LMC physical office closure
The Doncaster LMC office is now closed and all correspondence should be sent via email to office@doncasterlmc.co.uk.
We have a new telephone number 07876 502807 .
respect general practice
Resignation from Goodwill services
- Any service where a LES has not been agreed upon and signed up to by the practice
- Spirometry
- ECGs
- FENO
- Initiation of injectable medicines (e.g. Insulin, GLP1s, Inclisiran)
- Primary care phlebotomy
- Prescriptions on behalf of other providers outside of shared care, including the initiation of medications advised by another provider
- Onward referral for specialist advice on behalf of secondary care
- Recall and monitoring of conditions outside of QoF (e.g NAFLD, MGUS, bariatric aftercare)
- Interpretation and action of investigation results requested outside of general practice
- Letters to expedite appointments
- Advice and guidance to emergency services
- Attendance at safeguarding meetings
- Attendance at commissioning meetings
- Sharing of non-identifiable patient data for the purpose of commissioning and health screening
- Providing a daily set number of clinical appointments
Expanding Opportunities: How GPs can increase their involvement in private work.
Oliver Pool
Oliver is a commercial and partnerships specialist who spends almost all his time advising GP practices. He can help with all aspects of the partnership relationship, from putting in place your GP partnership deed, to advising you on its terms, to dealing with disputes between partners.
With a few limited exceptions, GPs cannot charge their registered patients for anything. The exceptions are listed in Schedule 5 of the GMS Regulations. Examples include travel vaccinations and certain medical reports. If it’s not on the list, you can’t charge your registered patients for it.
However, it is possible to charge people who aren’t your registered patients. GPs are entitled to charge people who aren’t on their practice’s list for anything they want. However, they can’t provide the service at reimbursed premises. If they do, they risk the practice’s notional rent being abated. This is true even if the service is carried out “out of hours” at a time the practice wouldn’t be using the surgery anyway. This position may seem unduly restrictive, but the new Premises Costs Directions, issued in May 2024, have done nothing to change the position.
One occasionally sees ‘buddy systems’ set up, whereby patients registered with practice A can be seen privately at practice B, and vice versa. However, there are constraints even on this, practice A can’t force (or even direct) its patients to use practice B. If practice A gets any financial benefit from sending its patients to practice B, it risks falling foul of the restriction on accepting a benefit “through any other person” (which is prevented by Regs 24(2) of the GMS Regs).
So, a GP (or a partnership) wishing to set up a non-NHS service must ensure they don’t treat any of their own patients, and they have to find their own premises to do so.
Though, the most important question is – ‘is it going to be worth it?’ It’s not just a case of ensuring that a private service is profitable – after taking into account premises costs, the additional costs of staff, extra insurance, CQC registration requirements, advertising, etc. To run a private service, a GP will likely need to reduce their GMS hours. The key consideration is whether the income from the private service will exceed the income from working those hours in the practice. In many cases the answer to this will be ‘no’. If the private service is going to be worth doing, it doesn’t just have to be profitable – it has to be more profitable than spending X hours per week doing normal GMS work. A good business plan will be necessary and a discussion with the practice’s accountant essential, of course.
New NHS Vaccination programme against Respiratory Syncytial Virus (RSV)
Following recommendations by the JCVI, two new RSV vaccination programmes will begin from 1st September 2024:
Adults aged 75 – 79 years old
Pregnant women to protect infants
NHSE intend to commission this from General Practice as an Essential Service. This represents a single vaccination. The routine programme means adults become eligible after the age of 75 commencing 1st September 2024, but a catch-up programme will be in place until 31 August 2025.
The programme for pregnant women, designed to create immunity in infants, will commence on 1st September with eligibility after 28 weeks. The antenatal service can be commissioned via a variation to the Trust NHS Standard Contract.
Whilst GPCE supports the delivery of this programme via the usual antenatal pathway, opportunistic or on-request GP delivery of antenatal vaccinations will be part of Essential Services, however, as commissioners want General Practice to routinely deliver this service it will need to be commissioned locally.
GPC have made it clear to NHSE that the current £10.06 IoS fee is not economically viable for practices and should be substantially uplifted. Whilst GPCE advise practices to deliver immunisation programmes included within Essential Services, it strongly recommends carefully reviewing the appropriateness of participating in any other non-core contract programme, if this were to be offered, where a £10.06 IoS
fee (or less, such as Covid-19 concurrent with seasonal flu, when the fee is £7.54) is offered.
A new RGV PGD template will be developed by UKHSA, available from the PGD collection here Immunisation patient group direction (PGD) templates – GOV.UK (www.gov.uk) .
Detailed clinical guidance on RSV and RSV vaccination is expected imminently within Chapter 27a of the Green
Book. Both professional and public facing information materials are available here Respiratory syncytial virus (RSV) vaccination programme – GOV.UK (www.gov.uk) .
Cervical Screening Management System (CSMS)
The CSMS Cervical Screening Platform | Cervical Screening Management System has gone live, replacing the previous Open Exeter call/recall IT system. The CSMS is accessed via an NHS smartcard. All providers are asked to update any internal operating procedures and documentation that supports delivery of cervical screening services, to reflect access to and how CSMS should be used. GP Practices should log on and review the notification section to check:
* that the contact email details for Prior Notification Lists (PNLs) are correct (click on ‘manage email’within ‘notifications’). If incorrect, amend on CSMS, ensuring it’s a generic email contact address.
* the details of any patients due to be invited and action accordingly.
For any technical support with using or accessing CSMS please visit: CSAS Cervical Screening Management System (CSMS) help – NHS Cervical Screening Administration Service (csas.nhs.uk)
Preparations for flu and Covid-19 seasonal campaign
NHS England has published a letter which sets out the arrangements for the Covid-19 and flu campaigns for this coming autumn.
Safe Working in General Practice
General Practitioners Committee (GPC) England has recently updated its Safe Working in General Practice guide, which aims to enable practices to prioritise safe patient care within the present bounds of the General Medical Services (GMS) contract. Topics covered include:
- Background and context • Appointments
- Unsafe working contacts • Patient Participation Groups (PPGs)
- Measurement of workload • External un-resourced workload
- ‘Core’ general practice • Practice list closure
- Primary Care Network (PCN) Directed Enhanced Service (DES)
- Understanding the expectations of the NHS England guidance
- Workload prioritisation
- Managing workload as a salaried GP
- Managing workload as a locum GP
Further information can be found here: Safe working in general practice (bma.org.uk)
Sessional GP Newsletter
Read the latest Sessional GPs newsletter ARM 2024 | our vision for sessional GPs | locum survey results (bma-mail.org.uk)
GP Diary – Your essential tool for workload management
The Sessional GPs Committee of the General Practitioners Committee (GPC) has launched GP Diary GP Diary app (bma.org.uk) – Your essential tool for workload management, which is available to GPs who are British Medical Association (BMA) members. The GP diary has been created for GPs looking to take control of their workload and achieve a better work-life balance. An introduction to the diary can be found here Introducing GP Diary – your essential work tracking tool (bma-mail.org.uk) .
LMC Buying Group
Doncaster LMC is been a member of the LMC Buying Groups Federation. This means that practices can access the discounts the Buying Group has negotiated on a wide range of products and services. If you’re not sure what the Buying Group is all about then this short video explains what they do: https://www.youtube.com/watch?v=FekMwFI5ILg.
By registering with the Buying Group: www.lmcbuyinggroups.co.uk/members/, you can view all the suppliers’ pricing, contact details and request quotes. The Buying Group also offers any member practice a free cost analysis which demonstrates how much money your practice could save just by swapping to buying group suppliers. Tel: 0115 979 6910 Email: info@lmcbuyinggroups.co.uk Website: www.lmcbuyinggroups.co.uk
