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GPC England's LMC Update: 31 August 2023

COVID vaccination programme update

NHS England has announced new changes to the previously published winter covid vaccination guidance, as part of an ‘accelerated programme’. Following the earlier notification of a reduction to covid fee payments, there will now be time limited ‘accelerated payments’ offered to bring forward the covid vaccination programme to 11 September for completion by the end of October (this relates to the enhanced fees and vaccination can continue after 31 October, but at the reduced IoS fee of £7.54). NHSE guidance states:

‘Vaccine providers will receive an additional payment of £10 (in addition to the Item of Service (IoS) fee) for each COVID-19 vaccination administered to care home residents between Monday 11 September and Sunday 22 October 2023 inclusive; and a separate one-off additional payment of £200 for each Completed Care Home by the end of the day on Sunday 22 October.

For other eligible groups, vaccine providers will receive an additional £5 acceleration payment (in addition to the IoS fee) will be made available for each COVID-19 vaccination administered to eligible people between 11 September and 31 October 2023’.

In line with previous BMA guidance, we continue to advise practices to consider and assure themselves of the financial viability of participating in the COVID vaccination programme under these shortened time frames.

Practices will now have until 5pm on 4 September if they do wish to sign up for the programme.

Read my statement in response.

Accelerated Access to Records Programme update

GPC England continues to support patients taking a proactive role in the management of their own health. This could be facilitated through access to a patient’s own electronic health records.

Following the imposition of the 2023/24 GMS contract, the Accelerated Access to Records Programme is currently scheduled to go live for all patients on 1 November 2023. From that date, patients in England will be given prospective access to information entered into their GP record.

However, GPC England believe there are patient safety and information governance concerns that remain outstanding, and which need to be addressed. For this programme to be successful and fulfil its potential we believe it should not be rolled out in a ‘big bang’ style on 1 November. Practices need to be given the appropriate time and resources to safely plan this in each practice across England, and we continue to press for this as well as further modifications.

Rollout dates

We are aware that EMIS have shared training dates to facilitate their ‘bulk upload’ and they are encouraging EMIS practices to use the new functionality which has been paid for by NHS England. Earlier this year, many practices wrote to system suppliers to turn this functionality off.

We will publish comprehensive advice and guidance for all practices and will continue to set out concerns and solutions to Government ministers. We will also be engaging with EMIS and TPP to ascertain how they can best support GPs with respect to bulk uploads in the lead up to and after the proposed switch on date.

We would therefore reassure practices that they have time to consider matters, and contractors do not need to make any quick decisions before our guidance has been published.

GP pressures

GP practices in England are experiencing significant and growing strain with declining GP numbers, rising demand, struggles to recruit and retain staff and knock-on effects for patients.

The latest GP workforce data showed that the number of fully qualified GPs has dropped since September 2015. In July 2023, the NHS in England had the equivalent of 27,177 fully qualified full-time GPs, which is 2,187 fewer than in September 2015.

The longer-term trend shows that the NHS is losing GPs at an alarming rate: over the past year (between July 2022 and July 2023) it lost the equivalent of 330 fully qualified full-time GPs and the equivalent of 358 full-time partners. This means that, on average, the NHS lost 28 fully qualified FTE GPs per month over the past year.

The number of GP practices in England has decreased by 102 over the past year – reflecting a long-term trend of closures as well as mergers primarily due to a lack of workforce. This coincides with a rise in patients. As of July 2023, there was another average of 9,834 patients registered per practice, and as a result, the average number of patients each full-time equivalent GP is responsible for continues to rise, and now stands at 2,305. This is an increase of 367 patients per GP, or 19%, since 2015, demonstrating the ever-mounting workload in general practice. Read more about the pressures in general practice here

Wes Streeting proposal to pay GPs more to allow patients to see the doctor of their choice

Responding to shadow health secretary Wes Streeting’s proposal to pay GPs more to allow patients to see the doctor of their choice, Dr Katie Bramall-Stainer, chair of GPC England, said:

“Mr Streeting was correct to say fewer patients were now able to see a doctor of their choice, but

argued it was vital to see this in the context of 2,200 full-time GP posts being lost since 2015.

Combine this workforce exodus where GPs at breaking point are retraining, taking on other roles or leaving entirely with millions of patients on NHS waiting lists and we have the perfect storm.

Every GP strives to deliver the best care to our patients in the most appropriate way we can based on patient choice, but the reality of the chronic workforce shortage makes this an impossible ask against the backdrop of increasing demand from a growing – and ageing – population.”

Every day over a million appointments are delivered across England, way more than even before the Pandemic - with less staff. GPs regularly see more patients than our safe working guidance recommends. And yet, we still cannot keep pace with demand.

We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract.

Junior doctor re-ballot results

The results of the junior doctor re-ballot are now in and we are pleased to confirm that their mandate for strike action has been extended for a further six months. Junior doctors are not prepared to let 15 years of real-terms pay cuts stand. Now with this renewed mandate, junior doctors, including GP trainees, and consultants will take joint action for the first time. The key dates are 19 – 22 September and 2 – 4 October and you can find full details on the BMA website.

England Conference of LMCs

A reminder that the England Conference of LMCs is due to take place on Thursday 23 and Friday 24 November 2023. The deadline for submitting motions is Wednesday 13 September at 12 noon and the deadline for registering to attend the conference is Friday 10 November. Please be advised that this is a registered event and only those LMCs registered will be permitted to attend the conference, no exceptions will be made.

Best Practice Show, 11-12 October 2023, NEC Birmingham

This year the BMA and GPC England will be at Best Practice Show, UK’s number one event for the primary care and general practice community, at the NEC Birmingham on 11-12 October 2023.

GPC England will have a dedicated theatre at the conference, with a programme focussed on the most pressing issues facing sessional GPs and GP partners including safe working and workload management, patient access to records, the future of general practice, GP contracts and more.

Free for healthcare professionals, the conference programme will provide up to 12 hours of CPD certified training, expertly tailored to meet the training requirements of healthcare professionals.

If you are interested in attending, you can register here.

Preparing for balloting on industrial action

We need to come together to save general practice, defend our profession, and make general practice safe for patients. In April, GPC England voted to prepare to ballot GPs on industrial action if the Government does not agree to improve the contract drastically in forthcoming negotiations.

If you are a member, make sure the details we hold for you are up to date to ensure your vote counts. Update your member details on or join us as a member today.

Wellbeing resources

As we continue to face overwhelming pressures in general practice, we encourage practices to continue to focus on their own team’s wellbeing and take time to meet to reflect on their wellbeing and what they can do to protect it. This will meet the requirements of the QOF targets in the GP contract to do your quality improvement project on staff wellbeing. We have produced a document which includes some tangible recommendations and tools for improving workload and safe working.

A range of wellbeing and support services are available to doctors, from our 24/7 counselling and peer support services, NHS practitioner health service and Samaritans. The organisation Doctors in Distress also provides mental health support for health workers in the UK, providing confidential peer support group sessions. See our poster with 10 tips to help maintain and support wellbeing.

Please visit the BMA’s wellbeing support services page for more information and resources.

GPC England committee pages and guidance for practices

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

Read the last GPCE bulletin

Read the latest Sessional GPs newsletter

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