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Doncaster LMC Update: Achievements and Strategic Direction

Dear Colleagues
 
Doncaster LMC met on the 4th November 2024.  
 
Following a request from a constituent member the committee discussed our track record of delivering benefits for our membership.  We discussed whether or not our approach was pro active, appropriate, effective, and whether or not our strategy should change moving forward.  The committee has been asked by the constituent member who raised the question to provide formal feedback. The committee has further asked for this feedback to be widely disseminated to member practices. 
 
Over the years, Doncaster LMC has evolved significantly to align with the needs and feedback from local practices. Our role as a “critical friend” has been carefully balanced—remaining assertive without becoming confrontational, and collaborative without compromising our advocacy. Our priority is to build and maintain respectful, productive relationships with partner organisations and commissioners, enabling us to be heard and respected as an influential voice in healthcare discussions at local, regional, and national levels.
 
Our achievements include negotiating all current local enhanced services and shaping impactful programs such as shared care, proactive care, wound care, and the severe mental illness (SMI) local enhanced services (LES). We have also been steadfast in minimising the shift of resources out of General Practice while preventing unsustainable workloads from being pushed in. This intentional strategy seeks to stabilise resources, avoiding the pitfalls of temporary funding followed by abrupt withdrawals, as observed in other areas across England.
 
In response to the challenge of change fatigue across the NHS, Doncaster LMC has advocated through our presence on the General Practitioners Committee (GPC) for long-term investment strategies, contributing to the development of the NHS Five-Year Forward View.
 
Our role as an innovator has been underscored by initiatives like the national Veteran-Friendly Practice scheme which originated from Doncaster LMC, the Primary Care Capacity and Demand Tool which remains the leading primary care stress test to align formally with the national OPEL standard, and the £20,000 “new to practice” incentive, which also originated from Doncaster LMC—all of which have set benchmarks in supporting General Practice. Additionally, we have championed the integration of pharmacists within GP practices as first-contact practitioners, prescribers, and medication management facilitators. Our alignment with national pharmacy unions is unique and enhances our advocacy for pharmacists’ roles in General Practice.  The new national standard for non GPs to issue FIT notes which came in force during the Covid-19 pandemic was also based upon a Doncaster LMC proposal. 
 
We are committed to informing practices about their contractual rights and obligations, empowering them to make choices about the services they deliver. Some practices opt to deliver beyond contractual requirements, accepting potential financial trade-offs, while others operate strictly within contract boundaries. Doncaster LMC respects both approaches without bias, supporting practices to make these decisions based on their specific needs.
 
Importantly, we operate with a clear understanding of our role as a non-union body. While some LMCs have recently faced legal scrutiny for encouraging specific actions during the BMA-led national initiative, our cautious and legally sound approach has shielded Doncaster LMC and member practices from similar risks. We have provided practices with a template letter for withdrawing from non-contractual “goodwill” services, a practice recently endorsed by the BMA for wider use.
 
Following consultations, feedback indicated that most local practices currently prefer a collaborative approach with commissioners, and so we will continue to advocate constructively. However, should the pressures on practices escalate, we are prepared to shift to a more assertive stance—pending collective readiness among practices for a united action.
 
Our aim is to continue fostering stability and growth within Doncaster’s primary care landscape, ensuring our members are fully supported in delivering sustainable and effective patient care.
 
At our meeting on the 4th November 2024, the committee reiterated unanimous support for this current approach
 
Kindest regards,
 
Dean

Temporary changes to Audiology Services at Doncaster and Bassetlaw Teaching Hospitals

Since October 2nd the Trust has been temporarily limiting some of its diagnostic activities and hearing aid services for both adults and children as part of a broader improvement plan.  This includes both adult and paediatric audiology services delivered by Doncaster and Bassetlaw Teaching Hospitals.

During this period, urgent cases will be prioritised, and DBH will be working closely with neighbouring providers in South Yorkshire and Nottinghamshire to ensure patients who need immediate support can continue to access services. 

Practices should continue to refer patients to the service as the Trust will hold referrals as a central point of contact.

Despite these changes, essential services such as hearing aid repairs, tinnitus clinics, and certain diagnostic tests like Auditory Brainstem Response will still be provided.

Full services are expected to resume early in the new year.

What this means for your patients: If you are contacted by a current patient of the Trust’s Audiology service, please advise them that colleagues from DBTH will be in touch directly, either by phone to arrange an urgent consultation or by letter, to provide updates about their ongoing care. If patients have concerns, or wish to raise a complaint, during this time, they can contact the Trust’s Patient Advice and Liaison Service (PALS) for support.

What to do if you have concerns about a patient: If you are concerned about a patient whose condition has deteriorated, please speak directly with the Audiology service for escalation and to discuss appropriate next steps, which will include potential mutual aid from neighbouring providers in South Yorkshire and Nottinghamshire.

Switchboard

Switchboard is the national LGBTQIA+ support line. For 50 years, their volunteers, who all identify as LGBTQIA+, have been available to discuss anything related to sexuality and gender identity; whether it’s sexual health, relationships or just the way someone is feeling. Switchboard’s support line is completely free, and available on the phone, via chat or email. 10am-10pm every single day.

 

Phone: 0800 0119 100 Chat: www.switchboard.lgbt Email: hello@switchboard.lgbt

Access the Meals on Wheels UK Map to help connect communities with Meals on Wheels services across the UK

This online map is free to use and is designed to help individuals and professionals across the UK easily find Meals on Wheels services.

You can explore the map in the unique Meals on Wheels UK website:

https://mealsonwheelsuk.org/

We also invite you to watch the launch webinar, which provides valuable context on why we developed Meals on Wheels UK and a demonstration of the website’s features. In the webinar, we also highlighted the community-wide benefits of using Meals on Wheels UK and our plans to ensure long-term sustainability of the resource. 

How this map can benefit you: We have created the map with several audiences in mind, and we encourage you to explore how it can best support your needs:

  1. For adults in the UK considering Meals on Wheels, their carers, and the wider public:
    Use the map to find providers that deliver directly to your area and access valuable information on the services available.
  2. For Meals on Wheels providers, health and social care professionals, commissioners, and policymakers: 
    The map serves as a hub for information, helping you connect with other providers, refer adults to services, and make data-driven decisions to improve service delivery.

Specific ways the map can support your work:

  • Adults with care and support needs: Find providers who can deliver meals to your home.
  • Carers: Find Meals on Wheels services for the adults you care for.
  • Healthcare, social care, and social work professionals: Easily find Meals on Wheels services to refer adults to.
  • Meals on Wheels providers: Connect with other providers, exchange good practices, and build a stronger network.
  • Commissioners and policymakers: Identify gaps in provision and use the map to inform decision-making for service enhancements.

The Meals on Wheels UK website also has a wealth of information and resources relating to Meals on Wheels, which we invite you to explore free of charge. 

With best wishes,

Dr Angeliki Papadaki

Associate Professor in Public Health Nutrition
School for Policy Studies, University of Bristol

Covid-19 vaccination service site sign up

Providers who wish to deliver the Covid-19 vaccination service from their healthcare premises from 1 April 2025 are invited to submit a request through the NHS Business Services Authority webpage. Providers whose existing contracts expire in March 2025 will need to re-apply via this process. Providers whose contracts extend to 31 March 2026 do not need to re-apply. Single practice primary care networks can now apply through this process.

Survey into the awareness and use of cauda equina syndrome guidelines in primary care

Jonathon Gill a National Institute for Health and Care Research Pre-doctoral Clinical and Practitioner Fellow, is currently running a research project which includes a national survey into the awareness and use of cauda equina syndrome guidelines in primary care. This project has ethical approval by the Health Research Authority.

He is keen to gain a representative sample of all clinicians working in primary care.  Please see the details and link to the survey below:-

 

Do you know how to manage patients with suspected cauda equina syndrome in primary care?

Help us advance practice by filling in a short survey (under 10 mins) on the use of cauda equina syndrome guidelines in primary care.

We are looking for:

  1. NHS clinicians, that
  2. Work in a primary care setting in England, and
  3. Assess or manage people with low back pain

Please follow this link for further details: https://forms.office.com/e/pSjHUp55h4

Cauda Equina Syndrome Guidelines in Primary Care (office.com)

GP Contract changes and implementation.

Please see below a summary of GP contract changes:

  • The Global Sum has been uplifted to £112.50 per weighted patient for GP practices to implement the DDRB uplift. • Locum reimbursement rates have increased, along with the pay elements of workforce-related transformational funding.
  • Newly qualified GPs could be recruited as part of the Additional Roles Reimbursement Scheme (ARRS), and Primary Care Networks (PCNs) can request the funding as outlined in the updated PCN Contract Directed Enhanced Service (DES).
  • Other PCN funding streams have been increased to reflect the DDRB uplift: core PCN support, the Care Home premium service and the enhanced access service.
  • The maximum reimbursement rates for existing ARRS staff have been uplifted to align with Agenda for Change pay scale uplifts.

General Practice Annual Electronic Self-Declaration (eDEC)

The electronic practice self-declaration (eDEC) is a mandatory collection which all GP practices in England must complete every year. The revised version was published on 11 October – read more here General Practice Annual Electronic Self-Declaration (eDEC) – NHS England Digital.

National Insurance Calculator

The BMA recently launched their National Insurance (NI) calculator, along with other resources that can be used to lobby for financial solutions to the rise in NI and national living / minimum wage from April 2025. The calculator is accessible to BMA members only. LMCs are being asked to promote its use, as the more figures the BMA gets back the more they can lobby politicians and in the media. All of the information is on a central hub here National insurance blow for GPs (bma.org.uk) .

BMA Pressure to phase out of the Physician Associate role in General Practice

Following the publication of the GPC and RCGP guidance Physician Associates in general practice: Scope of practice (rcgp.org.uk) on the role of physician associates, the General Practitioners Committee (GPC) UK met and discussed the role and safety of Physician Associates in General Practice. The committee overwhelmingly voted in favour of the motion below:

This meeting believes that the role of physician associates in general practice is fundamentally unsafe and:

  1. there should be no new appointments of physician associates in general practice 2. the role of physician associates in general practice should be phased out Page 4 of 4 S:Newsletters/NL Nov24 3. the role of a physician associate is inadequately trained to manage undifferentiated patients, and there should be an immediate moratorium on such sessions. The British Medical Association (BMA) believes that those in existing Physician Associate roles should be given opportunities to retrain into more suitable NHS roles, including the appropriate undergraduate and postgraduate training in medicine. Read the full press statement here GPs vote in favour of phasing out physician associate role in general practice – BMA media centre – BMA.

Respect

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