1
Oakwood Surgery, Masham Road, Cantley, Doncaster DN4 6BU
Tel: 01302 320010. Fax: 01302 371804
Chair Dr P Wilson Secretary Dr D Eggitt
Lay Secretary Jane Torn –
April2016
Reading the monthly LMC Update should be logged as 1 hour of CPD time. Actions taken as a consequence of this learning should also be logged for further CPD time as quality improvement activities
1 / LMC Chairman Retirement / 12 / TARGET cover / 2
3 / Cancer Research UK Health Professional Engagement / 3
4 / Commissioning LIVE 2016 / 4
5 / Sessional GPs subcommittee e-newsletter / 4
6 / Brexit Update / 5
7 / Zika Guidance Update / 5
8 / Clinical Healthcare Apprenticeship Scheme / 5
9 / Revalidation – Guidance for GPs / 6
10 / Information Prescriptions- Y&H Diabetes Network / 6
11 / Firearms – New Process / 7
12 / QoF Guidance 2016-2017 / 7
13 / Changes to Doncaster Weight Management Services / 8
14 / Focus on the Accessible Information Standard for GP / 9
15 / Job Vacancies / 12
16 / Goodbye / 23
LMC Chairman Retirement
On behalf of the LMC committee and Doncaster GPs we would like to say a huge thank you to Dr Paul Wilson who retired from the LMC committee at the end of March. Paul has been on the committee for 23 years and served as the Chairman for the last 14 years. We thank him for all his help and guidance.
Dr Rumit Shah will be replacing Dr Wilson as the Chairman from April, we wish him good luck.
Dr Deepti Alla has been elected as the new LMC East constituency candidate and will join the committee in April.
TARGET Cover
The Committee discussed the topic of arranging TARGET cover at length at the March 2016 LMC meeting. In previous years, TARGET cover was organised by Doncaster PCT. As Doncaster PCT was succeeded by NHS Doncaster CCG there was a need to remove the burden of organising TARGET cover from the CCG. This was partly a political move as NHS Doncaster CCG felt that they were being judged by NHS England for not only paying for GP education but organising subcontracting of care. It was also a move to reduce the time burden on the CCG in trying to organise TARGET cover. In 2014, Doncaster LMC offered to help facilitate subcontracting arrangements from this point. This offer of help was accepted by NHS Doncaster CCG.
You may recall that Doncaster LMC helped facilitate subcontracting of care between practices and DMSL for the purpose of TARGET cover in 2014. This was universally accepted by practices and all GP practices in Doncaster accepted this offer and signed an agreement with DMSL for the provision of TARGET cover for a period of three years. This year, DMSL was taken into administration and has left GPs without TARGET cover. Consequently, Doncaster LMC contacted four local provider organisations to ask for expressions of interest in delivering cover.
Whilst expressions of interest came into the office, the Committee discussed the process of appointing a provider for TARGET cover. Doncaster LMC is very clear that we do not have a mandate to award a contract for TARGET cover. Indeed, there is no single contract for TARGET cover. Consequently, our role was accepted as trying to get the best offer for GPs and facilitate a subcontracting arrangement that would exist between individual practices and providers. It was accepted by the Committee that due to economies of scale and to reduce confusion for patients a single provider would be preferred. The Committee discussed at length the difficulties of conflict of interest. To ameliorate this to the best of our ability we decided to put the vote for the provision of TARGET cover to practices as the subcontracting arrangement for TARGET cover would be held between the provider and each individual practice. We also agreed that it was not up to the LMC to unilaterally appoint a preferred provider. This is the first time since the inception of TARGET that this has ever been done. The LMC decided to extol the virtues of a single provider but decided not to show any preference to any of the providers who expressed an interest to deliver TARGET cover.
We received three expressions of interest to deliver TARGET cover after asking providers what they would like to deliver. Those three expressions were sent out by the LMC unedited so as not to have any undue influence of the outcome. The providers were listed in the email that went out to practice managers and GPs in alphabetical order. The email and reminders were sent out on three separate occasions to try to increase the return rate of votes. We received a total of 25 votes: 12 for the closer working group, 9 for FCMS and 4 for Hallcross.
As there is no demonstration of universal consensus amongst practices it would be inappropriate to facilitate a single agreement as was done in previous years. Doncaster LMC therefore made the decision to facilitate agreements between practices and providers if requested to do so, but will not organise a single pan Doncaster provider.
The Cancer Research UK Health Professional Engagement Programme
We are excited to introduce to you the Health Professional Engagement Programme which has been successfully running in many regions across England and is now a national programme following expansion into Scotland and Wales. In November 2015 it was introduced to the Yorkshire and Humber region. There are three facilitators working across Yorkshire and Humber who are looking forward to meeting and working with local GP practices, CCGs, secondary care, Public Health partners and all relevant stakeholders supporting the National Early Diagnosis Cancer Agenda.
We would like to introduce Sophia Baker, the new Cancer Research UK Health Engagement Facilitator covering South Yorkshire and Bassetlaw. Sophia is here to support you as a practice to help improve early diagnosis and cancer outcomes for your patients by:
* Providing cancer data for your practice *
* Assisting with the implementation of Risk Assessment Tools and new NICE guidelines *
* Providing templates for audits and assistance with completion and interpretation*
* Working with the CCG to identify local priorities *
* Organising training for clinical and non-clinical staff *
* Improving uptake of screening programmes *
Your Health Professional Engagement Facilitator is there to provide tailored support to suit your practices’ specific needs.
Contact Sophia for further information, advice or support.
Sophia Baker
Health Professional Engagement Facilitator
07979 607805
Commissioning LIVE Birmingham 2016
14th June – The National Conference Centre at the Motorcycle Museum
Developed in conjunction with The Commissioning Review journal, Commissioning LIVEBirmingham presents a diverse range of content delivered by experts in the field, focused specifically on the issues and topics you face day-to-day.
This year’s programme will see 50+ expert speakers present exciting and engaging sessions, panels and workshops that will keep you entertained and inspired throughout the day.
Here are the top 5 reasons you should attend:
- You can explore the latest updates in guidance, commissioning, technology and best practice to prepare you for the year ahead.
- You can earn up to 5.5 CPD hours across six streams of engaging content. With so much on offer, why not build your own personal agenda and gather insight specific to your needs?
- You can network with hundreds of healthcare professionals from across the UK to make sustainable connections that you can build upon long after the event.
- You will have access to presentations after the event which you can download and keep, so you have tangible learning tools to use in your role.
- You will leave the event with ideas and solutions you can actively implement in your local areas to improve care for your patients.
Plus, the event is free to attend!
Doncaster LMC is pleased to announce its involvement at this year’s Commissioning LIVE Birmingham. Dr Dean Eggitt,GP Principal,The Oakwood PracticeandMedical Secretary ofDoncaster LMC will be participating in the Yellow Theatre, on the panel: “Burnt out, stressed and understaffed – can primary care sustain a seven day service and should they have to?”
To view the full programme, click here:
To register for your free place, please visit, or call 0207 214 0555. When booking your place, please quote DNLMC16.
Sessional GPssubcommittee enewsletter Please find links to the latest copy of the sessional GPs subcommittee enewsletter, which can be accessed via the full link at . This month’s issue includes sections on - Working in new models of care, Do you want to make a difference to the lives of sessional GPs? Managing clinical risks for GP locums.
Brexit Update Following negotiations with other European heads of government in Brussels, David Cameron has announced a package of changes to the UK’s membership of the EU which will take effect immediately should the UK vote to remain in the EU in the referendum on 23 June 2016.
Recognising that this is a momentous issue whose result could have huge implications for the medical profession, the BMA will be releasing a briefing for members to highlight the significant impact — intentional or unintended, positive and negative — of EU policy and legislation on the UK’s medical profession and the health of the nation.
Additional information about the BMA’s work on this topic is available at the link below:
Zika Guidance Update The joint Zika guidance for primary care has been updated to reflect the new wording for travel recommendations for pregnant women and clarification of advice on sexual transmission. The changes include:
- Updated travel advice for pregnant women
- Clarification of advice on preventing sexual transmission to pregnant women and women planning pregnancy and their male partners
- Clarification of symptoms associated with typical Zika virus infection
- Further clarification on obtaining diagnostic samples and completing RIPL request forms
- Links to new advice on Zika and immunocompromised patients, and the Guillain-Barre syndrome
- New section on minor procedures in the primary care setting, including dentistry
The following Public Health England News Story has further information:
The guidance is also available on the BMA website.
Clinical Healthcare Apprenticeship Scheme Health Education England working across Yorkshire and the Humber (HEE YH) are running a second cohort of this successful scheme which aims to promote a standardised regional programme to ensure healthcare assistants (HCAs) in general practice have the knowledge and skills required to understand the role they are delegated.
Practices that meet a defined set of criteria are eligible to receive funding to support HCAs completing an apprenticeship in clinical healthcare support, plus primary care specific ‘bolt-on’ modules.
Information packs for practices for the HCA scheme, plus the application form can be obtained from . Practices will be required to submit all documentation to Sharon Simister by COP 2nd May 2016.
Revalidation –Guidance for GPs The RCGP has approved a new Guide to Supporting Information for Appraisal and Revalidation (March 2016).It is designed to ensure that any areas where there has been a lack of clarity are better understood. The guide confirms that:
· All time spent on learning activities associated with demonstrating the impact of learning on patient care, or other aspects of practice, can be credited as continuing professional development (CPD)
· Quality over quantity - GPs should provide a few high quality examples that demonstrate how they keep up to date, review what they do, and reflect on their feedback, across the whole of their scope of work over the five year cycle
· Only incidents that reach the GMC level of harm need to be recorded as Significant Events in the portfolio. Reflection on all such Significant Events is a GMC requirement and must be included whenever they occur
· GPs only need to do a formal GMC compliant colleague survey once in the revalidation cycle (like all doctors)
· there are many forms of quality improvement activity and they are all acceptable to demonstrate how you review the quality of what you do, and evaluate changes that you make. There is no requirement for GPs to do a formal two cycle clinical audit once in the five-year cycle.
The guide is available on the RCGP website –
Information Prescriptions- Y&H Diabetes Network
Information prescriptions are designed to give people with diabetes the information that that they need to understand, engage with and improve on their health targets. They are short (a single side of A4), easy to read and clinically accurate. They are designed to support care planning and behaviour change.
Information prescriptions are now available in both SystmOne and EMIS. Use this link for information on activating them in SystmOne, EMIS and Vision
·The information prescriptions automatically alert clinicians to patients who have diabetes and are outside the NICE targets for blood pressure, HbA1c or cholesterol.
·The information prescriptions are written in plain English and clearly explain what high HbA1c, high blood pressure and bad cholesterol is and how not controlling these factors will affect their health. Further to this it provides short and snappy information for your patients to eat well and be active to reduce their risk of Type 2 diabetes.
·Prompting patient action –The information prescriptions include a unique link to more information on Diabetes UK’s website- we know that over 13,000 patients in 2015 have been sufficiently motivated by the receipt of an information prescription to access more information on managing their diabetes, showing that they are working as a prompt to action.
·The information prescriptions auto populate with patient HbA1c, Blood pressure and Lipid data and support patient centred care planning.
Further information on activating the Information Prescriptions is available on
Firearms – New Processguidance update
Since the new firearms process went live from 1st April, the BMA has receiveda very large number of complaints from GPs regarding fees payable for responding to the initial letter received from the police. They have therefore issued amended guidance (see below) on their website which clearly states that it is up to the GP to decide whether to undertake the work with or without charging a fee.
It is up to the GP to assess how best to proceed, taking on board the following factors and guidance:
1. The work involved in responding to the letter is minimal and therefore can be undertaken easily without delay and without a fee.
2. The work involved in responding to the letter requires time and resources from the practice that necessitate a fee to be charged to the patient (the Police should not be charged). We would advise GPs to seek confirmation from the patient that they are in agreement to pay a fee before undertaking the work so not to cause additional confusion or delay. If there is a delay owing to this and you are unable to respond to the letter within the 21 days, please notify the police of this.
3. No one in the practice is available (e.g. on holiday or off sick) to complete the work within 21 days. Please notify the police without delay.
4. The practice does not have the capacity to undertake the work within the 21 days. Please notify the police without delay.
5. That the GP has a conscientious objection to gun ownership and no other GP in the practice is available or able to undertake the work. Please notify the police without delay.
QOF Guidance 2016-2017 The 2016-17 QOF guidance has been published on the NHS Employers webpage ( .
The BMA webpage ( has been updated to reflect the minor amendments made to QOF for 2016-17, which are:
· An adjustment to the value of a QOF point taking account of population growth and relative changes in practice list size from 1 January 2015 to 1 January 2016. The national average list size as of 1 January 2016 is 7460 and the value of a QOF point for 2016/17 will be £165.18
· No changes to thresholds for 2016/17
· No changes to QOF indicators
Changes to Doncaster Weight Management Services Following the Comprehensive Spending Review on the 25th of November 2015 and the publication of the public health grant allocations on the 11th of February 2016 the Council has had to review the investment in all its Public Health Services.
The outcome of this review has concluded that the Council will be unable to continue investing in the current Obesity Prevention and Tier 2 Weight Management Service. This service, known locally as ‘Healthy Weight Solutions Doncaster’ is currently delivered by the Department of Nutrition and Dietetics at Doncaster and Bassetlaw Hospitals (DBH). The Tier 2 weight management service will cease on the 31st March 2016.
There will also be changes to the current children and adults Tier 3 weight management services, known locally as Healthy Lifestyles Doncaster, both provided by DBH. The Tier 3 service for adults will be redesigned to focus on those patients who require a Tier 3 service prior to receiving Tier 4 bariatric surgery. This will result in an increase in capacity for this pathway. At the same time the children’s Tier 3 service will cease as this has been underutilised.
All patients currently receiving a Tier 3 service will complete their weight management programme.
Therefore, with immediate effect you should no longer refer or signpost any of your patients, clients or service users to Tier 2 weight management services or for children to the Tier 3 weight management services.
Referrals for the new Tier 3 adult weight management service will be accepted from GP, Consultant and self-referral for patients who meet all the following criteria:
• Have a BMI >35kg/m2 and co morbidities, or a BMI >40kg/m2 without co morbidities
• Have expressed an interest in accessing bariatric surgery and their GP/Consultant confirm that they meet appropriate criteria.
• Patients who self-refer will have discussed the option of bariatric surgery with their doctor/s.
• Patients have an understanding of the Tier 3 service requirements and commitment they will need to make.
The Health and Wellbeing Board is aware of these changes and is looking at how other approaches can be deployed locally to reduce overweight and obesity including increasing physical activity and access to leisure services, healthier food, better access to green spaces and the use of planning and licensing powers. The Board will also review the local approach once the national childhood obesity strategy has been published.