GPC England's LMC Update: 22 April 2022

PCN DES

The updated PCN DES specification was published at the start of this month. Whilst GPC England continues to support the principle of the DES – independently contracted practices collaborating, alongside other local NHS providers, to provide services which are designed to support local communities – and given the realities of the unagreed contract changes brought in by NHSE/I for 2022/23, practices should be aware of their options relating to the DES.

We believe that the newly added demands within the PCN DES are a risk to patient and practice staff safety in terms of potentially unmanageable/unsafe workload and burnout. Worryingly, the recent GP Worklife Survey confirmed that GPs are overworking, with around 33% likely to quit direct patient care within the next five years. This rises to over 60% for GPs over 50, which is a worrying statistic given over 44% of the GP workforce is over 45.

Following the conclusion of the 2022/23 contract negotiations and the release of the DES specification, we sought further clarification from NHSE/I and proposed practical solutions that we felt would alleviate the concerns of the profession and any potentially negative impact from the unagreed changes. None of them were accepted.

With this in mind, practices will need to carefully consider the DES changes for 2022/23 and how this may impact them going forward. In particular, the incoming Enhanced Access requirements from October 2022 and the expanded service offer.

PCN DES opt out window

Practices who do not wish to continue participating in the PCN DES have until 30 April 2022 as part of the current annual opt-out window, with additional 30-day windows following any in-year changes to the enhanced service specification. Practices must inform the local commissioner if this is their decision before the stated deadline. It’s important to note that opting out during a specified window is not a breach of contract.

Practices should take into account safe working levels from both a workload/staffing and patient perspective, bearing in mind the BMA’s safe working guidance.

Read more in our guidance about the contract changes to support practices in their decision making and next steps.

GP workforce data

The number of GPs in England has fallen every year since the Government first pledged to increase the family doctor workforce by 5,000, the health minister Maria Caulfield disclosed in a parliamentary answer. There were 29,364 full-time-equivalent GPs in post in September 2015, when the then health secretary, Jeremy Hunt, first promised to increase the total by 5,000 by 2020, however, it has now fallen to 27,920 as shown by the latest GP workforce data from NHS Digital.

These figures show that the lack of doctors in general practice is going from bad to worse for both GPs and patients, and patients are paying the price in the form of long waits for an appointment. Dr Kieran Sharrock, GPCE deputy chair, said:

“Despite repeated pledges from government to boost the workforce by thousands, it’s going completely the wrong way. As numbers fall, remaining GPs are forced to stretch themselves even more thinly, and this of course impacts access for patients and the safety of care provided.”

It’s time to rebuild general practice: support the campaign

The Rebuild general practice campaign continues to tackle the crisis facing general practice. The aim is to support GPs and their teams at an extremely challenging time to deliver the service that patients and staff deserve. Over the coming weeks, the campaign will build awareness of the key issues in the media, with the public and with politicians.

The campaign is calling for:

  1. Recruitment: the UK Government delivering on its commitment to an additional 6,000 GPs in England by 2024

  2. Retention: tackling the factors driving GPs out of the profession such as burnout

  3. Safety: a plan to reduce GP workload and in turn improve patient safety.

You can follow and share content, news and updates on the campaign Twitter account


Download the campaign materials here.

Join our campaign for fair pay

Over the last two years doctors have worked tirelessly, with many putting their lives on the line to keep patients safe during the pandemic. With the NHS facing a backlog that will takes years to clear, in the face of severe staff shortages, these extraordinary pressures are set to continue.

Inflation is soaring and doctors are being driven out of the NHS by punitive pension tax rules. The BMA is now calling on the UK Government to award doctors a minimum pay rise of RPI plus 2% for doctors, including those working in public health services.

The BMA is urging that doctors in England write to their local MP asking for their support for our campaign. Using the BMA’s online tool, you can add your name to a template letter, that will be automatically sent to your local MP.

Infection Prevention Control in healthcare settings

The UKHSA has revised the Infection Prevention Control (IPC) guidance for healthcare workers, and now advises returning to pre-pandemic physical distancing in all healthcare settings, including primary care, and returning to pre-pandemic cleaning protocols outside of COVID-19 areas, with enhanced cleaning only required in areas where patients with suspected or known infection are being managed.

The guidance continues to recommend all healthcare organisations should undertake local risk assessments to ensure safe systems of work in the context of the wider impact of COVID-19 on health services. Practices should assess the risk to patients and staff using this guidance, and make decisions based on the needs and risks of everyone entering their practice building. Practices should also continue to triage patients and cohort people with respiratory illnesses. Read our guidanceon risk assessments for practices

The guidance still advises that all patients, visitors and staff should continue to practise good hand and respiratory hygiene, including the continued use of face masks by staff and face masks / coverings by visitors and patients where clinically tolerated.

NHSE/I has published a letter setting out these changes

Read also the BMA’s briefing in response to the Government’s ‘Living with COVID-19’ strategy which sets out the plans for managing COVID-19 going forward.

Download our updated poster about using face coverings in practices.

Arrivals from Ukraine: advice for primary care

The UK government has published guidance Arrivals from Ukraine: advice for primary care to help primary care professionals assess and address the health needs of patients ordinarily resident in Ukraine who have arrived in the UK. Arrivals will usually be under the government visa schemes Ukraine Family Scheme and the Ukraine Sponsorship Scheme (Homes for Ukraine).

The guidance notes that it is important to adopt a trauma-informed approach that offers clear information and choice, supporting individuals to feel in control. Doctors of the World has produced the Safe Surgeries initiative (endorsed by the BMA) to tackle the barriers faced by many migrants in accessing healthcare, with GP registration being the first hurdle that this vulnerable group needs to overcome.

National flu immunisation programme 2022/23

UKHSA has published the annual National flu immunisation programme 2022/23 letter which sets out which groups are eligible for flu vaccination for the 2022/23 flu season.

NHSE/I will be publishing the specifications shortly, and have advised us that suppliers have committed to flexibility if the reimbursement letter has impacted current orders. Therefore, if practices are having trouble amending orders, they should contact the contact the NHSE/I flu inbox phco.fluops@nhs.net.

LMC UK conference 2022

The Agenda for the 2022 UK LMC Conference, which takes place on 10 and 11 May in York, has now been published and is available here

The Conference will be webcast live - for more information see here: Local medical committees

Please send any queries to info.lmcconference@bma.org.uk

LMC UK Conference elections to GPC UK 2022-23

Please be advised that LMC UK Conference elections are open for seven members to the General Practice Committee (GPC) UK 2022-23. Nominations will close 12pm Tuesday 3 May 2022.

To nominate yourself, click here.

For six seats, any registered medical practitioner whose exclusive or predominant medical commitment is to providing personally or performing NHS primary medical services for at least two sessions a week, whether a member of the conference or not, is eligible for nomination. Please note that nominations need to be made/supported by LMC representatives, and a representative may not make/support more than one nomination

The seventh seat must be filled by an LMC representative who must never have sat on GPC UK and who is also a member of the conference and a registered medical practitioner whose exclusive or predominant medical commitment is to providing personally or performing NHS primary medical services for at least two sessions a week.

Please send any queries regarding the election process to elections@bma.org.uk

GP Trainees Committee - Elections Open

Elections are now open for the GP Trainees Committee for a two term session for seven constituencies. Nominations close at 12pm Thursday 5 May 2022, with the ballot from 12pm on Monday 9 May 2022 to 12pm on Monday 6 June 2022.


In addition, by-elections for a one-session term are also open in East Midlands, and Kent, Surrey & Sussex. Nominations for the by-elections are open until 12pm on Tuesday 3 May 2022, with the ballot from 12pm on Friday 6 May 2022 to 12pm on Friday 20 May 2022.

Full details about the GP Trainees Committee and election eligibility can be found here

Please send any queries regarding the election process to elections@bma.org.uk

Read the latest GP bulletin (England) here


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