2015
Date sent: Friday 11 September 2015
Email sent by Wessex LMCs, on Wednesday, 11th Sep 2015 to all GPs and Practice Managers
Normally during August the LMC can look forward to a slightly quieter time as no one seems to want to have meetings because of holidays etc.. This year has been different and seems to have been much busier and I suspect that reflects the pressure that GPs and Practices are finding themselves under.
Many practices will have reviewed their Accounts for 2014/5 and once again noticed a fall in income. This has been reinforced by the recent publication which has stated that the % of NHS resource spent on general practice has fallen to 6.2%. In 2011/2 it was 6.7%, in 2012/3 it was 6.5% and in 2013/4 it was 6.3%.
If the NHS is serious about wanting to see more out of hospital care and this delivered at scale it cannot achieve this by year on year reductions in the % spent in general practice and the community. Hospitals also need to take more responsibility for the provision.
We need to continue making the case for a far greater % of the NHS Budget being spent in general practice, failure to achieve this will result in even less GPs being recruited and retained.
Despite this there are many positive things happening in the world of general practice.
1. Health and Care ExPO 2015
2. PMS Reviews
3. Cancer Care
4. Session GPs Newsletter
5. Duty of Candour
1. Health and Care EXPO 2015
This year I attended this meeting in Manchester, which was a 2 day event full of important people making speeches and announcements and also lots of organisations presenting on a number of topics related to health and social care.
There was good representation locally with a number of people presenting Wessex projects.
Some key announcements:
Seven day access
Ros Roughton, Director of NHS Commissioning, who today outlined the future for seven day services and primary care.
She acknowledged that general practice was under significant pressure and that finding had not matched demand but stated that significant investment had been made via the PM Challenge fund of over £200m.
She stated that there are three key enablers which are essential.
“Technology is the first, and that means not only making the most of technology, but also using it to ensure we handle data efficiently and safely.
“Workforce is the second, so that we can increase our capacity as well as develop new skill mix models.”
“Finally we need proper development support. In the same way that resources have been provided to support hospitals in tackling waiting times, we need to consider the support needed to transform GP access for the future.”
LMC Comment: The PM Challenge Fund is welcomed additional resource to support the transformation to delivering a new type of service but it is non recurrent funding so we need to be clear what happens in year 2 and beyond.
My personal view is that 7 day access cannot be delivered at practice level and if it can be delivered across a locality it will need significant additional recurrent funding.
Improving the health of NHS staff
Simon Stevens the CEO of NHS England announced there would be £5m spent of improving the health of NHS staff. The three pillars are:
- First, a major drive for improved NHS staff health, spearheaded by a group of leading NHS hospital, mental health, ambulance, community and clinical commissioning group employers, in partnership with NHS Employers and Public Health England;
- Second, a new nationally-specified occupational health service for GPs suffering from burnout and stress, in partnership with the Royal College of GPs and BMA General Practitioners Committee;
- Third, national action by NHS England working with Public Health England and other agencies to challenge and support catering contractors and PFI providers to raise the standards of food and nutrition.
LMC Comment: If we do not look after ourselves that we will not be there to look after our patients. I think the first point made was where the reference to Zumba classes came from – looking forward to the pictures of your all taking part! We will post them on our website.
The second pillar is important and we have made use of the occupational health service that is commissioned for general practice and it is essential this continues but has a greater focus on burnout.
In addition we have helped a number of GPs though the LMC’s Wessex Insight – more details available click here
The third pillar is more focused on hospital and other institutions.
More information is available – click here
Cutting reliance on paper will make patients safer
It was announced that:
From October all discharge summaries for acute or day care patients transferring from hospital to the care of their GP must be completed electronically.
The NHS is committed to making all patient and care records digital by 2020, meaning that whenever and wherever patients access services those caring for them have all of the relevant information available at their finger-tips – from diagnostic tests and clinical notes to case histories and records of personal preferences.
Access to GP records
The Secretary of State announced that patients would from 2018 have access to their full medical records.
They can do this now for GP records, all primary care records by next year and all medical records by 2018. This will include a read write capability that will mean that patients could add comments or correct inaccuracies.
LMC Comment: Access to GP records for patients is a contractual requirement now. Making all primary care records accessible will help in terms of the ability to connect records together and make them more visible to the clinicians looking after a patient.
Many of us would have concerns about the correcting errors, comments fine, they are after all the patient’s records, but the medico legal implication should mean that they cannot delete or amend a clinicians record.
2. PMS Reviews
On the 1st April 2014 all GMS practices started on a 7 year process to move to “equitable funding”. This will result in the MPIG funding is removed at a rate of 1/7 per year and then recycled into all GMS practices. It was expected that PMS practices would undergo the same process, but this has been delayed for various reasons.
The PMS reviews that are currently taking place will be implemented on the 1st April 2016 and will result in a 5 year programme of moving to “equitable” funding.
Any funding removed from PMS Practices will be retained by the CCG to invest across all practices.
Below is an email sent out by the LMC to all PMS practices this week
Thank you to those of you who have already made contact since receiving your letters and financial schedules in respect of the above.
Any changes to the PMS Contract must be by negotiation and at first sight the letter does not appear to offer negotiation. However we have spoken to the Area Team about this and will be working with them and the CCG over the next few months to ensure practices are given the ability to make representations.
Each practice must be given the opportunity to make a case as to what services they may be providing over and above GMS or to describe what ‘special’ population they serve. Any submissions of this nature will need to go to NHS England who holds the contract (unless there is a fully delegated CCG in place).
Given the above we believe that the time scale for submission of proposals is inappropriate and that practices need time to formulate these and discuss the financial schedules with their accountants. We are therefore advising practices to inform NHS England in writing that they will not be in a position to respond by 30th September 2015. We have already advised the Area Team and the majority of CCGs of this advice.
The LMC has not been provided with the financial schedules and it would be really helpful if you could email a copy of your schedule to us at email@example.com in order for the LMC to form a picture of the extent of the issue.
Please note that you do NOT have to sign a contract variation until 31st March 2016 and we advise that you do not sign anything until fully satisfied with the net position of your contract.
It should also be noted that any funding removed will be in equal parts over a 5 year period commencing in the 2016/17 financial year.
Many of you have requested a meeting to discuss your financial schedule and the next steps, we believe that the most efficient and effective way of meeting this need will be to hold a joint meeting with each practice, Area Team, CCG and LMC. We are therefore suggesting this to the CCGs who will take the lead in organising these meetings.
I hope the above provides some clarity on the current situation, I look forward to receiving a copy of your financial schedule and we will be in contact with any updates as they occur.
LMC Comment: This is a difficult time for all and it is difficult when income is threatened but even or so when we are in such challenging financial climate. The LMC will do all it can to help every practice.
3. Cancer care
About 30% of the population currently die from cancer which equates to about 170,000 patients per year and this means the average practice of 7,000 patients with have about 20-30 deaths from cancer per year.
More than 50% of patients are now surviving their cancer and therefore this means that there is a significant impact on patients, their families and general practice.
The LMC works closely with the local cancer networks and is planning a ½ day event in the New Year specifically to look at the new guidance for 2WW pathways and also the emergency presentation of cancer.
The RCGP is holding a meeting in the near future and a flyer is attached to this email.
The day is being held at Chilworth Manor on Thursday 1st October. The theme is early diagnosis.
The topics will cover the new NICE guidelines, working through cases, a discussions on Older people, TYA and exercise. The feedback from last year was very positive.
The RCGP has reduced the delegate rate to £125, and only £65 for WEGPT members.
If you wish to attend please contact: Victoria.Leason@rcgp.org.uk
The Macmillan PDFs summarising the new 2ww referral guidelines - first is suitable for mobile phone, second for a tablet.
Mobile - click here
Tablet - click here
Free Support for Cancer Patients in Wessex
Wessex Cancer Trust is a charity that offers counselling, therapies and practical support to people with cancer and their families. They have community cancer centres in the Isle of Wight, Southampton, Cosham, Hythe and Winchester. A new one in Chandlers Ford will open in October and further centres in Bournemouth and Salisbury will open early next year. The centres are for people at any stage of their illness, with any type of cancer, and of any age.
The charity also offers small financial grants, patient transport and holiday homes. Additionally it is piloting an exercise referral programme in Christchurch. Any GP can direct patients to the charity, either via the website www.wessexcancer.org.uk or by phone on 023 8067 2200.
4. Sessional GPs Newsletter
The August edition of the sessional GP newsletter is available here
One blog discusses the benefits of joining a local sessional GP group, another lists things you should consider before resigning, the third introduces Dr Faisel Baig (the newest member of the Sessional GP Subcommittee Executive), the fourth details a GPs difficult experience completing a ALS course and the final blog outlines how one sessional GP made sport their day job.
The CQC Duty of candour came into effect for all GP practices on 1 April 2015
This is covered by Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which sets out all of the Fundamental Standards. It aims to ensure that providers are open and honest with people when something goes wrong with their care and treatment.
When a service is meeting the duty of candour patients should expect:
A culture within the service that is open and honest at all levels.
To be told in a timely manner when certain safety incidents have happened.
To receive a written and truthful account of the incident and an explanation about any enquiries and investigations that the service will make.
To receive an apology in writing.
Reasonable support if they were directly affected by the incident.
If the service fails to do any of these things, CQC can take immediate legal action against that provider.
It is recommended that members read the mythbuster on the Duty of candour.
Dr Nigel Watson
Churchill House, 122-124 Hursley Rd
Chandler's Ford, Eastleigh
Hants. SO53 1JB (Registered Office)
Attached file: GPC-guidance-documents-9-Sept-2015.pdf
Attached file: Preventing-and-Surviving-Cancer-Agenda-Oct15-Draft.doc