Dear colleagues,
Here is the June newsletter from Waltham Forest LMC
Our Future, Our Say, Our Way event
Londonwide LMCs and GPC England are hosting an event this Thursday 13 June (12.30 for 1.00, 4.30 finish) at Friends House in central London, open to all GPs, GPRs, PMs and nurses in London region practices. It is to consider the next steps on the imposition of the GP Contract following the BMA referendum and formal dispute with the government. You can register for free here.
Advice & Guidance/ Advice & Referral
Londonwide LMCs has produced some advice for practices around Advice & Guidance.
Interface with secondary care
The LMC has begun attending meetings with consultants at Whipps Cross to seek ways that general practice and the hospital can work better together. We have initially put across that hospitals should provide complete care packages, including fit notes, prescriptions, and organising tests and follow-up. We are pushing for this in practice as well as in policy, supported by the right systems to make it easy for hospital clinicians to do the right thing.
The LMC has been talking with Whipps Cross about rejected 2-week-wait referrals. The hospital has a principle that they should not be rejected without alternative plans in place, but this does not seem to be happening in all cases. We are continuing to work on this.
There is information about referrals on the Barts website here.
GP Support
The LMC was briefed at its May meeting on support services available for general practice from Londonwide LMCs. Information is available here.
Shared Care
Concerns have 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 shared care which enable quick response to requests.
There is guidance from Londonwide LMCs on shared care agreements here.
There is information from the ICB Medicines Optimisation team here.
2024-25 local contracts
The LMC has been pursuing issues with commissioners, including that there still need to be CEG searches so that practices can know which patients are eligible for health checks.
Public Health contracts
The LMC has been analysing the prices offered for fitting and removing contraceptive implants and IUDs, and for sexual health checks. The prices have not kept up with inflation and the LMC is asking for a review. Claiming the payments can be a challenge, but is easier if the clinician uses the template from the start.
Omnes GP Direct Access community diagnostics
The LMC, along with others in primary care around NE London, raised issues with imaging services now being provided by Omnes, after the previous provider did not re-bid for the contract. There does not seem to have been sufficient engagement with general practice during the process and we are working to resolve issues now.
General Practice Alert Status – 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 to provide stronger evidence – under a quarter of Waltham Forest practices provide their data each week.
There is more information at this article by the LMC’s Medical Director Dr Elliott Singer, and you can sign up here.
Weight management
There is now a Tier 2 healthy weight service for adults and children being commissioned by public health. It is hoped that referral will be integrated into GP systems – we will keep in touch with this and hope to update. Patients can self-refer here.
LMC information
You can find information about LMC members, contact channels, meeting dates and so on at our web page.
If you have any feedback on the above, or anything you wish to bring to the attention of the LMC, you can contact via the Committee Liaison Executive ian.williamson@lmc.org.uk.
Best wishes,
Dr Mike Grenville, Chair, Waltham Forest LMC
Dr Asad Ashraf, Vice-Chair, Waltham Forest LMC