Local Matters

Cambs LMC Virtual Open Meeting – Tue 29 April 2025

Cambs LMC will be hosting a virtual Open Meeting on Tuesday 29 April at 7pm, delivering a briefing on the ‘2025/26 National GP Contract & Local Commissioning Briefing’. A next steps discussion focusing on:

• What’s new?
• 2025/26 GP Contract
• 2025/26 Local Commissioning Arrangements
• Next Steps
• Questions

Register here

Local Commissioning Agreement

The ICB Local Commissioning Agreement has been sent out with an extended sign-up deadline of 30 April 2025. Thank you to practices who have already sent in questions in to us. In light of the changes to the agreement which now pays for more services on a tariff basis we would encourage practices to use this time to review the funding offer against their practice populations and cost of providing the services. Please send any further questions or queries to office@cambslmc.org and we will collate responses and provide feedback over the next couple of weeks and at the Open Meeting.

National BMA Update 

Local action: Stay safe, stay organised, stay united

GPC England’s national dispute with Government may be over, following the acceptance of the 2025/26 contract, but the importance of local action to resolve ongoing commissioning gaps continues. Read the BMA’s latest local action guidance on their GP campaign page.

The BMA continue to strongly advocate for safe working and encourage practices to identify unfunded and underfunded work in their areas and to engage in local action to address commissioning gaps. When locally commissioned pathways fail or there are service gaps, practices should initiate re/negotiations, via their elected LMC representatives, with ICBs to secure appropriate resourcing.

Practices who are undertaking under/unfunded work should either be fully resourced, to ensure patient care – for some of the most vulnerable people in society – is sustainable, or, with the support of their LMC, consider serving notice to ICBs. LMCs are integral to facilitating fair and effective local agreements between practices and commissioners – supported by BMA national advice and resources. This is simply business as usual local action, coordinated by your LMCs, which has been happening for many years.

The BMA safe working guidance continues to be GPC England policy and is regularly updated. New planned 2025/26 contractual asks, such as patient access to e-consultations for routine care as well as requesting fit notes or medication queries, does not mean GP practices must offer unlimited capacity that jeopardises patient or staff safety.  The safe working guidance includes template letters which help practices manage workload and limit capacity to deliver safe, high-quality care.

All colleagues are encourage to read GPC England’s guidance on the 2025/26 contract changes, where further additional related guidance will be added in the coming days and weeks.

GP Contract Webinars 2025

All colleagues are invited to join the BMA to hear the GPC England Officer team discuss the detail of the changes in the GP Contract and its funding for 2025/26. After the presentation there will be time for questions and answers.

• Wednesday 9 April           19:00-21:00                        Register here
• Thursday 10 April             12:00-14:00                        Register here
• Wednesday 23 April        19:00-21:00                        Register here
• Thursday 24 April             12:30-14:30                        Register here

Read more about the contract changes, BMA advice and the webinars: GP contract 2025/26 changes

National Insurance Contributions Bill

The Government has continued to reject Lords amendments to the National Insurance Contributions (Secondary Class 1 Contributions) Bill which would potentially exempt GPs from ENICs (Employers National Insurance Contributions) increases. They have used the reason that the Lords Amendment ‘interferes with the public revenue’ which is inappropriate as the elected chamber The Commons has final say on tax and financial issues (a position dating from the Parliament Act 1911) and has used its majority to push the Bill through. The Bill will now receive Royal Assent, becoming law on 3 April 2025.

Over half of GPs in England have missing years of pensions data

BMA’s recent Freedom of Information request has revealed that 56% of GPs in England have missing pensions records up to 2022/23, with 156,896 years of pension data missing in total. This matters because without your pension record being up to date you cannot determine potential tax charges and whether you can increase work without penalty, nor make informed decisions about your pension savings. This is also important for those affected by the McCloud remedy. The BMA have highlighted Capita’s failures in the media and calling for an urgent solution to this significant issue.

The BMA continue to meet with Capita, NHS BSA and NHSE to put pressure on them, and although we had verbal commitment that they will write to affected members with specific personalised information in relation to missing years in pension records, no timeline was provided. Whilst the BMA firmly believe this is a problem that Capita, NHS BSA and NHSE need to work together to resolve, you can also take action to make sure your record is up to date and encourage you to do so and the BMA have produced step-by-step guidance to help you.

GP pressures

The Sessional GP Committee (SGPC) has opened voting for 16 elected members of the committee. Election counting rules will be applied to ensure that a candidate will be elected from each of the committee’s thirteen regions. The committee’s regions are based on the BMA’s ten English regional councils, in addition to one representative in each of Scotland, Wales and Northern Ireland.

Voting will close at 12pm on Monday 14^th April 2025. For more information on these elections, please visit the BMA Sessional GP Committee webpage.

Rotational training survey

The BMA, as part of the pay offer to English Resident Doctors, has agreed to undertake a review into rotational training with the UK Government. Additionally, the BMA is in discussions regarding reforms of rotational training in Scotland, Wales and Northern Ireland that are separate to this review. Rotational training is the current form of training whereby resident doctors ‘rotate’ between trusts/health boards and, in many cases, employers across their training programme.

In order to ensure the BMA can achieve the best possible reforms to the system, we are asking GPs who are educational clinical supervisors to respond to some questions about the role. The survey asks about the rotational training system from your view as an educational clinical supervisor for rotating doctors, which will inform how the BMA can deliver substantive, useful changes. Take the survey here.

GP focus group – primary care provision for refugees and asylum seekers project

As part of a project to improve the provision of primary healthcare to people seeking asylum and refugees, the BMA’s International team will be holding a focus group online on 4 June 2025, 14:30-16:30. Input from the group will help lobby the government to better support doctors in providing high-quality healthcare, and inform updates to the BMA’s Refugee and Asylum Seeker Patient Health Toolkit.

If you would like to attend the focus group or find out more, contact info.international@bma.org.uk.

Cambs LMC Virtual Open Meeting – Tue 29 April 2025

Save the date for our next virtual open meeting where we will be delivering a 2025/26 National Contract and Local Commissioning Arrangements Briefing.

Registration and joining information is to follow

Cambs LMC GPAS Monthly Highlight Report – March 2025

View full report here

GPC England receives commitment to full renegotiation of a new GP contract

On the 27^th February GPC England (GPCE) voted to accept the 2025/26 contract changes contingent upon written assurance to the profession from the Secretary of State Wes Streeting around a new substantive GP practice contract being negotiated in this parliamentary cycle.

Last week BMA received the Government’s commitment, in writing:

“to working with the GPC England to secure a new substantive GP contract within this Parliament, without preconditions, based on collaborative work, and in the spirit of mutual trust and good faith, with general practice at the heart of a neighbourhood health service”. Read the letter >

This means that BMA can now fully accept the 2025-26 contract changes. Online contract webinars and guidance are being developed to help support practices and GPs in better understanding what these changes will mean. BMA will be sharing more guidance and FAQs about the 2025/26 contract very soon.

GPCE believes that the 2025/26 agreement and written government commitment to the negotiation of a new GP contract, are important first steps of a longer journey of recovery and rebuilding of trust.  BMA hopes that this signals the start of a relationship reset, where the Government is listening to GPs’ concerns and acting on them.

GPC England met on 20 March, where next steps on key aspects of the 2025/26 contract were discussed and it looks forward to working with the Government on a new substantive contract to provide hope, safety, and stability, for our patients, staff and the future of general practice: enabling the return of the family doctor.

BMA offers sincere and deep thanks to everyone who has helped by their efforts in taking collective action.  Without you and your hard work this would have not been possible. Many of the items on the collective action menu are superseded by the 2025/26 contract. BMA will be focusing on what is needed locally and  strongly recommend practices follow safe working guidance.

Practices are advised to continue to engage with their LMCs and negotiate and secure appropriate resourcing to support the delivery of safe patient care, helping to stop patients falling through gaps in local commissioning.

These 2025/26 changes represent an important first step towards the recovery of General Practice services in England and set us on a path towards making NHS general practice once again the jewel in the NHS crown.

Read the press statement and watch Dr Katie Bramall-Stainer’s speech to conference:  https://www.youtube.com/watch?v=eEr6bHnHjMM

Declaration of completion for ‘simpler online requests’ in the 2024/25 PCN DES

As part of collective action, GPC England has previously advised practices and primary care networks (PCNs) to defer signing up to the 2024/25 PCN DES (Directed Enhanced Service) CAIP (Capacity and Access Improvement Payment) voluntary incentive component – “simpler online requests”, which requires PCN member practices to enable patient access for e-consultations with the intention of this being available throughout core hours.

Now that agreement has been reached on the 2025/26 GMS and PCN DES contracts, BMA advises PCNs and practices with outstanding claims for this component of the CAIP incentive, if they wish to accept this requirement, to submit their claim ahead of the March 31^st 2025 deadline.

As per the DES Specification a PCN “can notify the commissioner at any time prior to 31 March 2025” and following receipt of the CAIP payment form, the commissioner will arrange for payment of the relevant amount for that part of the CAIP, representing the full years’ payment in such a case.

BMA continues to encourage practices to follow existing GPC England Safe Working Guidance. Further information pertaining to the PCN DES for 2024/25 can be found here.

GP Contract Webinars

Register below to hear the GPC England Officer team update on the new 2025/26 GP contract changes. There will be an opportunity for Q&A.  Please see dates and times with registration links below:

• Wednesday 9 April 19:00-21:00   Register here
• Thursday 10 April 12:00- 14:00    Register here
• Wednesday 23 April 19:00-21:00 Register here
• Thursday 24 April 12:30- 14:30    Register here

Read more about the contract changes and webinars here: GP contract 2025/26 changes

Parliamentary Activity

National Insurance Contributions (NICs) Bill:  The National Insurance Contributions (NICs) Bill, which will enshrine into law the increases to NICs, was debated in the Lords on 25 February. During the report stage of the Bill a Liberal Democrat amendment to exempt the health sector from NICs hikes, which included GP practices, was passed.

However, when the Bill returned to the Commons, they Commons voted to reject the Lords’ amendment, meaning that GP practices and other healthcare providers will continue to face increased employer NICs. The Bill will now go on to complete its final stages.

Meetings:  Last week GPCE met with Dr Luke Evans MP, Shadow Parliamentary Under-Secretary of State for Health and Social Care, to discuss current issues impacting GPs, the discussion included funding, GP unemployment the NICs Bill, ARRS, workload pressures and general challenges facing GPs and practices.

Sessional GPs Committee Elections

The Sessional GP Committee (SGPC) has opened voting for 16 elected members of the committee. Election counting rules will be applied to ensure that a candidate will be elected from each of the committee’s thirteen regions. The committee’s regions are based on the BMA’s ten English regional councils, in addition to one representative in each of Scotland, Wales and Northern Ireland.

Voting will close at 12pm on Monday 14^th April 2025. For more information on these elections, please visit the BMA Sessional GP Committee webpage.

Cambs LMC Committee Election – Voting Opens 4 March 2025

All registered constituent GPs are invited to vote in this election from 4 March until midday on Tuesday 25 March 2025

Vote here from 4 March 2025

Cambs LMC GPAS Monthly Highlight Report – February 2025

View full report here

GP Contract Negotiations – next steps

GPC England met on Thursday 27 February where the officer team outlined the contract proposals, and a full discussion and debate occurred.

More information is coming soon.  Cambs LMC will publish any national guidance via usual channels in the comings days/weeks.

GP unemployment crisis

Despite the rising demand for family doctors to provide care, a Kafkaesque situation now exists in which a significant number of highly skilled GPs are struggling to secure work.

The BMA’s UK Sessional GP Committee surveyed salaried and locum members to help highlight this pressing and absurd situation of the growing unemployment/underemployment crisis among GPs. The survey closed on Monday and the results will be shared in due course.

GPC held a virtual rally to address the urgent issue of sessional GP unemployment.

If you missed the rally, you can watch the recording here.

Maternity Leave

We are thrilled to announce a significant enhancement to maternity leave benefits for salaried GPs, following a recent unanimous vote by GPC UK. The number of weeks at half pay for maternity leave will increase from 14 weeks to 18 weeks. This change aligns maternity leave provisions with those of hospital doctors and ensures salaried GPs are no longer at a detriment to their hospital-based colleagues.

https://youtu.be/cQLCUZ5Edsw

We have produced guidance, resources and template letters to aid the implementation of this change. The new maternity leave benefits are as follows:

• 8 weeks of full pay, less any SMP (statutory maternity pay) or MA (maternity allowance) receivable, including any dependants’ allowances.
• 18 weeks of half pay, rather than 14 weeks, plus any SMP or MA receivable, ensuring the total does not exceed full pay.

13 weeks at SMP or MA, as entitled under the statutory scheme.

This change was made possible thanks to the unity and collective resolve of our profession.

By implementing this new maternity leave pay change, we’re not just helping individuals, but also strengthening our profession. These enhanced benefits reflect our commitment to supporting salaried GPs throughout their working lives.

Next Steps: We recommend all practices discuss these changes with their salaried GPs. Following which, we recommend that a contract variation letter is issued to each salaried GP to reflect these changes. Further information and the relevant contract variation letters can be found on our website.

We recommend that you make these changes before 1 April 2025, but we encourage all practices to make these changes as soon as possible, to ensure that no salaried GPs miss out.

2023-24 Type 2 Pension Forms for Sessional GPs

We have recently highlighted the change of form and upload process for type 2 pension forms for 2023-24. Sessional GPs are required to complete a Type 2 Self-Assessment for each pension year, so that NHS England can ensure that all NHS pension contributions have been correctly paid and then accurately allocated to that GP’s NHS Pension Scheme record. 

The relevant forms must be completed by those who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024, and should be submitted to PCSE by 28 February 2025. PCSE and the BMA Pensions Committee have held two webinars to explain the new form and the process to upload the forms. Watch a recording of the webinar

Spending Review

The BMA recently submitted its representation to the Department for Health and Social Care for the Comprehensive Spending Review, setting the case for sustained investment. The BMA advocated for a 4.2% average annual increase in the day-to-day spending budget of DHSC, with funding reserved to deliver an uplift in the GP Practice core funding (Global Sum) by at least £40 per patient per year, amounting to £2.5 billion extra per year. In addition, the BMA also called on the government to build on the capital investment announced in the most recent budget and increase capital spending by a further £3.3 billion in real terms per year, to help deliver needed improvements to the primary care estate. The full submission can be accessed on the BMA website.

GPC England Regional Elections – coming soon

GPs Committee England will soon be seeking nominations for voting members of the committee for the 2024-2027 sessions, we will be electing one representative from each of the following regions:

• Cambridgeshire and Bedfordshire
• Hertfordshire
• North and South Essex
• Barking & Havering, Redbridge & Waltham Forest and City & Hackney
• Cumbria and Lancashire
• Wigan & Bolton, Bury & Rochdale and West Pennine
• South & West Devon and Kernow
• Hampshire and Isle of Wight
• Kent
• Surrey and Croydon
• East Yorkshire, North Lincolnshire and Lincolnshire
• Calderdale, Kirklees, Leeds and Wakefield

For more information about BMA elections

Special Rules for end of life benefits (SREL)

The Department for Work and Pensions (DWP) has released an online service for the SR1 form.

Healthcare professionals can support a patient’s benefit claim made with the Special Rules by completing an SR1 form. Once submitted, this tells DWP that a patient might be eligible for financial support as they may have less than 12 months to live.

The service aims to:

• Support GPs to complete and submit the form by providing an online option to current paper and email processes
• remove the need to create usernames and passwords
• allow completed forms to be downloaded and saved
• reduce time to complete a form with the ability to skip optional questions
• include clear and relevant guidance for specific questions
• increase the accessibility for people who use assistive technology to complete tasks

If you have any questions or problems using the service, email DWP at online.sr1@dwp.gov.uk

Access healthcare professional resources for the Special Rules for end of life

Cambs LMC Committee Election – Nominations Open!

Are you a Partner, Sessional, or Locum GP, on the Medical Performers’ list in Cambs & Peterborough?

Do you feel passionately about advocating on behalf of, and protecting local general practice?

Would you like to be part of the statutory representative voice for Cambs & Peterborough GPs?

Would you like to be one step ahead with key local & national issues among a dynamic committee?

Could you help shape the future of Cambridgeshire & Peterborough general practice?

If you’ve answered YES to the above, then you should nominate yourself to stand for election to join the Cambs LMC Committee – the collective professional voice of Cambridgeshire & Peterborough General Practice, funded by GPs, for GPs. 

Cambs LMC is the organisation that supports, represents, and advises all GPs across the county, regardless of contractual status.  There are 24 committee members and 3 registrars who are supported by a fantastic executive team.

We confidentially discuss a wide range of topics affecting both local and national general practice. Currently, we have excellent representation from partners, sessional, and locum GPs, which we want to continue. The committee is especially welcoming, describing themselves as the LMC family, we are supportive of each other and nurture the new members with a fellow committee member mentor.

Above all, we value the safe space we create to hear and respect each other’s views.  It is vitally important that Cambs LMC remains representative of general practice across the county.

Find out more here.

GP Collection Action – Secondary Care Guidance

Thank you all for continuing to develop and expand on our collective action to protect our patients and practices.

We recognise the particular challenges across the primary and secondary interface, and want to ensure all specialist colleagues are aware of the purpose and aims of GP Collective Action. To this end GPC England and the UK Consultants Committee have developed explanatory resources hospital and trust-based colleagues.

Our new webpage https://www.bma.org.uk/secondarycareGPaction outlines how secondary care colleagues may be affected and ways they can support GPs in this campaign. This includes a downloadable PowerPoint presentation which LNCs (Local Negotiating Committees) can use in their patch, an at-a-glance fact sheet that can be displayed in Trusts, and a recorded webinar offering further insights.

Please also continue to refer to our collective action Protect your patients, protect your practice webpage, which explains in more detail the nine actions that practices can choose to take. It also contains more information such as the Safe Working Guidance Handbook, Campaign resources and Patient materials.

As negotiations for the GP contract 2025/26 progress, this is a pivotal moment for all GPs to unite as a profession – not just for safe and sustainable general practice, but for a safe, sustainable and stronger NHS too.

Primary Care Joint Parliamentary Event – 28 January 

GPC England jointly hosted an MP parliamentary drop in event for MPs in Westminster. The event on the future of primary care was held jointly with the British Dental Association, Community Pharmacy England, the Optometric Fees Negotiating Committee and the Association for Primary Care Audiology Providers and was attended by over 40 MPs. These included members of the health and social care select committee and shadow health ministers. During the event we outlined key concerns related to workforce and funding and encouraged MPs to sign a joint letter to the Health Secretary calling for increased support for primary care.

NHS Mandate and NHSE Planning Guidance – improving access to General Practice

Published last week, the UK Government’s new mandate for the NHS and NHS England’s planning guidance for 2025/26 both emphasise improving patient access to general practice and primary care. Neither document establishes clarity in terms of how this will be achieved, but the new Mandate does refer to investment in upgraded GP surgeries and in data and digital tools.

2023-24 Type 2 Pension Forms for Sessional GPs

We have recently highlighted the change of form and upload process for type 2 pension forms for 2023-24. Sessional GPs are required to complete a Type 2 Self-Assessment for each pension year, so that NHS England can ensure that all NHS pension contributions have been correctly paid and then accurately allocated to that GP’s NHS Pension Scheme record. 

The relevant forms must be completed by those who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024, and should be submitted to PCSE by 28 February 2025. PCSE and the BMA Pensions Committee have held two webinars to explain the new form and the process to upload the forms. Watch a recording of the webinar

Resident Doctor dispute on exception reporting

Despite its best-efforts during negotiations, the BMA’s UKRDC (UK resident doctors committee) have announced they will be entering into a dispute with the Government over the contractual reform of exception reporting (ER).  The GPRC (GP registrars committee) met last week and passed a motion which offers their full support to UKRDC in entering a dispute to drive the negotiations to an effective resolution. Read more here

GPC England Regional Elections – coming soon

GPs Committee England will soon be seeking nominations for voting members of the committee for the 2024-2027 sessions, we will be electing one representative from each of the following regions:

• Cambridgeshire and Bedfordshire
• Hertfordshire
• North and South Essex
• Barking & Havering, Redbridge & Waltham Forest and City & Hackney
• Cumbria and Lancashire
• Wigan & Bolton, Bury & Rochdale and West Pennine
• South & West Devon and Kernow
• Hampshire and Isle of Wight
• Kent
• Surrey and Croydon
• East Yorkshire, North Lincolnshire and Lincolnshire
• Calderdale, Kirklees, Leeds and Wakefield

For more information about BMA elections

The LMC office will close at 12noon on Tuesday 24 December 2024, resuming usual office hours on Thursday 02 January 2025.

The teams own email accounts will not be routinely monitored.  Any urgent emails should be sent to office@cambslmc.org during this period, however we may take slightly longer than usual to reply to your messages.

From all at Duxford, we wish you and your practice teams a relaxing festive break.

National Insurance contributions

At the England national conference of LMCs on 22 November 2024, the impact that the increase in employer National Insurance (NI) contributions have on GP practices was debated and passed a motion demanding that the Health Secretary rectify the issue with funding to the core GP Contract.

The BMA continues to put pressure on the Government regarding our concerns and the Chair of GPC England, Dr Katie Bramall-Stainer, referenced the response from the Secretary of State for Health in her speech to the Conference, where she said:

“Mr Streeting recognises that we as GPs are so clearly the beating heart of the NHS family. We now need him to follow through and treat us as such”.

Please use the BMA online calculator to estimate the impact of the increases to employer National Insurance contributions and the national minimum/living wage on general practice in England.

Data from our online calculator submissions so far indicates that the average additional cost pressure runs to around £35,000 for each practice. This means practices are at risk of closure or, as a minimum, reducing staff and services as a result.

Help us to continue to put pressure on the Government by writing to your local MP and inviting them to your practices using our online tool >

The recent announcement about the NI increase has hugely affected the morale of the profession. Listen to Dr Adam Janjua explain why it is necessary for general practice to come together and take collective action as “enough is enough”. https://www.youtube.com/watch?v=jBon3HpazRI

BMA GP Opinion Survey 2024- have you had your say yet?

The BMA GP Opinion Survey is still open. This annual survey gathers GPs’ views on current issues facing General Practice and is helping to influence and inform this year’s contract negotiations, inn addition to our longer-term strategy of promoting and protecting the future of General Practice.

It is open to GPs in England working in all settings and practices, including partners, salaried GPs, locums, and GP registrars at ST3 and above.

Participants do not need to be a member of the BMA to participate but we will need a GMC number to ensure that responses are coming from eligible GPs based in England. All responses will be anonymised.

Take the survey here: https://www.research.net/r/FP9JLQJ

BMA Collective Action

Thank you to all those taking part in our collective action to protect our patients and practices. These nine actions will continue to make a difference: they are safe, sustainable, and do not breach your contract. For all General Practitioners to collectively participate continues to put pressure on the Government to do the right thing for patients and general practice.

At the Conference of LMCs in England last week, the GPC England Chair, Dr Katie Bramall-Stainer explained why collective action is needed NOW, as grassroots GPs are telling us that “this is going to break us”. Watch the speech:GPs are having to take collective action

Make sure you are involved to protect your practice, your staff and your patients.

‘Protect your Patients and Protect your Practice‘ campaign

The BMA’s ‘Protect your Patients and Protect your Practice‘ campaign webpage has information about all of the actions. Please also refer to other useful links such as:

• Safe Working Guidance Handbook
• Guidance for GP collective action for sessional GPs and GP registrars
• Background to the 2024/25 contract changes
• Patient materials (waiting room/website videos and infographics)

Campaign materials such as patient leaflets, lanyards, badges, window stickers and Beanie hats continue to be available from the BMA rep Hub.

We will be producing more guidance around individual collective actions to support those practices in undertaking specific actions.

We want GPs to feel safe and empowered to take action to protect their patients and their practices.

Data (Use and Access) Bill

Changes to UK data protection law have been proposed in the government’s new Data (Use and Access) Bill which had its second reading in the House of Lords in November. Our briefing highlighted concerns about the potential impact on health data should there be a departure from existing high standards of data protection. The BMA is particularly concerned about the erosion of transparency standards when data is processed for research purposes and the threat to the regulatory independence of the Information Commissioner’s Office.

The bill also addresses the technical deficit in the NHS that limits data sharing and sets out measures to address this. IT system suppliers will be forced to develop software for sale in the NHS in line with technical standards – which we have long called for, and our report on IT was acknowledged as a factor favouring the inclusion of  this measure.

Government review of Physician Associates

The Government has launched an independent review of physician associates (PAs) and anaesthesia associates (AAs). In response to this, the BMA Chair of Council, Dr Phil Banfield, welcomed that the Government has acknowledged the concerns of doctors and accepted there is a safety issue with the employment of physician associates. He said:

“So we need to know what immediate safety measures NHSE will put in place, how quickly they will pause their PA expansion plans, and in the meantime if they will adopt the BMA’s own guidelines to start protecting patients now.” Read the full statement here.

Read the BMA guidance: PAs in general practice: making it safe for patients and GPs

Flu vaccination survey

The NHS England vaccination strategy, launched in December 2023, contained a proposal for NHSE to explore the impact of a move to the centralised provision of flu vaccines. As part of that exercise, NHSE has launched a survey of  general practice and pharmacy providers to gather their views on both the current model of procurement, and the potential benefits and challenges of a centralised procurement model. Any such change will not be implemented for the 2025/26 season flu programme.

The outcome of the survey will inform any future discussion on potential changes of the procurement model that NHSE will have with GPC England. As such we would encourage as many practices as possible to make their views known. Take the survey here

GP pressures: latest workforce and appointment data

GPs continue to treat many more patients than they have done in the past. The latest data shows a record 63.66 million patients registered with practices in England, while there are over 1,300 fewer fully qualified full time GPs compared to 2015.

As a result, each full-time equivalent GP is now responsible for an average of 2,271 patients, an increase of 333 patients per GP (or 17%) since 2015, and appointments level at an average of almost 1.5 million per working day. Since September 2015, there has also been a decrease of 1,387 GP practices.

This fall in both GP numbers and practices coincides with a rise in patient numbers, which is putting staff at GP surgeries under immense strain, with knock-on effects for patient care.

Learn more about the pressures on general practice by visiting our website

Do you look after asylum seekers or refugees?

It is well-evidenced that this group of patients continue to face significant barriers accessing appropriate and timely healthcare. We’ve launched a survey to capture your experiences, so the BMA can update its Refugee and Asylum Patient Health Toolkit and influence government policy to better support you in enhancing healthcare services for asylum seekers and refugees. Share your views and complete this ten-minute survey by 14 December 2024.

BMA GP Opinion Survey 2024

The latest BMA GP Opinion Survey has opened, and we need to hear from all GPs across the country.

This annual survey gathers GPs’ views on current issues and opportunities facing General Practice, helping to influence and inform this year’s contract negotiations in addition to our longer-term strategy of promoting and protecting the future of General Practice.

The survey is open to all GPs in England, including partners, salarieds, locums, and GP registrars at ST3 and above. It is open to GPs working in all settings and practices, wider primary care roles, trusts, urgent care, and secure or out-of-hours settings.

Participants do not need to be a member of the BMA to participate but we will need a GMC number to ensure that responses are coming from eligible GPs based in England. All responses will be anonymised.

The survey will close on Monday, 11 November at 9am. We urge you to complete the survey as soon as possible, to ensure GPC England’s negotiating position is made as strong as possible.

Take the survey here: https://www.research.net/r/FP9JLQJ

BMA vision for General Practice

BMA has launched the vision for general practice Patients First: why general practice is broken and how we can fix it, presenting solutions for the new Government to work with BMA in rebuilding a transformed general practice for the benefit of patients and communities, and improving the long-term health of the nation.

GPs need an extra 11p per day, that’s £40 per patient per year in 2025/26 to provide the patient care that is needed.   This investment will help support safer, better continuity of care for our patients, recruiting more GPs and delivering more appointments.

BMA has shared Patients First: Why General Practice is broken and how we can fix it with the Secretary of State for Health, the Department for Health and NHS England. We look forward to working with them to bring about necessary changes, working to shape policies that will help fix the front door to the NHS and bring back the family doctor.

Safeguard general practice, and you safeguard the NHS.

Please share this vision with patients, friends and colleagues, while continuing to take collective action that will protect our patients and our practices www.bma.org.uk/patientsfirst and read the BMA press statement.

BMA Collective Action

Thank you to every practice now taking part in BMA collective action to protect our patients and practices. These actions have already, and will continue to make a difference: they are safe, sustainable, and do not breach your contract. Most importantly, these actions are turning up the pressure on the Government to do the right thing for patients and general practice. We are the bedrock of the NHS, but our services have been driven to near collapse.

We need you to take action to protect our patients and protect our practices.

BMA Focus On Action – Serving notice on voluntary services

BMA is producing more guidance around individual collective actions to support those practices in undertaking specific actions. This weeks focus is on serving notice on voluntary services.

Watch the two minute collective action video on unfunded work which shows GPCE colleagues’ views on this specific collective action. BMA is asking you to consider serving notice on any voluntary services currently undertaken that plug local commissioning gaps and stop supporting the system at the expense of your patients, practice and staff. BMA recommends liaising with your LMC for advice around communications and notice periods required (if any), around the cessation of these services, or alternatively contacting info.gpc@bma.org.uk for further information and advice.

The GP campaign page has more information about all of the actions.

Please also refer to the Safe Working Guidance Handbook and other useful links such as guidance for GP collective action, background to the 24/25 contract changes, and infographics that can be displayed in practices.

GP Additional Roles Reimbursement Scheme (ARRS)

The updated PCN DES bringing in the GP ARRS was released last week. GPs employed via the Scheme must be within 2 years of their CCT on 1/10/24 and PCNs will be required to provide terms no less favourable than the BMA salaried GP model contract, in line with the GMS/PMS contract.

GPC England and the Sessional GPs Committee have released guidance for PCNs, and individuals employed under this scheme. It can be found here.

Whilst there is progress in acknowledging the difficulties currently faced by many GPs struggling to find jobs, we continue to stress to NHSE and the Department of Health the underlying issue of GP unemployment and how this needs to be better addressed through additional support and funding at a practice level, reinforcing the need for a new GP contract to support this.

Read the blog by Dr Mark Steggles, Chair, Sessional GPs Committee

GPs vote in favour of phasing out physician associate role in general practice

Following the publication of the GPC England and RCGP guidance on the role of physician associates, the GPs Committee UK (GPC UK) met on 17 October and discussed the role and safety of physician associates in general practice. The committee overwhelmingly voted in favour of the motion below:

This meeting believes that the role of physician associates in general practice is fundamentally unsafe and:

1. there should be no new appointments of physician associates in general practice
2. the role of physician associates in general practice should be phased out
3. the role of a physician associate is inadequately trained to manage undifferentiated patients, and there should be an immediate moratorium on such sessions.

The BMA believes that those in existing physician associate roles should be given opportunities to retrain into more suitable NHS roles, including the appropriate undergraduate and postgraduate training in medicine.

The priority needs to be the recruitment and retention of more GPs into the workforce. We want to be able to give patients the care and services they need, when they need them, with the most appropriate clinician. The Government must urgently invest in practice staff such as GPs and general practice nurses.  Read the full press statement here

BMA legal action on MAPs

The BMA is to financially back a legal challenge against the GMC over its failure to distinguish between doctors and PAs (physician associates).

Campaign group Anaesthetists United has been joined by the parents of 30-year-old Emily Chesterton, who died after seeing a PA who she thought was a GP, in their legal action. Together, they allege that the GMC has not enforced a national scope of practice for MAPs (medical associate professionals) after they graduate, which they argue represents an unlawful failure in the GMC’s duty to properly regulate the clinical practice of these associate professions in the UK.

This follows legal proceedings started by the BMA against the GMC in June on the GMC’s decision to use Good Medical Practice for PAs and AAs rather than creating specific standards for those professions, and the GMC’s use of the term ‘medical professionals’ for PAs and AAs.

Use of patient data for research

Following the Health Secretary’s speech at the RCGP Conference, where it was stated that NHS England would take care of primary care data for research, where patients had consented for it to be used in studies, Dr David Wrigley (GPC England Deputy Chair and IT lead) commented:

“Research is fundamental to improving public health, and the BMA has been in conversation with NHS England, the Government, and relevant research organisations about how to safely make the data of those patients who have given explicit consent available for this use.

“We are pleased Government will thoroughly review the consent processes used by these research organisations and will take full responsibility for the safe and proper onward sharing of that data which originates from the GP record. We have made it clear that the agreement is strictly limited to circumstances where patients have given – and continue to give – their informed consent to the sharing of their medical record.

“Patient data is incredibly valuable, and we are pleased to see the Government has also committed to ensuring the highest security arrangements for its protection and appropriate use.”

GP contract changes and implementation

Here is a reminder of what has been uplifted from this month: Global sum has been uplifted to £112.50 per weighted patient for GP practices to implement the DDRB uplift. Locum reimbursement rates have increased, along with the pay elements of workforce-related transformational funding.

From 1 October, newly qualified GPs can be recruited as part of the additional roles reimbursement scheme (ARRS) and PCNs can request the funding as outlined in the updated PCN contract DES. In addition, three other PCN funding streams have been increased to reflect the DDRB uplift: core PCN support, the care home premium service and the enhanced access service.  The maximum reimbursement rates for existing ARRS staff have been uplifted with effect from 1 October to align with Agenda for Change pay scale uplifts.

GP Action

 The GPs Committee England met last week where we discussed the next steps of GP collective action as part of our ‘Protect your Patients and Protect your Practice‘ campaign and other upcoming issues affecting general practice.

We would encourage practices to continue to take action using our safe sustainable action menu. It is up to each practice to choose which actions to take, and whether to do one, or many. None of them represent a breach of your contract, but they will help you manage your workload and keep you and your patients safe. Your LMC will also provide you with additional advice, tailored to local arrangements.

Our GP practice survival toolkit provides for a menu of actions you can choose from, to support a safer delivery of services for patients and practice team:

• Limit daily patient contacts per clinician to the UEMO recommended safe maximum of 25
• Serving notice on voluntary services that plug local commissioning gaps
• Cost up the value of providing locally commissioned services and serve notice on contracts which are undermining practices’ ability to sustain a service
• Withdraw permission from secondary-use data sharing agreements
• Freeze sign-up to new data sharing platforms
• Stop engaging with the e-Referral Advice & Guidance pathway
• Stop rationing referrals, investigations, and admissions
• Switch off GP Connect Update Record Functionality
• Ignore medicine optimisation software which diminishes patient choice in return for system savings never seen by GP practices
• Defer your PCN declaration regarding online triage to 2025

We are urging the Government to engage constructively with us as soon as possible to determine short, medium, and long-term solutions to save General Practice.

Find out more here.

GP Additional Roles Reimbursement Scheme (ARRS)

The updated PCN DES bringing in the GP ARRS was released last week. Pay for these roles will be set at the lowest level of the DDRB recommended sessional pay range, with PCNs able to claim up to £92,462 (including on costs), together with London weighting if applicable. The funding available to PCNs to fund these roles will be £1,303 multiplied by the PCN Contractor Weighted Population on 1 January 2024. The GP in ARRS allocation is separate to the pre-existing ARRS allocation, and PCNs cannot cross-subsidise between the two funding streams

GPs employed via the Scheme must be within 2 years of their CCT on 1/10/24 and PCNs will be required to provide terms no less favourable than the BMA salaried GP model contract, in line with the GMS/PMS contract.  There are, however, no requirements on how these GPs should be utilised within the PCN.  GPC England and the Sessional GPs Committee will be releasing guidance for PCNs, and individuals employed under this scheme, shortly.

Whilst there is progress in acknowledging the difficulties currently faced by many GPs struggling to find jobs, we continue to stress to NHSE and the DHSC the underlying issue of GP unemployment and how this needs to be better addressed through additional support and funding at a practice level.

Safe working guidance

Last month we published a safe working guidance handbook to help GPs and practices in the delivery of safe, high-quality care for their patients and communities. The profession wants to provide care without risk to patients or ourselves. The handbook embeds and prioritises safe high-quality care for your patients by focusing on the delivery of prioritised core GP services. These actions will work, and will build growing leverage in the months ahead to support us in negotiations for you and your practice team.

Read more on Safe working, including social media graphics and a poster.

Shortages of doctors and patient increase – BBC analysis

A BBC analysis of NHS data has shown that the average GP in England has to care for 17% more patients than nine years ago. The areas struggling the most have more than 3,000 patients, nearly double those with the most doctors. The government said it was developing plans to train more doctors and relieve some of the pressure by giving pharmacists more responsibilities.

The GPCE Chair, Dr Katie Bramall-Stainer said these figures lay bare the realities of the workforce crisis in general practice and demonstrate how practices have been expected to keep doing more for less. This has led to the closure of 2,000 GP practices since 2010. General practice is collapsing. Rather than giving pharmacists more responsibility, patients want more GPs and we agree with them.

Labour party conference update

Last week GPCE Officers attended the Labour Party Conference. The NHS, and particularly general practice, was a key conference topic, alongside the Darzi Review and the NHS ten-year plan, anticipated for release next spring. Dr Katie Bramall-Stainer and Dr Samira Anane met with a number of MPs including Minister of State for Care, Stephen Kinnock, PPS to Wes Streeting, Mr Zubir Ahmed, Dr Simon Opher, Dr Beccy Cooper, Leigh Ingham, Nesil Caliskan and Josh Dean. Dr Bramall-Stainer also spoke at the BMA’s roundtable attended by a number of MPs. During these meetings GPCE outlined our upcoming strategy for the new Government; our priorities and our recommendations to urgently address the crisis in general practice and GP unemployment.

GP pressures: latest workforce and appointment data

GPs continue to treat many more patients than they have done in the past. The latest data shows a record 63.47 million patients registered with practices in England, while there are over 1,000 fewer GPs compared to 2015.

As a result, each full-time equivalent GP is now responsible for an average of 2,282 patients, 345 (or 18%) more than in 2015, and appointments level at an average of almost 1.5 million per day. All of this puts staff at your GP surgery under immense strain, with knock-on effects for patients.

Learn more about the pressures on general practice

RCGP changes position on physician associates

At its September UK Council meeting, the RCGP voted to oppose a role for physician associates in general practice, with 61% of members voting for the change of position. However, the college will still be pushing ahead with planned guidance development given the pe-existing presence of PAs in general practice. The RCGP also voted to expunge a paragraph from their draft scope of practice guidance which would have exempted PAs already working in general practice from the scope limits. The college now plan further work on this guidance before publication.

GPC UK recently published the guidance Physician associates in general practice: making it safe for patients and GPsand will be discussing the RCGP’s change in position at its next meeting on 17 October.

New dispensing feescales

The new dispensing feescales for England and Wales, effective from 1st October 2024, have been published, showing a reduction in the average dispensing fee to 218.7p per item (average), a decrease of 0.2p compared with April 2024. This reduction is based on a new methodology designed to further smooth out the fluctuations seen in the previous biannual fee adjustments.

Dispensing fees are intended to cover the costs of running a dispensary, including staff expenses. However, from April 2025, the average fee is set to reduce further by 5.37p per item (on average) to 213.3p (compared to the October 2024 rate). This continued downward trend may prove to be a tipping point for some dispensing practices, as the cumulative impact of underfunding in rural practices takes its toll. GPC England continues to work closely with the Dispensing Doctors Association; both organisations recognise and promote the value of dispensing practices to their patients and within their communities.

Launch of BMA GP Safe Working Guidance Handbook

Following the overwhelming YES vote in our ballot over the summer, practices are starting to take action as part of our ‘Protect your Patients and Protect your Practice‘ campaign.

GPC England have published a ‘Safe working guidance’ handbook to help GPs and practices in the delivery of safe, high-quality care for their patients and communities. The profession wants to provide care without risking harm to others or ourselves.

At a time of unprecedented pressures, we must make changes to our workload to preserve patient care in the face of a shrinking workforce and rising demand. This will help to protect the sustainability and future of general practice.

It is recommended that you do this by focusing on the delivery of General Medical Services, in line with the needs of your patients and practice, and deprioritising work and activities that fall outside of your core contractual requirements. This guidance reflects the contractual changes imposed by NHS England in April 2024. BMA offers ways of doing this that still enable you to stay within the terms of your GMS/PMS.

The guidance outlines how to manage workload effectively, setting safe limits of 25 patient consultations per day in line with UEMO recommendations, and encouraging practices to adopt systems that protect both patients and staff.

The BMA handbook can be downloaded and saved from the website:  www.bma.org.uk/GPsSafeWorking.

Further guidance and resources such webinars and FAQs can also be accessed, with patient information posters and social media graphics to download and share.

We cannot care for our patients if we do not care for ourselves and our colleagues.

Practice Finance Survey – DEADLINE MIDDAY 17 SEPTEMBER

BMA is inviting practices in England to complete a Practice Finance survey, to build evidence to support the annual contract negotiations. This is your opportunity to feed into an evidence base demonstrating the impact of inflation and rising cost over the last couple of years, on GP practices.

Please share the survey link with your practice manager colleagues so that they can complete the survey. The survey will close at 9am, Tuesday 17 September. 

It is recommended that respondents have relevant information to hand before starting the survey: they will need GP practice accounts for 2022/23 and 2023/24, expenditure data for April 2023 and April 2024, and information on staff numbers and practice list size. Take the survey

Action tracker survey

BMA is gathering data on any actions that practices across England are taking, and from 16 September, surveys will be sent monthly. BMA will share the survey with LMCs to distribute to practices and will be contacting partner members directly to ask you to input data per practice.

BMA wants to hear about the actions you are doing, or considering so please do reply when you receive the survey during the week commencing 16 September. Responses from practices helps to monitor how collective action is progressing across the country, supporting our negotiations and work towards a GP contract that is fit for purpose.  The data will not be shared outside of the BMA.

GPCE view on request for Cloud Based Telephony data

As part of the 2024/25 contract imposed on the profession in April, NHS England (NHSE) have sought directions from the Secretary of State to extract data from our clinical systems on our Cloud Based Telephony (CBT) usage. An email has been sent by NHSE outlining the instructions to comply with this data extraction under section 259 (1) (a) of the Health and Social Care Act 2012, stating:

‘All general practices are therefore mandated to comply with this invitation and approve the collection.’

The legal basis for the collection is explained in the Data Provision Notice, which will enable your call data to be extracted on a monthly basis.

The BMA has taken its own legal advice:

Practices cannot decline the instructions, as doing so will risk breaching their contract.

BMA has made it clear to NHSE that the data must not be used to performance manage practices or single them out for criticism.

The PCN DES includes three components of the Capacity and Access Improvement Payment (CAIP). This data extraction is the component pertaining to the existing use of CBT and the relevant metrics. GPCE advice is that should a practice fail to sign up ahead of the October 1^st deadline, there may be a risk of a breach notice being imposed as well as contravening the Health and Social Care Act 2012.

There is another component which relates to ask No 9 in our collective action campaign. BMA has significant concerns around online consultation software being available to patients from 08:00-18:30 given practices’ lack of capacity, and their responsibilities for ensuing patient safety.

GPCE advice continues to apply here: CDs and PCNs are advised not to sign this particular declaration presently, but to await further guidance closer to the financial year end.

Read the full update here and if you have any queries, please email us at info.gpc@bma.org.uk

Rollout of the medical examiner system in England

In England, the statutory implementation of the medical examiner system will take place on 9 September 2024. This will mean that independent scrutiny by a medical examiner will become a statutory requirement prior to the registration of all non-coronial deaths from this date. Information from the Department of Health and Social Care is here.

While many are using the medical examiner system, some are not. If you require further information on implementation in your area, please contact your LMC. For more wider information on the medical examiner system please contact the BMA.

Zero tolerance of racism: download our poster

Last month’s racist, Islamophobic and anti-migrant riots were hugely distressing with wide reaching impact felt across healthcare settings and communities. All healthcare workers have a right to work in an environment free from abuse.  Patients need to be warned that there will be zero tolerance of racist behaviour with resultant consequences, should this not be respected. BMA has produced a poster you can print and display in your premises, making it clear that racist abuse will not be tolerated.

You can also contact the BMA for wellbeing and support, and we have guidance for managing discrimination from patients, with clear steps to take when incidents of racist abuse against healthcare staff occur.

Successful RCGP legal challenge in support of disabled doctors

The BMA has won a legal challenge supporting a trainee GP who believed they had been unfairly treated by the RCGP because of its policy on the number of attempts at taking an exam. ​The BMA supported the doctor to bring judicial review proceedings challenging the lawfulness of the RCGP’s attempts policy, which only allows four attempts at the AKT/RCA exam required to complete GP training. According to the policy, no additional attempts would be granted, even in circumstances where a candidate discovered, after sitting a test, that they had a disability which would have entitled them to “reasonable adjustments”, including additional time for the taking of the test.

GP pension campaign in England

At the end of July, the BMA’s pensions committee launched a campaign to assist GPs in England to get their pension records up to date. There is a step-by-step guide for members to follow, with pre-populated email templates to assist. It is important to ensure that your record is as accurate as possible so you can make appropriate decisions about your pension and the McCloud remedy.

If you have received your 05 and AA statement from NHS Pensions, and your record is not updated to 2022-23, you can check what years are missing from your record by logging into your PCSE Pensions Online account. As the Pensions Online system is updated in sequential order, you will be able to see which type 1 or type 2 form is holding up your record from being up to date. You can then submit the required forms via your online account or through the online form.

If you have submitted all required forms and your record is still not up to date, you should raise a complaint with PCSE. If it not fully resolved within 40 days – follow the escalation process.

Practices taking action

Following the overwhelming YES vote in the BMA ballot practices are beginning to take action – the range of actions are all detailed on the toolkit menu on the BMA website. Each action is safe, effective, sustainable and clear, and it is up to each practice to choose which actions to take, and when.

Please do continue to liaise with your LMC to access additional advice, tailored to local arrangements.

BMA is continuing to collate the data in the weekly local action tracker surveys which have a deadline of 5pm each Sunday for completion.  These insights are vital to the overall campaign and securing the profession’s objectives.

Cambridgeshire & Peterborough constituent practices will receive the new survey link every Wednesday together with the GPAS submission reminder.

Read the BMA GP campaign page for more information about the actions you can take and how to order campaign materials and patient leaflet. There is also a patient-facing animation, complete with additional subtitles that can be activated for screen reading.

Read also the guidance for salaried GPs and locum GPs during collective action

Data Request for Cloud Based Telephony Statistics

You will have received in your practice a request to share telephony data due to a Data Provision Notice. This email will have been sent to the main practice contact registered with the CQC. We have received additional documentation and messaging from NHSE on this issue. David Wrigley and Mark Coley have met NHSE on the topic, having been given 24hrs notice of the data request and documentation associated with it.

BMA is analysing the information and will issue a further update with more information. At the present time practices are being asked to defer making a decision this week and await further communication from BMA.

Practice Finance Survey – Summer 2024

General Practice in England is being asked to complete the BMA Practice Finance survey. The aim is to build evidence for the GPC England team to support the annual contract negotiations.

We appreciate how hard the past few months have been for GP contractors and their managers. This is your opportunity to feed into an evidence base demonstrating the impact of inflation and rising costs, over the last couple of years, on GP practices across England.

Please send the survey link to your practice manager, so that they can complete the survey. The survey will be close at 9am, Tuesday 17 September. 

It is recommended that respondents have relevant information to hand before starting the survey: they will need GP practice accounts for 2022/23 and 2023/24, expenditure data for April 2023 and April 2024, and information on staff numbers and practice list size.

Take the survey: https://www.research.net/r/H9CYXCP

DHSC announcement to expand the ARR Scheme to include GPs

GPC England, Sessional GPs Committee and GP Registrars Committee have written a letter to the Secretary of State for Health, Wes Streeting, about our concerns over the DHSC announcement to expand the Additional Roles Reimbursement Scheme (ARRS) to include GPs, and how the expansion can be best implemented and possible long-term alternatives.

BMA has expressed concerns that providing this funding at PCN level does not provide GPs and patients with the desperately needed stability required, and instead suggested that it would be far more effective to provide this funding at a practice level, helping to address GP unemployment in the places most severely affected. In the long-term, GP contract funding must be increased so practices have full control over who they recruit to best serve their patients’ needs without the need for additional schemes like ARRS.

Other BMA Updates

GP pressures: latest workforce data

The latest workforce data showed that the NHS had the equivalent of 27,662 fully qualified full-time GPs in July 2024 – a decrease of 8 FTE GPs since the previous month, and 1,702 fewer fully qualified full-time GPs than in September 2015. The number of GP practices in England has decreased by 98 over the past year – reflecting a long-term trend of closures and mergers.

Between September 2015 and June 2023, the NHS had been losing FTE fully qualified GPs at an alarming rate. While some recent gains are positive, they have not been sufficient to make up for historical losses. During this time, there has also been a rise in the number of patients, with July 2024 seeing yet another record-breaking number. GPs are now responsible for about 18% more patients than in 2015, demonstrating ever mounting workload pressures. See more BMA infographics and data shoing the pressures in general practice here.

BMA sessional GP conference 2024: diversity, opportunity, safety

The BMA conference for sessional GPs is happening at BMA House and online on 20 September. It’s free for members, but non-members can also attend. This event will give you information and updates on topical issues including future models of general practice and establishing professional relationships with new clinical roles such as ARRS staff and PAs. Breakout groups will provide practical advice and guidance on a choice of topics in smaller groups. Check out the details of the day and register your place.

Clinical academic trainees conference 2024

The BMA’s clinical academic trainees conference is an exciting half-day event on 12 September. It aims to help you make the most of your academic training and develop your career, and provide an opportunity to share experiences with colleagues. Find out more and register >

August 2024 GMS Contract Variation Notices

ICBs will be sending out Contract Variation Notices for signature, if they have not already done so.  This is a nationally imposed change.

As you know, your Union, the BMA, has announced a period of Collective Action and the current imposed GMS contract and associated funding is widely seen as inadequate to deliver 21^st century General Practice.

Therefore, practices may (at any time, but particularly during Collective Action) opt NOT to sign the Contract Variation Notice. Signing may be seen as acceptance or even endorsement of the deal NHSE has imposed.

As always, these imposed GMS contract variations will take effect 14 days from the date they are served on the practice, regardless of whether or not the practice signs.  Not signing is a small but potentially useful message back to NHSE, and it will not harm patients or alter your services or funding in any way.

Cambs LMC supports any practice who chooses not to participate in “signing” an imposed contract.

Changes in Death certification coming into force from 9th September 2024

As you will already be aware, the definition of an attending doctor for legal purposes changes FROM “attendance during final illness and either seen within 28 days of death / after death” TO “attended at any point during the patient’s life” from 9th September 2024.

The cause of death will still be determined to “the best of knowledge and belief”.

From September 9th doctors will need to use the new attending practitioner Medical Certificate of Cause of Death (MCCD). These have already been sent to hospital sites, GP practices etc. Do not use them before then. The current MCCD will not be valid if written on or after September 9th.

From September 9th, the final wording of the cause of death will need to be agreed with the Medical Examiner. They will need access to relevant clinical records and be able to view the proposed cause of death.

A pragmatic approach will be taken but changes may be necessary if there are clear errors in formulation or an absence of supporting evidence.

If the death is referred to the coroner (Notification of Deaths Regulations 2019) and the coroner decides not to investigate, the attending doctor will complete an MCCD and Medical Examiner scrutiny will apply. Coroners have no jurisdiction over the MCCD.

The Medical Examiner will co-sign the new MCCD at the end of their scrutiny process which will include a discussion with the bereaved. The death cannot be registered without the Medical Examiner’s signature. It should be sent to the ME office (scan if remote) not the register office.

For a death certified with the new MCCD, cremation form 4 will no longer apply. There will be no fees. The Medical Examiner system is primarily about giving bereaved people an opportunity to ask questions about the death of their loved one, reviewed by an independent doctor.

If you have not engaged with your local medical examiner then now is the time to do so as the scrutiny process may differ between areas.

Your local examiner contact details can be found here: https://www.england.nhs.uk/patient-safety/patient-safety-insight/national-medical-examiner-system/contact-details-for-medical-examiner-offices-in-england/#east-of-england  

Further information can also be found here: https://www.gov.uk/government/publications/changes-to-the-death-certification-process/an-overview-of-the-death-certification-reforms

Cambs LMC GPAS Report – 30 August 2024

Please see attached this weeks report for your information