Friday, March 21, 2014

GPC report 20 March 2014

GPC Report
For East and West Sussex LMCs
Dr Russell Brown

20 March 2014

The GPC held its latest meeting today. 

Negotiation report
As usual, much of this part of the meeting was confidential.  
Contract 2014-15 Under sustained pressure from our negotiators, guidance on the contract changes for the next financial year should be out soon, after various last minute changes were rejected.  Likewise, guidance for the Unplanned Admission avoidance DES has been delayed as certain changes were proposed and rejected.  I understand the guidance will reflect the agreed position of some months ago. The GPC guidance documents have been ready for some time but need to be published after the "official" joint guidance documents that are published. Jeremy Hunt has said that there will be £5 per patient made available to further support the work around the Unplanned admissions DES.  However, it is likely that this money already resides within CCG budgets, albeit unbadged. LMCs will need to work with CCGs to ensure practices can access this money for their patients' benefit. Locally, I suspect there will be positive, proactive discussions.  Nationally, the picture is distinctly patchy. 
DDRB announcement We will be getting a 0.28% uplift, which is supposed to deliver a 1% rise in income for GPs. This figure has been arrived at because expenses have apparently fallen, a situation I do not recognise.  What this means is that the system for calculating expenses is flawed.  We are pressing for a review of the process to ensure the formulaic approach reflects reality in future.  The negotiating team are continuing to press hard on this.
MPIG/PMS reviews This is still chaotic, we continue to express dismay and anger that it is not sorted out.  There is a ready reckoner produced by NHS England to help practices get some idea how they will be affected.  I am not sure how accurate it is given the assumptions it makes.  However, my own non-MPIG practice would appear, on the face of it, to LOSE £6k per year, which seems odd.  NHS England persists with the fiction of local resolution of the PMS review process, given they are locally negotiated contracts, albeit with a de facto national "solution" to the differential funding “problem” between PMS and GMS practices.  Work is ongoing to ensure the £235M identified as NOT being mappable to additional work remains within General Practice.
Premises Work is ongoing, with discussions with health ministers.  They are aware their wishes for service changes will not work without some kind of premises strategy. Expect news at some point before the next general election...

Structure and function of GPC
Changes to nomenclature and processes were debated.  An attempt was mounted at the outset to have all the suggestions adopted en mass, facilitating an early lunch.  Sadly, my suggestion fell on deaf ears and lunch took place two hours later.
After last month's discussion with Tim Kelsey, Tony Calland, the chair of the BMA's Ethics Committee, presented further information on and it's implications.  There was a broad-ranging and lengthy debate.  The delay on extractions provides an opportunity to influence how this works.  It should be allowed to work, as it is potentially a valuable research tool.  Negotiations about potential changes are ongoing.

ICM perceptions survey
HPERU presented a summary of th results of a BMA perceptions survey, covering public perceptions of the NHS and GPs in particular,  As usual, we do well.

The latest edition of GPC news will be on the BMA website at soon.  I suggest bookmarking the URL as in future GPC news will be published there, often on a more frequent basis than in the past.

The next meeting is to be held on 17 April 2014.  I hope you have found this report helpful.  Please feedback so that I can ensure my reports are useful.  Feel free to email me 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

Dr Russell Brown