Local Medical Committee Meeting 4 October 2016
MINUTES OF THE COUNTY DURHAM AND DARLINGTON LOCAL MEDICAL COMMITTEE HELD ON TUESDAY 4 OCTOBER 2016IN THE BOARD ROOM AT APPLETON HOUSE
Present:
Tanya JohnstonChair
David Robertson Secretary
Caren Purvis Derwentside – Practice Manager
Niamh TelfordDurham
Kamal SidhuEasington
Norbert DielehnerSedgefield
Claire ElderLMC
Invited:
Andrea Jones Darlington CCG
Sarah BurnsDDES CCG
Chris GrayCDDFT
Number / ItemL16/84 / Apologies for Absence
Richard Harker (Darlington)
Heather Prestwich (Sessional)
Gopal Chealikani (Easington)
Sue Jacques (CDDFT)
L16/85 / Minutes of the Meeting held on 6 September 2016 – were agreed as an accurate record.
L16/86 / Matters Arising
Capita – Continuing report of problems. Questionnaire for practices to complete circulated.
Peterlee Urgent Care – Problems remain. LMC has highlighted difficulties with employment and working conditions of GPs in urgent care to CCG. CCG taking issues up with CDDFT.
Firearms – Meeting was cancelled by the Police, awaiting for this matter to be re-organised.
IFR – DAR had written to James Carlton about this matter. Although initially thought to be residual problem with Woodlands Hospital in Darlington, members around the table complained about the continual requests from CDDFT (and especially plastic surgery?) for GPs to complete the IFR form even though consultants have been continually told it was their responsibility. DAR asked for examples to be sent to him. Agreed to circulate letter to practices to clarify position.
GP Forward View – NHS England is providing Vulnerable Practice Funding although the distribution of this is yet to be determined. It was noted that the amount of money available was limited.
L16/87 / Clinical Commissioning Groups
Darlington CCG – Andrea Jones
DDES & ND – Sarah Burns
QiPP – There is a £20 million gap forecast for 2016/17 for all CDD CCGs and DDES alone is planning QiPP efficiencies of around £12-14 million in 2017/18.
CCGs exploring ways of making cost effective reductions on clinical pathways, eg Ophthalmology. There is a general feeling that PBR will move more towards block contracts. TEWV would continue to be a block contract as there is no intention to move mental health services to PBR.
Community Services –The CCGs are working with CDDFT to reduce waiting lists for services such as wheelchairs provision.
CCG are working with Finamore Consultants to identify a range of services which could be provided more efficiently. Members felt that the CCG had “told” Federations and its constituent members that this was happening with no consultation on this matter. As a result GPs felt forced into agreeing decisions. The Chair wondered what the role of the LMC was with regard to decisions being made within CCGs & Federations.
Community Service Hubs were being developed to provide both a degree of financial insight and control together with bringing community services more in line with what practices need for their patients.
STP continue to evolve with three local footprints:
1 / 2 / 3
DDES / North Durham / Newcastle
Darlington / Sunderland / North Tyneside
Tees / South Tyneside / Northumberland
Gateshead
L16/88 a / Local Authority
Nothing to report.
L16/88 b / Remuneration for Attendance at LMC Meetings
There was considerable discussion about payment for attendance at LMC meetings. It was decided to do further research and place on the November Agenda.
L16/89 / Secondary Care
89.01 Sue Jacques & Colleagues – Trust & Community Update
Prof Chris Gray attended on behalf of CDDFT and updated the Committee on the vacancy issues within the Trust. Although there were some areas of success (eg radiology) some departments are still struggling to recruit consultants:
- Ophthalmology;
- Cardiology
- Gastroenterology
The Emergency Department for the first time in a long time is very well staffed on both Darlington & Durham sites
CDDFT is working closely with neighbouring trusts (Sunderland & Newcastle) to provide cross cover in certain speciality areas such as Ophthalmology.
Discussions were had about the state of the letters completed by Junior Doctors. Due to the lack of consultants in some departments Junior Doctors could be doing discharge letters without even seeing the patient even though this was not good practice.
Ophthalmology – SB confirmed that there was work being done by DDES CCG in conjunction with CDDFT to look at changing pathways and to streamline contracts to reduce the stress on the system. While there has been a reduction in referrals by GPs, SB pointed out that the Trust cannot reduce their clinics until they are certain that referrals will not increase again.
CG reported that there was a great deal of work going on to try and adopt common policies and pathways over all its sites and that consultants were increasingly working between sites where this was possible.
Radiology – Radiologists have been recruited and is now a very good department and they only minimally outsource work.
IT – Continues to be an on-going project and will be quite some time until it catches up with Primary Care.
Shotley Bridge – Recent difficulties with Shotley Bridge had been identified that seemed to be related to the condition of the plumbing and a risk of flooding. NHS Prop Co own the building and apparently have carried a survey examining the problem however the results of the survey have not been shared with CDDFT despite requests from the Trust.
L16/90 / NHS England
90.01 Primary Care Workforce Tool
Providing workforce data is a contractual obligation and must be completed by Practice Managers. However under the existing scheme no data is ever fed back once entered. This revised tool does provide a feedback of information and offers practices the potential for benchmarking their staffing levels against others. Members though were concerned with the increasing amount of information and level of personal detail that is being sought, which is growing year on year. CP reported that it did not appear absolutely essential to provide all the information asked for. The LMC endorsed the proposed Primary Care Workforce Tool as an option for practices to useprovided it is not more onerous that the existing system.
L16/91 / Two Week Referral Forms
CP confirmed that in ND they were happy with the forms and felt they were better than previous ones.
The Committee approved the new form but were unhappy that this had not come before the Committee before it had been rolled out.
L16/92 / Out of Hours Issues
See Matters Arising
L16/93 / Communication from the BMA/GPC
Bureaucratic Workload – The BMA has produced an update of letters and were useable on System One and EMIS. Members felt they had to be used in great numbers for the Trust to realise the impact. Members felt that combined action could make a difference.
DAR would circulate to Practice Managers again.
L16/94 / General Correspondence
Chronic Fatigue letter– DAR informed the Committee of the dissolution of the Children’s Chronic Fatigue Clinic at CDDFT. Members wanted to know where to send children now – it was decided that DAR would write to the CCG to express their dissatisfaction that they had not consulted on this matter first or provided with more detailed advice about alternative provision.
L16/95 / Any Other Business
L16/96 / Date, Time and Place of Next Meeting
1 November 2016 @ 19.30 in the Board Room at ND CCG Rivergreen, Durham
Private and Confidential
Ref: CNE/MINUTES/AGENDAS/LMC/Minutes 2016/LMC Minutes 4 OCTOBER 2016