Avon LMCs Newsletter on 17-09-25

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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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It’s been a busy and eventful couple of weeks, with much of my time focused on preparations for the October 1st GP Access changes and how these will be implemented across practices. The BMA has now published guidance (linked below), which is helpful, but there remains some uncertainty — particularly around two key points that practices have been asking about:

• The ability to differentiate between urgent and routine care within an online platform
• The ability to temporarily switch off online access when demand exceeds safe capacity

These issues will be discussed further at tomorrow’s GPC England meeting, which I will be attending in my role as regional representative for Avon and Gloucestershire. To help shape my contributions, and to ensure I represent your views accurately, especially if a vote is called, a survey has been sent to all practice managers. I strongly encourage as many practices as possible to complete it so that your voices are heard.

Yesterday was a rare but very welcome day of face-to-face meetings, this time with colleagues from both the ICB and One Care. It’s always good to come together in person, and I’ve shared below some of the high-level joint LMC/One Care workstreams to give you a sense of how we are collaborating to support practices.

Finally, on a personal note, I would like to extend heartfelt thanks to our ICB, One Care, and Sirona colleagues for attending last week’s launch event at Charlotte Keel Medical Practice. It was a real privilege to mark a new 15-year contract with Brisdoc. The event was a chance to celebrate our newly redesigned waiting room and to hear from some fantastic guest speakers, including Kerry McCarthy (MP) and Helen Godwin (West of England Mayor). But the most memorable moment came from a longstanding patient, who spoke powerfully about the immense contributions that immigrants have made, and continue to make, to our city. His words stayed with me, as did some graffiti I pass in the M32 subway, which simply reads:

“Bristol is an anti-fascist city.”

It’s a reminder of why, 18 years after making the move here, I still feel incredibly lucky to call this city my home.

“Migrants and refugees are not pawns on the chessboard of humanity. They are children, women, and men who leave or who are forced to leave their homes for various reasons, who share a legitimate desire for knowing and having, but above all for being, more.” – Pope Francis

Dr Shaba Nabi
Chair: Avon LMC

The focus on 1^st October changes to contract can be found here.

The focus on online consultation requests can be found here.

This can be found here.

Avon LMC and One Care continue to meet monthly, and these are a few of the workstreams we are collaborating on:

• Violence and Aggression in practices (also involves Training Hub)
• LES costings model (with thanks to Surrey/Sussex LMC)
• Opal framework for general practice (with thanks to the urgent care working group within One Care)
• Clinical pathways

If you would like to join our broadcast only LMC WhatsApp group to hear about things as they happen, please email us at info@almc.co.uk.

Question: Please can you offer some advice about keeping online consultations open throughout core hours? We already hold a waiting list for routine appointments, and we are concerned about how the October changes will impact our practice.

Answer: Thank you for your query regarding the upcoming requirement for online consultations, alongside phone and walk-in access, to remain open throughout core hours, as part of the GP contract variation coming into effect on 1st October.

While the official “go live” date is now only two weeks away, the situation remains fluid. Safeguards and mitigations are still under active negotiation at a national level. GPC England is scheduled to meet on 18th September, and there have been strong calls from several LMCs to consider re-entering dispute if adequate safeguards are not agreed.
While we await national clarity, there are some practical steps you can start to consider: 

1. Clinical Triage
   • Identify who will be responsible for initial triage and explore ways to make this process more streamlined.
   • Consider whether certain tasks can be delegated or supported by admin teams with appropriate protocols.
2. Digital Tools
   • Explore newer digital solutions that can help manage incoming demand more efficiently.
   • Examples include Rapid Health and eConsult, which offer AI-driven triage and workflow management features.
3. Demand Mapping
   • Assess current patterns of demand and predict potential surges once the new access requirements take effect.
   • This can help you anticipate pinch points and plan resource allocation more effectively.
4. Routine Waiting Lists
   • If demand exceeds capacity — which is likely — routine wait times will inevitably extend.
   • Practices may need to prepare for these to increase from 3–4 weeks up to 6–8 weeks.
5. Capacity Limits
   • The LMC is currently working closely with One Care to develop a set of capacity limit principles for agreement with the ICB.
   • These will provide practices with a framework to manage workload safely and sustainably.

We appreciate how challenging this is for practices across the country. While we cannot offer complete reassurance at this stage, we want to stress that we are actively raising concerns with the ICB, particularly around:

• The unintended consequences of these changes,
• The likely increase in diversion to NHS 111 and emergency departments, and
• The urgent need for clear, practical safeguards.

This can be found here.

Our Annual General Meeting is scheduled to take place remotely on 6 October 2025, 7:00 pm. This meeting is open to all Avon LMC members, but there will be one vote per practice.

Thank you for completing the form for attendance.
Annual General Meeting Registration

• 6th October 2025: ALMC Annual General Meeting (Virtual), starting from 19.00
• 4th November 2025: Virtual LMC drop in, 13.00 – 14.00

• Tuesday 16 Sep General practice bulletin
• Thursday 11 Sep General practice bulletin

We’re proudly celebrating the successful conclusion of the GPNC Development Project on 31/08/25. Launched to strengthen training and development opportunities for non-clinical staff across general practice, it has delivered a comprehensive training catalogue and development pathways for non-clinical roles, laying the groundwork to support long-term workforce sustainability and retention.
 
The collaborative foundation of the project has been truly impactful, with the BNSSG Training Hub, One Care, Avon Local Medical Committee (ALMC), and the Institute of General Practice Management (IGPM) working closely together to codesign solutions, share resources and expertise, and facilitate engagement.
 
Thank you to all colleagues who gave their time to engage—your insights, feedback, and support were instrumental in shaping our approach. The project will transition to business-as-usual over the coming months, and we will shortly conduct a project evaluation to include a survey to general practice non-clinical and management staff.
 
For further information about the GPNC Development Project, please contact Louise Carthy, Project Manager, at L.Carthy@nhs.net. 

As we prepare for our BNSSG Practice Management Development Launch Event on Tuesday 23rd September, we’d be grateful if colleagues would take a few minutes to complete our short MS Forms survey. This survey will help shape the session to ensure it is underpinned by what is most important to you.
 
The survey and the event are open to Practice Managers, PCN Managers, Deputy & Assistant Managers, and anyone aspiring to work in practice or PCN management.
 
If you would like to attend the event and have not yet signed up, please see the attached flyer which includes a link to book your place.
 
For further information, please contact Louise Carthy, Project Lead, at L.Carthy@nhs.net.

Those numbers may be considerably higher where a verdict of suicide cannot be reached, but indicators suggest that suicidal thoughts may have played a part in an unexpected death.

For the last ten years at Practitioner Health, they have been collecting the names, photos and details of those they hear about and now NHS England have introduced a programme to collect these formally and create a better understanding of the factors and issues which may lead to suicide in the workforce.

To remember each individual and provide a day each September where we can take a moment for reflection and remember those people, who were our friends, our colleagues, our family and who are no longer with us.

View the National Suicide Memorial Day Communications Tool Kit

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