MWord – Issue 23 – November 2015 now available

  • Mword
This week will see the arrival of winter with its crisp blue skies and the hope of snowy white flakes falling on Christmas day. And no doubt you’ll already be gathering in wood from the local municipal forest to place in your surgery log fire, preparing to welcome patients one and all with a warm waiting room glow as they sip on free gluhwein and savour sachertorte supplied from the sterile kitchen of your most ‘favourite’ patient.

Meanwhile, in the real world, these:

  1. Junior Doctors industrial action
  2. Eight days a week
  3. Our own Londonwide workforce survey
  4. Londonwide LMCs’ evidence to Parliamentary Health Select Committee (PHSC)
  5. Christmas and winter

As always, any thoughts or comments you might have are very welcome and can be emailed to

Dr Michelle Drage MBBS FRCGP

Chief Executive
Londonwide LMCs

1. Junior Doctors industrial action
The ballot ends today. It is anticipated that juniors will vote substantially in favour of industrial action. The planned industrial action to be taken is:

  • Emergency care only – 8am, Tuesday 1 December to 8am Wednesday 2 December 2015
  • Full walk out – 8am to 5pm, Tuesday 8 December 2015
  • Full walk out – 8am to 5pm, Wednesday 16 December 2015

The BMA has issued clear guidance to practices on what to expect and what you can do. You can find it here.

One thing worth remembering – during the Israeli doctors strike mortality went down – Have a read of this from Dr Raj Persaud.

2. Eight days a week
The current situation for GPs and practice team members is intolerable and unacceptable. A halving of the share of NHS funding and a quadrupling of consultations along with the paucity of available community, mental health and social services is taking its toll on all of us and blocks patient flow through practices. Add to that the backflow into practices – networked, federated or neither – from hospital behaviours, games and tricks, and the inevitable gumming of the practice day ensures, with its inevitable impact on patient access. And then some. The demand. The expectation. The numerous surveys and the endless meetings that are either badged as ‘mandatory’ (as if) or incentivised financially to ensure an ‘engagement’ box is ticked by someone somewhere in CCG land. All of which suck out your supply and wear down even the once highest performers or the most resilient of us.

So here’s my resilience tip of the month:

Ask yourself this: do I really, really need to be at external meeting X? If the answer is no, then don’t go. Don’t take the incentive. You won’t miss out. Use the time you free up to talk with your partners and the team about something positive that’s happened in your week or life. Life will go on. Your patients will thank you. And you and your partners and staff will feel the benefits of you being present for yourself and for each other. It’s all about Taking Control.

None of this applies to anything organised by Londonwide LMCs, like our own surveys obv!

ALSO, don’t forget to use our acclaimed Take Control – Resilience resources on our websites.

3. Our own Londonwide workforce survey
So here’s your first challenge. Do you or don’t you fill out our own survey? Yes!

I really do hope you will make space in your hectic day to complete our short survey. This is a follow-up to the responses that so many of you gave six months ago and which enabled us to get front page national Sunday newspaper cover in The Observer and subsequent media exposure, highlighting the pressures you are under. Our comms team is constantly looking for ways to help you get your stories out there, and either counter the negativity or expose the real issues as we face them. Please do help us to represent you effectively.

At the end of this week practice leads will receive an email with a link to our new workforce survey. Please complete it and help us to help you.

4. Londonwide LMCs’ evidence to Parliamentary Health Select Committee (PHSC)
Last month we submitted our own evidence on your behalf to the PHSC chaired by GP Dr Sarah Woolaston MP. You might want a read. I’ve deep-dived my inner Balint, Pendleton, Neighbour and Marmot to try and explain to MPs and the public what it is that p’s GPs and practice teams off, and what it needs to recommend to Parliament to turn it around. Essentially these fall into the following areas:

Summary from Londonwide LMCs.

The following activities are key to securing the future of general practice in London:

  • Reducing bureaucracy: to free up more time to spend with patients, it is also the biggest influencing factor on recruitment and retention.
  • Existing services need funding properly before additional ones can be added on, particularly where there is a diverse and economically deprived population.
  • Cuts in health and wellbeing, community services and mental health services are impacting on GPs, particularly in areas with large numbers of vulnerable people.

Please take a look and do let me know what you think at

5. Winter and Christmas
And finally, I’m sure you won’t have missed the lead article in our newsletter on the Christmas opening issue which has caused practices many tears over the last two years. This year will be different as a result of appeals sponsored by Londonwide LMCs working with LMC Law. The letter for 15/16 from NHS England will be much more measured in its tone and recognises your autonomy as an independent contractor (ICs), to balance the needs of both your patients and your staff.

More details can be found in our Winter Planning Resilience Guide which should be hitting your inboxes next week. Practice Managers – this will be a must-read for you, with its top tips and take control points.