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SOUTH ESSEX LOCAL MEDICAL COMMITTEE
Minutes of a General Meeting of South Essex Local Medical Committee held at
Rayleigh Parish Centre, Rectory Garth, Rayleigh on
Thursday 24th January 2013 at 2.15 pm
PRESENT: Dr B Davies (Chairman) Dr K Porter (Vice Chairman)
Drs Aung, Balmer, Brown, Deshpande, Hunt, Kittle, Kumar, McCarthy, Nanda, PJ Patel, Raja, Saad, Siddique, DG Singh, Staunton, Taylor, and Waiwaiku, Mr Bradshaw.
PART ONE
The Chairman asked if there were any matters members wished to take in Part Two. There being none, she proceeded with the Agenda.
APOLOGIES FOR ABSENCE
Apologies for absence had been received from Drs Barusya and Chaturvedi, and Mrs Pedder.
DECLARATION OF INTERESTS
The Chairman asked members present to declare any interests in respect of the discussion items. The following declarations were made:-
Dr Saad - Chair of CPR CCG
Dr Porter - Clinical Lead, EQUIP
MINUTES
The Minutes of the meetings of the Committee held on 22nd November and 6th December 2012 were confirmed and approved for publication on the LMC website.
MATTERS ARISING
November
P1 Sessional GP Conference: Dr Porter informed members that this year’s Sessional GP Conference will be held on Saturday 12th October 2013 at the Post Graduate Medical Institute, Chelmsford.
P2 Medication/Investigations Instigated by Secondary Care: Dr Adey had provided a draft motion to the LMC Conference which will be considered at the February meeting.
P2 NHS 111 Clinical Sign Off: Dr Balmer had attended a Clinical Governance meeting on 15th January and reported that both North and South Essex are proceeding towards authorisation. He will endeavour to attend the authorisation meetings.
December
P3 LMC Schedule of Meetings 2013: As the March meeting falls on Maundy Thursday, members were asked if they would prefer to re-schedule. However, it was agreed that this is outside of school holidays and the meeting should go ahead as planned on 28th March.
P4 Transforming Pathology Services: The Southend Echo has instigated an e-petition opposing the proposed changes, the implementation of which has been delayed until 1st October 2013. It is still uncertain as to whether all CCGs will remain signed up to the proposals, and there is a possibility that Southend Hospital will be given a twelve month contract to continue to provide the service. Members asked that the LMC write to Cllr Graham Butland, Chair Essex Health Overview and Scrutiny Committee to formally convey the Committee’s concerns about the proposed changes and, in particular, the apparent lack of proper consultation with key stakeholders.
DISCUSSION TOPICS
1. GMS Contractual Changes 2013/14
Members received a letter from Richard Armstrong to Dr Laurence Buckman, together with a summary of the GPC concerns regarding the proposed changes to clinical QOF and details of GPC and LMC roadshows. Whilst there was some concern as to what action could realistically be taken to prevent any imposition, it was agreed that members should encourage their constituents to ensure that at least one representative from each practice attends a roadshow. To date, approximately 80 delegates have registered for each of the LMC events which will be held in Marks Tey and Basildon.
The BMA is currently conducting a survey of all GPs in England. The results of the survey will help shape the GPC response to the consultation on the proposed changes which closes on 26th February 2013. The LMC office has circulated details to all practices and LMC representatives and would urge as many GPs as possible to complete the survey.
One specific change discussed by members was the requirement to provide online access to practice services. Practices that do not have appropriate IT systems will automatically be disadvantaged. Whilst members recognised the need to incorporate technology into general practice and the potential benefits to patients, particularly with regard to booking appointments and ordering repeat prescriptions, it is essential that appropriate systems are in place to ensure confidentiality is maintained. Members agreed that the responsibility for installing systems to safeguard the security of information should rest with the NHSCB, not individual practices.
2. Thurrock CCG
Members received and considered an extract from the Thurrock CCG site visit report and a letter from Thurrock CCG to member practices dated 16 January 2013 enclosing a Memorandum of Agreement.
Despite the involvement of several management consultants, the creation of a single CCG for the Thurrock area remains problematic. Dr Deshpande reported that 19 of the 33 member practices have still to sign the Constitution due to concerns over apparently conflicting statements and the appointment process for the Accountable Officer. There is a further internal issue in the form of a complaint that has been raised against the CCG by one of the Practice Manager members of the CCG Board. There was also a suggestion that one of the lay members of the CCG Board was possibly ineligible to hold the position.
Whilst Dr Balmer acknowledged that the revised Constitution contained some inaccuracies and numerous typographical errors, the latest version shared with the LMC office appeared, on the whole, to incorporate the major components of the LMC Model CCG Constitution. With regard to Accountable Officers, these are appointed by the CCG and ratified by the NHSCB.
Members were of the opinion that many of the outstanding problems arise from historical difficulties and that arguing about the semantics could result in the CCG not gaining authorisation and “direct rule”, from either the NHSCB or another CCG, being imposed. The LMC, as the representative body of GPs, has a duty to act in the best interests of all GPs and their patient population. Members therefore agreed that the LMC office should e-mail all Thurrock practices advising that the LMC has no major objection to the Constitution and recommending that practices sign. Dr Deshpande is due to meet with Dr Tresidder, Chair Thurrock CCG on 29th January. Members will be updated as to the outcome of this meeting in due course.
3. Safeguarding Children and Young People
Following lengthy discussion at the December meeting, it was hoped that Dr Barusya would be able to present this item. However, as Dr Barusya has had to offer apologies for today, this item will be deferred until the February meeting. The notes from the December meeting have already been shared with Dr Barusya. Dr Balmer will request that Dr Barusya produce a report/update that will be e-mailed to members prior to the meeting on 28th February.
4. Chief Executive’s Report
4.1 Regional Meeting with NHSCB
Members received notes of the meeting held on 27th November 2012 for information. Dr Porter noted the reference to the Chambers Model on Page 4 and has e-mailed Dr Richard Fieldhouse regarding its effectiveness for larger groups of sessional GPs. Dr Balmer will feedback to the regional meeting accordingly.
4.2 Everybody Counts: Planning for Patients 2013/14
Members received a summary of NHSCB planning guidance for CCGs for information.
4.3 Securing Excellence in GP IT Operating Model
Members received an e-mail from Tracey Grainger (NHS Connecting for Health) dated 4th December 2012 together with key facts for information.
4.4 Market Entry and the NHS Pharmaceutical Regulations 2012
Members received notes taken at a recent training event for information.
4.5 Future Appraisal Arrangements
Members received correspondence with Andrew Pike which they felt did not provide reassurance that the excellent service currently provided by EQUIP would be sustained under the proposals. Dr Porter had received confirmation that Sarah Powell, Appraisal Manager at EQUIP, will be required to relocate to Swift House. Ms Powell does not wish to transfer and EQUIP have done their best to seek agreement for her to remain employed at EQUIP. However, it would appear that the NHSCB is intent on dismantling the current team. Furthermore, there is no guarantee that sufficient administrative support will be provided to enable the efficient running of the appraisal service following transfer.
Members felt that if it is a requirement for appraisal to be managed by the NHSCB, it would be more appropriate for staff to be employed by the NHSCB and seconded to EQUIP, thus negating any disruption to the service and the dedicated staff that provide it. Members had serious concerns for the future of the service, particularly in view of the imminent introduction of Revalidation, and asked that the office formally raise these again with Andrew Pike.
Dr Balmer informed members that approximately 300 GPs in Essex have still to book their appraisal for this year and appraisers will have limited capacity between now and 31st March. An up to date appraisal record is imperative for revalidation purposes, Furthermore from the appraisers’ perspective, with the imminent dissolution of PCTs, it will be important to submit claims for appraisal work in a timely manner. Members agreed that the LMC should send an e-mail reminder to practices urging any GP that has not yet booked their appraisal to do so as soon as possible.
4.6 Performers’ List Regulations 2013
Members received a copy of the LMC response to the consultation for information.
4.7 CQC Regulatory Fees Consultation
Members received a copy of the LMC response to the consultation for information.
4.8 LMC Professional Indemnity Insurance
Members received the annual renewal form for completion. Declarations are required from all members and should be returned to the LMC office by 30th January 2013.
4.9 LMC Annual Conference 2013
Next year’s Annual Conference of LMCs will be held 23rd and 24th May in London. South Essex has been allocated three representative places. Drs Brown, Porter and Taylor will be attending. Due to over subscription, a reserve list is being held (Drs Davies and Raja). In order to enable as many representatives as possible to attend from South Essex, Drs Barusya and Deshpande have agreed to attend in their capacity as GPC Representatives.
5. FOR INFORMATION
a) GPC News 21st December 2012 (Received)
6. DATE OF NEXT MEETING
The next meeting will be held on Thursday 28th February 2013 at Rayleigh Parish Centre, Rectory Garth, Rayleigh at 2:15pm.