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GPC England's LMC Update: 26 May 2023

Safe working and preparing for balloting on industrial action

Current working conditions are not safe, for patients or GPs, and the contractual changes imposed by NHS England in April do not recognise the immense pressures that GPs are under. Practices are strongly encouraged to continue to use our safe working guidance to help prioritise safe patient care, within the present bounds of the GMS contract.

We need to come together to save general practice, defend our profession, and make general practice safe for patients. The BMA’s GP committee has voted to prepare to ballot GPs on industrial action if the Government does not agree to improve the contract drastically in forthcoming negotiations. The BMA will be communicating directly with GPs and LMCs over the coming weeks and months.

At the LMC UK Conference last week, representatives passed a motion calling for the GMC, who has already confirmed they will not act against junior doctors taking industrial action, to extend this pledge to GPs, should they also invoke their legal right to take industrial action.

We are asking you to join us as we prepare for potential industrial action. By law, only BMA members can participate in a ballot on industrial action, and the more BMA members working collectively sends a powerful message to government that the present situation must urgently change. If you are a member, it is essential that you make sure the details we hold for you are up to date to ensure your vote counts. Update your member details on the BMA website www.bma.org.uk/my-bma or join us as a member today.

Workforce data

The latest workforce data, published yesterday, show that the number of fully qualified GPs has significantly declined since September 2015. In April 2023, the NHS in England had the equivalent of 27,231 fully qualified GPs, which is 2,133 fewer than in September 2015.

Over the past year the NHS has lost the equivalent of 512 fully qualified, full-time GPs, and on a headcount basis, we have lost 428 GP partners and 149 salaried, locum and retainer GPs – creating a net loss of 577 individual GPs from the NHS since April 2022 – more than 1 GP per day.

This coincides with a rise in patients: as of April 2023, there was a record-high of over 62.43 million patients registered with practices in England. As a result, the average number of patients each full-time equivalent GP is responsible for continues to rise, and is now 2,292. This is an increase of 355 patients per GP, or 18.3%, since 2015, demonstrating the ever-mounting workload in general practice.

These figures both demonstrate the need for government to take urgent steps to make general practice sustainable again, and the government must focus its efforts on addressing the workforce crisis across the NHS, investing in the health and appropriately valuing staff. That is the only way to tackle the record-breaking backlog and help patients who are desperate to be treated swiftly and close to home.

Read more about the pressures in general practice here

BMA member briefing on the GP delivery plan

In May 2023, NHS England and DHSC jointly published their Delivery plan for recovering access to primary care, setting out how they intend to tackle the ‘8am rush’ and make it easier and quicker for patients to access primary care services.

Whilst some of our recommendations have been incorporated into the plan, in our view it falls short and fails to address the severe inflationary cost pressures all practices currently face. We are also very concerned that the continuing cuts to public health funding and the lack of adequate investment in practices and community pharmacies will negate the commitments set out in the plan.

Alongside our initial press statement responding to the plan’s publication, we have also produced this member briefing on the report.

We will share with practices and LMCs some resources to support local implementation of the primary secondary care interface elements of this plan.

Labour Party's NHS plan - Building an NHS fit for the future

Earlier this week Sir Keir Starmer announced the Labour Party's NHS plan Building an NHS fit for the future and in his speech he declared that Labour will modernise appointment systems and get salaried GPs to serve all communities. We will be writing to Sir Kier to ask how they are planning to do this, highlight the huge benefits of the independent contractor model, and offer to help shape their finer detail. Read the statement in response to the plan by Phil Banfield, Chair of BMA Council.

Annual flu letter

UKHSA and NHS England have published the annual flu letter for the 2023/24 flu vaccination programme. Practices should be aware that there are no changes to the reimbursable vaccines from the 2022/23 programme. Further details will be available once the specification has been agreed and published.

Oliver McGowan Mandatory Training on Learning Disability and Autism

All GP practices in England must ensure their staff receive training in learning disability and autism, including how to interact appropriately with people with a learning disability and autistic people. This requirement was introduced by the Health and Care Act 2022 in July last year. The government’s preferred training programme is the Oliver McGowan Mandatory Training on Learning Disability and Autism. However, the Act does not specify a training package or course for staff. The CQC cannot tell practices specifically how to meet their legal requirements in relation to training, and while NHS England and ICBs may share the government’s training programme preference and encourage uptake, it is ultimately for practices to determine how their staff are trained to meet their legal requirements. Further information is available here.

EMIS reverses panic button decision

BMA lobbying has helped GP practices to retain the EMIS panic button, which is used in emergency situations, as EMIS has decided that the EMIS panic button will continue to be available for practices who wish to keep it.

The number one priority for any doctor is ensuring patient safety, which is why changes to the EMIS system have an impact. We have a duty of care to voice our concerns when there is a risk, and are pleased to see they have been taken seriously.

Although we know that some practices face technical challenges with the system so do not use it, this is a sign that the NHS IT infrastructure is seriously inadequate. We need to see actual investment in practices to not only help them stay open, but ensure that they are as safe a space as possible.

OpenSAFELY

In recent months GPCE’s Digital Transformation Policy Group, along with the Joint GP IT Committee, have been providing scrutiny to the forthcoming Data Provision Notice (to be sent under the COVID-19 Directions from the Secretary of State for Health and Social Care) that will allow OpenSAFELY to continue to operate as a Trusted Research Environment (TRE) once its COPI permission expires on 1 July 2023. It has been a complex process with regard to information governance.

The proposal speech to Motion 12 at the conference of England LMC representatives last November referenced the OpenSAFELY TRE as one that has the support of the profession. This remains the case. Practices will not need to do anything and formal communication from NHS England explaining the evolving legal basis for operation will be coming soon.

LMC meetings

The GPC England officers are keen to continue to engage with LMCs throughout the country. This is a vital time for the profession and GPCE’s leadership wants to be on hand to answer any queries and provide information that LMCs require. If it would be beneficial for a GPCE officer to virtually attend your LMC meeting, then please get in contact with Karen Day (kday@bma.org.uk) with the time and date of the meeting, as well as which LMC you are contacting GPCE on behalf of.

ARM 2023 - agenda

The Agenda for the BMA’s ARM (Annual Representative Meting), which will be held 3-5 July, has now been published - access it here.

Read more about the work of the Committee

Read practical guidance for GP practices

See the latest update on Twitter: @BMA_GP / Twitter @TheBMA / Twitter


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