Monday, December 21, 2015
For East and West Sussex LMCs
Dr Russell Brown
17th December 2015
The GPC held its latest meeting on 17th of December.
As ever, much of the contract negotiations information imparted to us is confidential. However it is worth noting that the NHS £3.8 billion increase announced in the comprehensive spending review has at least a proportion coming to general practice. Details of how this will be spent are as yet unclear. Colleagues may be aware that already £1.8 billion has been ear marked to essentially bailout acute trust deficits.
Scotland on the other hand have concluded their negotiations with QOF moving into core payments in 2017. Indeed there is much that could be admired and indeed emulated in the Scottish agreement.
A survey undertaken by the BMA on the primary-care infrastructure fund found that the situation is fraught with delays and threats even to funding approved schemes. There seems to be some difficulty with NHS England realising that they need to be funding revenue costs going forward rather than simply providing a pot of money at the outset
Indemnity costs have been considered but seemingly only superficially: £2 million has been ear marked by NHS England to help offset the costs of working in an out of hours setting this winter. It is unclear how this will be allocated presently but no doubt that will occur seamlessly and with an elegant simplicity. This obviously won't help in the longer term.
A Multi-specialty Community Provider contract advisory group has been set up. This is not to design a new GP contract but rather to try and properly formulate the environment in which MCPs will work. The presence of the GPC on this group has been moderately effective in emphasising the need for how any contracts will affect primary care to be addressed. The group does not appear to be hostile to general practice.
The atrocious comments written by Professor Steve field in the Daily Mail has resulted in a vote of no confidence by GPC. I have no doubt that, satisfying as it is, absolutely nothing will happen as a result. I understand the Royal College also posted a highly critical response. Quite how he thought this would improve the standing of CQC in the profession's eyes is beyond me.
The Special Conference of Local Medical Committees will occur on 30 January. By the time you read this motions will already have to have been submitted by the LMC. We will see what the agenda committee make of everything but I anticipate that there will be half a dozen themed debates during the day.
In the afternoon there was a presentation by Dr Arvind Madan, the new Director of Primary Care at NHS England. His previous work experience includes being a partner in the Hurley group and being an owner of WebMD. I understand his conflicts-of-interest have been appropriately managed since his appointment in the Department of Health. The presentation was apparently confidential though nothing was said that is not already in the public domain. Given there is a degree of agreement between NHS England and GPC, there was no surprise that much of what he spoke about was to do with workforce and workload. After his presentation there was a question and answer session during which the inestimable Dr Katie Bramall-Stainer from Hertfordshire was extremely clear with him exactly what we all thought. Unaccountably, he was not at the traditional post-December GPC mince pies and mulled wine event.
During the afternoon 4.2% increase in funding for general practice each year for the next few years was announced by NHS England via Pulse Today. Although this has been trumpeted as something of an improvement it actually simply allows us to standstill at current levels of funding taking inflation into account.
The current edition of the official GPC news is available at the BMA communities website here.
Other than that I hope you all have a peaceful and satisfying festive season, however you choose to celebrate it. All of us will be working for at least some of the time over the Christmas period, at a time when many of our patients will no doubt be grateful for our presents (sorry, that was appalling). I am keeping my fingers crossed for an improved 2016!
The next GPC meeting is scheduled for February.
I hope you have found this report helpful. Please feedback so that I can ensure my reports are useful.
Dr Russell Brown
Tuesday, November 24, 2015
Tuesday, October 20, 2015
Saturday, September 26, 2015
Tuesday, July 28, 2015
- GPC is looking to set up some kind of emergency practice support fund to try and proactively avoid a crisis in a locality which may then result in a domino effect.
- the formula review group looking at the Carr-hill formula includes representatives from GPC but is in the very early stages of work. There is also a parallel work stream going on to look at atypical practices. This may be ready for 2017-18, but will be subject to review and agreement. Practices should not depend on the review from making any long-term decisions on funding.
- Workload and efficiencies: monitoring and quantifying GP workload is needed to help in negotiations and for our DDRB
- Gp networks: work continues to facilitate the development of GP networks including the development of the database of organisations
- in November there may be regional meetings as pilots of GPC and LMC’s meeting together. It will be interesting to see how this works
- premises: GPC is in the middle of negotiations about the Reformation of regulations. The standard lease is still a work in progress but should be ready soon. In the meantime practices should not sign any lease without checking with the LMC and their own independent legal advisers.
Friday, March 27, 2015
We are seeking a six session Partner to replace a Partner who is relocating due to family circumstances, from 5 October 2015. Salaried positions with a view to Partnership would be considered. We are keen to introduce further dynamism into our established but forward thinking team. We are a friendly, well regarded, and high performing GMS Practice of 6,400 patients, served by 4 Partners (3FTE) from two surgeries, both of which have their own bean-to-cup coffee machines. Both premises are rented with no "buy-in" and prospect of major new development for main surgery in collaboration with neighbouring practice in the next 2-3 years. No extended hours.
Saturday, March 21, 2015
For East and West Sussex LMCs
Dr Russell Brown
19 March 2015
The GPC held its latest meeting today. In two parts, the morning was GPC proper with the afternoon being group sessions to discuss the future form and function of the GPC with particular reference to its relationships to LMCs. I discovered this week that in an uncontested election I was returned as your representative to GPC for another three years. I am delighted to be able to continue with this element of my work though I am always a little uneasy about uncontested elections. I have chosen to believe that you, my constituents, think I am doing a good enough job that you are happy to leave me to it and so would like to say thank you for your continuing supportive comments and feedback.
As usual, the first part of the meeting was a report from the Executive Team on recent meetings and negotiations. Much of this focused on the recently announced "pay rise" we have all been given, with a 1.16% increase in funding. It would be fair to say the formula for calculating expenses is pretty hopeless, a fact acknowledged by the DDRB. Work is ongoing to attempt to address the weaknesses of the calculations, as well as pension issues, given yesterday's Budget announcement reducing one's lifetime allowance cap further, which I suspect will catch a large number of GPs (eventually). Standard advice to seek independent financial advice from someone with expertise in the NHS pension scheme/s applies. The returners scheme is still causing problems all over the country, with one example cited of a GP from New Zealand, UK trained but a Fellow of the RCGPNZ who, because of the labyrinthine processes, is unable to start working for six months. Apparently he was advised by someone in NHSE that he could always go and do some locums in A&E while he was waiting!
Discussion was had about the results of the recent GP survey, which had a remarkable response rate. The results are likely to be published in the next few weeks and months but will I have no doubt strongly support GPC's position in discussions with Government. There have also been two patient events, where groups of patients have contributed ideas to what the future of General Practice should be. Results are currently a closely guarded secret but there are several common themes which will be described in due course with the survey results.
A discussion paper on future models of service provision which I had previously been involved in the writing of as Deputy Chair of the Commissioning and Services Development Subcommittee was discussed and will be developed further. GPC will be observing the progress of the 29 vanguard sites with a beady eye. I forget if I mentioned last month that, in Ancient Rome, the vanguard were traditionally slaughtered to a man. I offer this only as an observation on classicism.
A move towards demanding recognition of our craft as a Speciality in its own right is on the cards. Apart from Austria and Italy, we are alone in Europe in not being recognised as such, despite leading the world in the quality and breadth of the training and service we provide. The RCGP are partners in this with GPC, so perhaps news soon.
The afternoon session will hopefully result in a proposals paper being presented to the Annual Conference of LMCs, to be held in May. Fingers crossed.
No doubt the official GPC news will be published shortly. It will be available through the BMA Communities web site. Additionally, the most recent Sessional's newsletter has been published on the BMA website.
I hope you have found this report helpful. Please feedback so that I can ensure my reports are useful. Feel free to email me on email@example.com if you would like to comment or ask me anything. Comments can also be posted on my blog where this report will also be posted at www.thebrownstuff.blogspot.com
Dr Russell Brown