Mword Issue 95 – Dr Michelle Drage’s latest update for GPs and practice teams

  • Mword

22 December 2021

Dear Colleague,

As we move through a December that feels like a carbon copy of the last one, I have three things to cover:

  1. Thank you for all you’re doing
  2. Masks
  3. Prioritising care
  1. Thank you for all you’re doingOver this year, practices across the country have given more than half (52m out of 97m) of all first, second and booster jabs, and the numbers only tell part of the story. You worked through the night to get clinics ready, visited the vulnerable, talked around the hesitant, made volunteers from your communities part of something that gave them meaning in those dark months, kept yourselves and your teams going – often at great personal cost – and you moved mountains to mitigate mistakes further up the chain and keep caring for patients. And whilst the vaccination campaign may bring some comfort and hope, it doesn’t offset the political, media and system scapegoating that you have had to endure despite giving the best level of care you can under so many difficult circumstances.I have lost count of the number of times the powers that be missed obvious opportunities to thank us for the care we provide, and for the sacrifices we and our teams have made and continue to make. So once again, in case no one else does, I want to offer my own heartfelt appreciation to you, for all your immense efforts over these days, weeks and months of chaos. I also want to thank my own GP – she knows who she is – for the time and care she showed me during my own months of serious illness. I know each and every one of you would have done the same. I am so grateful to be here.
  1. MasksThe government has actually managed to produce a patient-facing poster for display in surgeries about masks. It’s difficult to grasp how such a complex resource could have been created by the powers that be in such a short period of time. Then again it doesn’t of course offer any actual means of helping you enforce the message without risk of abuse or complaint. But you can at least find it here.We are currently pressing the BMA to raise the absence of meaningful help on this and other areas of abuse at the highest political and professional level.
  1. Prioritising careRemember that some very short-term measures are now in place to ‘ease’ GP workload and allow you to prioritise essential care and vaccination work:
  • Fit notes no longer need to be issued for periods of absence less than 28 days. Official guidance is here and you can download a template letter here to respond to any official requests for one for fewer than 28 days.Thank you to Dr Anne Murphy from the Ellis Practice in Wembley, who shared a letter which formed the basis of this template.
  • Re-certification requirement for existing prescription charge medical exemptions is suspended, NHS Business Services Authority are due to contact patients with certificates expiring before 26 January and offer a six-month extension.
  • The DVLA will renew driving licenses without medical reports until 12 January, excluding bus and lorry drivers.

These measures sit alongside the suspension of CQC suspensions until the end of erm, next month, and elements of QOF and IIF until end of March (see my update from the end of November). A planned return to the status quo from 1 April is extremely revealing of the transactional lens through which the political powers that be see the value of general practice. They could have chosen to do so much more to help us and in turn help the communities we care for.

Also, Sajid Javid and various media cheerleaders seem to have gone quiet on how we should be providing face-to-face appointments on demand, which is some respite, although they never should’ve been calling for it in the first place.

And STOP PRESS: The BMA’s GPC England and the RCGP have co-produced a fresh Covid-19 workload prioritisation guide for practice during the accelerated booster campaign.That’s a lot of priorities. Please don’t shoot the messenger if you were hoping for more scope on what could be paused or de-prioritised. The list of activity practices could pause or do less of reads:

  • Routine non-urgent screening
  • All non-essential paperwork
  • Data collection requests
  • Blood monitoring for lower-risk medications and conditions
  • Vitamin B12 injections
  • Routine care review or care management for those with long term conditions, who are not considered ‘high risk’
  • Non-essential procedures
  • Complaints
  • Minor surgery
  • Non-urgent investigations that will not impact on treatment

We know that patients still value and need community based general practice and their local neighbourhood practices, though it’s harder than ever to notice the unassuming majority who come and go from their appointments while remaining quietly grateful.

Just as before the pandemic, your Londonwide LMCs teams continue to track the dozens of funding streams you’re all supposed to access and trying to ensure they reach the frontline. We’re still supporting practices with mergers, regulatory investigations, contractual issues and so much more. And please remember, our GP Professional Support Network is there for you.

And so from me and the whole Londonwide team, Season’s Greetings to you and your loved ones, and here’s hoping again that 2022 will turn out to be a safe and peaceful one.

As ever, I welcome your feedback at The team of experts and leaders here at Londonwide LMCs are by your side.

Keep well. Stay safe.

With best wishes

Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs