Avon LMCs Newsletter on 02-07-25

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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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I’m sure you’ve been reading about elements of the ten-year plan as it’s been dribbling its way through media outlets. In another bid to cut ‘wasteful spending’, the government has announced the abolition of bodies such as the National Guardian’s Office and Commissioning Support Units, to name a few. We are fast entering a culture where it’s fashionable to axe the managers, but it leaves me wondering who will actually fill these gaps and how this will impact on general practice. With so much of the GMS/PMS and PCN DES contract delegated at a local level, who are we actually doing business with once the ICBs merge and face workforce haemorrhage? As always, those of you who have been round the block a few times, will see a replication of previous diktats just wrapped up in slightly different bow.

Today marks the start of a two-weekly LMC newsletter in place of a weekly one. I’m sure you will welcome the reduction of email traffic, as we all need to minimise workload where we can. Of course, if something time critical or important arises, we will stand up an additional newsletter to share any relevant information.

Today also marks my daughter’s 17th birthday. Seventeen years ago, I was blue lighted into Southmead Hospital at 35 weeks gestation, haemorrhaging from a placenta praevia. A recent UN report confirmed that a woman dies every two minutes during pregnancy or childbirth, highlighting the immense global health challenge posed by this maternal mortality rate. Gratitude doesn’t even come close to what I am feeling right now, simply for the environment I was born into.

“I don’t have to chase extraordinary moments to find happiness – it’s right in front of me if I’m paying attention and practicing gratitude.” – Brene Brown

Shaba Nabi 
Chair: Avon LMC

As GPC England is no longer in dispute with the government, Avon LMC has been reviewing GP collective actions.

One of these areas is the DSA for Population Health Management. After careful consideration in association with One Care, we feel that there are more benefits for general practice signing up for this, than there are risks.

As always, the final decision lies with the individual practice.

Question: We have a patient seeing a Right to Choose provider for an ADHD assessment. They are a remote service, and the provider has stated it is our responsibility to perform an ECG on their behalf because they cannot make an onward referral for this.

Answer: Unfortunately, this is a common scenario with remote providers. However, a provider’s inability to organise a test does not mean that this defaults to general practice.

In BNSSG, practices are commissioned to provide ECGs for their own patients under the supplementary services basket LES but are not commissioned to provide this on behalf of other providers. Feel free to pushback using the LMC workload transfer letter.

I had the pleasure of hearing Becks speak about the future of the partnership model at a recent GPC meeting. As a GP Training Programme Director, I am always keen to hear about the career aspirations of GP Registrars and their appetite (or not) for GP Partnerships.

This briefing paper published in March articulates the attrition of GP Partners and what can be done to mitigate this.

A summary document produced by the national LMC support network can be found here.

This includes a GPC summary and response to the ICB model footprint, as well as guidance on on-line consultations. It can be found here.

Due to practice interest, Avon LMC is offering new and update flu training in preparation for the flu season. This training does incur a charge and would need Practice authorisation. Please see the flu training booking form below:

https://forms.office.com/e/4ywURtEsuH

Once completed, an invoice will be provided, and places will be confirmed upon receipt of payment. Spaces are limited. 

If you have any questions, please don’t hesitate to contact info@almc.co.uk

• 2nd September 2025: Virtual LMC drop in, 13.00 – 14.00
• 4th November 2025: Virtual LMC drop in, 13.00 – 14.00

To support practices with the upcoming changes to the routine childhood immunisation schedule from 1 July 2025, the NHS England SW Vaccination and Screening Team will be holding regional webinar via Teams:

• Thursday, 3 July – 11.00 am – 12.00

These webinars are open to all healthcare professionals, practice managers and supporting staff in primary care. You only need to attend one session.

The webinars will provide an overview of the changes and an opportunity for primary care colleagues in the SW to ask any questions related to the changes.

If you have any specific questions relating to the childhood schedule changes please submit these via: https://forms.office.com/e/r2ND4xdMdJ in advance of the webinar where possible.

The New to Practice Programme is a ONE YEAR programme for any nurse that is new to general practice (Registered Nurses and Nurse Associates), we also offer preceptorship for newly qualified nurses.  It includes:
 

• Paid CPD time (amount dependant on contracted hours)
• An overview of the GPN role (a 6-month taught programme, a 2-hour session every 2 weeks which can be attended in person or online).
• Regular one-to-one meetings/ mentorship and/or supervised clinics with our Legacy Nurses, Helen Russell, and Jenny Bowen to support nurses in their new role. 
• Peer support with other new to practice nurses.

Please find attached programme flyer for details.

According to the most recent UK census data, we know that roughly one in five of the UK adult population has a disability. Some 80% of those disabilities are hidden or invisible.

Despite this statistic, we see in the 2023 NHS England Workforce Disability Equality Standard (WDES) report that a mere 4.9% of staff employed there reported a disability. And while the reporting has increased from 3.1% in 2019, the reporting rate is still 400% lower than that of the general population.

It is inconceivable to think that our health service workforce could be that statistically different from the population as a whole. Rather, it is much more likely that the fear of disclosure – something I have written about previously – is what is preventing mainstreaming of disability and disclosure of conditions.

The 2023 NHS WDES findings would also support this argument. It states that employees who have a disability are twice as likely as able-bodied colleagues to be involved in capability proceedings. They were eight percentage points more likely to report bullying, harassment or unfavourable treatment than their peers without disabilities. This figure remained broadly similar whether looking at bullying and harassment by management, by colleagues or indeed by patients.

Find out more from here.

Hannah is currently studying for an MSc in Health Policy at Imperial College, while also working at the Department of Health and Social Care. For the dissertation, she is conducting research exploring how general practice staff engage with housing-related health issues such as damp, overcrowding and housing insecurity.

The project has involved a series of interviews with GPs, and she is now building on this with a short, anonymous survey aimed at a wider range of general practice staff — including GPs, registrars, nurses, ANPs, PAs, receptionists and others. The goal is to better understand how these issues are encountered and responded to across roles and settings.

The survey takes around 10 minutes to complete and is available here: [https://forms.office.com/e/mecxLJK6Ph

If you’re able to share the survey with practices/staff in your area, that will be hugely grateful.

• Tuesday 01 July General practice bulletin
• Thursday 26 June General practice bulletin

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