GPCE report 20 May 2021

 GPCE Report

For East and West Sussex LMCs

Dr Russell Brown

20 May 2021

GPC England met remotely this week.  This was the first meeting after the recent LMC UK conference.

There were verbal reports from the Exec/Policy Leads, Sessionals and Trainees committees and a written report will be sent out to LMCs shortly after the meeting.  There was also a verbal report from Dr Rachel Ali, the GPC’s gender champion. She is assisting SSLMCs in our own development of a similar role for our federation of LMCs.

The main item for discussion was the emergency motion regarding the NHSE letter of last week about face to face appointments, seconded by our own Julius Parker which you may have seen reported in Pulse before the meeting, below:

GPC England is outraged by NHS England and NHS Improvement’s lack of understanding of the pressures facing General Practice and:  

1. Calls for formal BMA action by escalating concerns about NHS England’s apparent lack of knowledge of the applicable contracts and regulations relating to the delivery of General Practice services 
2. Seeks both senior explanation and public action from the Department of Health and Social Care in view of the unacceptable decision to publish letter BO497 on 13 May 2021 
3. Has no confidence in the Executive Directors of NHS England 
4. Calls upon the Chair of BMA U.K. Council to support the Chair of GPC England in demanding an urgent meeting with the Secretary of State for Health & Social Care, to discuss the spiralling crisis in General Practice 

v)   Calls for GPC England’s Executive to immediately cease all formal meetings with NHS England until a motion is brought back to GPC England by the Executive, requesting a vote on their recommendation that sufficient steps have been taken to restore the Committee’s confidence in the Executive Directors of NHS England, to justify the resumption of such meetings.

This is an issue I would describe as probably the most important vote I have contributed to in the time of my GPC service.  The anger in general practice from clinicians and non-clinicians alike has been palpable.  I am delighted to be able to report that the motion was passed in all its parts, with at least an overwhelming majority.  (There were two abstentions for iii and two votes against for v, with 55 GPC members being able to vote on this occasion, the stem and other parts were passed unanimously. It should be noted that voting is anonymous.)

Workload pressures were discussed after the themed debate at the recent LMC conference.  Next steps are being formulated but the new contractual obligation on CCGs and trusts in the NHS Standard contract to develop a meaningful primary-secondary care interface system is promising.

The issue of whether Sessional GPs should be represented as a separate branch of practice to the rest of GPs was discussed. It should be noted that sessional GPs now form the biggest group of GPs, with contractors being the minority.  

A Contract negotiations update was given.  Obviously, future discussions may be delayed after the passing of the motion in the morning session.  Ongoing support for COVID-related matters, an inadequately resourced obesity and overweight enhanced service and updates on the position on new PNC service specs and IIF indicators and an Access offer (the combination of extended hours and access) were discussed.  More details as things get fleshed out.

Issues for Dispensing practices were also discussed.  This includes a relatively small number of practices in Sussex than in other areas but dispensing services are vital to some communities and practices, especially those with a high rurality.  Meetings are being sought at a ministerial level to try and resolve some of the issues, which include reimbursement/EPS, the now defunct Falsified Medicines Directive, deductions after scripts were not signed by dispensers (especially at the start of the pandemic lockdown periods) and the Green agenda (in that the drug tariff will now be available online and not printed each month).

GPC has once again written to NHSE about the parlous Gender Identity Development Services commissioning arrangements or, more accurately, their lack. 

Finally, the recently motions passed at LMC Conference were discussed briefly in terms of how they will fit in to policy group work streams.

After GPC, I attended a meeting of the Representation Policy Group, where we discussed the sessionals branch of practice issue mentioned above,  a survey of LMCs, an update on the GPC UK review, multi member constituencies and standardising standing orders across the GPC committees.

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

Dr Russell Brown

GPC UK and GPC England report 18 March 2021

 

GPC UK and GPC England report

For East and West Sussex LMCs

Dr Russell Brown

 

18 March 2021

 

GPC met in 2 parts today. The morning session was GPC UK meeting in the afternoon session GPC England meeting. Technically, this was the last GPC UK meeting for this session of the BMA year. This would normally be until July but as the BMA ARM has been postponed until September, the session finishes then. However there will be no further GPC UK meetings between now and then. There are 2 more GPC England meetings in the current session.

 

At the time I write this report, we are in the closing hours of the election for the next 3 years of your GPC rep. I stood again and I was delighted that Dr Andrew Sikorski also stood. This is the first time I’ve had a contested election in a little over a decade so regardless of the result I would like to thank Dr Sikorski for sticking his head above the parapet alongside me.

 

GPC UK

 

There has been much work going on in the background between the GPC Executive and the policy leads. A lot of this is summarised in the latest GPC newsletter which is available on the BMA website at https://www.bma.org.uk/what-we-do/committees/general-practitioners-committee/general-practitioners-committee-uk-overview

 

There was a lengthy and complex item on the changes in the NHS pension scheme after the recent age discrimination decision by the courts against the government. Neither the LMC nor I are regulated financial advisors so any advice we give will be limited to speak to regulated independent financial advisor about your pension! However it would be fair to say that there is ongoing work both in terms of providing guidance to GPs and their accountants or financial advisors and in conversations with government about fairness and Equity with other members of the NHS pension scheme. There are likely to be several levels of support from the BMA, both for non-members and members though as you might expect members are likely to get an enhanced package of support. Given the complexity of GP pensions it may well be that there will be a need for extra expense for advice and at the moment I am not clear whether this will be something that the government pays for, the BMA pays for all that GPs will have to fund themselves. No doubt we will have more pensions information from the BMA in due course, some of it possibly even comprehensible.

 

A working group is being set up involving people within and without GPC to look at the future structure and function of the committee. This will involve a variety of people including some grass roots LMC members.

 

 

 

GPC England

 

The current GPC executive team were reappointed recently. This was advertised in several communications over recent months.

 

There has been significant ongoing meetings with NHSEI to discuss Covid related matters including the vaccination campaign, which has been remarkably successful. I think all of our colleagues involved in the provision of that service should be congratulated. Personally, I remain concerned about the sustainability of the scheme especially given that we are having to move back to something more resembling business as usual (though NHSEI are clear that “BAU” does not mean pre-pandemic BAU) in the next few weeks. For example there will be no protection for QOF this year. Remote reviews however will be an acceptable way to deliver this for most patients.

 

However the GMS contract deal has included minimal changes from April and there will be no further IIF indicators or additional PCN services introduced before October 2021.

 

Vaccination phase 2 planning is proceeding and by the time you read this PCNs will have had to decide whether to move ahead and vaccinate people in cohorts 10-12, the 18-49-year-olds. Colleagues choosing to do so will need to provide assurances to the CCG is that they can continue to deliver clinical services to patients including QOF.

 

There have been discussions about VAT on “services” and staff involved in PCN work. The executive team have written to ministers to see what mitigation on VAT obligations can be put in place, if any. There is still much uncertainty about a variety of issues around ARRS staff and the training needs for example and dialogue continues between the executive team and NHSEI.

 

Colleagues would have seen Julius’s recent communication about appraisals locally. National discussions about this continue.

 

CQC are considering restarting inspection of practices but have revised the position several times already. They appear to be concentrating currently practices who were previously graded as “inadequate” or “requires improvement”.

 

There was an update and discussion about the ICS white paper. It would be safe to say there is still a significant amount of uncertainty and BMA and GPC both continuing to work on making sure that GP representation is adequate and based around our statutory representative bodies, namely the local medical committee.

 

There was also discussion around shared parental leave which received broad support although there are some issues in the SFE. My feeling is that these should be addressed so that shared parental leave becomes the norm rather than a benefit.

 

The GP gender pay gap persists for several reasons. For salaried GPs the gap is 22.3% but even partners have a 7.7% gap. The committee discussed ways in which to develop a negotiating position to attempt to move things forward. Again, although the concept is simple working our way through it appears to be very complex. Again, a personal view is that I find it in comprehensible that anybody would treat colleagues differently based simply on their gender.

 

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

 

Dr Russell Brown