6
NEWCASTLE AND NORTH TYNESIDE
LOCAL MEDICAL COMMITTEE
(www.newcastleandnorthtynesidelmc.org.uk)
Secretary
Dr. G. Rae
47 Marine Avenue
Whitley Bay
NE26 1LZ
Tel: 0191 2514548
Minutes of a meeting of Newcastle and North Tyneside Local Medical Committee held on Tuesday 10th January 2012.
12.01 PRESENT
Dr., G., Rae (Secretary) Dr. N. Lawson
Dr. B. Afoladi Dr. J. Matthews
Dr. D.A. Black Dr. K. Megson
Dr. S.E. Blair Dr. G. Pilkington
Dr. M. Chaudhary Dr. A.J. Podogrocki
Dr. C. Cock Dr. A.L. Ramshaw
Dr. H.G. Cookey Dr. G. Reissmann
Dr. R. A. Flint Mr. N.P. Strong
Dr. M. Guy Dr. J. Weatherstone
Dr. Rae announced that Dr. Cummings has been unwell since the last LMC meeting but is recovering well and has been in contact with him, and it is hoped that he will be able to attend LMC meetings in the future.
Dr. Rae welcomed Dr. Ken Megson who is taking on the role of Assistant Secretary in order to move the LMC’s structure forward to develop a robust and representative LMC. Dr. Megson is involved in the secretariat of the Regional LMC and has been involved with Gateshead & South Tyneside LMC for a long time.
12.02 APOLOGIES FOR ABSENCE
Apologies for absence were received from Dr. R.A. Cummings.
12.03 MINUTES OF THE LAST MEETING
Dr. Rae announced that the minutes that had been sent out had been the original minutes which had been sent to Dr. Cummings and Dr. Black. However, because of Dr. Cummings’ illness he had not been able to go over them, but Dr. Rae and Dr. Black have gone over them and made a number of alterations. Dr. Rae read out the amendments with which the Committee agreed. He stated that the amended minutes would be sent out again with the minutes of tonight’s meeting.
12.04 MATTERS ARISING FROM THE MINUTES
(a) Item 11.93 (b) Dr. Rae stated that he had written to the CCG leads.
(b) Item 11.93 (d) Dr. Guy stated that the Day of Action had not created any problems.
(c) Item 11.93 (g) Dr. Rae stated that, following the LMC Secretaries Conference in November, he had sent out a Newsletter explaining revalidation.
(d) Item 11.93 (h) Dr. Guy stated that he had taken the issue of minor surgery to the PCSA and had fed this back to Dr. Cummings. This will be brought back to the next meeting.
(e) Item 11.94 (a) There had been a suggestion that an LPC member should attend LMC meetings and vice versa. Dr. Rae will write to Mr. Lowe concerning this.
(f) Item 11.95 Dr. Rae stated that there is to be a Pensions meeting on the 12th January. At the present time 285 people have expressed interest in this. Andrew Dearden will be guest speaker. There are only five such meetings being held in England, three in Scotland and seven in Wales.
(g) Item 11.97 (b) Dr. Choudhary stated that the Commissioning Group had been informed about the situation of patients being identified as being in hospital but who had never been admitted, but he is still waiting for a reply.
12.05 NoT PCT BUSINESS
(a) Dr. Guy stated that CCGs are now being prepared for authorisation. There is a draft document on Role Outlines that concerns him because some of the requirements, for the majority of GPs, to become Accountable Officers are unachievable, and he feels that they want managers to be Accountable Officers rather than GPs.
(b) Dr. Guy stated that they are developing one Commissioning Support Service for the NHS North East. The Regional Leader is Mike Proctor. A prospectus has been produced for this Regional CSS. However he emphasised that there is no plan to discuss this with the private or commercial sector. The question was asked about how much involvement, by the CCGs, had there been in the development of the CSS and it was noted that they had been invited to one meeting last November.
(c) Dr. Guy stated that with regard to the local NCB they are not clear what this is going to look like as local structures are not yet in place. The NCB will commission all services from primary care. It is anticipated that over the next two months staff will align behind the CCGs and the NCB.
(d) Dr. Guy reported that Dr. Morris has resigned as from the 31st March as he is taking up a more expanding role in Gateshead. This will leave a big gap in terms of Responsible Officers that Dr. Guy will take on for a year, until CCGs become designated bodies.
(e) Dr. Guy reported that preparation continues for revalidation with Responsible Officers going through training. The date for implementation is still 1st January 2013.
(f) Dr. Guy stated that on the question of breast implants, there have been none of the suspected implants used in the North of Tyne by any NHS hospitals. However patients who have had them under the private sector are not included in this.
12.06 ACUTE TRUST BUSINESS
(a) Dr. Afalodi stated that they have got agreement to build the new hospital at Cramlington.
(b) Dr. Blair queried about Community Nursing in North Tyneside. Dr. Rae suggested asking Daljit Lali back to an LMC meeting. However he felt that there has been positive movement towards Community Nurses coming back into GP’s surgeries. Dr Rae will write to Ms. Lali to see what exactly is happening at the present time and ask for a further copy of the report on community nursing.
(c) Dr. Black stated that his practice looks after a nursing home in Kenton and recently there have been a number of patients admitted with no discharge letters. They have been going to the patients GPs to get summaries on their condition but these are out of date because they do not include the latest hospital admission. This has resulted in a number of prescribing issues. Mr. Strong stated that if Dr. Black contacts him with details of individual cases he will undertake an investigation.
(d) Dr. Reissmann queried the money the PCT has to set aside as stipulated in the Operating Framework document for the reorganisation of the NHS. Dr. Guy stated that the organisation has to put aside 2% and he will pass Dr. Reissmann’s concerns to the Director of Finance. Dr. Rae will write to the Director of Finance to try and obtain a break down of this money.
12.07 CHAIRMAN’S BUSINESS
(a) Dr. Rae stated that he had written to all the CCG Leads in North Tyneside and has also been part of a shared letter by the GPC members for the North East showing the concerns that are to be debated later in the meeting.
He had also attended the LMC Secretaries Conference, which had been addressed by Mike Farrar and Sir David Nicholson. At his presentation, Dr. Farrar stated that they had not set up CCGs to fail, and the one thing he wanted was for CCGs to have genuine choice of how to get commissioning support. They then split into workshops talking about the role of LMCs and how to interface with CCGs. It was stated that quite a lot of LMCs have members who attend CCGs as observers and Dr. Rae felt that this was a good idea.
Dr. Rae stated that he had spent a long time with Dr. Megson speaking about the election and the Constitution as well as enhanced services and they also discussed the LMC web site which needs to be updated.
12.08 SECRETARY’S BUSINESS
(a) Dr. Megson thanked the Committee for inviting him to join the Committee as Assistant Secretary and that he thought he would be able to work well with Dr Rae and help realise Dr Rae’s view in making the LMC a robust representative structure in the future. He stated that there is an election overdue and that the Constitution needs to be updated in the future following the inception of the new committee. He said that he has already done some work on the Constitution but that together with Dr. Rae and Dr. Black there is still more work to be done.
The Constitution states that half the Committee should be re-elected every two years in order to have continuity. There is a need to elect a Returning Officer and it was unanimously agreed to elect Dr. Megson for this position, and it was agreed that the new Committee should be elected by the March meeting. Dr. Rae stated that electing only half of the Committee is the way that the BMA Council is run. Dr. Megson stated that the size of the Committee needs to be reconsidered as there are officially 28 members but there are only 18 names on his e-mail list. Dr. Rae reported that there are certain members who, for genuine reasons, have been unable to attend but the Constitution states that any member who fails to attend for three consecutive months should be stood down and this hasn’t been adhered to. Dr. Megson stated that 28 members is a big committee for one constituency.
Dr. Megson suggested having 20 elected members along with co-opted members from the CCGs. There was also a discussion on how to get Sessional GPs involved in the Committee and it was suggested that the PCSA be asked to contact Sessional GPs to see if there is any interest in them joining the LMC. There is a real concern that young Sessional GPs do not see the significance of the LMC and it was also suggested writing to all Practice Managers to find out where the Sessional GPs are working. This was agreed. Dr. Chaudhary suggested contacting NELG who have all Sessional GPs e-mail addresses. Dr. Rae stated that this is a huge issue and in the past the Committee has tried very hard to involve Sessional GPs without much success.
It was agreed that half of the Committee would be elected with the other half continuing for a further two years. Dr. Rae stated that in the last two Newsletters he had brought up the topic of the election and he is hoping to do a further Newsletter in the near future to emphasise this.
Dr. Black stated that one of the problems is that there are two levies, Voluntary and Statutory, and if these were unified it would make the collection of them much easier and it was agreed to discuss this at the Executive meeting.
(b) Dr. Rae stated that there is great concern about the Commissioning Support Organisations in the BMA because of a draft document that came from the Department of Health (Developing Commissioning Support – Towards Service Excellence). The GPC showed concern in November, but the BMA Council changed its stance and now has come out totally against the White Paper on NHS Reforms. Dr. Rae stated that the one part GPs want is clinical commissioning but the NHS Reforms are not necessary to bring this about. Dr. Guy had stated that there had been no private sector involvement to date but there is a feeling that 2016 approaches then the Commissioning Support Organisations will have to undergo a competitive procurement process. It is felt that GPs want CCGs to be a success and to be in control of their own destiny.
Dr. Pilkington stated that he feels it is right that these concerns should be raised and he felt surprised that the issue of commissioning support was the issue that tipped the BMA Council over. He stated that in his opinion there are some things about the challenges that don’t quite resonate and as CCGs they have to decide about how much is bought in-house and how much is bought in from outside. One option would be to have enough people to be able to have their own commissioning support therefore reducing the need for outside support. The other option, if CCGs are to have choice they can choose not to involve the private sector.
There followed a long discussion on involving the private sector and concerns were expressed by several members that in the future CCGs would be coerced into involving the private sector. Dr. Rae stated that this debate will be ongoing and that the big CSOs will assume control of the commissioning process and CCG Leads will end up being Clinical Advisers. He feels that there should be a conference between the Regional LMC with the Clinical Commissioning Groups Leads in order to move this forward.
12.09 PRACTICE MANAGERS
Dr. Blair stated that there is a regional group between the NEPCSA and practice managers that GPs knew nothing about. He had queried at the last meeting whether the Regional LMC knew about this. Dr. Megson replied that it did, but there had been no input into the Terms of Reference of that group from the Regional LMC. Dr. Blair stated that he felt there should be some representation by doctors to the NEPCSA. Dr. Megson stated that he is the Regional LMC Secretary and that it meets every month to share the views from all the LMCs in the region and will raise this issue directly Dr. Rae stated that the way information is sent out to GP practices is through Practice Managers and there must be liaison between the LMC and Practice Managers. Dr. Rae suggested that some Practice Managers be co-opted to the LMC. Dr. Megson stated that other LMCs in the region already do this. The Committee felt that this would be a good idea. It was also agreed that the Regional LMC’s minutes should be sent out to the LMC and DR Megson confirmed that this was already the case.
12.10 SESSIONAL GP ISSUES
Dr. Rae stated that he has tried to involve Sessional GPs with the LMC but has had very little interest expressed. However he will continue to try and involve them. He stated that the National Sessional GP Committee is very strong.
12.11 GMS/PMS CONTRACT MATTERS
Dr. Rae stated that there was not a lot to report at this stage.
However he felt that Laurence Buckman was the most open Chairman of the GPC for some time and that he gets advice and feedback from the GPC members.
Dr. Black stated that with QOF his practice will drop 3 points for LD02 (thyroid function tests for patients with Down’s Syndrome). They only have 5 patients with Down’s Syndrome on the list. Three are already on thyroxine and the remainder are children and thus excluded from the indicator. Under these circumstances the points are automatically lost. He has raised this with the NSPCA but there is nothing they can do. Dr Megson stated that this is a national problem.