As we head into what is already shaping up to be a challenging winter for general practice we want to emphasise that your LMC is here to represent your interests and those of everyone working in general practice.
We are aware of the issues remaining around staff recruitment, retention and morale. Underfunding because of the Carr Hill formula, lack of space for ARRS roles and issues with staffing the enhanced access hubs (via fed) on Saturday afternoons (PCN issue). Lack of capacity over winter to do additional IIF work. Patient demand is at an all-time high and resources at an all-time low.
Over the last year your Wandsworth LMC representatives have continued to work with the neighbouring LMC Chairs, Londonwide LMCs, Battersea Healthcare CIC, the new ICS/B and public health colleagues at Wandsworth Council to represent your interests and concerns including:
- Monitoring terms of reference and the establishment of various new boards as part of Integrated Care Systems (ICS) to ensure there is adequate general practice representation on the ICSs
- Responding to the Fuller Report, NHS Wellbeing Initiatives, GP Campaigns and daily abuse in the media
- Participating in the SWL review of locally commissioned services and proposed changes to acute trust pathways and impacts of changes on primary care, thereby pushing back against unreasonable expectations on practices
- Attending regular meetings on Prescribing, Enhanced Access and Primary Care Management
- Providing comments on new local/SWL guidance and pathways (including HRT & menopause, Cardiology referral and Adult Weight Management) to ensure the process has adequately considered resourcing, funding and time required for GP workload
- Pushing back and continually ensuring the safe integration of Electronic Patient Access
- Feeding into the development for new Advice & Refer pilots and highlighting major concerns regarding further transfer of workload to primary care
- Collaborating with the Federation on concerns around CLCH
- Raising concerns over duplication of administration from local trusts
- Tracking distribution of funding and advocating for its timely delivery
Specific issues to update you on include the following:
Kingston Hospital Emergency Discharge Summaries Incident
An issue recently came to light whereby it became apparent that a significant number of ED discharge summaries from Kingston Hospital were not sent to practices between December 2021 and July 2022, due to an IT issue which has now been resolved. The incident has been investigated by Kingston Hospital in collaboration with general practice, LMC and commissioning colleagues in SW London. There are patients from 1168 GP practices and 94 CCGs, and the following has been agreed in relation to the summaries which pre-date July 2022:
- For practices with 10 or fewer summaries an explanatory letter is being sent, with accompanying summaries, which should be reviewed
- For practices with between 11 and 100 and practices over 100 unsent discharge summaries a letter is being sent which will include an offer of administrative support at £20 per hour and an offer of clinical support at £35 per incident resulting from review of a discharge summary which results in a patient consultation or referral.
- In cases where over 11 or over 100 discharge summaries are to be received by a practice it is open to the practice to decline if they do not have the capacity, to manage this additional workload. In this situation the hospital should be informed. The LMC would ask all practices receiving 100 or few discharges to try and process these (with the additional payments available) if at all possible.
- In all cases if review of the discharge summary results in the identification of clinical harm, according to the accompanying pathway and definition provided, please contact the hospital with this information using the email addresses to be provided. The hospital will respond to the patient under its Duty of Candour and practices are not expected to undertake this.
Incorrect MMR letters sent to patients
The LMC is concerned about the letter which NHSE recently sent to parents advising them that their children’s vaccination might not be up to date. No prior warning had been given to practices that this communication would be sent out and practices have been inundated with telephone calls from concerned patients in response to the letter. It appears in the majority of cases that the vaccinations were up to date and have been coded correctly so it has caused an unnecessary increase to the GP workload. The LMC will try and ascertain what data NHSE used as it could impact on CQC if this using the same data.
Real time information on GP Pressure – General Practice Alert System (GPAS)
Londonwide LMCs has launched the general practice Alert System (GPAS) to five pilot practices in Waltham Forest. GPAS is an easy-to-use digital reporting system, used to gather and present real time information about the pressures on general practice across the Capital. Each week practices will be asked to answer five simple questions on workforce capacity, demand and practice list size. Collection and submission of this important data should only take between 6-10 minutes once a week. GPAS will collect practice information in an anonymised and unidentifiable way allowing us to make comparisons with existing reports, like the OPEL system used by hospital trusts, about the pressures affecting primary care. We hope that this information will help to improve capacity and work life balance for general practice.
The London rollout has begun with the five pilot practices and will be scaled up over subsequent weeks across the rest of Waltham Forest and then the remaining North East London sector. This will be followed by South East London, North Central London, South West London and North West London. Once we are ready to go live in your area, Londonwide LMCs will contact you with more information.
Who in your practice is the best person to provide this information? We need two named contacts, a primary and then a backup second contact, to ensure that we only receive one entry per practice per week. Please send your first and second contact details (name, email, phone number, job title) to the GPAS Project Manager Ann Ayamah, firstname.lastname@example.org or submit these here by Monday 31 October 2022 .
We will be providing lunch and learn sessions over the coming months, so all doing this will be familiar with the system. Information on this will be on our website, via our marketing and advertising of events and via your local newsletters, so please keep a look out for the sessions. If you do have any queries, please do not hesitate to contact the Project Manager Ann Ayamah
We would like to take this opportunity to remind you of your current Wandsworth LMC committee for 2022-23:
- Dr Alexander Lai (Chair), Grafton Medical Partners, Nightingale PCN
- Dr Soleman Begg, Begg Practice, Wandsworth PCN
- Dr Penelope Smith/ Dr Shafaat Bari, Grafton Medical Partners, Grafton PCN
- Dr Zahid Ghufoor, Streatham Park, Balham Tooting & Furzedown PCN
- Dr Jeremy Gray, South West Hub 1, Battersea PCN
- Dr Ashleigh Helm, Putneymead Group, West Wandsworth PCN
- Dr Harriet Wheldon, Battersea Rise, Brocklebank PCN
- Dr Harriet Wingate, Bridge Lane Group, Salaried issues
- Dr Jyoti Patel, Wandle PCN & Locum issues
- Dr Angelique Edwards, Mayfield Surgery, Prime PCN
- Samuel Metcalf, Elborough Street, Practice Manager Representative
Please contact any one of us regarding any primary care issues you might want to raise, however we will be continuing the PCN representative relationships, so if you would like you may contact your associated PCN liaison through nhs.net.
Wandsworth LMC committee support details:
The LMC is supported by the following team at Londonwide LMCs:
Dr Asiya Yunus, Medical Director (covers SWL), email@example.com
Greg Cairns, Director of Primary Care (covers SWL), firstname.lastname@example.org
Nicola Rice, Assistant Director of Primary Care (covers SWL), email@example.com
David Moore, Committee liaison executive (covers SWL), firstname.lastname@example.org
If you have any queries about the Wandsworth Local Medical Committee, please contact email@example.com at the LMC office, tel: 02038186247.
Dr Alexander Lai