Tower Hamlets LMC newsletter – June 2024

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Here is the June 2024 newsletter from Tower Hamlets Local Medical Committee. We hope you find this newsletter informative: we are always very happy to hear from you and will do our best to help.

Dear colleagues,

Here is the June 2024 newsletter from Tower Hamlets Local Medical Committee. We hope you find this newsletter informative: we are always very happy to hear from you and will do our best to help.

Our Future, Our Say, Our Way event
Londonwide LMCs and GPC England are hosting an event this Thursday 13 June (12.30 for 1.00, 4.30 finish) at Friends House in central London, open to all GPs, GPRs, PMs and nurses in London region practices. It is to consider the next steps on the imposition of the GP Contract following the BMA referendum and formal dispute with the government. You can register for free here.

ICB lobbying
LMC members, alongside colleagues from other boroughs in NE London, have been lobbying the ICB to invest in general practice as an essential and highly cost-effective part of the NHS system, despite the budget deficits that the ICB faces. ICB managers have acknowledged the principle and discussions continue.

The LMC also asked on behalf of constituent GPs for plainer English in ICB communications and for emails to come from named individuals. Dr Roberto Tamsanguan, Clinical Director of the Tower Hamlets Together partnership for the ICB, agreed to take back the feedback.

Advice & Referral
The LMC has been pushing for some time to ensure that payments already due under the Advice & Referral LIS are made. The ICB has in response done work to identify payments owed, which are to be checked and then approved – progress was promised very soon.

The Advice & Referral LIS has now ended and new cases do not attract payment. Londonwide LMCs has produced some advice for practices.

Shared Care
Concerns have been growing about shared care, including unresourced work transfer and the involvement of medications that are challenging for GPs to manage. Shared Care agreements require the agreement of all parties, including primary care, secondary care and the patient. Options for practices include setting policies about certain types of agreement which enable quick response to requests. There is guidance from Londonwide LMCs on shared care agreements here.

Weight management
Patients can now be referred to weight management services via EMIS. The service provider is the same as for smoking cessation, and the EMIS button may look like just a smoking cessation button. The LMC has asked for this to be clearer. There is more demand for the service than capacity, and there is a waiting list – the LMC has asked for waiting times to be publicised.

GP direct access community diagnostics
The LMC raised some questions about recent developments in this service. Additional funding has been provided for community diagnostic pathways, some of which seem to duplicate existing secondary care pathways and some of which are not available in Tower Hamlets. The LMC heard that previous pathways are still available if desired but that the new ones may be faster, and that the providers are responsible for uploading images and following up within 5 days – the GP is not responsible.

End of Life care
The LMC gave feedback to St Joseph’s Hospice and ELFT as they are updating their policy on family members or carers giving injections to end-of-life patients being cared for at home. We have ensured that it is clarified that GPs are invited to give any views or flag known issues for a nurse-led palliative care decision, rather than GPs being required to give approval for every case. We are also giving input about the support and supervision for families, which we felt should be a daily visit rather than just a phone call.

GP Support
The LMC was briefed at its last meeting on support services available for general practice from Londonwide LMCs. Information is available here.

There have been positive cases of measles in the area, not all connected to each other. Doctors are advised to ensure their protocols are up to date about assessment, triage and isolation – phone greetings should advise patients with rash-like symptoms not to come to the practice.

Vaccination rates among young adults are low – it is never too late to get the MMR vaccine, which is very effective against measles.

General Practice Alert Status – anonymised GP-led pressures reporting
Over the last year Londonwide LMCs has been rolling out GPAS on behalf of London’s general practice. It is to identify and track the pressures area-wide in general practice and flag them to NHS partners, as hospital and ambulance trusts do with their OPEL system.

NHS England is requiring ICBs to have a reporting system for general practice, and we hope to establish GPAS in this role, as it is general-practice-run, confidential and anonymous, while we cannot be confident that an ICB-established system would be. In GPAS, practice-level data is not passed to the ICB, only borough-wide aggregates.

GPAS is simple to use and takes on average 2-3 minutes per week in response to a data request email. Practices receive a copy of the weekly situation report with the borough- and sector-wide pressure levels. The LMC uses this report to press the NHS system for support where and when needed. Currently, the numbers of practices participating need to be higher to provide stronger evidence – under a third of Tower Hamlets practices provide their data each week.

There is more information at this article by the LMC’s Medical Director Dr Elliott Singer, and you can sign up here .

LMC information
You can find information about LMC members, contact channels, meeting dates and so on at our web page

Best wishes,

Dr Jackie Applebee
Tower Hamlets LMC