17 June 2024
Dear Colleague,
At NHSExpo24 (IKR) last week Amanda Pritchard, NHS England CEO said that the NHS must grow to cope with an ageing population (who knew?) but can’t afford to only grow, it must ‘reimagine’ and ‘we will start with primary care‘.
I think we can probably all appreciate that when she says primary care, she is really aiming at general practice. Have we not been reimagined enough? Core services funding cuts leading to insecurity and unsafe working. ARRS funding rigged against GPs and practice nurses.
With that in mind, along with the 99.2% GP referendum vote in favour of rejecting the 24/25 NHSE imposed contract, on Thursday we held a double-header event to give early sight of our Londonwide LMCs safety pack for practices, and to enable London GPs, practice nurses and manager colleagues to be briefed by GPC England leaders on the next steps, starting with a non-statutory Ballot of GP Contract Holders which is now open: “Are you prepared to undertake one or more examples of collective action as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice?”.
With all of the above at the forefront of our minds, I have six items for you:
- Safety first – safety pack
- BMA non-statutory ballot of GP contract holders is open now: “Are you prepared to undertake one or more examples of collective action as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice?”
- BMA resources/campaign materials for you, in your surgeries
- GPCE “Focus on” restarts
- Pathology services in South East London
- GPAS and getting involved
- Safety first – safety pack
Increasingly practices in London tell us that they feel unable to deliver care that is safe for patients, or for staff. That’s why we have developed and launched our new safety resource pack. With new and refreshed resources to help manage workload, our new guide on dealing with abusive and violent patients, guidance on managing access, a patient participation pack, template letters and responses, posters, and guidance on reporting operational pressures, these dedicated resources will help practices manage the growing demands they face.We are responding to staff concerns about safe practice driving stress and worsening mental health – whether due to pressure to operate beyond the limits of their expertise, system operational failings, or the demand: capacity/ capability mismatch. If we don’t find a way to address this soon GPs will continue to leave and if workforce numbers keep dropping the safety and quality of the service we offer to our patients will decline even faster.
With thanks to my Deputy CEO Dr Lisa Harrod-Rothwell, Medical Directors Dr Elliott Singer and Dr Hannah Theodorou, GP Support Director, Vicky Ferlia, Head of Communications, Alex Orton, and the rest of the team who have worked hard to pull these resources together, I urge you to check them out, share them, and most importantly… use them!
- Safe working pack – a new collection of resources designed for GPs to have open during consultations, gathering together new, updated and existing materials.
- Abuse and violent patient guide – a new document providing extensive advice and tools for practices to help manage and mitigate the unfortunate rise in patient abuse.
- Patient participation support pack – these new materials help practices to build support and understanding of how they are prioritising work to safely meet patient needs, while under unprecedented pressures.
- Template letters – these updated letters can be used to push back on un-resourced work, so GPs can focus on essential activity that keeps their patients safe.
- Posters – used alongside the template letters, these refreshed posters can help to build patient understanding of what they can expect from their GP.
- Guidance documents – covering a wide range of topics, our guidance helps GPs and practice teams to navigate what activity they are responsible for and stay safely on the right side of regulations and requirements.
- BMA non-statutory ballot of GP contract holders is open now: “Are you prepared to undertake one or more examples of collective action as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice?”
The GP BMA online ballot opens today, 17 June, and closes on Friday 29 July. Please please please participate! To ensure you have a say you must be a GP contractor/ partner member of the BMA. Non-members can join now for 3-months free membership.The GPC England team has now launched a public-facing communications campaign (see below) and profession-facing resources. Alongside the ballot will be information about a menu of actions which will not breach GP contracts, but which collectively, will have a significant impact on ‘the system’. Following our event last week, where we provided a platform for GPC England Chair Dr Katie Bramall-Stainer to set out what is being asked of you, the risk mitigations in place and how the possible actions fit into a long-term, strategic approach, the time to act is now!And if you are wondering if all this is still necessary with a possible change of Government around the corner, it is clear that – as Katie said last week – whoever is in the Department of Health and the Treasury come the 5th of July, it’s still going to take a loud and clear message from general practice to get the changes that our practices and patients so badly need. Such as a new contract. The model isn’t broken, the contract is.
- BMA resources/campaign materials for you, in your surgeries
General practice is collapsing and with every practice struggling to keep its doors open, the latest GPC England campaign couldn’t be more timely! We value our patients. We know that most patients value us too, especially when they need us regularly. The problem lies not with GPs and our teams, but with the budget-setting, the culture, the behaviours and the decision-making of the NHS. And that is what we need our patients to understand too.These new patient-facing resources (posters, social media graphics, PPG-facing slides) set out for patients in clear unambiguous terms, with clear graphics and easy to understand messages, just what we mean when we say we need more support for and understanding of general practice. And why. When a practice receives just £107.57 per year for each patient, whatever their health needs, that’s less than the cost of an annual TV licence (let alone the cost of Sky TV!). And so much more important.
- GPCE “Focus on” restarts
GPCE has (after a very long absence) once again started to produce guidance documents known as “Focus on ….”. They are published on the BMA website and being circulated via the usual means, so keep your eyes peeled! It is good to see such helpful documents once more. Covering vax and imms, premises cost directions, PCN DES capacity and access payments, enhanced access appointments, medical associate professionals, LLPs and GMS contracts, dispensing and prescribing, and GP data sharing and data controllership, these are hugely valuable and a round of applause to GPCE for reinvigorating their guidance! - Pathology services in South East London
Following the recent news of a significant ransomware cyberattack on Synnovis and resulting in interruptions to pathology services, general practice teams across South East London are endeavouring to manage the impact on patients. Synnovis is a partnership between two London-based hospital Trusts and SYNLAB.We are working closely with the South East London ICB critical response team and Synnovis to ensure that critical and urgent samples from general practices are prioritised, and to secure and support arrangements for mutual aid from other areas to enable investigations for medical care and referrals.
Current predictions are that disruption to blood testing services may continue for a number of months, and we are aware that all GPs across South East London are affected and many are concerned about the potential for patient harm that can result from delayed or missing blood test results. We will continue to work to advocate that patients and their families are kept informed of the measures put in place to minimise the impact of this cynical attack on patient care.
- GPAS and getting involved
– highlight the pressure you are under
The General Practice Alert State reporting system, which we are currently rolling out in London, highlights the pressures on general practice across the Capital in real time. By answering just six questions each week you can give us valuable, high quality, data to evidence the challenges you face and to change the narrative from individual practices being to blame for patients struggling to get appointments, to the more accurate reasoning that pressures on general practice are due to system-wide problems. If you haven’t already signed up, you can do so here.– help tell the story of London general practice
We use data from our regular workforce surveys and elsewhere whenever we can, including the recent excellent workforce, patient and practice data GP dashboard created by colleagues in Bedfordshire & Hertfordshire LMCs, showing the impact of ten years of under investment on London region and individual constituencies in the Capital between 2014-2024. But human stories are far more impactful than data and we need people working in general practice to tell your story and show the people behind the jobs in general practice.These human stories help us to get media coverage, illustrate issues when meeting with local MPs and opinion formers, and create online campaigning resources. Anyone in the practice team can take part in these activities, as long as you can speak clearly about your work, what you do, and how that affects patient care. Our communications team can tell you more.
– join the London GPs WhatsApp group
The London GPs WhatsApp group will be used to share information from GPC reps, seek views from frontline GPs and consider next steps. Follow this link from the phone where you have your WhatsApp account and join the group.– vote in the GPC England ballot
Opening today and closing on Friday 29 July, this ballot is a clear and specific way to show solidarity with your fellow GPs. The time to act is now!– attend the Channel 4 election health debate
Channel 4 have contacted LMCs asking if any GPs are interested in attending their election health debate recording in Hammersmith on the evening of Monday 24 June. You can read more and register your interest here.
Please do share this MWord with your practice colleagues. As ever, I welcome your feedback at [email protected]. And do know that the team of experts and leaders here at Londonwide LMCs are here for you and by your side.
With best wishes
Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs