Newsletters
Index
Newsletter June
2002
New
Contract
This document, if implemented will change the face of General Practice.
In June all General Practitioners will be balloted to ask whether or not
they consider the document is a worthwhile basis for further negotiation
and pricing. This document has been approved by the GPC and the NHS
Confederation, as such it is a compromise and not a GPC wish list for
General Practice, inevitably there will be parts of it which we do not
like, but equally some parts which will be welcomed. We must decide
whether on balance it represents a way forward for General Practice. I know that a large number of colleagues are unhappy that the contract
has not been priced and feel very strongly that they cannot vote for the
new contract without this basic information. The GPC’s view is that we
will be able to reject the new contract at a later date if adequate
resources are not available. The looming manpower crisis, together with
the announcement by government of further resources for the Health Service
make them optimistic that resources will be available. I wrote to the GPC on 1st May expressing the sentiments of
the meeting we held on 30 April. I asked whether one of the negotiators
would be willing to attend a meeting in North Staffordshire. Simon Fradd
was available on 13 June, but unfortunately this date clashed with the
Annual General Meeting of the Doctor’s Co-operative. So far it has not
been possible to arrange another date. There will be discussion on the
proposed contract at the LMCs Annual Conference in Mid June. We propose to
circulate comments and feelings on this soon after the meeting. The exact
timing of the ballot is not yet known. A GPC document of “frequently
asked questions” about the contract can be found on the LMC website at www.northstaffslmc.co.uk.
I hope colleagues will be able to make an informed and well-balanced
decision in this ballot. The outcome is crucial to the future of General
Practice.
Appraisals
Appraisal for all GPs principals was introduced in
April. This process must be fully funded by PCTs. This means that the PCT
must provide full funding for locum cover, where needed. (e.g. locum cover
for when the GP is preparing for appraisal, for when the GP is undertaking
appraisal, for when the GP undertakes any remedial training, and for any
catch-up time One to one
locum cover should be provided. It is not sufficient for a PCT to only
provide cover by the local co-operative service as this only covers
telephone calls and urgent cases. GPs
will only be required to participate in appraisal when and if properly
resourced and supported appraisal schemes are in place. Discussions are taking place on how these will be arranged and funded in North Staffordshire. It is hoped that there will be a North Staffs wide model which would allow a larger pool of appraisers. The proposals will be discussed at the June LMC meeting. Barry Edwards, the Clinical Governance Lead for Newcastle PCG is taking the lead on this issue.
Allocations
Officers of the committee have recently had discussions with the Family Health Services Directorate over the workings of the allocation system. The number of patients who require allocation to a GP is increasing considerably. In some areas GPs have rightly closed their lists in order for them to keep their workload to manageable levels. Patients currently have a right to be on the list of a GP and these two ideals are mutually exclusive. Unfortunately the tensions in the system have resulted in the staff at the Family Health Services Directorate receiving some verbal abuse when they phone a practice with an allocation. It would appear that the allocation of patients is done as fairly as possible. There are very few patients on “allocation rotas”. The “block” allocation of patients in nursing homes will no longer apply. The possibility of faxing all allocations, rather than using a personal phone call was discussed, however it was decided to continue with the personal approach but to change to faxing where a practice continues to cause problems for the allocations staff. There is an appeals procedure which should be used if a practice feels that an allocation has been unfair or inappropriate. Practices should use this when they feel aggrieved. The practise of allowing practices to voluntarily accept patients rather than receive an allocation is to be discontinued. There are a number of reasons for this, the chief one being that the reported number of allocations is lower by these voluntary acceptances and the true level of pressure on local practices is thus being under recorded. Practices will also receive payment for allocated payments immediately and the payments are not then dependent on when a patient presents at surgery. GPs have a responsibility to inform the Directorate staff of any relevant issues e.g. violence when a patient is removed, so that this information can be passed on. Similarly the records of any patients removed should also be returned to Heron House as soon as possible. Where a patient is known to be aggressive or presents any potential risk, a telephone call will always be made to the practice alerting them to the risk and giving them details, including the name of the patient’s previous doctor.
GPRs
(Formerly PMARs)
The agreement regarding fees for the above has expired. Practices are now free to set their own charges. For example £60.00 per GPR, £92.50 for a medical examination, or a varying scale depending on time taken for a reply, e.g. £75.00 for a reply within three days, £50.00 for a reply within two weeks. So far most practices have not experienced any difficulty collecting increased fees although there have been occasional reports. I would like to hear about any difficulties encountered with increased charges. Negotiations are continuing to set a new agreed rate, but in the meantime it would be helpful to ensure that all practices are charging a “market” rate.
Payments
from PCTs
The committee is concerned that payments from PCTs for various activities are being delayed by PCTs. Some projects (e.g. payments for asylum seekers) are funded from different pools of money across the PCTs, and other payments are not being made promptly. We would like to hear of any examples practices have of delays. We have invited the Finance Officer of the Family Health Services Directorate to the July LMC meeting to discuss any problems.
Cardiology
Department
The committee is concerned about the serious and dangerous delays in receiving letters from the cardiology department. Our concerns have been made known to the hospital centre who have promised to take appropriate action. The time taken to receive an X-ray report has also lengthened recently, but we have been assured that the system in the department has been changed and the problems should soon be remedied.
Residential
Parking
A number of practices have recently raised problems with parking within Residential Parking Scheme areas in the city. Two problems have been identified. Firstly, parking during surgery hours and secondly during visits to patients. In the first instance, the council is willing to issue parking permits to businesses in the areas concerned to allow on street parking. The second is more difficult. Each area covers a fairly small number of streets and permits are specific to each area. Residents often hold Visitors Permits, but it is obviously impractical for a GP to collect one of these from the patient and place it in his/her car prior to attending the patient. It is also not advisable for GPs to use “Doctor on-call” stickers. I have been in contact with Mrs S Clarke at Parking and Security about this. She is willing to discuss specific problems with any GP. Her contact number is 01782 232228.
Membership
Following his appointment as Chair of Staffordshire Moorland’s PCT Professional Executive Committee, Dr Sunil Angris has resigned from the LMC. The committee has appointed Dr Rob Jones, runner up in the recent elections, to serve the remainder of Sunil’s term of office. DR P GOLIK (Secretary)
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