Minute of the meeting of Grampian Local Medical Committee held in the Conference Room, Summerfield House, Aberdeen on Monday 15th August2016 at 4.30 pm
Present
DrsNeil MacRitchie, Denise McFarlane, Craig Beattie, Stuart Reary, Caroline Howarth, Rebecca Riddell, SamanthaMcCann, Tom Philip, GregorHowarth, Peter Kiehlmann, Peter Watson.
- Welcome and apologies
No apologies were received.
In attendance Audrey Ritchie.
2. Draft working notes and minutes of last meeting
The paragraph regarding Pharmacy is to be edited/corrected by NMacR.
3. Matters arising
* Transfer of work.
Nothing new to add.
Moray had been asked to stop sending every x-ray result to GPs. This has not been properly addressed.
NMacR informed the committee that a working group for Transfer of Work has been set up. The committee did not report any change in the level of transfer of work than that noted previously.
CB raised the issue of diabetic retinal and foot screening. There is some confusion about whether patients have had the screening or not.
NMacR informed the committee that a letter had come out about 2 weeks ago regarding the 2016 quality transitional arrangements for data extractions. The issues that it mentions inludes diabetic foot checks.
It does not imply, from SGPC’s point of view, that the responsibility for that moves to practices. This is more an expectation foot checks will be done throughsecondary care.
This information can be extracted so that practices and clusters can look at this information if they wish to.
Feedback must be given to the HSCPs.
If this is an issue, then practices must inform, especially if it is creating an increase in workload.
DMcF suggested that the LMC write to the CHP Leads/HSCPs for clarification and to establish whether this is an issue. If it is an issue then it will be brought to the contract meeting.
Clusters need to know if this is an increasing workload for practices.
It was pointed out that Foot Screening is on Enhanced Service and so there is an obligation here even though QOF has finished.
Discussion followed.
TP raised the issue of an increased requestfrom the Gynae clinic for GPs to carry out a variety of blood and hormone tests for transgender patients.
DMcF informed the committee that transgender issues are being discussed at GMC.
Monitoring is not part of the GMC guidance,which states that GPs can prescribe to transgender patients as part of GP prescribing, even though this is such a specialized area
The reason why GMC has reworded their guidance is to do with having to consider GP competency in this very specialised field.
The guidance refers only to prescribing to transgender patients, and not the monitoring of bloods and hormone levels.
TP will write to the GynaeClinic quoting the relevant BMA Guidance.
Primary Care funding allocation for Pharmacists (attached letter from Aberdeen City HSCP for information).
Discussions have been happening about how the money is being allocated from Scottish government and how it is best managed.
Verbal and email communication has taken place with David Pfleger and there has been the attached letter from DrSteve Lynch.
Need proper talks with HSCP Leads to make sure there are proper discussions together to make sure that this funding is equitable across Grampian.
There will be no changes at this time but future shared funding will be looked at.
*GMed.
NMacR informed the committee thatin the North Aberdeenshirecell there has been a change to12 hour shifts (7pm – 7 am) for summer months only, due to a shortage of GPs.
These shifts are paid at an enhanced rate.
Feedback was asked for as to whether anything similar was happening elsewhere.
Discussion followed and questions were raised as to the safety of 12 hour shifts and the practicality of these hours.
CH reported that there was a City meeting with GMed which highlighted the lack of support ED now that they are co-located.
DM questioned that if ED and GMed are in theAcute budget this meant a greater challenge, however it was suggested that GMED are now in the HSCP devolved budgets.
A different way of working happens at Dr. Gray’s in Elgin, which was discussed.
CH mentioned a proposal for a Grampian event which all could attend.
The new GMed Clinical Lead appointment has not been made as yet, but it was felt that it would be important to have this person involved in future discussions.
4. Update on IT provisioning
This is still at an early stage but it has been agreed. It is going out now for procurement. There will be no developments until next summer.
Currently working with Scott Sim focusing on EMIS practices to look at the support levels these practices get.
The LMC is to put out a further monkey survey to find out if there are any ongoing issues.
5. Feedback
i) SGPC
Meets 1st September
ii) GPC
(Papers attached for information)
Confidential Workload paper (which relates to England only) has already been circulated. Not full engagement from GPC.
GPC England has now been restarted and GPC UK will continue. There will be fewer meetings nationally as each of the 4 countries are working separately.
There was discussion about the ‘Quality First’ website which has been produced and updated by the BMA.
Another issue discussed was that of shotgun licenses and an issue about no consent from the patient before the police send letter/form to GP.
BMA website provides information and up to date guidance.
iii) Death certification implementation Group.
No meeting.
iv) ESG
Proposals discussed were about changing ABI LES with the need for FAST screening taken out as there seems to be a correlation between it’s introduction and the actual number of ABIs being done..
There is a proposal from Public Health that FAST screening be seen as a useful tool, but that it could be removed from the contract. This is still at the discussion stage.
Suggestions as to how to increase ABI uptake were welcomed.
Latest CMO advice is that the recommended maximum of 14 units of alcohol/week should be for male and female. Patients in excess of this can be offered an ABI.
v) Premises Group
As reported previously, the Premises budget is tight. Some large projects and essential work is going ahead.
However, there are 12 practices with old phone systems and money will be available for the upgrades from Central (not Premises) Funds.
Some GP premises improvement funding may be considered & practices could receive 50% NHS funding. Endowment Funding may still be applied for if the project is for patient benefit.
vi) LMC/NHSG Negotiating Group
*No further forward with Community Hospitals Contract, although there may be some progress with HR regarding GP contracts.
*It has been recorded that there are a lot of temporary residents (TRs) in nursing homes. Primary Care Contracts did an audit of the nursing homes across Grampian to see how many residents were TRs on a specific date and the result across the board (50% return) was zero. This result needs to be checked and the LMC will now contact GP practices to see if there are any other issues involved.
Discussion followed and issues raised included payment and respite care.
*PLT dates (already circulated) have been verified and will be covered until April 2017.
*Golden Hello Scheme issue has been clarified. There has been agreement regarding conditions of application.
*GAFUR issues were discussed. Agreed refunded postage has not gone out to practices. Also, there seems to be a reintroduction of thyroid letters coming out from the Health Board, which is confusing practices and should be stopped.
*There had been some problem with GPwSIs having had no uplift in their contract. Agreed this will happen automatically and it will be backdated to 2015.
vii) Contract monitoring Group.
There was discussion about PQLs and Cluster Leads which the LMC has discussed previously.
Practice boundary changes are now coming to this group and also to the LMC/NHSG negotiating group to make sure of agreement.
Boundary changes can happen but it was stressed that it can only be suggested to patients that they can change GP practice, even if they are now living outside the agreed new practice boundary.
viii) Patient Safety Group.
No meeting.
On 1st September there will be the Patient Safety Conference to look at support, help and quality work.
ix) Immunisation Group.
Now down to 2 Med C vaccines instead of 3.
x) Workforce, education and training sub-committee.
Meets this week.
6. Items for noting.
1) GPC letter on Safe Working (England document. This has been circulated to LMC members for information.
2). LMC Conference feedback (for information only).
7. Dates for noting.
LMC UK Conference in Edinburgh – 18th/19th May 2016. Seats will be available.
8. AOB
PW raised the issue of PVG checks and staff starting work without one. Advice given was for this to be discussed with the Defence Union.
TP raised issue of PF contact and committee was reminded of previous request for problem details to be forwarded to the office for collation (preferably with dates and times)
9.Date of next meeting - Monday 19th September2016, 4.30pm, Summerfield House.
* Please note that the October meeting will be on Monday 24th due to school holiday.