Junior Doctor strikes
Key dates: 13, 14 and 15 March
Junior doctors are taking strike action in 2023 to:
- to achieve full pay restoration to reverse the decline in pay faced by junior doctors since 2008/9
- to agree on a mechanism with the Government to prevent any future declines against the cost of living and inflation
- to reform the DDRB (Doctors’ and Dentists’ Review Body) process so pay increases can be recommended independently and fairly to safeguard the recruitment and retention of junior doctors.
The 72-hour walk out is the first round of action.
This means that junior doctors are not expected to attend any shifts starting after 6:59am on 13 March. They will be expected to resume shifts starting from 7am on the 16 March.
GP Registrars are classed as junior doctors.
You do not have to be a BMA member to be involved in this strike action.
It is perfectly legitimate to ask a staff member if they intend to participate in strike action, but there is no obligation for them to respond or to proactively inform an employer.
Update on the Digital Firearms Flag
The digital firearms flag will soon be relaunched on SystmOne (TPP) and EMIS Web (EMIS) systems and is scheduled for deployment on Cegedim/Vision systems in March 2023. We anticipate the relaunch to take place towards the end of January. The digital marker and flag have been tested and brought before the Joint GP IT Committee since being taken down in July 2022. GPs should add the appropriate Snomed code to a patient’s record when they receive notification of a firearms certificate application or when a certificate is granted, and this will automatically add a marker to the patient’s record. If a potentially relevant condition of concern is added to their medical record during the application process or after a certificate has been issued, an alert will pop up. Further information will be announced in due course via the BMA and NHS Digital.
Reduce risk of heart attacks and strokes with statins
Draft guidance from the National Institute for Health and Care Excellence recommends that the risk threshold at which statins should be offered to prevent cardiovascular events such as heart disease and strokes remains unchanged, but they can also now be considered for people at a lower threshold. For further information please click the link below
Patient access to health information
Practices yet to switch on access to patient records are encouraged to use the resources available on FutureNHS and the NHS Digital website, particularly the readiness checklist and SNOMED code flowcharts. For further information please click on the link below:
Voting is now open for seats to the General Practitioners Committee (GPC) in the Barnsley/Doncaster/Rotherham/Sheffield region.
To submit your vote for any of the above seats please visit BMA Online Nominations and Elections https://elections.bma.org.uk/. (The deadline for voting 12pm Thursday 30 March 2023).
To be eligible to stand or vote in a constituency, you must be one of the following:
- a GP engaged exclusively or predominantly in providing personally or performing
- NHS primary medical services for a minimum of 52 sessions distributed evenly
- over six months in the year immediately before election*
- a GP on the doctors’ retainer scheme
- a medically qualified LMC secretary.
Voting is open to members as well as non-members. To vote, non-members are required to have a BMA web account. If they do not have one they can please click here to create one. They should then click the link to ‘request a temporary non-member account’ and email their temporary membership number to email@example.com to get access to vote in this election. It is essential that they email their temporary number to the elections inbox as voting access is granted manually. If you have any queries regarding the election process, please contact firstname.lastname@example.org
Election statement - Dr M Rahim
I need your vote.
We all know that NSH is struggling and primary care, being the foundation of the NHS, is struggling even more. It is creaking under the unmanageable workload and dwindling resources and workforce.
The people who make policies are repeatedly failing to see and understand the problems that we face daily. It is no surprise that some of our colleagues have voted to strike just to have their voices heard.
There exists a clear disconnect between the grassroots of our profession and our leadership that urgently needs to be bridged.
We need someone new to represent us who is unsullied by political wrangling. Someone from the coalface who has lived these challenges day in and day out. Someone who is willing to speak truth to the political elite about what is happening to General Practice. That is why I am standing for election to represent you at the British Medical Association.
I have been a GP in South Yorkshire for 12 years and have recently joined my LMC to enable me to speak out for our profession and patients.
I have lived the challenges of general practice, having spearheaded a merger with two neighbouring practices, to pool resources and maintain the level of care that our patients deserve.
I have leadership experience as a GP Partner and retired Director of Primary Care Doncaster, our local federation of practices.
I have unique knowledge and experiences that allow me to speak truth to power and advocate for the solution of problems we face.
A vote for me to represent you at BMA would be a vote for your voice to be heard, for our problems to be highlighted, and for a solution to be sought.
To vote for me, you must be a GP, engaged exclusively or predominantly in providing personally or performing NHS primary medical services for a minimum of 52 sessions distributed evenly over six months in the year immediately before election: a GP on the doctors’ retainer scheme or a medically qualified LMC secretary.
You can log in to your BMA account, go on to this webpage to vote for me and make Yorkshire shine: https://elections.bma.org.uk/userVoting/GetAllSubElectionVoting/1919
Dr M Rahim
Local GP Retirement
After 43 years Dr Ravi Nayar is retiring at the end of this month.
He started a new single handed GP Practice in February 1981, then known as The Bungalow Road Surgery and was soon joined by his wife Dr Humera Nayar. Sadly, Humera suddenly died in early 2018.
They moved to the Martinwells Centre premises in 2009 and the partner’s decided to name it The Nayar Practice.
Dr Nayar has been part of FPC, PCG, PCT, CCG and now ICS
Dr Martin Cassar and his wife Dr Mona Cassar, (Dr Nayar’s elder daughter) joined the Practice about twenty years ago.
Dr Nayar will be sadly missed and we would like to thank him for the 43 years of service he has given to Doncaster and wish him well in his retirement.
7 day medicines initiative
“A Doncaster wide initiative” from Community Pharmacy Doncaster (LPC) supported by Doncaster LMC
Over the years, the NHS has moved towards adopting the Electronic Prescription Service (EPS), which has given rise to an expectation that a prescription will be ready shortly after it has been requested.
Sadly, it is not possible to have every patient’s prescription ready for collection as soon as the EP is sent.
This is because there are several complex checks and steps that need to take place to ensure the right drug is sourced, checked, and dispensed to the right patient. Further, community pharmacy is establishing an extended role with patients to support primary care and needs more time to be able to do this safely.
48 hours between prescribing and dispensing of repeat medicines is not consistently possible.
We are moving to a 7 day prescription order & collection timeframe for regular repeat prescriptions. Please note, that the 7-day timeframe does not apply to acute or urgent medication.
We have taken time to engage with patients, pharmacy providers, LPC and LMC
We fully appreciate that there are organisational and workload consequences to this change.
We have been reassured that your LMC will support you to understand any adjustments that you may choose to make to facilitate this initiative.
We will roll out this initiative slowly over 2-3 months to ensure that we maintain patient confidence in the service and to maintain overall system stability. Local pharmacists will be working hard to support this change and to alleviate anxieties and solve unforeseen problems.
We are aware that you may have some concerns about these changes
The first prescription following the change will need to be issued 10 days early. Subsequent prescriptions will follow the usually 28-30 day pattern and therefore will not result in chronic stockpiling of medicines.
Primary care team members who process prescriptions will need to know about the changes to ensure that prescription requests are not accidentally rejected when the patient is ordering their medicine 10 days in advance, for the first prescription.
Particular care will need to be made of checking requests for controlled drugs.
If you have any questions relating to the information in this letter, please do not hesitate to contact your Local Pharmacy Team or Doncaster LMC.
With thanks in anticipation of your support in this matter.
Changes to the GP contract 2023/24
- The Delivery Plan for Recovering Access to Primary Care will be published shortly and sets out how practices and PCNs can be supported to improve access during 2023/24.
- To ensure consistency in the access that patients can expect, the GP contract will be updated to make clear that patients should be offered an assessment of need, or signposted to an appropriate service, at first contact with the practice. Practices will therefore no longer be able to request that patients contact the practice at a later time. The IIF focus on access will support practices and PCNs working towards achieving this during 2023 recognising the changes that will need to be made.
- To make it easier for patients to access their health information online without having to contact their practice, the GP contract will be updated so new health information is available to all patients (unless they have individually decided to opt-out or any exceptions apply) by 31 October 2023 at the latest.
- All practices need to be aware, that from the end of 2025, all analogue ISDN and PSTN lines will be removed for use in all home and business settings. From this point, only cloud-based platforms will be supported. A Better Purchasing Framework (BPF) has been developed by NHS England to provide recommended suppliers and assure value for money. As part of the 2023/24 GP contract changes, practices will be required to procure their telephony solutions only from the framework once their current telephony contracts expire.
- The number of indicators in the IIF will be reduced from 36 to five (worth £59m) and will focus on a small number of key national priorities: two indicators related to flu vaccinations, learning disability health checks, early cancer diagnosis and 2-week access indicator.
- The remainder of the IIF will now be worth £246m and will be entirely focused on improving patient experience of contacting their practice and receiving a response with an assessmentand/or be seen within the appropriate period(for example same day or within 2 weeks where appropriate, depending on urgency). 70% of the total funding, equating to £172.2m, will be provided as a monthly payment to PCNs during 2023/24via the Capacity and Access Support Payment.
- The remaining 30% of the total funding, equating to £73.8m, will be assessed against an access improvement plan agreed with the commissionerin quarter 1 of 2023/24. At the end of March 2024 ICBs will assess for demonstrable and evidenced improvements in access for patients and then award funding. ICBs will be provided with guidance to assist in determining the appropriate payment.
- In 2023/24, all the QOF register indicators points will be awarded to practices, based on 2022/23 outturn once finalised, releasing £97m of funding and reduce the number of indicators in QOF from 74 to 55 (a reduction of 25%). Two new cholesterol indicators (worth 30 points~£36m) will be added to QOF along with a new overarching mental health indicator. One indicator(AF007) will be retired and replaced witha similar indicator from IIF in 2022/23.
- This year’s QOF QI modules will focus on workforce wellbeing and optimising demand and capacity in General Practice with an emphasis on using data to analyse potentially avoidable appointments and build on care navigation and use of wider workforce or local services to reduce pressure on General Practice.
- To support PCNs to recruit the teams that they need, there are a number of changes to the ARRS, including adding Advanced Clinical Practitioner Nurses to the reimbursable roles, increasing the cap on Advanced Practitioners to three per PCN and removing the caps on Mental Health Practitioners.
- During 2023/24 NHS England will review the ARRS to ensure that it is tailored to deliver future ambitions for general practice. Staff employed through the scheme will be considered part of the core general practice cost base beyond 2023/24 as previously confirmed, and PCNs can offer permanent contracts where appropriate. We encourage PCNs to continue to recruit, making full use of their ARRS entitlement.
- There will also be changes to childhood vaccinations. These include the removal of the vaccination and immunisations repayment mechanism for practice performance below 80% coverage for routine childhood programmes along with changes to the childhood vaccination and immunisation indicators within QOF which will see the lower thresholds reduced to 81% -89% (dependent on indicator) and the upper thresholds raised to 96%.