Primary Care Networks (PCNs) are to be required to offer (themselves or by sub-contracting) 60 minutes per 1,000 patients per week of additional appointments in specified hours on weekday evenings and Saturdays. Newham Local Medical Committee (LMC) is involved in discussions on GPs’ behalf about how to deliver this. Issues being discussed include model of delivery, delivery sites, processes for recording notes, degree of standardization between practices (including points of access, IT interoperability etc.), equity between small and large providers, and use of any surplus by sub-contractors.
NHS England London region has produced a template for PCNs to complete, outlining their plans for extended and enhanced access: please see Londonwide LMC’s annotated version of this which includes the areas that have to be completed according to the PCN DES specification and which areas are not essential to complete. NHS England national team have also produced a template for this; the LMC is currently discussing with the CCG how they would like to receive this information.
Secondary care issues
There is an ongoing issue with workload being transferred from secondary / community care to general practice. The LMC continue to raise this issue with the Trusts and CCG, especially relating to requests for blood testing and prescribing. Dr Tammy Hibbert (LMC Chair) has been working with the endocrine consortium specifically to reduce inappropriate prolactin testing, to develop guidance for common endocrine conditions and to plan future education sessions to support primary care CPD.
The group is keen to work with mental health colleagues to agree the correct timing and frequency of prolactin testing and when escalation to secondary care is needed. The LMC has lobbied the CCG to share learning from service alerts and develop systems to resolve the underlying issues.
Like all areas there are difficulties in recruiting clinicians and other staff to practices, which are worsening. The available workforce is insufficient to fill posts, and in response some employers are offering higher wages. Staff are taking these opportunities to move on. This results in repeated recruitment costs and further job vacancies, perpetuating the cycle.
Additionally, practices are not gaining the benefit from investing in staff training and development, which then becomes a disincentive to invest in their team. The LMC continue to discuss measures practices can take, including offering ongoing training and internal progression and recognition, to address these problems.
Supplementary Network Services (SNS) payments
We are aware that at least one practice had trouble getting payment for overachievement last year. Please notify us if you are not receiving payments from the CCG for services delivered. The LMC raised this with the CCG, and will continue work to ensure that practices are appropriately recompensed.
Extending the LMC’s engagement with local partners
Rhe meeting was attended for the first time by the Chair of Newham GP Co-operative, Dr Hamida Begum. The LMC Chair, Dr Hibbert, has also made contact with Newham Council public health and anticipates welcoming a representative to future meetings. This will supplement the established regular engagement with PCN CDs, Newham Health Collaborative, and the CCG (and in future its successor the Integrated Care System). The LMC continue to strive to develop a unified voice for GP in Newham.
Dr Tammy Hibbert