LMC Update – 30-August 2024
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 21st 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