Avon LMCs Newsletter on 19-06-24

The ALMC Newsletter

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

– LATEST NEWS –

Is it really only the middle of the week today? Sometimes I feel like I’ve done a week’s work in a few days and I’m sure you know the feeling. But it helps when your work is rewarding and purposeful, as much of LMC work is.

We had a virtual LMC Committee meeting at the start of the week which was very well attended. It’s an enormous achievement to have secured 100% PCN committee representation, when there were a number of gaps in representation a year ago. We are planning to share information about all the LMC Committee and Board representatives on our website in due course, so you know who to access for queries.

I’ve been kept busy with attendance at a number of meetings discussing various interface issues such as the physical monitoring of AWP patients, the HSP pathway, and the requirements of the NHS hospital contract with regards to the interface. Everyone involved in these meetings is aware that much of the activity taking place within general practice sits outside the core contract and I am trying to convey a sense of urgency around moving away from this goodwill which is unlikely to be sustainable.

Thinking ahead of the GPC ballot which opened earlier on this week:

“Out of the fires of desperation burn hope and solidarity” Sharan Burrow

Dr Shaba Nabi
Chair Avon LMC

Avon LMC Committee Meeting: 17th June

It was great to see so many faces representing PCNs across BNSSG at this virtual meeting. Some areas of discussion were as follows:

Financial update
Board Director contractual options
Proposed constitutional changes in advance of the AGM in September
GPCE ballot and menu of options for action

Our next Committee meeting will be the AGM on 16^th September which will be open to all members.

GPC England Ballot: 17th June – 29th July

This ballot for GP Partners who are members of the BMA opened this week and you can vote until 29^th July. If you are not yet a member, you can join now for three months free membership. If the ballot is successful, these are some of the actions practices are invited to consider:

Limit daily patient contacts to 25 per clinician
Stop engaging with advice and guidance pathways
Serve notice on any voluntary services currently undertaken which plug local commissioning gaps
See patients face to face as the default
Switch off medicines’ optimisation software
Stop rationing referrals and investigations
Stop unsafe risk holding and admit patients if clinically appropriate to do so

GPC England Roadshow: 20th June 19.00 – 21.00 (virtual)

This is your last chance to sign up for this virtual roadshow which is open to all practice staff members. Come and hear more about the ballot and possible actions you could take on a practice level.

CQC Webinar: 25th June 13.00 – 14.00

Join us for this webinar, hosted by Avon LMC, to learn more about achieving CQC compliance from national primary care representatives.

Please click here for the link

LES sign -up

As you may have heard, the deadline for the sign up to the enhanced services contract has been extended to 8^th July. It’s possible that some practices may be awaiting some further negotiation on the funding of this contract.

The LMC has met with the ICB contracts team who have made it clear that there will be no additional funding associated with this contract. This is in spite of the LMC sharing data (attached below) which illustrates the five-year inflationary projection for the tariff from 2019.

As there is minimal inflationary uplift for a two-year contract, practices will need to make individual profit/loss decisions about the sustainability of this contract

LES tariffs with Inflationary Projection

Process for Medicines Management for Non-Prescribing Practice Nurses

At this week’s lead nurse community of practice, Director of Nursing Kim Ball discussed safe medicines management practices, following consultation with the Royal College of Nursing and the BNSSG ICB Medicines Optimisation team. This discussion follows a recent significant event in the Southwest that led to a fitness-to-practice referral to the Nursing & Midwifery Council, prompting clarification from Avon LMC.

Key points:

Nurses who are not prescribers should not add medication to the EMIS medicines screen.
The safest practice is to send a task to the prescriber with the request, providing clinical assessment and rationale for decision-making.
Nurses can note medication on a patient’s electronic record for PPA claims under PGD/PSD, provided that the legal mechanism for the supply and/or administration is clearly documented and they are trained/competent to do so.

Although this guidance is about practice nurses, safe practice for other practice non-prescribers is currently being developed in collaboration with the ICB medicines optimisation team

More information can be found in the slides here.

You asked, We said

Question: With the release of the service specification for the COVID-19 vaccination programme, what does this mean for funding should a practice sign up?

Answer: Before looking at the funding potential of this service specification, it is important to highlight that is covers an 18-month period that includes two Autumn-Winter campaigns as well as a Spring campaign. This means that, unless the Commissioner announces any changes, this will be the agreement for next year as well.

Section 14 of the Service Specification (Payment Arrangements) stipulates the funding up to March 2025 with a caveat at 14.2 that the payment arrangements would remain the same from 1 April 2025 unless notified by the Commissioner. The item of service (IoS) payment is set at £7.54 with an enhancement of £2.50 for patients who do not receive co-administration. This will also take place during a timeframe that will be determined by the Commissioner.

It is important to bear in mind that co-administration is not applicable during a Spring campaign and therefore the enhancement may not be applicable. As with previous campaigns, the £10.00 enhancement for housebound is offered and this excludes patient’s resident in Care Homes.

Advice would be for Practices to assess the financial viability of participating in the programme and to familiarise themselves with section 15 of the Service Specification (Variations to and subsequent withdrawal from this ES) and, in particular, section 15.3 that notice must be received no later than 42 days after the publication of any relevant variation. If no variation is made before the Spring campaign, Practices would be outside of the window to provide notice to the Commissioner.

GPC England have also confirmed that Flu/COVID guidance is coming soon and advised Practices and PCN’s to please await this information.

Preparations for an Autumn/Winter 2024/25 flu and COVID-19 seasonal campaign

Junior Doctors Industrial Action

The next dates for industrial action are 27^th June to 2^nd July. Avon LMC would like to remind practices that they should not be asking any doctors in training posts if they are planning to take industrial action, and they are under no obligation to inform you of this. The best course of action is likely to be to block out their appointments until the day of action, unless they voluntarily update you with their intentions

GPC England update to LMCs

Read the latest GPC England bulletin here

OneCare’s latest Bulletin