Tuesday, November 24, 2015

GPC Report 19 November 2015

GPC Report
For East and West Sussex LMCs
Dr Russell Brown
19th November 2015

The GPC held its latest meeting on 19th of November.  

The meeting began with the news of the junior doctors ballot result, which has provided their leaders with an overwhelming mandate going forwards. The unfortunate intransigence displayed by Jeremy Hunt is unhelpful. Since the meeting I understand that the Department of Health have approached ACAS to demonstrate their willingness to engage.  Whether this is with Mr Hunt's knowledge or blessing I know not. 

The meeting ended (I will return to the middle bit in a moment) with a motion being passed unanimously, with the motion being displayed below in an unusual photo from within the BMA Council Chamber. Ordinarily there are automated sentry guns monitoring use of electronic devices by GPC members, authorised to use lethal force against transgressors.

CQC fees consultation: GPs can apparently not be treated differently to any other providers, and given the Government is removing much funding from CQC as they should be self funding (as in, paid for by us) they have suggested a seven-fold increase in fees, phased in over either two or four years. Given the incompetence of the organisation, the lack of any evidence of benefit whatsoever and the huge cost the very concept of such an increase is staggering.  The DH has apparently found £15M down the back of the Departmental sofa with which to reimburse GPs, but we are not entirely sure either how they have calculated this nor whether that money is recurrent and adjustable for future increases assuming CQC continues to exist in some form. I should perhaps say that I have no idea whether there are any plans to scrap it but I live in hope. In fact I was asked by one of the patient representative observers at GPC what I thought the CQC should be replaced by. I suggested that the millions wasted would be better spent on patient care and supporting services towards excellence rather than wielding a punitive clipboard. Inspection regimes are a waste of time: if you inspect and a service is good, why bother? And if it is bad or worse, you've missed the boat and should have intervened earlier.

The Premises Infrastructure fund is proving interesting. Schemes and payments will be allowed to slip but there is an intention by NHS England to make sure the entire billion is spent but how that will equate to local procedures is uncertain.  Going forward, bids will need to be made by CCGs and not practices.  This does not seem unsensible, as any new building will need to be designed with local needs and priorities in mind.

The escalating costs of indemnity for GPs is a matter of concern not only for GPC but also NHS England and the DH, if only because it is another pressure which will likely stymie their plans if not addressed.  It is being discussed on a regular basis but whether any solutions come of it remains to be seen.

Reducing bureaucracy has taken a step forward with the announcement by Jeremy Hunt recently, as a direct result of conversation between him and GPC representatives, that hospitals will in future not ask for a further referral if a patient fails to attend an appointment. I understand there is to be a clause written into the standard hospital contract, which I am sure will be a great comfort to you all.

A meeting with my own organisation, Resilient GP, was reported. Though we were described as a pressure group when we are actually educational and supportive, the meeting was useful for both organisations and, unsurprisingly, there was to quote Chaand a "staggering amount of common ground”.

A contract working group has been set up by NHS England.  This is not to discuss and sort out the GMS/PMS contracts but to discuss a way forward for the new Multi-speciality community provider models, considering both how they can be contracted to provide services and how organisations such as General Practices might fit into them without there being too much destabilisation.  Indemnity issues have been raised again and there is recognition within the NHS that this will cause significant problems for them if not resolved.  Numerous solutions have been proposed but all come at a not inconsiderable cost.

Negotiations for the GP Contract 2016/17 have begun and almost immediately stopped again until after the details of the comprehensive spending review are formally announced.  Colleagues will be aware of the announcement on Tuesday 24 November of an extra £3.8 billion.  Interestingly, a quick back of an envelope calculation would suggest that, with the changes to National Insurance contributions being brought in, roughly £2 billion of that will head straight back to the Treasury…

A Special Conference of LMCs has been announced, likely to take place in January or February 2016.  The LMC office has already written to practices about it and more details will be shared in due course.  I am sure this will be on the agenda for LMC meetings in the next couple of months.

GPC is also looking at how to encourage more Early career GPs into medical politics, to improve the number of less experienced GPs and motivate and develop the leaders of the future.

There was a discussion about how an activity based GP contract might be made to work, after last yer’s LMC conference passed a motion proposed by Kent LMC suggesting it as a way forward.  I find it difficult to see how this can be progressed, given it doesn’t fit with the current direction of travel espoused by both the DH and Government but it is being examined.

The “official” GPC news can be found at the BMA Communities website. 

The next GPC meeting is scheduled for December. 

I hope you have found this report helpful.  Please feedback so that I can ensure my reports are useful.  Feedback is always appreciated

Dr Russell Brown