Chair’s introduction
I met with Luke Taylor, Liberal Democrat MP for Sutton and Cheam in September as part of LMC engagement with local political leaders. Luke was keen to have insight into the waiting times for outpatient appointments, and it was highlighted the long waits for gastroenterology, dermatology, and gynaecology. It was discussed how this adds to additional workload in general practice.
Managing and reviewing patients whilst they present to general practice when symptoms worsen, but also A&E utilisation which is outside the control of general practice. It was noted that the Sunflower clinic and Skin lesion community clinics have highlighted they have capacity to support with gynae and dermatology activity, essentially the left shift as per the NHS Medium term plan, but so far, no uptake of this. It was also highlighted that general practice can offer more services if funding was available, such as specialist clinics, above and beyond that of the GP contract.
Obesity was discussed in terms of health trends and the current issues in Sutton with large numbers of fast-food shops opening. The morbidity and mortality as well as NHS pressures in the years going forwards was highlighted, if this is not addressed and the need to have the prevention agenda focussing on this.
The option to have funding for GP locums was finally a turning point, but that when announcements are made so late and when it is not known if this will be a recurrent arrangement, this funding cannot be fully utilised as intended by practices. Practice premises being limiting factors in some cases, and also with ARRS roles located on same site.
It was also highlighted that the data monitoring activity in general practice meant time was spent on where the demand was which limited resources and time on proactive care of patients.
Dr Vidhya Thiagamoorthy
Chair
Sutton LMC
What is the LMC and what do we do? We:
- Are the representative body for General Practice in Sutton. LMCs are recognised in statute.
- Consult with NHS bodies, integrated care boards (ICBs) and local councils, negotiating local contract terms for general practice
- Work for and support individual GPs and practices and are the professional voice of general practice at a local level.
- Support GPs via knowledge of contracts, systems, stakeholders at all levels, including borough, ICB, regional and national.
- Inform and engage with workforce development, planning, education and training for all roles within general practice.
Your LMC
Your Sutton LMC committee members are listed below. Their term runs until 31 August 2028. One of our members, Dr Cristina Augood, has recently stepped down, as she is now working in a different Borough, and we thank her for her work with the committee.
As a result, there is now a vacancy on the committee. We will engage with constituents over the coming weeks, with a view to filling the vacancy, please look out for our comms on this.
- Dr Junaid Masud, Salaried, Mulgrave Road Surgery
- Dr Priyadharshini Senthilkumar, Salaried, Wrythe Green Surgery
- Dr Vidhya Thiagamoorthy, Principal, The Grove Road Practice
- Dr Brygida Wimbush, Principal , The Old Court House Surgery
- Dr Adam Wright, Partner, Benhill & Belmont Centre
- Dr Charlotte Mason-Apps, VTS Rep, Sessional
- Katie Thorpe, Practice Manager Rep, James O’Riordan Medical Centre
What has Sutton LMC been working on recently?
Updates from recent Sutton LMC meetings – the LMC regularly meets with senior representatives from both the ICB and Sutton PCN. Below is a summary of our recent discussions:
- LCS funding: A forecast underspend of approximately £357,323 has put timely funding changes in focus. Paying for shared-care work is the leading priority, alongside possible changes to coil fitting and other activities. The team will identify what can change this year and what needs wider contract and procurement approval. The LMC have proposed the following areas where the underspend could be utilised:
Shared-care prescribing and monitoring: This should be the first priority for alternative use of underspend. The current service is significantly underfunded, and payments do not reflect the substantial workload associated with medicines such as methotrexate, azathioprine and amiodarone. An uplift to this payment would recognise both the prescribing and ongoing monitoring activity undertaken by practices which is not adequately resourced in the current specification.- DOAC monitoring: The specification should be extended beyond initiation to fund call and recall, ongoing monitoring and the associated practice workload.
- Coil fitting and women’s health: Payment rates should be reviewed and uplifted, informed by benchmarking against comparable services elsewhere.
- Existing training and backfill funding: The ICB should communicate clearly and promptly the funding already available to practices, including the sums available for nursing and pharmacy training and for backfill when non-GP staff attend learning events.
- Proactive care MDTs: No additional requirements should be added without agreement on the specification and full funding of the associated workload. The ICB was asked to first review the ARRS staff capacity and costs currently being used for this work, including the neighbourhood-level analysis requested at the 22 October LMC meeting. Further LMC engagement would be required to progress this.
We would welcome views from constituents regarding other areas of general practice that you feel could benefit from the underspend being redistributed to.
- CKD/CVRM: Sutton’s pilot takes shape: The pilot will initially cover three Sutton GP practices, with the aim of aligning with the wider Southwest London model. The ICB will share the business case with the LMC. Experience from other areas will help shape the longer-term approach, including a possible general-practice delivery model.
- Winter access: Winter funding is expected to stay at £514,000, with the intention of commissioning the same service as last year. Operating hours and the final specification are still being checked against contract requirements. Substantive changes could trigger a new procurement process.
- DART: The recent DART system license expiry left practices reliant on downtime forms. The problem with queuing blood test result is still ongoing and has been raised. Interface and safety concerns have been raised through Southwest London and Sutton channels. X-Wave replacing DART will be available from April with hard stop date for DART on 19th of April.
- Urine samples: clearer instructions needed: New ACR and culture sample bottles have created difficulties for practices and patients. Although introduced to meet laboratory equipment and specimen-containment requirements, they need clearer patient instructions, which will be sought.
- Shared care: Practices and individual prescribers must decide whether each shared-care request—including those from Right to Choose providers—is safe and appropriate to accept. For any proposed transfer of stable NHS ADHD patients into general practice, the LMC is calling for safe shared-care arrangements, not automatic discharge.
LMC representation:
The LMC also represents Sutton constituents on the following groups:
- Sutton Primary Care Operations Group (PCOG)
- Primary and Community Care Transformation Group (PCCT)
- Planned Care Interphase Group
LMC comments on referral forms, pathways and guidelines:
LMC engagement with proposed SWL/SEL Integrated Weight Management Pathway
SEL and SWL LMCs have been engaged in discussions with the ICB regarding the proposed integrated primary care weight management pathway. While supporting the aim of improving access to obesity services, LMCs remain concerned about contractual safety, clinical accountability, governance, data sharing, discharge arrangements and the potential transfer of unfunded workload and risk to general practice.
The ICB has shared revised proposals which do not resolve LMCs fundamental concerns, in fact they introduce further complexity, fragmentation and uncertainty, which leaves the LMCs unable to reassure practices that this is safe, equitable and sustainable work to undertake. Responsibility for resolving these issues rests with the ICBs and LMCs have advised the ICBs that they will be unable to engage further until they have received a revised, coherent and appropriately funded proposal.
Upcoming events
Next LMC conference
The next national conference will be the England LMC Conference, which will be held in November in London. Dr Adam Wright will be representing Sutton LMC at the conference. The full agenda for the Conference can be viewed here.
Motions that have been submitted by LMCs across England are debated, and if passed, are then taken forward by GPCE when engaging with government. An update on the motions that were passed at the conference will be provided in our next news update.
Londonwide LMCs’ team supporting Sutton LMC:
- Dr Asiya Yunus, Medical Director, Asiya.yunus@lmc.org.uk
- Kate Hudson, Director of Primary Care, Kate.hudson@lmc.org.uk
- James Winstanley, Assistant Director of Primary Care, James.winstanley@lmc.org.uk
- David Moore, Committee Liaison Executive, david.moore@lmc.org.uk
- Kat Lederle, Committee Administrator, katharina.lederle@lmc.org.uk
Other services that Londonwide LMCs provides on behalf of general practice across Sutton
GP Support team
The General Practice Support team comprises non-medics (Vicky Ferlia, Jan Swannell, Jacqui Perfect, Yvonne Frank, Vanessa Douglas) and Medical Directors (Dr Elliott Singer, Dr Kirsa Morganti, Dr Sara Riley, Dr Lowri Kew).
The team operates at different levels providing confidential, tailor-made, expert advice and assistance to individual doctors, practices and PCNs in difficulty. They offer contractual support to our primary care teams. Feedback/responses to papers & briefings to LMC reps. Policy influence at London level e.g. NHSE/ICBs, CQC. Attendance at Performance Advisory Group (PAGs) and Performers Lists Decision Panels (PLDPs). General Practice support includes:
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PCN Support
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For help or support please contact the GP Support team at gpsupport@lmc.org.uk .
Workforce-Training and Innovation (WTI)
Update from the Workforce, Training and Innovation (WTI) Team
Our refreshed Buying Group offer was relaunched in October, and we encourage you and your practice teams to explore the wide range of high-quality products, services, opportunities and offers now available to London general practice—at competitive prices and with excellent deals.
There is no sign-up required. Simply let the supplier know that you are a practice within the Londonwide LMCs area when placing an order.
Visit the Londonwide LMCs Buying Group to start benefiting from opportunities to:
- Save – access exclusive discounts, offers and deals
- Earn – benefit from rebates and funded projects, including research opportunities
- Sustain – support staff wellbeing and environmental sustainability
We also invite you to explore our training offer in the events brochure
If you have any questions or ideas, please get in touch at WTI@lmc.org.uk — we would be delighted to hear from you.
Ann Ayamah (Head of Workforce-Training and Innovation) on behalf of the team.
FP69 advocacy and information gathering
Londonwide LMCs have continued to raise the issues affecting London practices, including meeting with MPs, briefing journalists, speaking to the voluntary sector and gathering first-hand details from some of the hardest hit practices. Our most recent analysis of NHS data shows that London has lost over 315,000 registered patients between January and September.
If your practice has not recently updated us on how FP69 is impacting you please do so via this form or email us. To make the case for a change of approach we need individual figures and insights, alongside official statistics.
Get new deals with the Londonwide LMCs Buying Group
Our Buying Group suppliers not only offer great deals to practices looking to switch, they also aim to offer the best value to existing customers in the Londonwide LMCs area, including explaining new products and features as they get rolled out.
- X-on Health – Brings together cloud telephony, AI-powered care navigation, voice agents, ambient voice technology, and data to improve access and reduce practice pressure.
- Practice Index – Pick and choose what you need out of their learning platform, or software to manage HR, finance, compliance and rotas.
- Hippo Labs – Have your call-and-recall work smarter, reach more patients and improve QOF attainment. Now with a new pay per appointment booked, subscription-free option.
- Equity Energies – Reduce energy costs, save time, become greener and remove the administrative burden of managing utilities by having experts do it all for you.
- MIAB – You existing policies may have more gaps than you think, particularly in developing areas like cyber and ARRS employment. Rely on MIAB’s specialist expertise to ensure you are fully covered.
- Restore Information Management – Whether you need a room full of records doing or a steady flow of new registrations, Restore take the hassle out of digitising patient records.
- Tickets for Good – Reward yourself and your colleagues with free and discounted tickets to concerts, theatre shows, sports and more!
- Hillcroft Surgery Supplies – Get next day delivery and industry leading stock availability, thanks to their investment in substantial warehouse facilities.