Avon LMCs Newsletter on 05-11-25

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The ALMC Newsletter

Welcome to our weekly newsletter, sharing the latest news and topics of interest for practices.

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– LATEST NEWS –

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As last week was half term – and with much of the LMC Board taking some well-earned leave – we stood down our usual newsletter to give everyone a brief respite. This week, therefore, comes with an additional newsletter, and I return refreshed after a wonderful eight days in Essaouira and Marrakech.

The colours, craftsmanship and rhythm of the Medina were a feast for the senses. Between haggling for treasures and admiring the artistry of local makers, I found myself inspired to try my own hand at something creative – perhaps wood painting or embroidery. Who knows, it may even feature as a PDP objective at my next appraisal!

Before my travels, Avon LMC continued to work collaboratively both within our local system and across the wider region. Our recent all-day meeting with fellow Southwest LMCs in Taunton provided a valuable forum for discussion – with access remaining a dominant theme. We also continue our regular monthly meetings with One Care, whose tireless work on developing the OPEL escalation framework for general practice deserves recognition. This framework will be vital in helping to mitigate the pressures arising from the recent access changes.

Those changes are already being felt. Some practices have reported up to a 50% surge in demand in the past month alone, stretching already-thin teams to their limits. To cope, many have had to divert clinicians from direct patient care to front-door triage, an unfortunate necessity that paradoxically reduces appointment availability further. The outcome? Waiting lists in general practice – a concept once unthinkable.

It raises an important question: has the public truly been asked whether they would prefer to swap the ‘8am rush’ for a waiting list of several months, before being seen for menopause symptoms or mental health concerns?

I’m reminded of the Iron Triangle principle: Good, Fast, Cheap — you can only ever have two. For years, general practice has delivered good-enough care both efficiently and at remarkably low cost. Now, we remain good-enough and cost-effective, but far slower. Ultimately, it will be the public who render their verdict – and perhaps their choice – at the next general election.

“The greatest challenge is not balancing priorities but knowing what truly matters.”  – Stephen Covey.

Dr Shaba Nabi
Chair: Avon LMC

Question: We have charged for a medical report required for a Gender Recognition Certificate, but one of our patients has complained it is discriminatory. What is the LMC view on this?

Answer:
Thank you for your query about a patient alleging discrimination on the basis of being charged for a medical report required to apply for a Gender Recognition Certificate. (GRC)
The medical report for the GRC process is not covered by the NHS, and GP practices are permitted to charge for completing it, and the charge is at the practice’s discretion. This is confirmed by GIRES.
This is not discriminatory if:

1. Charging is lawful (which it is)
2. The practice charges for other non-NHS work
3. There is transparency about the charging process

Best practice would be:

1. To have a written policy in place for non-NHS fees and apply it consistently
2. Train staff to manage these requests sensitively
3. Display fees publicly to ensure transparency

Our regular lunchtime drop-in took place yesterday and topics discussed included:

• An update on local commissioning negotiations
• Access requirements since October
• National Landscape
• Interface work

This is now on the website and can be found here.

This was published last month and can be found here.

This was published last week and can be found here.
The key headlines for general practice are:

• Review of Carr-Hill Formula
• Pre-referral Advice and Guidance for 10 specialities through e-RS/template form
• Support Ambient Voice Technology to create additional capacity
• 90% target for same day urgent care
• Increased neighbourhood/community care

It goes without saying that most of the above is a Santa’s wish list without the contractual mechanisms in place to mandate this. However, it does give you a flavour of what the government may wish to include in the 2026/27 GP contract.
 

The Cameron Fund is the only medical benevolent fund that solely supports general practitioners and their dependants. They provide support to GPs and their families in times of financial need, whether through ill-health, disability, bereavement, relationship breakdown or loss of employment.

Please consider offering a Christmas donation to this worthy cause as per this appeal.
 

This can be found here.
 

The key information can be found here.
 

We are glad to announce that the scheduled training dates will go live on November 17 (Mon). If you are looking for the training scheduled between January 26 and March 26, please visit our webpage at https://avonlmc.co.uk/events-calendar/.

Furthermore, delegates already on the waiting list will be moved to the additional training scheduled for upcoming months. A separate email will be sent out for confirmation.
 

Dear colleague,

How is your practice managing with the new requirements over online consultations? We’ve opened a quick survey to find out how it’s been going during the first four to five weeks since the contractual changes came in on 1 October. We know it is a real challenge for some of you and this survey allows us to find out how practice teams are coping.

We’re aiming to develop a picture of how practices are managing these changes and colleagues overall view of the requirements the Government has brought in without adequate safeguards and support. 

This is your chance to tell us how it’s going so far and if the introduction of mandatory online consultation requests has altered your view on whether this Government is truly supportive of NHS general practice?

The survey is open for just 2 weeks from today until 12pm on Wed 12 November. It will take just a few minutes to complete. 

Your responses will be confidential and will give us valuable information to act on your behalf, with ICBs and with the Government. Thank you for taking the time to complete this important survey.

Dr David Wrigley

Deputy chair GPC England

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– LATEST TRAINING AND EVENTS –

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Please see the attachment for Learning Hub events here. 

For further information, please contact almclearninghub@almc.co.uk.

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