First Annual South Yorkshire Primary Care Conference
Mark your calendars for April 27th – we’re thrilled to announce an exciting event you won’t want to miss. Primary Training Solutions are hosting the First Annual South Yorkshire Primary Care Conference, and we think you’ll be interested in what we have in store. This event plans to unite up to 150 General Practitioners, Nurses, and Pharmacists from diverse backgrounds to convene and exchange best practices on relevant topics in the medical field.
This years’ conference will be focused around Cardiometabolic Health and feature three sessions presented by industry experts, all led by our superb Chair, Dr Andrew Hilton:
- Dr Rani Khatib: CVD Prevention – Challenges Delivering the ABC’s
- Dr. Patrick Holmes: Managing Type 2 Diabetes in 2024 and Beyond
- Dr. Matthew Capehorn: Epidemiology and Pathophysiology of Obesity
If you’d like to attend, simply click the following link to book your place: First Annual South Yorkshire Primary Care Conference – Click here to book your place
We’re also seeking sponsors for this groundbreaking conference. If you believe this aligns with your interests, please don’t hesitate to email pts.clientcontact@gmail.com for further details.
wound care update
From April 2024, based on changes to national guidance, The Wound Care Alliance suggested last year that the classification of “Lower Leg wounds (Venous, Mixed, Arterial, Chronic Oedema/Lymphoedema) that have had a lower limb assessment completed and diagnosis confirmed in a Tier 3 or 4 Service and is now showing signs of healing – 50% or less slough/necrotic/devitalised tissue” move from Category 3 to Category 2. (NB The finances will change accordingly as will the training plan). We agreed that we would go with the majority of practice responses as to whether this was or wasn’t accepted. A majority of practices agreed and this was reflected within the contract, MOU and specification and payment schedule for 23/24.
However these changes caused some confusion last year as to what practices were and not agreeing to deliver so the Wound Care Alliance, and partnership with the LMC have drafted and agreed the new attached changes to the Tiers, clearly stating Tier 2, Tier 2 (lower limb), and Tier 3. If you sign up for Tier 2, it is on the understanding that you are NOT undertaking Tier 2 (lower limb) activity. If you sign up to Tier 2 (lower limb) it is on the understanding that this is all of Tier 2 activity. It is acceptable if your practice wants to continue to do either or both for 24/25. As previously stated any additional activity that is undertaken by your practice will be funded as this is an activity-based contract, and any training that is required will continue to be funded and provided by the
By 31 March 2024 practices need to confirm whether or not they intend to sign up to the 2024/2025 Wound Care Services contract.
You are reminded that in signing up to deliver Wound Care Services during 2024/2025 the practice agrees to guarantee continuity in service provision and commits to the delivery of services signed-up to throughout the full 52 weeks of the year (the practice must ensure practice cover for annual leave and sickness) Please be clear in your response whether this is Tier 2, Tier 2(lower limb)or Tier 3 or none.
Once practices and the community provider have agreed participation a finalised MOU and contract this will be circulated for review/signing at a later date (with the other paperwork relating to the GP LES 24/25 National Contract Variation).
As in previous years, payment for Wound Care Services during 2024/2025 will be made in arrears following submission of activity data to NHS South Yorkshire Integrated Care Board (Doncaster Place) via the Primary Care Matrix. As outlined in the GP LES Contract, activity must be submitted each month (within 14 days of the month end) for payment at the end of the month following the activity. Providers are reminded that the ICB reserves the right to withhold payment for Wound Care Service activity that is not recorded/submitted within the monthly submission deadline outlined within the GP LES Contract.
We are currently unable to confirm what the increase in prices will be, but we can confirm that we will be applying the Nett Tariff Increase once this has been finalised for 2024/25.
RESPECT QI sessions
RESPECT QI sessions
Eclipse Live
In line with our colleagues in Barnsley, Rotherham and Sheffield within NHS SY ICB, Doncaster Place Medicines Optimisation Team are implementing a primary care clinical support service called Advice & Guidance (Eclipse Live) free of charge. This service offers GP practices dynamic risk stratification of patients to enable proactive clinical support.
It is specifically designed to:
• Improve patient safety.
• Reduce admissions into hospital and enhance GP practice work efficiency through automated specific patient alerts, which identify patients with genuine reversible risk needing urgent intervention.
It is fully compatible with both SystmOne and EmisWeb GP clinical systems. Data from GP clinical systems will need to be extracted to populate the Advice and Guidance (Eclipse Live) service. EMIS Web practices will be able to utilise direct extractions to their secure database and there is a similar process for SystmOne practices using Strategic Reporting.
The service is being rolled out across Doncaster supporting the strategic aim to provide the best health and care for our local population. More than 24 ICBs and regions in England are now live including our neighbours, Sheffield, Rotherham and Barnsley.
The service is funded through GP IT Futures and was the first risk stratification subsidiary service to receive full NHS Digital assurance under the GPSoC framework in March 2017. It was developed by Dr Julian Brown, a GP from Litcham in Norfolk, the Eclipse Clinical Lead, a Primary Care Network Clinical Director who has served as his local CCG Long Term Condition and Prescribing Lead.
Other useful functions include: –
Radar500 alerts, which can identify patients who are at potential risk of adverse events or harm from their prescribed medication, and stratifies this risk in Red, Amber and Blue alert profiles allowing clinicians to prioritise those who are at the highest risk of harm.
This function can help to: –
• Reduce medicines related preventable events, that result in hospital A&E attendance and non-elective admissions.
• Reduce costs associated with the number of preventable events.
• Support medicines optimisation, including Structured Medication Reviews (SMRs) and CQC requirements.
• Enhance Quality and Outcomes Framework performance.
A diabetes module based on National Diabetes Audit (NDA) criteria and provides updated information of the key diabetes indicators such as the eight Care Processes and Treatment Targets.
There are 7 practice who have already signed up and Scawsby and Don Valley are now live. If you have already signed up well done 😊
There will be a further set of Eclipse Live Overview tutorials via MS Teams once more practices have signed up , you will receive an invitation to these in a separate email and you are welcome to forward to invitation on to your practice colleagues and staff. The sessions will be recorded and will be available for anyone to watch at a later time if they are unable to attend.
The webinar that was recorded on 23rd January can be accessed by this link 
Eclipse Live Overview for Doncaster Practices-20240123_123408-Meeting Recording.mp4
Dean Eggitt has developed a privacy notice template for practices to fill in and embed onto their face book / web pages to communicate to patients.
The Eclipse team will support practices during rollout and help you to navigate these and other functions. Once Eclipse Live is launched there will be webinars organised where the support team will talk you through live data and show you how to get the best from the information available.
Eclipse support team contact details:
• Lucas Vajas, Regional Accounts Manager lucas.vajas@prescribingservices.org
• Keri Whitmore, Implementation Lead keri@prescribingservices.org
• Paul Taylor, National Training Lead. [paul@prescribingservices.org%20%20]paul@prescribingservices.org
Eclipse Helpdesk support@prescribingservices.org
If you need help with filing in the contract and sending it back contact me directly [karen.jennison@nhs.net%20]karen.jennison@nhs.net
Is your Partnership Agreement up to date?
The following article was written by Oliver Poole from VWV
In some senses, partnership deeds are like insurance policies. If nothing ever goes wrong, you won’t need it. But it’s better to have it and not need it, than to need it and not have it.
In fact, even if the partners never end up falling out, the time and money spent on drawing up their partnership agreement is not wasted. The very process of drawing it up, and discussing every aspect of the business relationship, is a valuable exercise; going through this process, and ensuring that there is the necessary ‘meeting of minds’ between the partners helps head off any disputes from arising in the first place.
Without a partnership deed, the partners are in a very difficult position if there is a dispute, or anything unexpected happens, like illness, sudden retirements, suspensions, or even death. If there is no partnership agreement in place then the partners have to fall back on the rules set out in the Partnership Act 1890, which is about as out of date as it sounds. Its default rules include:
- Equal shares for all partners
- No ability to expel. No matter what has happened, even a partner who has been struck off cannot be expelled and may therefore have to be paid off
- Any partner can dissolve the partnership at any time. This makes partnerships at will the least stable business structure known to mankind. If a partner dissolves then the GMS contract can go out to tender, the bank loan can be called in, and the partners can end up in an expensive dispute about which partners (if any of them) get to carry on the practice, or whether it has to be wound up.
Many practices think they have a partnership deed, when in fact they don’t. Partnership deeds can fall away in certain circumstances, the most common of which is when a new partner joins without signing anything. Some case law suggests that, in such situations, not only is the new partner not bound by the existing deed, but neither are the incumbent partners – even if they signed it, and are all, in fact, a partnership at will! This is why when a new partner joins, the aim should always be to get them to sign the deed on or before the date they become a partner.
A common misconception is that it is all right to wait until the end of probation before signing a new deed. This is a very bad idea. Firstly, the arrival of a new partner can change dynamics within the partnership and lead to disputes – so it is a bad time to be without a partnership deed anyway. Secondly, the only way you can enforce a probation in the first place is if the new partner has signed the deed!
Outdated partnership agreements are better than nothing, but given how often things change in primary care, it is important that the agreement is updated every few years. A partnership agreement that hasn’t been touched since 2015, for example, will be flawed in a number of respects, in that it will not reflect:
- Changes to the rules on reimbursement during suspension in 2015 (which could leave the practice out of pocket if a partner is suspended)
- The introduction of PCNs, the state-backed indemnity scheme, and reimbursement for shared parental leave,
- Increased reimbursement for sick leave – which may have caused the practice to adjust its locum insurance arrangements,
- Tax changes which make cross-options on retirement less useful, and more of a risk, than they used to be, and
- Challenges to green socks clauses (which still remain valid, but can benefit from some updated wording)
For further information please contact opool@vwv.co.uk
Practices sending paper records
In most instances, patient medical records are electronic and transfer between GPs via an electronic GP2GP file transfer upon successful registration at a practice.
GP2GP does not allow an electronic summary to move outside England, or vice-versa. When a patient moves to a practice outside of England, the English GP Practice will need to use the established CitySprint collection procedure to send patient records. You will need to:
- print out the patient summary notes on paper and ensure that the notes are clear for the receiving practice to read them
- use a transit label and check that it shows the documents are leaving England
Please note that files in digital formats, including CDs, DVDs and USB files, will not work as these files are often encrypted.
Incorporating a GP Practice – is it right for your practice?
What is incorporation?
‘Incorporation’ means to constitute (a company, firm or other organization) as a legal corporate entity separate from its owners.
You may already have set up a limited company, for example, to hold your premises, deliver consulting services or to subcontract some of your core services. This blog concentrates on transferring the whole of the practice – namely the core GMS or PMS contract – into a limited company.
Why incorporate?
Whilst there are clearly many positive attributes to the partnership model, there are also a few problems, including:
- unlimited joint and several liability
- lack of a legal entity to contract. In a partnership it is the partners who contract personally
Some of the benefits of delivering your core services from a limited company include:
- a limited company is a legal entity in its own right and may hold assets and liabilities and enter into contracts in its own name. The directors and shareholders may change, but ownership of the assets and liabilities by the limited company remains the same. This simplifies matters when dealing with changes in property ownership, as there will be no need to change the name of the registered owners at the Land Registry, deal with Bank refinancing, or change the names on any contracts.
- a shareholder’s liability is limited to the value of their shareholding, which is usually limited to a few hundred pounds. Incorporation separates business assets from personal assets and creditors cannot come after a shareholder’s personal assets for a debt owed by the limited company.
- the management and ownership roles are separated. This allows for a wider range of business models than the partnership model allows, such as bringing in business managers as directors without the requirement for them to contribute capital or incur risk. Similarly, shareholders may contribute capital and receive profits without having any day to day involvement in the running of the practice.
- all staff, including directors, are normally employees and therefore paid under PAYE and have full employment rights. The partners in a partnership are self-employed and have very limited employment law protection, but what they lose in employment protection they gain in tax relief and partnership status. With the current challenges in recruitment of new partners, the protection afforded by a directorship in a limited company may be more attractive to some.
But incorporation does present its own problems, including:
- you are bound by the strict regulations set out in the Companies Act 2006. These override all your own governance rules, and you are not at liberty to run your business in a way that suits you and your partners, without reference to the Act. Partnerships by contrast are governed by the Partnership Act 1890 which is a much simpler and more flexible set of regulations, most of which you are able to tailor to your own needs.
- whilst limited liability is a major benefit for the shareholders of a limited company, it is a significant disadvantage for creditors who may be unwilling to lend to a limited company unless it has sufficient assets (such as a surgery) over which they can take security. Banks may ask for personal guarantees from the shareholders, and landlords could ask for guarantees from the directors.
- there is no ‘expulsion’ mechanism to remove a partner in the event that you can no longer work together. Special rules need to be written into the company’s Articles but even then, it is likely to be complicated to expel as it will involve terminating a person’s status as an employee, director and shareholder.
- you will need to make annual filings, including accounts, at Companies House and such information is publicly available. You will need to hold regular board meetings, record the minutes and document certain decisions in a specific way.
- shareholders do not have individual capital accounts. When a company makes a profit (or loss) this is not divided up amongst shareholders, but is retained by the company for its own benefit. The directors may then recommend that a dividend is paid to the shareholders as a return on their capital invested in the company, but this is only made from a combined ‘pot’ of retained profits. It is illegal to make a dividend payment unless there are sufficient retained profits in the company as a whole.
Conclusion
Whilst limited liability is a hugely attractive benefit, limited companies are not panaceas to all the issues of running a primary care practice, and there are definitely both pros and cons. We have certainly seen a trend towards practices incorporating, but any decision to do so should only be taken after seeking expert advice from both tax accountants and specialist primary care solicitors so that you can be advised on your particular situation. Incorporating a GP Practice certainly works for some, but many others discover that it is not for them.
Our specialist team at DR Solicitors are happy to answer any queries you may have about incorporating a GP Practice, and can also put you in touch with some expert accountants. Please contact us here or telephone 01483 511555.
GP end of year forms: submission deadline extended to 31 March
All Type 1 and Type 2 practitioners must complete the relevant certificate or form and submit to Primary Care Support England (PCSE) for work in England, or their local Health Board for work in Wales.
The release of both they Type 1 and Type 2 forms was delayed this year, and as a result the deadline for submitting these has been extended to 31 March 2024.
NHSE GP Fellowship Scheme cessation
NHSE has announced that the NHSE GP Fellowships and Mentor schemes will end on 31 March 2024.
We would like to remind and encourage those GPs who are within 24 months of having CCT’d on 31 March, and who have not yet taken advantage of the NHS GP Fellowship Scheme, to sign up for the programme in advance of the 31 March deadline. Those successful in securing a place ahead of the deadline will have funding secured for two years. Please get in touch with your local Training Hubs for details regarding how to register.
Please share this information across your trainers and First 5 groups. Please also send any feedback on the programmes to info.gpc@bma.org.uk
Wound Care
Doncaster LMC has re-instated negotiations. It is expected that these will conclude in time for a new contract starting in April 2024.
LGBTQ+
SAVE THE DATE: Return To Training Conference Tuesday 11th June 2024, Sheffield
The following information was supplied by Susie Stokes
s.stokes4@nhs.net Future Leaders Fellow for SuppoRTT Innovation, Professional Support, NHSE WT&E YH
Secretary of the Trainee Executive Committee and Trainee Wider Forum, NHSE WT&E YH
Honorary Clinical Lecturer, University of Leeds
Shout out to trainees who are currently Out Of Program, contemplating time OOP, or recently returned from time OOP
Register your interest now at england.supporttconference@nhs.net for this free one-day flagship event, aimed towards Doctors and Dentists in Postgraduate Training (DDiTs) in Yorkshire & the Humber at any postgraduate level who are currently Out Of Program, planning time Out Of Program, or who will have recently returned to training (RTT).
We are bringing together trainees, leaders, and educators to explore our themes this year of Autonomy, Belonging, and Competence. Please join us to learn how to build safe, sustainable, working habits, with talks and interactive workshops designed to share tools to help trainees succeed. Delegates will also have the opportunity to collaborate with and question experts and senior faculty through open panel discussion, and network with like-minded individuals. Poster prize competition with a call for abstracts due any day now!
Keynote speech from Dr Rachel Morris, host of the popular You Are Not A Frog podcast
Rachel will also be running 2 workshops in line with her Shapes Toolkit course.
Trainee Executive Forum (TEF), Future Leaders Program (FLP), and IMG support presence.
Whether OOP for research, experience, training, caring / parental responsibilities, sickness, or on a career break, this conference is for you!
Current OOP trainees and recent returners will have priority. Please state in your expression of interest email how the conference will be applicable to you.
Babies under the age of one are invited.
Look out for updates on our conference webpage (https://www.yorksandhumberdeanery.nhs.uk/learner_support/supported-return-training-conference-2024) and please reach out if you have any questions.
Dermatoscopy Training
This promotional meeting is organised and funded by LEO Pharma. LEO Pharma medicines will be discussed at this meeting.
Dr George Moncrieff, Dermatology Lecturer will be presenting via Virtual TEAMS meetings on the following dates:-
Tuesday 5th March 2024 at 7.30pm – Flat pigmented facial lesions
Tuesday 12th March 2024 at 7.30pm – Dermatoscopy and management of keratotic cancers
Tuesday 26th March 2024 at 7.30pm – Dermatoscopy of acral lesions, nails and quiz
If you would like to attend, please reply to Katie Wright, Dermatology Account Manager KWRUK@leo-pharma.com so that you can be added to the register.
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: info@lmcbuyinggroups.co.uk Website: www.lmcbuyinggroups.co.uk
