In wintry bosom, where yuletide’s glow doth dance,
An NHS GP, with noble heart, takes stance.
Amidst the jolly revelry’s merry chime,
Doth wield their care in this auspicious time.
With stethoscope in hand and spirits high,
They traverse halls where kindness doth imply,
A healer’s touch, a balm for souls in need,
Dispensing hope with every virtuous deed.
Through snow-kissed days and starry-lit eves,
Their dedication, steadfast, never leaves.
Each patient, a tale, they patiently hear,
Granting solace, allaying every fear.
While carols echo and merry bells sound,
The GP’s service knows no bound.
In tender service, they staunchly steer,
A gift of healing that spans the year.
Hail to these noble souls, whose selfless art,
In echoes of Shakespearean heart,
NHS GPs, this Christmas’ grace divine,
Thy care and love, as stars shall ever shine.
UPDATE 15th December
Doncaster LMC has been contacted by the commissioner and positive discussions have led to the re-instatement of negotiations. It is expected that these will begin shortly and conclude in time for a new contract starting in April 2024.
- it was NOT negotiated by Doncaster LMC
- it is time-consuming
- it is resource-intensive
- it requires extra training that is not usually in the scope of general practice nursing
National Insurance Contributions (NICs) rates
The government has announced a cut to the main rate of Class 1 employee NICs from 12% to 10% from 6 January 2024 and a cut to the main rate of Class 4 self-employed NICs from 9% to 8% from 6 April 2024. It has also announced that no one will be required to pay Class 2 self-employed NICs from 6 April 2024. Details of this change are:
- from 6 April 2024, self-employed people with profits above £12,570 will no longer be required to pay Class 2 NICs but will continue to receive access to contributory benefits including the State Pension
- those with profits between £6,725 and £12,570 will continue to get access to contributory benefits including the State Pension through a National Insurance credit without paying NICs as they do currently
- those with profits under £6,725 and others who pay Class 2 NICs voluntarily to get access to contributory benefits including the State Pension, will continue to be able to do so
The government will set out next steps on Class 2 reform next year.
HMRC have asked employers to take steps now to start work with your payroll software provider, and where applicable IT delivery partners, to get ready to implement the change to Class 1 employee NICs that comes into effect from 6 January 2024. HMRC’s Basic PAYE Tools product will be updated to reflect this change.
Information on all the measures announced can be found in Autumn Statement 2023. For an overview of all the tax legislation and rates announced, read the Autumn Statement 2023: Overview of tax legislation and rates (OOTLAR).
Launch of a new mental health and wellbeing platform, DonnyDot!
DonnyDot is an online platform which has been developed to provide a range of verified practical advice and accurate contact details for local, national, and online mental health and wellbeing services in Doncaster.
The platform has been developed and designed to make it as easy as possible for people living in Doncaster, whether they are in need themselves or for someone who is concerned about someone else, to engage with the online platform enabling them to find the right and most relevant information they need all in one place, as quickly as possible.
To support connecting people living in Doncaster to the platform a series of assets have been created. It is hoped that practices will download and use the downloadable assets to actively promote DonnyDot via their communication channels – helping raise awareness of the online platform.
Changes to Immunology services at DBTH
From the 18th December 2023, there will no longer be an Immunology services on site at DBTH. In future the required tests will be sent to the Sheffield Immunology Laboratory at the Northern General Hospital for testing.
New Process for Requesting Tests
All Immunology tests must now have a separate request and have a separate form and blood tube.
Requests on ICE – From Mon 4th December, if requesting a mixture of Chemistry, Haematology and Immunology tests on ICE – ICE will automatically separate out the immunology tests onto a separate request.
Manual Requests – If you are using a manual request form, Immunology tests need to be requested on a separate form to any Chemistry and Haematology and sent with a separate specimen tube. This is because these tests will only be registered at Doncaster and they will be able to track which samples have been sent. The sample and form in their entirety will be transferred directly to Sheffield for processing. Please ensure that all Immunology tests are received at Doncaster pathology laboratory before 12pm on a Friday so they can be transferred for testing in adequate time.
The add-on testing service for Immunology will no longer be available and a fresh sample will need to be collected for any additional testing. Please be aware that from 18th December date, requests for Immunology tests that do not have a separate sample and request form will not be processed.
Changes to service delivery
From 18th December DBTH will no longer have the capacity to provide these tests on site at Doncaster. During the initial change of service to Sheffield immunology turnaround times are expected to be impacted as the new service becomes embedded. The access to Consultant Immunologists will not change as they currently oversee this service and this aspect of the service will not be changing. Any urgent requests will now be approved by Sheffield Immunology service.
Changes to Reflex testing
As part of the process, there will be the following changes to testing procedures to reflect current practices at Sheffield.
- MPO and PR3 analysis is currently performed on all ANCA requests; however, these tests will now only be performed if ANCA immunofluorescence is positive.
- There will be no reflex testing based on ANA results (e.g. dsDNA Crithidia, LKS, ENA). If you require dsDNA analysis, this will be available to request on ICE as ‘dsDNA ELISA’.
- Titres are currently performed on all positive ANA, dsDNA Crithidia & LKS requests, however these test results will now be reported qualitatively (e.g. weak positive, positive, strong positive).
- IgA will continue to be reflexed as required for Tissue Transglutaminase and Endomysial antibody requests.
BMA Ballot – message from BMA
Next year marks both the 20th anniversary of the introduction of the 2004 GMS contract, and the end of the current 2019-24 five-year investment framework. A general election is also likely at some point in the year, and potentially, a new government. With change comes opportunity, and a window to influence how we deliver patient care now and for the years ahead.
Manifestos from the main political parties, think tanks, charities, and other health bodies will seek to influence these changes. In advance of these, GPC England will publish its own vision outlining the future direction for general practice by those who know it best: GPs themselves.
This is where you come in. We want to give you a voice.
If you only respond to one survey, make it this one. General Practice: Your Career – Your Future Survey (research.net)
We want to hear from all fully qualified GPs in England, whether you’re a BMA member or not. Share it with all GPs: partners, salaried, retainer and locum GPs; those working in wider primary care roles, in trusts, urgent care, secure or out-of-hours settings, and GP Registrars at ST3 and above. (A separate survey for all GP Trainees ST1+ will be opened by the BMA in the new year – our survey is targeted at ST3+ to ensure that respondents have appropriate experience working within the practice setting to enable them to answer as many questions as possible.)
Participants do not need to be a member of the BMA to participate but we will need a GMC number so we can corroborate responses as coming from qualified GPs based in England.
All responses will be anonymised.
The survey will close on Sunday 21 January 2024. Please: complete the survey as soon as possible, to ensure our negotiating position is as strong as possible.
Share the Survey with ALL your GP colleagues now: https://tinyurl.com/GPSurveyShare.
Updated measles guidelines and resources
This year has seen a steady rise in measles cases. The UK Health Security Agency (UKHSA) has published updated national measles guidelines and resources, with a new slide set for healthcare professionals and support staff in primary care, including community pharmacy. These guidelines advise how to manage cases of suspected measles, what patient details to take, who to notify and assessing risk of disease spreading in close contacts.
MMR Catch-up campaign
NHSE has now confirmed the vaccination ‘catch-up campaign’ for 2023/24. As with last year this will focus on MMR vaccinations and NHSE have set out a number of actions for practices to support the campaign. As per the SFE, practices will receive an item of service fee for every vaccination.
The campaign will run from November 2023 to March 2024 in two stages:
- From November 2023 to March 2024 – practices will be required to undertake local call and recall for eligible individuals aged 12 months up to and including 5 years.
- From January 2024 to March 2024 – practices are asked to support requests for vaccination from individuals aged 6 years up to and including 25 years. This cohort will be identified through phased national call and recall, and where individuals or parents/carers contact their practice following receipt of the invitation, practices are required to check the individual’s vaccination status for valid vaccinations (e.g., given at the correct age and at the correct intervals) and book an appointment for vaccination if clinically appropriate. Further information will follow, via the Primary Care Bulletin and Regional cascade, to provide advanced notice of the phased national call and recall, including the schedule of call and recall communications. This catch-up will be supported by the School Age Immunisation Service (SAIS) for the relevant age cohorts, alongside general practice activity.
Funding for participation in the national catch-up campaign is included in global sum payments. Practices are also eligible for an item of service payment of £10.06, in line with requirements set out in GP contracts, for each MMR vaccination administered because of this catch-up activity.
The MMR vaccine continues to be available for practices to order through IMMFORM.
1. Practices must:
- ensure the named Practice Immunisation Lead is engaged and oversees the practice’s participation in the catch-up campaign, including informing the local commissioner of the outcome of the campaign;
- apply the V&I core contractual standards to the planning and delivery of the MMR catch up campaign (see part 9A of the GMS Regulations and guidance);
- undertake the following proactive systematic checks as part of this campaign:
- check patient paper/electronic records (Electronic Patient Record) and if necessary correct computerised record to ensure accurate MMR vaccination status recording.
- confirm that the patient is still in the area – if they are not, remove them from the list and inform the local CHIS.
- actively invite all those missing one or both doses of MMR to a vaccination clinic held in the practice or to book an appointment. Priority should be given to patients missing both doses as this is where most clinical value is gained. A minimum three invitations per patient as follows:
- First invitation to offer an appointment.
- Second invitation to offer an appointment, confirm receipt and/or check if the parent/guardian already has a record of vaccination e.g. in the Personal Child Health Record.
- Third invitation should be a practice healthcare professional discussion with the parent or guardian, either face-to-face or via telephone. Practices can make use of the UKHSA resources in call/recall discussions to support informed choice and improved uptake and coverage. At this point also check for any other missing childhood immunisations and offer these.
- consider options to offer vaccinations more flexibly to the eligible cohort;
- ensure that parents/guardians of patients who need a second dose are invited and attend for the second dose (three invitations);
- continue to follow-up, recall and update computerised records for patients who do not respond or fail to attend scheduled clinics or appointments, and offer opportunistically as and when;
- if there is no response achieved by following the process outlined above, practices must notify school nursing service/school aged immunisation provider to follow-up/offer at school; and
- inform local commissioning team of outcome of the campaign.
2. New to the 2023/24 campaign, practices must also:
- Utilise opportunistic booking and clinically appropriate administration of MMR vaccine when eligible unvaccinated patients are presenting.
- Implement a Make Every Contact Count (MECC) approach for review of MMR vaccination status and administration of MMR vaccine. Every point of patient contact (e.g. booking, attending the practice, text and written communications) should promote a review of MMR vaccination status and if required booking.
- For the 6 to 25 year old cohort only: Have a practice specific process in place to support patients aged 6 years up to and including 25 years who have received national MMR call and recall reminders, the process should include checking the vaccination status for valid vaccinations (e.g. given at the correct age and at the correct intervals) and booking an appointment for vaccination if clinically appropriate or updating patient records accordingly following vaccination history check where patients contact the practice as a result of the national invite. This activity will be supported by the School Age Immunisation Service (SAIS) for the relevant age cohorts and further information will be cascaded via Primary Care Bulletin and Regional Teams on the call/recall scheduling.
LMC Buying Group
Doncaster LMC is been a member of the LMC Buying Groups Federation. This means that practices can access the discounts the Buying Group has negotiated on a wide range of products and services. If you’re not sure what the Buying Group is all about then this short video explains what they do: https://www.youtube.com/watch?v=FekMwFI5ILg.
By registering with the Buying Group: www.lmcbuyinggroups.co.uk/members/, you can view all the suppliers’ pricing, contact details and request quotes. The Buying Group also offers any member practice a free cost analysis which demonstrates how much money your practice could save just by swapping to buying group suppliers. Tel: 0115 979 6910 Email: email@example.com Website: www.lmcbuyinggroups.co.uk