Dear colleagues,
Here is the June 2024 newsletter from City & Hackney LMC.
GP Support
The LMC was briefed at its last meeting on support services available for general practice from Londonwide LMCs. Information is available here.
Secondary care issues
LMC members have begun to establish more systematic working with hospital colleagues to find better ways of working together. We have raised issues like hospitals asking GPs to re-refer when patients miss appointments, and the importance of consultants and trusts providing complete care packages in accordance with their contracts. If GPs have recurrent difficulties with secondary services, please let us know (contact via any LMC member or the office at ian.williamson@lmc.org.uk).
Individual patient issues can also be raised directly with the Homerton via the Quality Alert process – the RP document template can be found within your Emis documents section and is straightforward to complete. A particular hesitation we have heard by clinicians is the tick box asking for patient consent – we have been assured that this is not mandatory as it is not always appropriate, so please do not let that prevent you from raising a legitimate quality concern.
Another issue that we have begun to tackle with secondary colleagues is Advice & Guidance. Londonwide LMCs has produced some guidance for GPs, available here.
Concerns have also been growing about shared care, including unresourced work transfer and the involvement of medications that are challenging for GPs to manage. Shared Care agreements require the agreement of all parties, including primary care, secondary care and the patient. Options for practices include setting policies about certain types of agreement which enable quick response to requests. There is guidance from Londonwide LMCs on shared care agreements here.
CCE contract
This contract is to be renewed. No additional money is available so the LMC will talk with commissioners about reducing the work required to claim, because costs have increased since the previous contract was put in place.
7-year Long-Term Conditions contract
This contract is also to be renewed. Commissioners are making a business case to level up funding for general practice across NE London, continuing and extending the additional funding that City & Hackney already has for providing additional services. The LMC supports this levelling-up principle and will engage with the detail as it comes out.
ARRS
The LMC raised the sustainability of the management costs of ARRS positions with the Office of PCNs. We have been assured that they are fully aware of the issue and Agnes and Urfan from the office are working hard to acquire the necessary additional funding through ongoing negotiations with NEL ICB and the Training Hub.
General Practice Alert State – anonymised GP-led pressures reporting
Over the last year Londonwide LMCs has been rolling out GPAS on behalf of London’s general practice. It is to identify and track the pressures area-wide in general practice and flag them to NHS partners, as hospital and ambulance trusts do with their OPEL system. NHS England is requiring ICBs to have a reporting system for general practice, and we hope to establish GPAS in this role, as it is general-practice-run, confidential and anonymous, while we cannot be confident that an ICB-established system would be. In GPAS, practice-level data is not passed to the ICB, only borough-wide aggregates.
GPAS is simple to use and takes on average 2-3 minutes per week in response to a data request email. Practices receive a copy of the weekly situation report with the borough- and sector-wide pressure levels. The LMC uses this report to press the NHS system for support where and when needed. Currently, the numbers of practices participating need to be higher across NEL to make a more compelling case. City & Hackney as the newest area in the NE London rollout of GPAS has the lowest participation rate with less than a third of practices signed up so far. It is important that the area is represented equally with other boroughs: you can sign up (or update your contacts) here. There is more information at this article by the LMC’s Medical Director Dr Elliott Singer.
LMC information
You can find information about LMC members, contact channels, meeting dates and so on at our web page.
Best wishes,
Dr Vinay Patel, Chair, City & Hackney LMC