Following the Flu Consortium Adjudication Meeting on 24th January 2000, we can announce that Solvay Healthcare will supply the LMC Flu consortium for the 2000 campaign.

A discount of 60% has been achieved on Solvay’s List price of £5.08 giving a cost per dose of £2.03 compared with £2.18 last year.

The consortium this year includes practices from Stockport, Manchester, Salford & Trafford, West Pennine, Wigan & Bolton and Cheshire. To date almost 120,000 doses have been provisionally ordered compared with the 45,000 last year.

It is clear that the success of last years campaign and the larger consortium have contributed to a keenly fought tender battle.

Terms and conditions of this years contract are much the same as last year. Full details will be available on the LMC Web page in the near future.

After long drawn out negotiations involving Social Services, the HA and the LPC we have managed to agree a protocol for the use of 7 day scripts.

Agreed by the full LMC, it is to be presented to the LPC and HA. Discussions emphasised that general practitioners were under no obligation under their terms of service to provide the service and that they would, on a discretional basis, only to vulnerable patients without carers to enable them to continue to live in the community.

The full protocol will be sent to all GPs as soon as possible. We now hope the monitored dosage system can be used in the community without overwhelming general practice.

We were pleased to receive a number of responses from practices recommending “Odd Job” persons. There details will appear on our Web Page in the very near future.

In addition we were delighted to receive the following correspondence from Dr Roddy Lennox at Woodley Health Centre:

Editors Comment:

Thanks very much for your e-mail. It is our intention to make all Newsletter, present and back copies available via the web site. As for e-mailing Newsletters, and saving paper that is certainly a consideration for the future once we get a feel for the numbers of our colleagues who regularly utilise e-mail facilities.

It appears the powers that be have not yet taken the hint that many clinicians are particularly unhappy with the arrogant act of naming the lecture theatre without consultation.

After canvassing opinion from our hospital colleagues the LMC officers have written to Linda Espey at Stockport Acute Services (who we gather is the appropriate person to write to) requesting that the lecture theatre should revert to its original name.

Ranjit Gill, our Chairman, forever the diplomat has suggested a compromise in that the other lecture theatre be named after a clinician who has been instrumental in establishing the Postgraduate Centre.

If you have any comments in respect of this issue please contact Keith Wells at the LMC Office.

We await the reply with interest. Read the next news letter for further instalments

There have been two documents published recently, which all GPs who have worries about what the future holds should read:

HSC 1999/246 Primary Care Groups: Taking the Steps

This sets out the Government’s agenda for general practice. Copies can be downloaded from the DOH web site at www.doh.gov.uk/coinh.htm

2. Primary Care Trusts: Implications for General Practice

This is a very well balanced paper from the GPC, which sets out the advantages and dangers of proceeding to PCT status.

In line with national guidance all pregnant women will, in the next few months, be offered HIV testing, as part of their routine ante-natal screening.

Those GPs who are closely involved in providing ante-natal care, (such as GP unit care) may therefore wish to participate in training to enable them to appropriately counsel women to make an informed choice regarding the option to have a HIV test.

As training programmes are established, we’ll keep you informed, but if you have any questions, please do call the LMC office.

Each year practices are encouraged to bid for a share of “cash limited GMS monies”. This financial year the Health Authority has around £4.7 million for this. These monies are for GPs to invest in their premises, computer equipment and staff.

Unfortunately each year some practices bid for a share of these monies to buy equipment, or engage staff, which the regulations do not allow for, such as autoclaves or counsellors.

If you are unsure whether your practice’s needs can be fulfilled by using GMS monies, please contact one of the LMC’s Officers who will be pleased to help you through the red tape.

Remember a one-way valve protects these monies. PCGs and the Health Authority shouldn’t use these monies for other than investment in general practice-these are funds for the exclusive use of general practice, so practices should now be formulating investment plans so that bids can be submitted by the second week of March.

Help wanted

The Stockport Disability Database needs your help to identify children with disabilities or special needs. GPs are probably some of the first people to meet them. The database already has 400 children on the register, but know there are about 150 as yet unidentified.

Practices can help by either:

Referring the children with parents’ permission to the database co-ordinator

Referring the children with parents’ permission to their health visitor

Giving the families a database leaflet

Passing The Stockport Database name and number to relevant families

Ring Elaine Mounter at the Disability Database, Springwood House on 0161 419 9937 for:

Discussions have commenced between the Health Authority and your LMC regarding the verification process for the Quality Scheme Payment introduced from April 1999.

Many Practices have been claiming the payment having certified that their practice will meet the criteria once established. We know that our practices on the whole provide the highest possible standards of patient care, however, it is certainly worth ensuring your practice will meet all areas of the soon to be introduced verification process as the Health Authority will be able to reclaim monies already paid to practices if they fail their inspection.

The inspection process will probably be linked to the Post Payment Verification Scheme ensuring all practices are inspected on a 3 year rolling basis.

Your LMC wishes to ensure all practices are incentivised to reach the standard and believes too onerous a standard in the early years may actually be counterproductive.

Discussions to date have established that practices with GP trainees and retainers should automatically qualify for the payment.

All practices will need to ensure their patients notes are filed neatly in chronological order. In addition it is likely that accurate summary details of Repeat Medication should be physically present within the notes at the time of inspection (a computer print out will suffice).

The third area of Chronic Disease Management will almost certainly be CHD which all practices should already be participating in.

Practices will need to achieve higher level target payments and certify that patients can obtain urgent appointments within 24 hours. Verification of the latter will be on an exception basis via the complaints received.

We will provide more details in our next newsletter, in the meantime, for further information please contact your LMC office.

Stockport Doctors Co-operative now covers 80% of Stockport GPs. It was established by GPs and is run by elected GPs.

It operates effectively and efficiently and coped with the double whammy of the millennium and flu outbreak without too much trouble with the flexibility which is one of the strengths of general practice. Even GPs who are not members acknowledge that the co-op has had a beneficial effect for all Stockport GPs on out of hours provision.

In the future attempts may be made by other organisations to gain control over the co-op.

The management board of the co-op should have the support of all GPs to resist this so they can continue to develop and provide an out of hours service for Stockport of the highest quality, without excessive bureaucratic interference.

Following on from last edition’s gas and electricity analysis, this time we take a look at alternative telecommunications suppliers. These can be used for Private and Business calls and there are substantial savings to make particularly when calling long distance or abroad.

Competition to British Telecom exists between traditional telephone service providers, through Cable & Wireless and practices or private customers can benefit from swapping between the providers particularly if they also take cable TV.

However, greatest savings can be made by rerouting either Long Distance & International Calls through companies such as ACC Telecom or First Telecom. This will usually involve the installation of a piece of technological wizardry to automatically reroute your calls along the cheapest route or the dialling of a prefix code to access the service. The table below details the potential savings to be made.

Your LMC is currently exploring the potential for a link up with the service providers listed below to offer practices the opportunity to benefit from cheaper telephone calls.

With the Chief Medical Officer’s recent (controversial) consultation paper “Supporting doctors, protecting patients” emphasising the difficulties that we face in general practice, relating to our own health and that of our staff we have begun to look, with the Health Authority, at the potential to develop an occupational health scheme for GPs and their staff. As part of the scheme we would like to pursue the idea of a GP (perhaps employed by the Health Authority) to provide locum cover for sickness or sabbatical study leave.

If any of you have an interest in the subject and would like to share you thoughts please contact us at the office.

If you have a practice web page and would like a free hypertext link from your Stockport LMC web page please let us know!

Send your web page URL to Paul Stevens on info@stockport-lmc.org.uk.

Let others see your creativity!

This is the mechanism through which the Government wishes to see investment in Primary Care. PCGs and the Health Authority, by February each year, should have in place detailed plans for Primary Care investment. Last year this effectively meant a roll over of the existing plans to spend GMS monies.

It seems this year that the amount of new, “growth” and “modernisation” monies, will be quite limited (surprise surprise!). You may remember the government announced a 3 year modernisation fund for the NHS of £21 billion, with monies being released for specific purposes each year.

For example one tranche of money was released last year to increase the number of Stockport GPs by, wait for it, 1, and another tranche was released to enable 1 surgery to be modernised.

PCGs and PCT(s) are meant as part of their central function to be investing in primary care. They have an obligation to consult the LMC on their plans.

Social Services are also supposed to have the approval of PCGs for their plans to spend their share of modernisation monies.

Our goal is to encourage our 3 PCGs to help practices invest GMS monies in both staff time and IT equipment to provide the improvements that the expected National Service Framework (NSF) for coronary artery disease will demand, as well as the demands of the mental health NSF.

Discussions with the Health Authority are progressing well regarding the introduction of an Incentive Scheme for General Practitioners who achieve high levels of target group flu vaccination.

Such a scheme will be an excellent example of Primary Care assisting the perennial Winter Pressure issues.

Your LMC has drafted a Business Plan in conjunction with the Health Authority which should be presented to Health Authority Management Team and the PCG Boards shortly.

It is likely that the process will commence with a simple audit during February / March of the 1999/00 campaign. Practice’s will be suitably remunerated for undertaking this work.

We will keep you informed of developments!

Following the Bristol Inquiry and the Shipman Case the public confidence in the medical profession has been tarnished.

The Government has set out in its White Paper, Supporting Doctors—Protecting Patients, a proposed framework for dealing with poor clinical performance. The message is clear be pro-active not reactive. Therefore dealing with performance issues at an early stage of development before they become a GMC referral.

Your LMC in conjunction with Stockport Health Authority and post graduate tutor, Dr John Adams, have formulated a panel whose function is to investigate and advise those small number of GPs, estimated to be 3-5 per Health Authority according to DoH statistics whose performance is a cause for concern. It is imperative that this procedure is objective and is not criticised for being a witch hunt.

There have been 3 meetings of the panel to date, and the panel is formulating criteria for referral to it. For further information please contact David Gilbert or Ranjit Gill at the LMC Office.

he DDRB pay award for GPs is 3.5%; there is no acknowledgement of increasing workload, and recruitment problems or the fact that we are falling further and further behind comparable professions.

GPs remind me of Boxer, who was the carthorse in “Animal Farm”. He was easily duped and his reaction to all problems was "I must work harder”

Hopefully, by the time you have read this newsletter our web-page will have clocked up over 100 hits!!

www.stockport-lmc.org.uk has undergone substantial development since its launch towards the end of November 1999.

It now carries a progress report on the current Flu Purchase Consortium along with the terms and conditions applicable to last year’s agreement.

Look out for new features planned for the Spring including details of your LMC representatives as well as the role of the LMC.

Please do visit the site and give us your thoughts and any ideas for future features or information.

Please send comments, articles or information to Paul Stevens at the LMC office or by Email to info@stockport-lmc.org.uk..