5
NEWCASTLE AND NORTH TYNESIDE
LOCAL MEDICAL COMMITTEE
(www.nntlmc.co.uk) (email: )
Chief Executive Officer Executive Officer Executive Officer
Dr. George Rae Dr. David Black Dr. Ken Megson
Beaumont Park Surgery 2 Betts Avenue 29 Beverley terrace
Hepscott Drive Benwell Cullercoats
Whitley Bay Newcastle North Shields
NE26 9XJ NE15 6TQ NE30 4NU
Tel: 0191 2514548 Tel: 0191 2743767 Tel: 07803 989960
Minutes of the meeting of Newcastle and North Tyneside Local Medical Committee held on Tuesday 2nd February 2016.
16.17 PRESENT
Dr. G. Rae (Chair) Dr. K. Megson
Dr D. A. Black Dr. R. Keogh
Dr H.G. Cookey Dr R. Curless
Dr R.A. Flint Dr A. McCubbin
Dr J Matthews Mr L. Miller
Dr N. Morris Dr A. L. Ramshaw
Dr G. Reissmann Dr G. Pilkington
Dr M. Scott Mr. A. Welch
Mr J. Snaith Mr M. Smith
Miss J. Lumley
16.18 INTRODUCTIONS/APOLOGIES FOR ABSENCE
Apologies for absence were received from Drs Graham, Ralph and Roberts.
16.19 DECLARATIONS OF INTEREST
There were no new declarations of interest. The committee was reminded of the procedure for Declarations of Interest.
16.20 GP COMMISSIONING
(i) Continuing Health Care
Regarding the continuing health care assessments, and the reviews that have been undertaken by CCGs, it was mentioned that several practices have expressed concerns around requests by CCGs for whole sets of patient notes, and whether or not this is appropriate. It was mentioned that this problem had mainly been experienced in North Tyneside, and it was said that practices would be able to charge the CCG their normal fees for this service if the CCG continue to make these requests. It was felt that requests for full sets of medical records by the CCG are unnecessary.
ACTION NEEDED: Agenda Item for March
(ii) Support for Federations
This is a very important topic, and that there had been some concerns especially amongst doctors in North Tyneside about the possible re-procurement of the muscular-skeletal services, as this was felt to be an integral part of the Federation there. It was stated that the CCG is looking at muscular-skeletal services in the community in North Tyneside, and that this is an agenda item at the next Council of Practices meeting.
There were some concerns within the committee that the tendering of this service could undermine the GP Federation directly leading to concerns around the viability of the Federation should this go ahead. It was felt that it is very important not to destabilise the Federation, as this could be bad for General Practice in the long run. It is important to have a strong GP Federation, in order to collaborate successfully regarding Primary Care Strategies. It was felt, by some, that the Federation needed to be prepared to compete for the provision of services, and be able to adapt to such changes.
(iii) NHS 111 & Emergency Care Vanguard
It was mentioned that the Emergency Care Vanguard would suggest ways in which GPs can engage with the NHS 111 service, to try and ease the problems that are currently experienced with the service. The possibility of telephone triage was mentioned, and it was said that a pilot for this in Durham had received mixed feedback. It was felt that negative press around the NHS 111 service must be addressed and changed in order to encourage practices to engage with the service.
Currently the service has no or little credibility with many GPs and it was felt that practices do not necessarily have the time to engage with the service, but that it is important to take the opportunity to try and work with NHS 111 to improve the service. It was suggested that GP Federations could be resourced to provide this opportunity but that there is a need to re-educate patients as to appropriate use of services for first points of contact.
16.21 ACUTE TRUST BUSINESS
Representatives from both acute trusts reported that currently they are experiencing issues with patient flow, which in some cases had resulted in cancellations to elective patients. Capacity issues were mentioned, as were some issues with repatriation of patients from Newcastle to North Tyneside. It was mentioned that the Trust in Newcastle had been visited in January by the CQC, and that feedback received so far had been reasonable. It was also mentioned that Northumbria Trust were expecting a CQC inspection in November 2016. It was again reiterated that the Acute Trusts are supportive of the junior doctors in their on-going disputes with the Department of Health.
16.22 MINUTES OF THE LAST MEETING
The minutes of the meeting of Newcastle and North Tyneside Local Medical Committee held on Tuesday 6th January 2016 were confirmed as a true record.
16.23 MATTERS ARISING FROM THE MINUTES
(i) Min .16.4(iii) NHS 111 Service
It was mentioned that the discussion around this at the last meeting had been subsequently fed back to the regional LMC. The Regional LMC had agreed to ask for representation on the regional governance group of NHS 111 and this had been accepted.
16.24 GENERAL DEBATE – New model of care – Plan B
Thanks were extended to the LMC officers for creating the alternative option to the proposed ACO model. It was mentioned that the proposed Plan B is a five year plan, and the document had been sent out to members prior to the meeting was noted. It was felt that the document is well written and comprehensive, and with this in mind, it was also felt that it would be useful to provide a summary document when sending the plan out to practices, in order to encourage recipients to read and understand the scheme.
It was thought that it would be more helpful to get everyone informed somewhat using this summary document, rather than a small amount of individuals informed completely using the original document. It was noted that a summary was contained within the document and overall the document was a very good basis to build upon. There have been concerns with the lack of information and detail around the ACO proposal, and it was felt that Plan B is much more concrete and robust, and has advantages over the ACO proposal in this respect. It was felt that there is a need to try and sell the best parts of option B, and several different forms of publication were suggested.
A suggestion that a summary of the agreements and disagreements of both models of care should be prepared was thought a good idea and the officers agreed to do so. It was also felt that there is a need to make sure that Practice Managers are fully aware of the potential impact of any new model of care on their position.
16.25 CHAIRMAN’S BUSINESS
It was mentioned that the Chairman had been nominated for the BMA council, and that this appointment would have tenure of 2 years.
16.26 SECRETARY’S BUSINESS
(i) Roles and Responsibilities of LMC members
The region had circulated a new policy document for the above, and the committee was asked to approve adoption of this document. This was approved.
(ii) Report on Special LMC conference
A brief report was given on the Special LMC conference. It was said that there had only a small number, but very specific, motions debated at the conference, and that key themes had been clearly identifiable throughout. It was felt that there had been some misrepresentation by the national press regarding some of the motions discussed at the conference. The final motion was debated extensively and called upon the DH to “rescue” general practice with clear plans within 6 months. Failing this the GPC would develop plans for taking action including canvassing on undated resignations from the NHS.
(iii) Feedback from Regional GPC meeting
Feedback from the Regional GPC was provided, and it was mentioned that Alexa Clarke had been written to, and a reply received. It was agreed that Dr Clarke be invited to attend the LMC once the new palliative care standards were ready for dissemination.
(iv) Election of Returning Officer
It was proposed that the LMC administrator be nominated as Returning Officer, and the committee agreed this.
16.27 TREASURER’S BUSINESS
Following on from the discussion around the LMC accountant at the last meeting, it was mentioned that the current accountants had price matched the alternative quote, so the decision had been made to stay with the existing accountants.
16.28 PRACTICE MANAGERS’ ISSUES
(i) HSCIC Data Provision Notice Letter
It was mentioned that the BMA had issued guidance indicating that compliance with the above notices is compulsory, but the committee was reminded that practices could inform patients of their rights to opt out of data provision.
16.29 SESSIONAL GP ISSUES
(i) Medical Indemnity Cover Issues
It was mentioned that there had been issues around certain medical indemnity providers, with the result that individuals may not be correctly covered for certain work that they undertake. There were concerns around the costs of cover for Out Of Hours services, and it was suggested that GPs should fight for NHS indemnity.
16.30 ANY OTHER BUSINESS
The committee was informed that there had been an application by a practice to change their area boundary, and that the committee would be asked for their opinions/support in due course. It was asked what the criteria for not supporting such a request would be, and it was said that it would difficult for the LMC not to support this type of request, and that the LMC were generally supportive of practices. As it is essential that practices are allowed to control their own workload if appropriate.
16.31 GPC NEWS
There were no matters arising from the GPC news.
16.329 DATE AND TIME OF NEXT MEETING
The next meeting will be held on Tuesday the 1st of March 2016 in the Board Room at the Freeman hospital at 6:45pm.