For East and West Sussex LMCs
Dr Russell Brown
18 October 2012
This month was a meeting in two parts. The morning was spent in various subcommittees. I am a member of the Commissioning and Services Development Committee, which has a very wide brief.
Discussion was mainly about the ethically rather dubious incentive schemes being published in a variety of places, Harrow being a particularly harrowing example. These schemes aim to directly financially reward GPs for reducing referrals. This has obvious (I hope) implications. The GMC, when asked for comment, were not terribly helpful. I suspect any GP signing up will be on their own if anything untoward happens as a result of schemes like this. The BMA is intending on making it clear what it considers ethically appropriate. It is conceivable this will exceed what the GMC suggests is acceptable. I must confess to some confusion as to why the GMC is not being more clear in its position.
The other main topic under discussion was performance management of primary care (for which read general practice). The relevant team from the DH have been meeting with a small group of LMC secretaries to discuss how this may work. It should be noted that these are not negotiations, more of a feeling the way forward. The LMC secretaries concerned are being robust in their feedback. Eventually, these meetings may pave the way for negotiations about how to might work in a useful way. In the mean time, I recommend that GPs get in the habit of practicing the following mantra, so it can be recited at appropriate junctures, making any appropriate deletions: "My professional registration is with the GMC. My GMS/PMS contract is with the PCT/LAT. I have a contractual obligation to be a member of a CCG. And that's it. Further queries should be discussed with the LMC." We seem to have very good liaison with local emerging CCGs, so hopefully you will never need to use it. I will let you know if anything changes on that front.
There was a brief discussion on the commissioning of Local Enhanced Services. To reaffirm, unless a single contract is going to exceed £100,000 there is no need to go to tender. There is also no requirement on CCGs to use either the AQP route or competitive tendering. In e context of a LES, the contract size depends on the size of the practice, not on the size of the budget. So a budget of £250,000 does not require tendering if all practices will be taking part in a LES, as the individual contract with each practice will be under the limit.
The afternoon session was the full GPC meeting.
The need for confidentiality was repeated, forcefully.
The GP IT Subcommittee reported that work is ongoing to try and make the transition of GP IT support services as painless as possible. Many of the problems arise from the fact that the amount of funding in many areas is uncertain, so many PCOs are unable to tell the NHSCB with any certainty how much money it needs to budget for these services.
I will now report on other matters, including the current state of negotiations for GMS/QOF for 2013/14, as far as I am able to:
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I hope this report is useful. Please feed back any comments if you would like me to present it differently. Additionally, if you have any matters you wish to discuss or that you would like me to raise at GPC, please contact me by email at my email address, which I'm not posting on blogger :)
Dr Russell Brown
GPC and Chair East Sussex LMC