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LMC Update 28th Jan 2018

Date sent: Sunday 28 January 2018

Christmas and New Year seems a long time ago and the peace and tranquility this brought to many is long forgotten.  

We seem to have entered the winter viral season with a vengeance.  Not only did the Australians "do us over" in the Ashes Test Matches but they have also sent us one of the more virulent strains of influenza for several years.

In my last email update, I shared with you my concern that the winter pressures felt by the hospitals was appearing in the media every day and it seemed that this was the only part of the NHS that was seen to be struggling, no mention of general practice.

The LMC decided to issue a press release that went to all the local newspapers, radio and television stations explaining that general practice was also under significant pressure.  As a result of this, many local newspapers ran stories about the winter pressure felt by GPs and this was linked to the current increase in the number of patients being seen with flu and importance of flu vaccination.  This led to several radio interviews, a couple with radio stations that I had never heard of and  I also did an interview for South Today and ITV Meridian. Hopefully this had four positive outcomes:

1. It helped the public understand that if there is pressure in hospital this is a reflection of the major increase in pressure that is felt by general practice.

2. Those in the at risk groups and who had not been vaccinated, should contact their practice and be vaccinated before stocks run out.

3. If members of the public are not in one of the at risk groups, flu vaccination is still beneficial and they can have this at their local pharmacy for a small charge.

4. This year flu is more virulent than normal and as a result there are more people affected, complication rates and hospital admissions are greater so even more reason why individuals should be vaccinated.

I recently met with the Dean of Southampton Medical School to discuss undergraduate training and how general practice is promoted in a positive way. The meeting was helpful and I was reassured at the prominence and positive experience of general practice that the students were receiving. This is very important as at least 50% of them will become GPs and in the future a significant number of traditional hospital consultants will be working with primary care in a far more integrated way.

Many practices take 3d and 5th year students and find it is a positive experience. I know in my practice we have both medical and nursing students and many of the GPs enjoy the teaching and interaction this provides. The funding for these placements has improved and is subject to national review  because with the expansion in the number of medical school places there will be greater need for community placements.  If you are interested in becoming a teaching and or training practice then please let me know and I will put you in touch will the relevant person.

In Wessex we have been successful in filling the posts for GP Trainees, which is good news as there are some areas that have not been able to fill them.  It is essential that GP Trainees get a great experience in general practice that offers experience, support and the atmosphere in the practice is one that is positive and is looking to the future.  It is therefore no surprise that the practices who are finding it easier to recruit GP partners (yes some are still able to do this) and salaried GPs are the larger, training practices who are forward looking and innovative.

In my previous emails I have referred to the "Next Generation of GP leaders programme", this was the brainchild of a GP Trainee, Dr Nish Manek, who was working as a GP Fellow with Dr Arvind Madan, Deputy Medical Director of NHS England. The programme was initially launched in London and attracted a number of GPs either in training or in their early years of being a GP and supported them over a 6-9 month period to meet on a regular basis and to invite various NHS Leaders to be interviewed or to discuss their experiences of being a leader within the NHS.  Wessex LMCs supported two of our younger GPs to attend this programme which proved to be very successful. 

Following our support for the programme, Nish approach the Deanery and the LMC to see if we would support a Wessex Programme, which we of course did. The second Wessex event was held recently which I was fortunately able to attend. For those who fear for  the future of general practice can I reassure you, the 60 plus GPs who attended were a breath of fresh air. They are at the begriming of their career and enthusiastic and full of energy and ideas, but unlike my generation when we started out as GPs they have a much clearer idea of what they want and how they see the future.

In my view we need three things to happen to have a bright future for the NHS and general practice:

  1. We need to invest in our future leaders and I believe this porogramme will create a number of future leaders, you can observe the group and already see a number of people who stand out.
  2. We need to make general practice a better place to work and that takes two things, firstly practices need to develop and evolve and embrace change and secondly the NHS needs to put additional resources in and around general practice to allow it to deliver the great services it is able to do.
  3. We need to listen to the new young leaders and how they see our profession developing. This does not mean you throw away the experience and wisdom of those who have been doing the job for some time but what the next generation are looking for may not be the same as those who entered the profession 20-30 years ago.

Wessex is clearly the place to be if you want a great career in general practice!

 

Contents

1. High Court ruling for Dr Bawa-Garba

This is the tragic case of a hospital paediatrician who has been in the news lately who was struck off by the GMC. The implication for all doctors is significant.

2. IT Conference 25th April 2018

IT has become an essential part of every doctors life working in general practice. Here is your chance to learn more about what you have in your practice and to gain an understanding of what may be available to you that you have not got at present.

3. General Data Protection Regulation (GPDR)

This replaces the 1998 Data Protection Act, should you panic now or wait and see what the real impact will be of this legislation?

4. Sharing records on TPP SystmOne Software

An update from the GPC and RCGP.

5. Sessional GPs

This provides a link to information for sessional GPs.

6. GP Trainees

Information available from the GPC's Trainees Sub-committee and also information encouraging Trainee GPs to become more engaged with the LMC.

7. Collecting GP Practice Demand Information 

8. Implementation of the 2016 junior doctor contract

Information provided by the BMA relating to contractual changes.

9. Guidance for GPs on working for online providers

GP at Hand and Babylon have been in the news quite a lot recently, although this is largely a London issue we are aware of more and more GPs working for online providers. The GPC have produced guidance which is shared with you.

 

1. High Court ruling for Dr Bawa-Garba

There has been widespread concern and anger from many doctors about this tragic case of a child that died in a hospital and the actions taken by the GMC to remove this doctor from the medical register.  

The BMA has issued a statement following the decision by the High Court in response to an appeal brought by the GMC. Dr Bawa-Garba believed that working without a break may have contributed to her mistakes, further highlighting pressures in the NHS.  The BMA is seeking an urgent meeting with the GMC as this case raises very serious concerns that will affect doctors from all branches of practice.

Dr Chaand Nagpaul, BMA Council chair, said "The case involving Dr Bawa-Garba is a tragic one and it is understandable that it has also triggered wider concerns about how we can continue to protect patient safety in the NHS and support doctors working in a health service that is under extreme pressure. As the GMC has recently stated, the medical profession is at a "crunch point" where a number of factors, from a lack of resources to staff shortages, are combining to impair the ability of clinicians to provide safe, high quality care. It is vital that these critical system pressures are addressed by politicians, as well as this being fundamental to the GMC's aim of ensuring patient safety.”

The Health Secretary, said in an interview on the Today programme, that “doctors need to be able to reflect openly and freely about mistakes they have made”.  He warned of “unintended consequences” of the ruling.  “Patients would be safer if doctors were able to learn from mistakes”, he said.  “In medicine, all over the world there are always going to be mistakes made. For patients to be safe, we need doctors to be able to reflect completely openly and freely about what they have done, to learn from mistakes, to spread best practice around the system, to talk openly with their colleagues. I want to make sure doctors are able to do that."  You can see and listen to the interview click here:  

 

2. IT Conference 25th April 2018

The LMC has held 3 very successful IT Conferences in the past and therefore by popular demand we are organising a further one. This will take place on Wednesday 25th April at St Mary's Football Stadium, Southampton.

There are significant developments happening at present including:

The draft agenda is attached, if your are interested and want to attend please book early to avoid disappointment - there are a limited number of places and when I looked over 40 places were booked within the first couple of hours of sending out the information.

Click here to book a place.

 

3. General Data Protection Regulation (GPDR)

I am all too aware of the concern that the imminent arrival of GPDR is causing to practices.

The EU's General Data Protection Regulation (GDPR) will apply from 25 May 2018, when it supersedes the UK Data Protection Act 1998.

There have been a number of emails circulated,  whereby individuals are putting their own interpretation on what GDPR will mean for practices.  

The area that causes me greatest concern is about sharing patient data.  

You are required to share patient data for the direct care of patients. This is embedded in the GMC Good Medical Practice Guidelines and reinforced by the updated Caldicott Guidelines. 

The LMC advice is that if you are compliant with current regulations on data sharing, do not change what you are doing at present. National Guidance for GPs relating to the GPDR is being worked on at present and I have been contributing to that in terms of the areas that needs to be clarified for general practice.  The guidance will be issued in the next few weeks.

At the LMC Conference there will be a session on GDPR with advice provided by a Barrister from LMC Law, Shanee Baker who specialised in all aspects of regulation as it related to general practice.

There is some excellent information on the LMC website, with the details of the headlines and top tips - click here .

 

4. Sharing records on TPP SystmOne Software


The BMA have worked with TPP and other relevant stakeholders, to resolve issues regarding the sharing of patient records in TPP's SystemOne software. Attached is more information regarding the resolution from the Chairs of the Joint GP IT Committee.

 

5. Sessional GPs

The latest Newsletter and other information that might be of interest to all sessional GPs - click here .

 

6. GP Trainees

The Local Medical Committee (LMC) represents and supports all GPs who work in the Wessex area, including GP Trainees.

If you have not received this email directly from us but were forwarded it from someone in your practice, you will not be on our database. If this is the case, then please send us your details to ensure you receive the appropriate information – email your name, practice details, to:  joanna.welch@wessexlmcs.org.uk

The GP Trainees Subcommittee is part of the BMA and has representatives sitting on the national committee of GPs - the General Practitioners Committee (GPC).

Please follow this link to the new GP Trainees’ Newsletter – click here - This will provide you with information about Capita and trainees pay, OOHs, Indemnity and the new Scottish GP contract.

Wessex LMCs is made up of  3 Committees:

As part of your training experience we would encourage you to attend an LMC Committee meeting, these take place 5-6 times a year. This is supported by the Deanery as an important part of your education and training. Dorset LMC meets on a Thursday afternoon and the other two committees meet on a Wednesday afternoon.

Each Committee has a place reserved for a GP Trainee to represent your colleagues. If you are interested then please let us know, email: laura.edwards@wessexlmcs.org.uk

 

7. Collecting GP Practice Demand Information 

I attend many meetings representing GPs, Practices and the wider view of the profession.  Many of these meetings are focused on the current pressures that exist locally and potential solutions.  These include the STP (Sustainability and Transformation Partnerships), Local Delivery Boards and emerging Accountable Care Systems (ACSs).  

We have been successful at getting a "seat at the table" so at least now our voice is being heard along with the hospital and community service.  

The major problem we are face  in these meetings is that the hospital will detail how busy they are and produce figures about;

All of this paints a great picture that there are insufficient funds being invested in hospital based care and they need more.

I then plead the case for general practice and state that:

There are then lots of sympathetic nods and smiles (although some are getting fed up of me keep raising the issue of general practice) , great I think they now get this it is not just about A/E or hospitals.  The key building block of the NHS is the registered list and the care provided by individual practices. 

Then the crunch comes:

I have probably just sat through a presentation of 20 - 30 slides all providing detailed information about everything that relates to the data that hospitals can provide but there is diddly squat about general practice.

I am sure practices are all too aware of hospitals declaring "Black Alerts" meaning they are under severe pressure and the system needs to be made aware so that alternatives to admission should be sought (as if we sit there in our practices, twiddling our thumbs thinking " I am a bit bored, what shall I do, I know I will admit a couple of people to hospital"!

Wessex LMCs works closely with all the LMCs in the South West and we are looking to collect data from practices to help us to support you.  Somerset LMC are leading on some work in trying to extract information to establish the demand in practices on a real time basis which would enable practices, localities or larger groups to declare when they are on "Black alert".

We are also contributing to some national discussions relating to workload.

In Wessex there were over 20 million patient contacts with general practice in the last 12 months. We need to have a better idea for example what the urgent care demand is on a particular day.

 

8. Implementation of the 2016 junior doctor contract

The BMA continues to support GP practices and trainees with the implementation of the 2016 contract.

They have produced extensive guidance and materials that can be found on the BMA  website , and also continue to provide detailed advice to BMA members through their first point of contact service which can be contacted via 0300 123 1233 or support@bma.org.uk  

A GP practice helpdesk was also set up by NHS Employers to assist with initial implementation queries. However, as arrangements are now more established, NHSE will be withdrawing their helpdesk service on 31 March 2018.

 

9. Guidance for GPs on working for online providers

The GPC has recently produced some updated guidance for GPs - click here to view.

 

Best wishes

Nigel

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

www.wessexlmcs.com

 

Attached file: Draft Agenda V3.docx

Attached file: 18.1.26 TPP update.pdf

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Updated on 28 January 2018 445 views