LMC Update – 16 April 2024

CAMBS LMC EVENT:  Thursday 18 April 2024 – 12:30 – 2:00pm via Zoom

Directors duties and responsibilities, corporate governance and running your company

Cambs LMC is hosting an online training session for those that have, or are considering, setting up a limited liability, incorporated structure for your PCN, we are pleased to invite you to attend the following Cambs LMC hosted online training session:

LMC Law offers a practical seminar for incorporated organisations which includes general corporate governance and director’ duties and responsibilities, directors’ liabilities, decision making, difficult directors, conflicts of interest and company housekeeping.

If this is of interest, please email office@cambslmc.org with details of those who would like to attend from your PCN. 


CAMBS LMC EVENT: Tuesday 23 April 2024 – 7:30pm-9:00pm via MS Teams

GP Contract Imposition, GP Referendum, local commissioning and impact on constituents

Reminder to register!  We are delighted to invite all GPs (including partners, salaried, locum and registrar colleagues) and Practice Business Managers to attend our online webinar, via Zoom on Tuesday 23 April 2024, 7:30pm – 9:00pm with our chief executive, Dr Katie Bramall-Stainer, to discuss the recent GP Contract Imposition and GP Referendum, including:

  • What this means for Cambridgeshire & Peterborough constituents
  • Local commissioning plans
  • Q&A session

There will be the opportunity for questions and answers at the event, however should you have any questions you’d like to share with us ahead of time, please email them to office@cambslmc.org and we will look to include these at the session.

The Cambridgeshire & Peterborough Training Hub are kindly managing the bookings for this event on our behalf, registration link here: https://cptraininghub.nhs.uk/event/cambs-lmc-webinar/

We look forward to seeing you on 23 April 2024.


GP Referendum BMA voting review

We wish to thank the profession for their support and engagement with the GP Referendum.  We are aware of some database issues identified within the BMA which meant that, despite everyone’s best efforts, some GPs who wanted to vote weren’t able to.

In order to better understand why GP colleagues couldn’t vote, we are collating information to make sure that no GP is disenfranchised in any future votes.  We are asking our local GP colleagues who were entitled to vote but didn’t manage to, to complete this form: https://forms.office.com/e/Wk3P4PjzPE

Any information you share will be used strictly for the purposes of working with the BMA membership department to amend these issues.


GPAS Report – 12 April 2024

Last weeks GPAS report can be found below:

LMC Update – 05 April 2024

CAMBS LMC EVENT:  Thursday 18 April 2024 – 12:30 – 2:00pm via Zoom

Directors duties and responsibilities, corporate governance and running your company

Cambs LMC is hosting an online training session for those that have, or are considering, setting up a limited liability, incorporated structure for your PCN, we are pleased to invite you to attend the following Cambs LMC hosted online training session:

LMC Law offers a practical seminar for incorporated organisations which includes general corporate governance and director’ duties and responsibilities, directors’ liabilities, decision making, difficult directors, conflicts of interest and company housekeeping.

If this is of interest, please email office@cambslmc.org with details of those who would like to attend from your PCN.


Cambs LMC Communications

Further to our email last week around the changes to the LINK, we would like to issue a correction to the information given around the available local WhatsApp groups.

The Cambridgeshire GP WhatsApp group is for GPs only and independent of the LMC.  We apologise for any confusion around this or upset caused.

The Cambs and Peterborough GP SOS WhatsApp group was set up to inform GPs predominantly of national communications and is hosted by the LMC.  As your GPCE representative,  Dr Diana Hunter, Chair of Cambs LMC receives information from central communications that require cascading out locally.  It is mostly broadcast only although we have opened the chat up around webinars.

The membership of this WhatsApp is for GPs initially, however this may be open to change and we will inform you accordingly.

With the changes to the LINK mailing list , our next planned step is to add all those who are current members of the SOS group to a new LINK equivalent WhatsApp group for local communications and discussion.  This membership will be for GPs and PMs, in the same way that the link always has been.

We will let you know when that group is up and running and we are planning to add numbers across.

You will have the option to opt out, either by emailing us at office@cambslmc.org or removing yourself from the group at any time.


GP Referendum BMA voting review

We wish to thank the profession for their support and engagement with the GP Referendum.  We are aware of some database issues identified within the BMA which meant that, despite everyone’s best efforts, some GPs who wanted to vote weren’t able to.

In order to better understand why GP colleagues couldn’t vote, we are collating information to make sure that no GP is disenfranchised in any future votes.  We are asking our local GP colleagues who were entitled to vote but didn’t manage to, to complete this form: https://forms.office.com/e/Wk3P4PjzPE

Any information you share will be used strictly for the purposes of working with the BMA membership department to amend these issues.


National update from BMA

On behalf of GPC England, I want to thank every single GP and GP registrar across the country who took part in our referendum. Let us not forget, this referendum wasn’t even a ballot, it was merely a dress rehearsal for what’s around the corner. Either way, had it been a ballot, it would have comfortably passed the required thresholds.

This referendum was a temperature check of the profession – and make no mistake – in the week where we have a third consecutive contract imposition, we are at boiling point. I’m overwhelmed to share the result that more than 99.2% of you have voted firmly against this contract. This is an unequivocal result that will demand NHS England, the Department of Health and Social Care, Government, and other parties now sit up and take notice.

It is now clear that we are one profession, which has spoken with one voice and said enough – time’s up. This contract imposition does not give practices stability. It does not give us hope. This contract, which NHSE are choosing to impose upon us, is not safe.

The contract changes, which will be imposed by the Government and NHS England from 1 April 2024, include a national practice contract baseline funding uplift of just £179m for England’s general practices, way below inflation in recent years, meaning many practices will struggle to stay financially viable over the next six to 12 months and risk closure.

The day after the referendum closed, GPC England met to decide and determine the next steps we’ll be taking as a profession knowing you’re standing right behind us. We are now starting to receive the full dataset and results breakdown from Civica, and we’ll share that with you in due course too.

When I qualified as a GP in 2008, we were called the ‘jewel in the crown of the NHS’. General practice has been demeaned, diminished, diluted, bullied and gaslit long enough. We now start the fight back, bringing our patients with us. Patients want access to their family doctor in a surgery that feels safe, with a well-resourced team ready to meet the needs of our communities, and that’s what we want too.

We are the bedrock upon which the rest of the NHS stands, with 400 million patient contacts a year. Almost 1.4 million every single day. That’s a lot of voters.

So congratulations, ‘team GP’. The battle to save general practice has begun. I’m proud to represent you, and I know that your BMA committee, GPC England, is proud to serve you.

We will be in touch soon with more information, guidance on the 2024/25 contract and next steps for us all.  Watch my video about the GP contract referendum results: GPCE contract referendum resultsFind out about the contract changes and read our FAQs to learn what this means for you.  Link to press release: GPs vote overwhelmingly to reject contract changes in BMA referendum

Dr Katie Bramall-Stainer, GPC England chair


GPAS reports for 05 April 2024 & monthly highlight report for March 2024

Please see most recent GPAS reports below:

LMC Update – 12 March 2024

Practice Manager update from your regional representative of the Institute of General Practice Management

IGPM statement on the initial pay proposal offer for the 2024/25 GP contract: https://igpm.org.uk/category/news/

For associate members – for just £50 a year fee the following free webinars are imminent.

Upcoming Webinars

Thursday 14th March at 1.45pm: One less task for NHS staff – Automation with Healthtech-1. There’s a growing appetite for automation and AI in primary care, but what’s the difference between these technologies? Dr Lydia van Hamel-Parsons, GP and Founding Clinician at Healthtech-1 will help explain this and where to get started with automation (within a week!) so you can join in on the time and cost savings as well as the relief in workload from using this tech. Email info@igpm.org.uk to book your place.

Thursday 21st March at 12.30pm: IGPM Finance for Practice Managers with Medics Money. We will be looking at the GMS statement breakdown, along with tips and aspects of the business to concentrate on when looking at how to help make the 2% increase in funding work as a business.


Measles outbreak – practice staff and MMR vaccinations

This is an issue we are all facing in our practices, and we have been doing searches for patients who need vaccinating. We have written to NHSE asking for funding to do this additional work and pressed for negligence scheme cover. We can now advise that cover is in place and is outlined in the message below.

On behalf of Jane Freeguard, deputy Director of vaccination – medicines & pharmacy

In light of the national measles outbreak and urgency to support rapid uptake of the MMR vaccine, we are permitting practices to administer MMR vaccines to their eligible staff who are registered with another practice under INT (immediately necessary treatment). Please note this is a time limited arrangement until 31 March 2024 in light of the on-going national incident and only applies to MMR vaccinations.

An item of service fee cannot be claimed for the administration of MMR vaccines to staff registered with another practice. However, indemnity cover will be provided through CNSGP and nationally supplied MMR stock can be used to vaccinate eligible staff. Staff must be strongly encouraged to inform their registered practice that they have received an MMR vaccine, requesting it be included in their medical record.


PC0241 | MMR Vaccination Survey Comms For Practice Staff | 11.03.24:

A reminder of the email that was sent to GP Practices yesterday following information circulated from the East of England Immunisation team and confirmation below on vaccinating their own staff:

Can GPs vaccinate their own staff, and can they get paid? (update 23rd February 2024) Practices are formally endorsed to administer MMR vaccines to their eligible staff who are registered with another practice under a temporary registration for INT (immediately necessary treatment).

  • This is in light of the current high risk measles situation and whether all of these vaccines continue to qualify as ‘immediately necessary’ will be reviewed in March 2024. Clearly in certain exposure situations, vaccines may be immediately necessary and clinicians should use appropriate professional discretion.
  • This arrangement does not apply to other staff
  • The national NHSE team have confirmed that indemnity cover for this activity will be provided through CNSGP and nationally supplied MMR stock can be used to vaccinate eligible staff.
  • Staff must be strongly encouraged to inform their registered practice that they have received an MMR vaccine, requesting it be included in their medical record.
  • In the East of England, we are encouraging staff to get vaccinated in their registered practice where possible, to support accurate and timely record-keeping

For clarity, the first port of call should be for staff to attend their own GP practice or one of HCT’s walk in vaccination clinics. A list of walk-in clinics can be found on our website The Vaccinators | CPICS Website.

As a reminder, any staff member that is exposed to measles without documented evidence will need to isolate from day 5 to day 21 after exposure and should be strongly encouraged to be protected. Documented evidence includes:

  • 2 x MMR vaccinations
  • 2 x Separate Measles Vaccinations (updated guidance from UKHSA and NHSE)
  • Positive antibodies for measles test

NATIONAL UPDATES:

2024/25 GP Contract Referendum – webinars

GPC England has rejected the 2024/25 GP contract changes. The contract has now been put to BMA GP members in a referendum. The referendum cannot prevent the Government from choosing to impose their changes to the contract, but it will send a strong signal as to how the profession feels about the contract, a potential third successive contractual imposition by Government and where we collectively go next. Find out more about the current contract changes here. You can watch Dr Katie Bramall-Stainer discussing the GP referendum here.

To ensure you can feel fully informed before you vote, BMA is holding a series of webinars and as you feedback we FAQs will be added to the BMA webpage http://www.bma.org.uk/gpcontract early next week, which you can read and reflect on with your practice colleagues.

What to expect:

  • A presentation from GPC England Officers outlining the context of the 2024/25 contract and what it means both for your practice, and you as a GP.  A summary of next steps and the choice BMA GP members will need to make in the referendum.
  • A roadmap of what the months ahead may look like.
  • The opportunity to have your questions answered – please send your questions in advance to gpreferendum@bma.org.uk

Webinar dates, times and Microsoft Teams joining links:

South East Coast: Wednesday 13th March: 19.30 – 21.00 Microsoft Teams link
North East: Wednesday 13th March: 19.30 – 21.00 Microsoft Teams link
North West: Thursday 14th March: 12.30 – 14.00 Microsoft Teams link
West Midlands: Tuesday 19th March: 19.30 – 21.00 Microsoft Teams link
South Central: Wednesday 20th March: 12.30 – 14.00 Microsoft Teams link
South West: Wednesday 20th March: 12.30 – 14.00 Microsoft Teams link
Yorkshire & Humber: Wednesday 20th March: 19:30 – 21:00 Microsoft Teams link
East of England: Wednesday 20th March: 19:30 – 21:00 Microsoft Teams link
National Catch-Up: Thursday 21st March: 12.30 – 14.00 Microsoft Teams link 19.30 – 21.00 Microsoft Teams link

These webinars will NOT be recorded, so please attend your regional slot, or a national catch-up session. The referendum opened on 7 March and closes midday Wednesday 27 March. You should have received an email with a unique voting link. How you vote will determine BMA’s next steps as a profession.


GP Workforce – January 2024

There are 48 more fully qualified, full-time equivalent GPs in January 2024 than in December 2023, marking seven months of sustained increases. However, we have the equivalent of 1,830 fewer fully qualified full time GPs than we did in September 2015. During this time, there has been a rise in the number of patients registered at practices, with January 2024 seeing another record-breaking rise. GPs are now responsible for 18% more patients than in 2015, creating ever mounting workload pressures.

  • In January 2024, the NHS had the equivalent of 27,534 fully qualified full-time GPs. This is an increase (48 FTE) from the previous January 2024 marks seven months of, albeit small, increases in full-time equivalent fully qualified GPs, with an additional 382 fully qualified GPs joining the workforce during this time.
  • However, the NHS been losing fully qualified GPs at an alarming rate since 2015, with GP partners making up a substantial part of this shortfall (when this data set began). We now have the equivalent of 1,830 fewer fully qualified full time GPs than we did in September.
  • The GP Partner workforce in particular has been shrinking since 2015. There were 16,579 FTE GP partners in January 2023 but 16,176 in January 2024: a total loss of 403 FTE GP partners in the past 12 months alone.
  • The number of GP practices in England has decreased by 106 over the past year – reflecting a long-term trend of closures and mergers.
  • This fall in both staff numbers and GP practice coincides with a rise in patients: as of January 2024, there was another record-high of 63.15 million patients registered with practices in England – an average of 10,005 patients registered per practice.
  • As a result, each full-time equivalent GP is now responsible for an average of 2,294 This is an increase of 356 patients per GP, or 18%, since 2015, creating an ever-mounting workload in general practice.

Read more on our analysis – “Pressures in General Practice”


HRT guidance updates

An updated HRT PPC guidance document has been published by DHSC. This is to reflect changes to the definition of products in scope of the HRT PPC, following the launch of new products onto the market, and an agreed process for managing discontinuations. The latest version can be found here: HRT PPC guidance | NHSBSA.


Preparing for the Spring 2024 COVID-19 vaccination campaign

Preparations are underway for the Spring 2024 COVID-19 vaccination campaign, following the achievements of the 2023 Autumn campaigns. The NHS is focusing on delivering a seasonal COVID-19 vaccine dose, aligning with government recommendations. Eligible cohorts include adults aged 75 and over, care home residents, and immunosuppressed individuals. Efforts are being made to ensure equity in access and address variations in uptake. Funding and contract arrangements are extended to support vaccination activities, with plans for supply and delivery to be finalised soon. The commitment of healthcare professionals is crucial for the campaign’s success. Read more here.



PRSB survey – GP activity data

The Professional Records & Standards Body (PRSB) are surveying GPs as part of a set of proposals to implement a standard set of SNOMED codes to capture consultation mode and GP activity data. The surveycloses on 15th March and seeks to garner views from practices on how day-to-day activity that takes place can best be defined and recorded.


 NIHR in-Practice Fellowship

The NIHR in-Practice Fellowship (IPF) initially offered academic training to fully qualified general practitioners, general dental practitioners, and community dentists, who are in NHS practice in England. The eligibility for this scheme has been broadened in 2024 to cover all other health and care professionals working in a primary care setting, including (but not restricted to) nurses, midwives, pharmacists and health visitors. This enhanced offer will enable a larger cohort of health and care professionals to access research training and development, to advance their academic research careers In-Practice Fellowship (IPF) Round 18 | NIHR


Professional Record Standards Body

The PRSB is aligning its standards to the new Pathology standard (DAPB4101) going through approval at the DAPB in March. The current components used in PRSB standards were developed before the recent pathology standards. The PRSB need to ensure that test results and reports that clinicians receive can be shared digitally with their colleagues and can be incorporated into shared care records. The PRSB are asking clinical informaticians with an interest in pathology to review PRSB standards in light of the new standards to ensure that they align. To support this work, the PRSB are holding a webinar on Thursday 21 March, 11am – 1pm, to register click here.


Cloud based telephony

GPCE has written to NHSE to raise concerns over the rollout of CBT (cloud-based telephony) and the financial and workload impact this is having on practices along with pressure to sign complex contracts on very short deadlines. NHSE advised last year that there would be no increased costs to practices for their monthly contracts. We have relayed concerns raised about these issues and are seeking an urgent meeting with NHSE while calling for a pause of the roll-out of this contract mandated procurement exercise.

We want to hear if you are seeing increased costs and please do email info.gpc@bma.org.uk

with details of what you pay now and what you are being asked to pay going forward with the telephony provider.

GPs have been pressured at the last minute to sign up to new telephony systems at huge extra cost – despite reassurances from NHS England this would not be the case. Deputy chair Dr David Wrigley thinks this is a huge mistake and has called for an immediate pause, read more here.