Mword Issue 61 – Dr Michelle Drage’s latest update for GPs and practice teams

  • Mword
Mword Heading - Issue 61
15 May 2020

Dear Colleague

Happy Friday one and all.

Today it’s the Hokey Cokey DES … & other stories.

  1. PCN DES decision time – use our Londonwide LMCs PCN DES decision-making tool to help you make the right choice for your practice – deadline 31 May.
  2. Spring Bank Holiday – 25 May is an actual real and genuine Bank Holiday for GPs and practice teams.
  3. Londonwide Covid-19 Living Guide version 7.
  4. Death in service pension benefits.
  5. Resources for nurses in our general practices now on our website.

1. PCN DES decision time – use our Londonwide LMCs PCN DES Decision-making tool to help you make the right choice for your practice – deadline 31 May.

Our new decision-making tool provides a factually based, critical analysis and risk assessment of the PCN DES for this year, which practices can use to help you make an informed decision whether to remain opted in, or to opt out, of the DES.

Implications of both the “Opt In” and the “Opt Out” options are reviewed in the table and are grouped under the following headings:

  • Contractual
  • Financial/funding
  • Service specification requirements
  • Staff
  • Impact on patients

The deadline for practices to submit their decision remains 31 May 2020. I say this because we have been made aware that in some London areas CCGs are pressing practices to inform their PCN Clinical Directors (CDs) by 20 or even 15 May (today), so that CDs can collate all practice responses and submit one single declaration on behalf of the whole PCN by 31 May. While this may make the process administratively easier for commissioners, it is not in line with national guidance and practices are under no contractual obligation to act now. This is because, as the care homes issue has shown, we are in a rapidly evolving environment due to the Covid-19 pandemic and practices need to make a decision based on the most up to date information that is available to them which may mean that you choose to wait up until the 31st to submit your final your decision, for which our decision-making tool should be of assistance.

Please note that even if you decide to opt in and notify your PCN and your CCG of this but then you reconsider before the 31st, you can still opt out as long as you declare this by 31 May at the latest. In that situation, please be aware that the notice requirement for opting out of the DES is one month, therefore if you opt out by 31 May this will not become contractually effective until 30 June.

As per our previous advice, the window for deciding to opt in or out of the DES is set and commissioners will only consider practice applications to opt out after 31 May in exceptional circumstances. Therefore, your ability to opt out of the DES outside of this set window will be limited, but we will be there to advise you if you find yourself in this situation. Once you have opted in, you will have committed to delivering the DES for the rest of this financial year and your next opportunity to opt out will not be until April 2021, when you will again have one month to decide.

2. Spring Bank Holiday – 25 May.

All current signs from NHS England point to the 25 May bank holiday being the same as any other, so no requirements to provide additional services because of Covid-19. Everyone in practice deserves this day with their families even more than normal and we will continue to support the BMA GPC’s work to press for the days lost on previous bank holidays to be reinstated.

3. Londonwide Covid-19 Living Guide version 7.

Our Living Guide this week contains only one update – section 9.2: Healthcare professional testing for Covid-19 infection.

4. Death in service pension benefits.

Dr Krishan Aggarwal, Vice Chair of Kensington, Chelsea and Westminster LMC and member of the BMA’s Sessional GP Committee, has written a very useful blog on pensions and death in service benefits. Following on from our own medical director Dr Vicky Weeks, Krishan has been doggedly pursuing pension issues for a number of years, and we thank him for the progress made on them.

5. Londonwide LMCs website resources for nurses in our general practices.

This week we celebrated International Nurses Day (IND) and I would like to re-iterate my message that that we here for our nurses and the whole practice team, and point you to our new long-term conditions guide which is also on our developing nurse resource section of our website. We also joined IND celebrations on social media. This year’s IND fell on the 200th anniversary of the birth of Florence Nightingale, who risked her own health to help others and pushed the powers that be to take infection control measures seriously. How times have changed…

As ever I welcome your feedback at, and know that my team of experts and leaders here at Londonwide LMCs will always be by your side

Keep well. Stay safe. And thank you for reading.

With best wishes

Dr Michelle Drage MBBS FRCGP

CEO, Londonwide LMCs


Last updated : 20 May 2020