Haringey LMC news update – May 2022

Dear colleague,

Your LMC is here to support you in times which are very difficult for GPs and everyone working in practices. We meet once a month – any Haringey GP who needs support with a professional issue can contact us via sarah.ocran@lmc.org.uk. We will be sending out short regular newsletters so that you know how we are acting on your behalf – some of our recent achievements are as follows.

1. Local urology departments had been discharging patients who were referred for a high PSA but do not have prostate cancer, asking the GP to do an annual PSA and/or digital rectal examination. This is unresourced work and we are delighted to announce that NMH now have a nurse led clinic and will carry out this monitoring themselves. If you have any such patients who you are monitoring in primary care then they should be referred back for nurse led monitoring in secondary care – the lead consultant on this is Mr. Almpanis. This is different from PSA monitoring for patients who have had prostate cancer, which is done in primary care under a resourced enhanced service.
2. We fully support the BMA and Londonwide LMCs campaign on unresourced work and would encourage GPs who experience workload shift to return this work to the hospital and submit a quality alert to the CCG via the contacts on this page.Examples of workload shift include the following:
   1. A consultant asking a GP to carry out a test e.g. blood test or x-ray. The consultant should give the form to the patient directly.
   2. A consultant asking a GP to chase the result of a test requested in secondary care.
   3. A consultant asking a GP to repeat a test shortly after discharge e.g. repeating renal function three days after discharge. This is part of the same episode of care and should be followed up by secondary care.
   4. A consultant asking the GP to carry out monitoring which is not resourced in primary care, e.g. annual bloods patients with MGUS – this should routinely be done by the consultant and their team unless there is a resourced enhanced service protocol, such as there is for DMARD monitoring.
   5. A consultant discharging a patient with a request that the GP refer back e.g. in three years for a repeat colonoscopy. The hospital should hold this patient on their books and recall them themselves.
3. We are in discussions with the council about the fees for foster care medicals and would be grateful if GPs could share their experiences (via sarah.ocran@lmc.org.uk) about whether they do these for the set fee or set their own fees and any difficulties in being paid once the report is done.
4. With significant changes in the organisation of primary care about to happen, we are providing representation at key meetings. In particular we are vociferous about the difficulties in retaining staff in Haringey (where outer London weighting is paid) compared to other boroughs of NCL where inner London weighting is paid and have advocated for standard pay across NCL, to reduce this inequality.
5. Work is ongoing to clarify thresholds, coding and payments for a variety of LCSs, as well as the new extended hours DES and whether a GP needs to be on site at all times.
6. Public health are concerned as very few practices have signed up to the Public Health GP contracts (e.g. LARC and smoking cessation). If practices would like to sign up but need assistance with the paperwork, the Federation will help if contacted. We would like practices to feed back to us (via sarah.ocran@lmc.org.uk) if they have made a conscious decision to not sign, including the reasons why.

Finally, all members of the LMC were shocked and saddened to hear of the recent sudden death of one of our colleagues, Dr. Mohammed Akunjee. We extend our deepest sympathies to his family and colleagues.

Best wishes,

Dr Sue Dickie

Chair
Haringey LMC