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January 2025 Update

The January 2025 Doncaster LMC update

A Heartbeat of Hope for 2025

Oh beacon of care, steadfast and true,
In England’s heart, we turn to you.
Through every storm, you’ve held your ground,
A haven of healing, where hope is found.

With doors wide open, dawn till late,
You greet each soul, no matter their state.
The child’s first cry, the elder’s sigh,
You walk with us as years go by.

From bustling cities to quiet moors,
Your service extends, crossing all shores.
A tapestry woven of trust and grace,
A pillar of strength, you embrace every face.

In the whispers of stethoscopes, the scribble of pens,
You battle the trials again and again.
The challenges rise, the pressures weigh,
Yet your spirit endures each passing day.

Oh guardian of health, resilient and kind,
To every ailment, a cure you’ll find.
Through winter’s chill and summer’s glow,
Your dedication continues to grow.

As the new year dawns, with its unknown tide,
We stand together, side by side.
For in your halls, community thrives,
You breathe new hope into countless lives.

So here’s to you, General Practice divine,
A jewel in England’s health care line.
May this year bring strength, courage, and cheer,
For you are the heart of all we hold dear.

Collective action

There remains ongoing discussion among GPs in England regarding collective action as a response to longstanding concerns about workload, funding, staffing, and working conditions in general practice. Many GPs feel that these issues have reached unsustainable levels, with increasing patient demand, administrative burdens, and recruitment challenges contributing to significant stress and dissatisfaction within the profession. Collective action, which could take various forms, is currently underway in some areas of England and being considered in other areas as a way to highlight these pressures and push for meaningful reform.

Supporters of collective action argue that it provides a unified voice to amplify concerns, making it harder for policymakers to ignore the challenges faced by GPs. By acting together, GPs can demonstrate the critical importance of their role in the healthcare system and the consequences of neglecting primary care. Some believe that collective action could lead to tangible improvements in funding, workforce support, and policy changes that better reflect the realities of modern general practice.

However, there are risks and potential drawbacks associated with collective action. It may lead to disruption in patient care, which could strain relationships between GPs and their communities. There are also concerns about professional repercussions, as participation in certain forms of action could conflict with contractual obligations or regulatory requirements. Additionally, some GPs may feel that collective action could further divide the profession or undermine public trust in general practice.

If you feel strongly about this topic and wish to contribute your perspective, Doncaster LMC is keen to hear from you. Your thoughts and experiences are invaluable in shaping the collective understanding and response to these important issues. Please don’t hesitate to reach out and share your views.

The English General Practitioners Committee of the British Medical Association will hold a special conference on the 19th March 2025 to debate the next steps in collective action.  Doncaster LMC will meet with SYB ICB leads on March 27th 2025 to discuss this further.

Physician associates in General Practice - an update

Physician Associates (PAs) are an evolving part of the primary care workforce, offering valuable support to clinical teams in managing patient care. They work under the supervision of doctors, assisting with tasks such as patient histories, physical examinations, and managing common conditions. While their contributions are intended to complement existing teams, their role remains distinct from that of doctors, with differences in training, responsibilities, and scope of practice.

The introduction of GMC regulation in July 2024 marks an important step for PAs, aiming to establish clear standards and accountability for their practice. As part of this regulation, the GMC plans to explore the possibility of enabling PAs to prescribe medications and request certain investigations, such as X-rays. However, these changes are still under consideration and have not yet been implemented.

The integration of PAs into primary care has raised concerns in some quarters, particularly in the context of ongoing challenges faced by resident doctors (formally known as junior doctors) and the wider medical workforce. These include issues such as pay, working conditions, and recognition of the extensive training and expertise required to become a doctor. It is important to emphasise that PAs are not a replacement for doctors but rather an additional resource designed to support patient care within the limitations of their training and role.

The Royal College of General Practitioners (RCGP) recently expressed objections to the expanded use of PAs in general practice. Their concerns focus on the risk of undermining the doctor-patient relationship and the unique expertise that GPs bring to patient care, particularly in complex cases. The RCGP has called for greater clarity about the roles and boundaries of PAs, emphasising that while they can provide valuable support, they must not be seen as a substitute for fully trained GPs. The College has also highlighted the need to address systemic issues, such as GP shortages and unsustainable workloads, rather than relying on the expansion of alternative roles.

The transition to GMC regulation provides an opportunity to ensure that the role of PAs is clearly defined, with appropriate safeguards, supervision, and a commitment to maintaining high standards of care. Practices should approach the integration of PAs thoughtfully, recognising the value of their contributions while continuing to support the development and wellbeing of all members of the healthcare team. Open dialogue and collaboration are essential to ensure that the evolving workforce strengthens, rather than detracts from, the quality of care delivered to patients.

Update for Partners: Impact of National Insurance Increases on Your Practice in 2025

The planned increase in National Insurance (NI) contributions, which is set to take effect in 2025, will have an impact on both the practice and staff finances. The rise in NI contributions, confirmed as part of the government’s fiscal policy, will affect employers and employees, including GPs, practice staff, and any contractors. This increase is expected to place an additional financial burden on practices, as it will raise the cost of employing staff.

As a partner, you will need to factor these increased costs into your practice’s budgeting and financial planning. This includes both the employer’s contribution and the impact on staff salaries, which may require adjustments to remain competitive and retain key staff. Given the ongoing financial pressures faced by general practice, it will be essential to carefully balance these costs with the available practice income.

On a more positive note, the GP contract for 2025 is expected to include an uplift in funding, which will help to offset some of the costs arising from the National Insurance increase. This contract uplift will be aimed at addressing inflationary pressures and supporting the ongoing financial sustainability of general practices. However, it is important to note that while the uplift will help, it may not fully cover the entirety of the increased National Insurance burden. Therefore, partners will still need to plan carefully for any shortfall in funding and ensure that other areas of the practice’s finances are managed efficiently.

In response to these financial pressures, Doncaster LMC has been actively advocating for increased funding to support general practice. We recently met with Sally Jameson MP and Helen Morgan MP to discuss the impact of rising National Insurance contributions on local practices and to request additional support. We have also written to the Department of Health and Social Care, urging for an increase in GP contract funding to help ease the burden of the NI rise. Our efforts are focused on ensuring that the financial challenges of general practice are fully recognised and addressed by policymakers.

In light of the expected NI rise and contract uplifts, it’s crucial for partners to review their financial models, reassess staffing and operational costs, and make adjustments as necessary to maintain practice stability. Clear communication with your team about these financial changes and how they may affect pay and benefits will be important in managing expectations and ensuring continued morale.

Ultimately, careful planning will be key to navigating the financial challenges posed by the National Insurance increases and ensuring that your practice remains financially viable in 2025 and beyond.

Update for Partners: Understanding Staff Pay Rises and Financial Planning

Pay rises for practice staff members are not determined by national negotiations or the annual contract uplifts provided to practices. Instead, these decisions are made at the practice level and depend on the available profit and what the partners are prepared to allocate toward staff salary increases. This allows each practice to manage its finances according to its unique circumstances.

For salaried GPs employed on the BMA standard contract, the situation is different. Their pay terms are influenced by national uplifts recommended by NHS England and the BMA, which practices are generally expected to honour. This means any changes to salaried GP pay are partially outside the direct control of the practice and need to be factored into financial planning.

To remain financially viable and stable, it’s crucial for partners to regularly review the practice budget, understanding the income and expenses to determine what funds are available for salary increases while ensuring the practice can meet its other financial obligations. Balancing the need to retain and motivate staff with the practice’s financial sustainability is key. This may involve making incremental increases based on what the practice can afford, considering patient demand and income projections.

It’s also important to incorporate expected national pay increases for salaried GPs into the practice’s financial planning to ensure compliance with contractual terms and maintain goodwill. Clear communication with staff members about how pay decisions are made can help manage expectations and foster understanding.

By aligning pay decisions with the practice’s financial health, partners can ensure they maintain stability while continuing to provide fair compensation to their teams.

Evergreen Connect: Teledermatology updates and top tips!

Join Dan O’Shea, Product Specialist from Evergreen Life for a webinar session supporting you to make the best use of Evergreen Connect.

Topics covered to include:

  • Refresher training for using Evergreen Connect
  • Useful updates to save you time and effort
  • Top tips for ensuring your images are crystal clear! 
  • Q&A session

Everrgreen Life will be running this session on the follow days, please click below to pre-register for the date and time most convenient for you:

Wednesday 12th February at 1pm: CLICK HERE  Microsoft Virtual Events Powered by Teamsto pre-register

 

Wednesday 19th February at 1pm: CLICK HERE Microsoft Virtual Events Powered by Teams to pre-register

 

 
 

If you are unable to attend a session but require any technical support in accessing the service for e.g. passcodes, equipment etc, please contact support@evergreen-dermatology.co.uk

Kind regards,

Dan O’Shea

Lead Product Specialist, Digital Access | Evergreen life

Tel: 01509 458256

Catch up on the latest episodes in our askmyGP webinar series here

Guide to the changes to primary care premises policy

NHS England has introduced the National Health Service (General Medical Services Premises Costs) Directions 2024, effective from 9 May 2024, replacing the 2013 Directions.

These updated Directions enable commissioners to invest more flexibly and substantially in GP practices, offering improved terms and technical updates.

Notably, the previous cap on commissioner contributions to premises improvements has been lifted, allowing grants of up to 100% of project value, subject to business case assessment and local prioritisation.

Additionally, grant values have increased, and abatement and guaranteed periods of use have been adjusted to better support practices.

The updated Directions also permit improvement grants for purchasing land intended for premises extensions and for tenant fit-out works of new builds.

To alleviate concerns regarding premises liabilities, especially for contractors considering retirement, the Directions offer options such as selling the premises and repaying the remaining grant or retaining the premises with appropriate arrangements.

These changes aim to provide greater flexibility and support for GP practices in managing and improving their premises, ensuring facilities are fit for purpose and capable of meeting evolving healthcare needs.

 

https://www.england.nhs.uk/long-read/guide-to-the-changes-to-primary-care-premises-policy/

 

Focus on DDRB Pay Award

As part of their Guidance on the 2024/25 GP contract, the British Medical Association (BMA) has published a NHS England » Guide to the changes to primary care premises policy

The main topics covered include:

  • What the DDRB recommended for 2024/25
  • How the uplift will be funded
  • Is it part of the DDRB’s remit to recommend pay uplifts for non-GP salaried staff?
  • Why doesn’t every practice get enough funding to pass on any pay uplifts?
  • Will this funding be enough for all to pass on a 6% pay uplift to every member of the practice team?
  • What are the possible answers? 
  • Premises review
  • New directions
  • Key changes
  • Improvement grants
  • Improvement grants and premises liabilities
  • Other changes
  • Changes to the directions

Changes to the GP Pension Type 1 and 2 Forms 2023-24

NHS England (NHSE) has emailed GPs with details of how type 1 and type 2 forms for the year ending 31 March 2024 should be submitted to Primary Care Support England (PCSE). Previously forms were submitted either through a PCSE online account or the ‘Contact us’ GP Pensions enquiries | PCSE section on the PCSE website. Instead, GPs or their accountant will now need to submit the form via the ‘Contact us’ GP Pensions enquiries | PCSE section on the PCSE website. This will not impact on pension records, just how forms are submitted. The forms must be completed by those who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024 and should be submitted by 28 February 2025. PCSE has scheduled webinars to explain the new form and the uploading process. One date remains – Tuesday 4 February, 6 pm to 7.30 pm. Further details on the webinar and how to register can be found here GP Pensions 2023/24 End of Year webinar . The British Medical Association (BMA) has issued guidance The NHS pension scheme as a sessional GP , which covers topics such as:

  • What pension tier to use
  • Forms needed
  • Who needs to complete a type 2 form
  • Total Rewards Statement (TRS)
  • Amnesty form
  • Annualisation
  • Submitting forms and money
  • Webinar

British Medical Association Guidance on Physician Associates

In response to member queries regarding the future management of PAs within their practices, please note the additional guidance below: GP practices are entitled to follow BMA Guidance Physician associates in general practice: making it safe for patients and GPs and RCGP guidance Physician associates on employing PAs. However, it is for individual practices to decide whether to follow the guidance, and if they do decide to follow it, what steps to take to implement any changes. A GP practice may decide to restructure how they deliver their services in order to follow the guidance. If such a restructure results in duties being removed from one or more PA in the practice, this could result in a redundancy situation arising, ie where there is a reduced requirement for PAs to carry out work of a particular kind. Any GP partner who is a BMA member and is considering redundancy as an option in their practice, or who has questions regarding how to manage the employment relationship with their PA, can contact the BMA’s Employer Advisory Service BMA employment advice form – Contact us – BMA

Care Quality Commission MythBusters 

National Clinical Advisors and Policy Team have issued guidance GP mythbusters – Care Quality Commission to clear up some common myths about CQC inspections, as well as sharing guidance on best practice, which practices may wish to be aware of.

The following mythbuster has been added or updated in recent weeks:

 

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

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