Bereavement services have highlighted an issue that requires the attention of all certifying clinicians. When completing the MCCD, it is a legal and safety requirement that any hazardous implantable device must be clearly identified, including what the device is and where it is located.
In several recent cases, the MCCD simply stated that an “implant” was present. Without further detail, crematoria and funeral directors were unable to determine whether the device posed a risk. This resulted in enquiries being escalated to the Medical Examiner’s Office, who then had to review clinical records to identify the device. These delays are avoidable and place unnecessary pressure on bereavement teams.
To support safe and timely processes, please ensure that:
Hazardous devices such as pacemakers, ICDs, radioactive implants, and intrathecal pumps are explicitly named
The precise anatomical location is recorded
Non‑hazardous implants (e.g., hip or knee replacements) are not listed as hazardous
Accurate documentation protects staff, prevents delays for families, and ensures compliance with cremation regulations. Thank you for helping maintain high standards in this important area of practice.
Please be reminded that GPs should not issue sick notes, letters, or medical certificates for school‑aged children. This applies to all short‑term illness and the vast majority of longer‑term attendance issues.
Parents are expected to notify the school directly. Schools should not require medical evidence for short absences, and GPs should not be drawn into validating them.
It is essential that we do not embed the idea that if a child is struggling with school attendance, for any reason, a GP will provide a medical note to legitimise absence.
Attendance difficulties are often complex and rarely hinge on a medical diagnosis. In these situations:
General practice must remain focused on clinical care, not administrative validation.
If a child has ongoing health issues that may be affecting attendance, the appropriate route is the Doncaster School Nursing Service, not general practice.
School nurses are equipped to:
This ensures children receive the right support without creating inappropriate GP workload.
Clear boundaries protect clinical time, reduce inappropriate demand, and ensure that children and families access the services best placed to support them. Maintaining a consistent message across Doncaster will help prevent the normalisation of GPs as certifiers of school attendance.
Practices continue to seek clarification on their obligations when patients request to register, particularly where the individual is a resident of a care home. The position under GMS, PMS and APMS regulations is clear: registration is a matter of patient choice, and practices are required to accept applications except in a very limited set of circumstances. A patient living within the practice boundary who wishes to register must ordinarily be accepted, and this applies equally to residents of care homes. A practice cannot refuse registration because a patient is complex, because they live in a care home, or because another practice already provides care to that home. Care homes cannot assign residents to a particular practice, and practices cannot assign themselves to a home. The only determinant is the patient’s own preference.
There are only a few lawful reasons for declining a registration request. The first is where the patient lives outside the practice boundary, and this must be based on the formally published boundary rather than any informal or historic arrangement. The second is where the practice list is formally closed with commissioner approval; a practice cannot simply decide to stop taking new patients. The third is where the practice can demonstrate reasonable grounds for refusal that are unrelated to the patient’s health status, care needs or accommodation type. This category is narrow and must be applied cautiously. A legitimate example would be a patient who lives within the boundary but in a location that the practice cannot safely or reliably reach for home visits, such as an isolated rural property accessible only by private unpaved roads. Another example would be a patient who has previously exhibited violent or threatening behaviour, where the appropriate processes have been followed and the commissioner agrees that re‑registration would be unsafe.
By contrast, many commonly cited reasons are not lawful. A practice cannot refuse because it already looks after a particular care home, because it does not have capacity for complex patients, because the home is demanding, or because another practice is aligned to the home under a DES or local scheme. None of these reasons meet the contractual threshold for refusal.
Residents of care homes have exactly the same rights as any other patient to choose their GP practice. A care home cannot enter into an arrangement that restricts this choice, and a practice cannot refuse registration simply because it does not wish to take on the home or because another provider is already delivering an enhanced service. Local care home models, DES arrangements and ICB‑level schemes do not override the core GMS duty to accept eligible patients.
Improper refusal of registration is treated seriously by commissioners. A practice that declines applications without lawful grounds risks receiving a breach notice, followed by a remedial notice requiring immediate corrective action. Contract sanctions, including financial penalties, may follow if the issue is not resolved. Persistent or systemic refusal can escalate to contract management panels and may attract regulatory scrutiny, particularly where vulnerable adults are affected. In the most serious cases, repeated improper refusals may be interpreted as a failure to provide essential services, which is one of the most significant forms of contractual non‑compliance.
At its meeting on 21 May, GPC England voted by a large majority to proceed to a profession‑wide ballot on what has been described as a “Plan B” for general practice. This follows a motion passed at the recent UK LMC Conference calling for exploration of alternative contracting models, including means‑tested or subscription‑based arrangements, or hybrid models similar to those used in NHS dentistry.
The decision does not commit the profession to any specific model. Instead, it initiates a formal consultation and engagement process over the summer to gauge the appetite among GPs for alternative contractual frameworks that could, in theory, allow practices greater flexibility in how they provide services, including the potential to offer private or non‑NHS elements alongside core NHS work.
For many practices, this development reflects the ongoing concern about the sustainability of the current contract, workload pressures, and the widening gap between demand and funded capacity. For others, it raises important questions about equity, access, and the future shape of NHS general practice. What is clear is that the debate is now formally underway, and the profession will be asked to consider whether alternative models should be developed further.
The LMC will continue to monitor the consultation process closely and will ensure that local GPs are kept informed as more detail becomes available. Practices may wish to begin internal discussions about the implications of any potential shift away from the current national contract.
Further background can be found in the public statement issued following the vote: GPC England vote overwhelmingly to explore an alternative strategy for general practice.
UK Biobank has published its formal report into the recent incident in which participant health data was offered for sale on a website operated by the Alibaba Group earlier this year. Although the investigation confirms that the breach did not originate from general practice systems, the event has understandably raised concerns among participants and the wider public about the security of large‑scale research datasets.
UK Biobank has agreed to meet with the Joint GP IT Committee later this year so that the implications for primary care, data governance, and public confidence can be explored in more detail.
There has been some confusion nationally about whether GP data is currently being transferred to UK Biobank via the repurposed GDPPR dataset held by NHS England. The position is clear:
This point may be important for reassuring patients who are aware of the breach and are concerned that their GP records may have been involved.
Some participants may contact their practice seeking clarification or reassurance. Practices are not expected to provide detailed explanations about UK Biobank’s internal systems or security arrangements.
If approached:
The full Oversight Committee report is available here:
Oversight Committee report into data security at UK Biobank published
The BMA has released a new briefing on the national development of Neighbourhood models and Integrated Health Organisations (IHOs), both of which sit at the centre of the Department of Health and Social Care’s proposed “left shift” – the movement of more care out of hospitals and into community‑based structures.
Although these reforms are still evolving, they represent a significant strategic direction for the NHS in England and will have major implications for general practice.
Neighbourhoods are being positioned as the operational building blocks of integrated care, typically covering populations of 30,000–50,000. They are intended to bring together:
The stated aim is to deliver more care closer to home, reduce hospital demand, and coordinate services around local population needs.
While the ambition is understandable, the practical impact on practices, particularly around workload, accountability, and resource distribution, remains unclear.
IHOs go further. They are being explored as new organisational forms that could hold contracts, employ staff, and deliver services across neighbourhoods or wider footprints.
The BMA briefing highlights that IHOs could:
For general practice, the most significant concern is that IHOs may evolve into prime providers, with practices becoming subcontractors – a structural shift that could fundamentally alter autonomy, funding flows, and the future viability of partnerships.
Although these models are still in development, they are being actively promoted within national policy. The direction of travel is clear: more integration, more system‑level control, and a re‑shaping of how community‑based care is organised.
For practices, the key issues include:
These reforms will shape the environment in which practices operate for years to come.
The BMA briefing can be read here:
Neighbourhoods and Integrated Health Organisations
Please see the request below from Angharad (Sian) Jackson
My name is Angharad Jackson and I have spent my career making technology work for humans, to deliver better health and care outcomes. I have been a DPO, a SIRO, a Caldicott Guardian and a health and care commissioner working with the NHS, local authorities, government and third sector. I am now conducting research into clinical and commissioning perspectives on the use of AI as medical device (AIaMD) with the aim of developing an ethical governance framework for their use.
Starting with this survey, my research aims to gauge understanding and experience of the opportunities and threats of using AI in healthcare in general and within medical devices specifically. This survey has received ethical approval from Manchester Metropolitan University (EthOS 83951).
The survey is here https://mmu.eu.qualtrics.com/jfe/form/SV_6tfyy66OU3Bsi9w and should take about 20 minutes to complete.
Invitation from Christina Harrison, Programme Director – Waterdale
I am writing to share an exciting new initiative, possibly the first in the country for children and young people, “Children’s Health on the High Street,” which aims to bring accessible health and wellbeing services closer to our communities by utilising high street locations.
The services currently planned to deliver from the new building are Child and Adolescent Mental health (CAMHS) and Zone 5-19 (Contraception & Sexual Health, Drugs and Alcohol Services and clinics for Long Term Conditions (Epilepsy and Continence, ADHD post diagnosis care)
This initiative will not be a typical NHS building and some ideas gathered by young people include, hanging chairs, a swing to help regulate in the waiting area, study nooks and artwork displayed by local young people changing monthly to showcase Doncaster talent. We are working on a hotel standard specification.
As part of this work, we are particularly keen to engage with local GP practices to ensure that the voices, needs, and ideas of young people are reflected in how these services are developed and delivered. We recognise the vital role that you play in supporting the health and wellbeing of children and young people, and we would value your input.
We would welcome your thoughts on the following:
If you would be willing to share your views, we would be happy to arrange a short conversation, attend a meeting, or gather feedback in whatever way works best for you and your team.
Thank you in advance for your support and collaboration. We are keen to ensure that this initiative truly meets the needs of local young people, and your insight will be invaluable.
Please feel free to contact me at christina.harrison1@nhs.net if you would like to discuss further.
HIN Oxford and Thames Valley are running webinar series on breathlessness, cough, and sleep pathways (5 webinars in total). Please can you see the invite bellow for the first session on 13 July.
Better elective respiratory pathways: early insights and practical guidance
Date: Monday 13 July 12.00 – 1.00pm
Registration Link: https://events.teams.microsoft.com/event/c59921b9-d572-4cd3-8753-fc42b0e68096@2a9cd5ba-2408-4347-8400-7c5d88c277fb
This webinar provides an overview of the national Elective Care Respiratory Pathway programme, focused on improving pathways for sleep, breathlessness, and chronic cough. You will be introduced to our implementation toolkit, with practical guidance on how to adopt and scale best practice pathways in your own organisation, and hear directly from early adopter sites.
Why attend
Whether you are looking to reduce referral to treatment times, address unwarranted variation, or strengthen multidisciplinary working across primary and secondary care, this webinar will give you practical tools and real-world perspectives to help you get started.
Who should attend
This webinar is for clinicians, service leads, commissioners and anyone working in or across respiratory services who wants to improve the sleep, breathlessness and/or chronic cough pathways for their patients.
About the programme
The Elective Care Respiratory Pathway programme is commissioned by NHS England and led by Health Innovation Oxford and Thames Valley (HIOTV). HIOTV is coordinating delivery across England and supporting NHS teams to implement recognised best practice in sleep, breathlessness and cough in a way that works in real services. The programme supports providers to reduce referral to treatment times, address unwarranted variation and strengthen multidisciplinary working across primary and secondary care.
Following recent changes within the ICB, practices are reminded of the correct contact routes for primary care queries and patient complaints.
Contractual queries
Email: syicbdoncaster.primarycare@nhs.net
GP Sickness Claims (from 1 April 2026 onwards)
Email: syicb-sheffield.primarycare@nhs.net
These claims will now be processed by the Sheffield team.
Patients can raise complaints through the following channels:
Email
syicb-sheffield.icbcomplaints@nhs.net
(Covers all South Yorkshire areas: Barnsley, Doncaster, Rotherham, Sheffield)
Telephone
03330 410021 (option 1)
Post
FAO Complaints Team
NHS South Yorkshire Integrated Care Board
Sovereign House
Heavens Walk
Doncaster
DN4 5DJ
Doncaster LMC is been a member of the LMC Buying Groups Federation.
Buying Group membership entitles practices to discounts on products and services provided by the Buying Group’s suppliers.
Membership is free and there is no obligation on practices to use all the suppliers. However, practices can save thousands of pounds a year just by switching to Buying Group suppliers. To view the pricing and discounts on offer you need to register for access to the Buying Group’s online portal: https://buying.plexusportal.co.uk/Register.
What is the purpose of the Buying Group and how does it work?
The sole purpose of the Buying Group is to save its member practices money by negotiating discounts on goods and services which practices regularly purchase. The Buying Group team negotiate with suppliers, after which they identify ‘approved’ suppliers, who guarantee to give you significant discounts over what you would otherwise pay for their services, in return for the Buying Group’s endorsement and help in making you aware of what they offer.
Does it cost us anything to be part of the group?
No, membership is free and members are free to use as many discounts as they wish.
Is there any obligation to take up the deals offered?
No. Each practice is free to take up or decline any of the deals the Buying Group have negotiated. If you wish to take advantage of any of the offers in question, you will be given contact details, and all communications take place between you and the individual supplier*.
*The Buying Group accepts no liability for any contract willingly entered into by a practice with an approved supplier. Practices are advised to check that the terms of any contract with suppliers are consistent with those the Buying Group have negotiated and are advised to inform the Buying Group team of any discrepancy. The Buying Group do not, however, accept any responsibility for any member practices’ failure to check the terms of the relevant contract and the principle of caveat emptor (buyer beware) applies in all cases. Your rights as a consumer under the Consumer Protection Act are unaffected. With respect to any services to which the provisions of the Financial Services Act 2000 might apply practices are advised to seek independent financial advice as may be appropriate.
What happens to my details?
When a practice signs up for Buying Group membership, they will keep your basic contact details (practice address) on a secure system. On the membership application form, they also ask you how they can use your personal data (i.e. your email address) but even if you do sign up to receive their emails you can stop them at any time by clicking the unsubscribe button.
What if I am not happy with the quality of goods and services supplied?
Always let the Buying Group know if you encounter any problems getting what you want, and they will endeavour to sort it out.
Contact the Buying Group
The Buying Group is managed by Plexus Support Services Ltd:
Tel: 0115 979 6910
Email: info@plexussupport.co.uk
Website: https://www.plexussupport.co.uk
