Don’t miss the Stockport LMC & Consultants’ Summer Ball!

Mottram Hall, Mottram St Andrew, near Prestbury, Cheshire is the splendid setting for the first Stockport Consultants and GPs Summer Ball.

Tickets priced at only £30 per head are available from the LMC Office, and over night accommodation can also be arranged at specially negotiated prices. Contact Paul Stevens for further details (Old Telephone Number).

Weather permitting the evening will commence with a drinks reception in the gardens, followed by dinner. Entertainment will be provided by way of a live band and disco.

Naturally for such an occasion, attire will be Black Tie.

A schedule showing details of the two successful bids is displayed on page 3. As can be seen, Solvay is the best offer, marginally better on profit per dose and better terms and conditions across the board including up to 6 months credit.
An innovation this year is that both Wyeth & Solvay are offering to pay an additional sum of money to the consortium to cover “administration”. This effectively makes the Consortium more competitive than a single practice buying once the consortium has distributed these monies to practices.
Given the very small difference in profit per dose between Solvay & Wyeth it has been decided to offer all practices the option of either tender or a 50/50 combination of both.

All practices who have taken part in the consortium in previous years should by now have received a letter explaining how to order for 2001. Please contact the office if you have not received this documentation or wish to take part in the consortium for the first time this year.

There are currently 17 LMC members (one vacancy), 6 for North Stockport, 5 for West Stockport and 6 representing East Stockport. Taken into account the numbers of GPs in each of the three areas an equitable distribution of members would be North Stockport (5), East Stockport (6) and West Stockport (7).

The LMC membership will debate and decide upon the election process at its June meeting and details will be announced shortly thereafter. It is anticipated that the elections will take place in June or July this year.

Your LMC Officers can be contacted by email at the following addresses:

Dr Ranjit Gill ranjitgill50@hotmail.com

All email addresses are avilable by hypertext link from our Website—www.stockport-lmc.org.uk.

Your GPC representative is Dr Malcolm Fox.

For your further information, your LMC Officers are detailed below by PCG.

Follow this link to find your LMC Officers detailed by PCG.

No prizes this month, answers will be available in our next edition, however for those of you that cannot wait answers will be available on our website following publication of this edition. Follow this link.

Now may therefore be the time to review your Locum Insurance Policy to ensure you are adequately covered in case of sickness or disability.

Remember a locum will cost you approximately £800 per week, and whilst the Red Book will allow a full time GP (subject to length of service) to claim approximately £450 per week for the first 6 months of disability and £225 per week for 6 subsequent months (providing your list size is greater than 2,700 patients per remaining full time partner) this will not be enough!

Insurance Brokers specialising in the provision of locum insurance can offer cover tailored to meet a practitioner’s need taking into account whether they would qualify for red book locum reimbursement, are single handed or to include varying deferment periods.

For example if you qualify for locum reimbursement you may look to cover of £400 per week deferred for 4 weeks and a further £200 per week deferred for 26 weeks. Before discounts this could cost approximately £35 per month.

Your LMC is currently looking to negotiate preferential rates for Locum Insurance. For further information please call Paul Stevens at the LMC office.

General Practice Surgeries are valued tri-annually by the District Valuer. The rental value they put on the premises is invariably on the low side.

General Practice surgeries should not be valued as domestic nor office accommodation, but they should be valued as general practice surgeries, as they need investment and conversion to make them fit for the purpose. This is the policy of the Royal Institute of Chartered Surveyors. It benefits practices in particular and the profession in general if all tri-ennial rent reviews are handled by a surveyor who is experienced in this field.

Even if the valuation is carried out when there is a cost rent in operation, it means that each time the valuation is carried out you have a higher base. The District Valuer, when assessing the value of surgery premises, will also take into account the rents of surgeries in that area. Therefore, if several practices in one area use a professional to negotiate the rent and the other practice does not, the latter will not only have their rent reduced, but also have a knock-on effect of having other rents reduced.

The LMC can suggest suitable local surveyors who are experienced in these matters and who have had good results with the District Valuer. For further details contact either Dr Keith Wells or Paul Stevens at the LMC office.

Your LMC has received and submitted the following motions to this year’s London based LMC Conference (June 20/21).

1. This conference urges the GPC negotiators to immediately bring to the attention of the Chancellor of the Exchequer and the Secretary of State for Health the tidal wave of resentment amongst GPs about the pittance offered as a pay rise by the DDRB.

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The LMC is represented by Drs Gill and Gilbert, the Health Authority by Jan Hewitt, Clare Parker & Dr Rebecca Baron, the CHC by Annette Donegani & the Hospital Trust by Dr Shirley Remington. Should problems of clinical practice be a concern a Manchester University developed assessment is offered to the Practitioner to help identify areas of practice that can be developed. A team of local GP mentors is being trained to support practitioners subsequent to the assessment. Thereafter, a review of performance takes place.

The process is intended to helpful to Practitioners, to genuinely "Support doctors & to protect patients". The new Clinical Assessment Authority established this year expects some local assessment process before any referral occurs.

If you would like to know more contact either Ranjit Gill or David Gilbert.

This would have massive implications, not least if NHSD failed to cope when there be nothing to fall back on. The Coops would have been dismantled to a great extent, especially as regards call handling. Who knows what would have happened to deputising. Who knows what would happen full stop. AND, remember, you would still have 24 hour responsibility which could leave you getting out of bed at 3am like the bad old days. As it happens this recommendation has been scrapped!! Put on hold sine die! So much for the pivotal change proposed. We can, and my advice is that we should, stay exactly as we are so far as our Coop/OOH structure is concerned.

Recommendation 6: All providers of OOH should put in place appropriate systems for call abandonment, time taken to answer the call, call recording and the recording of all clinical consultations.

This will be very expensive, prohibitively so for single-handers or small groups.

Recommendation 11: Every arrangement involving a GP devolving OOH to an OOH provider should only be entered into with an accredited provider approved by the PCT/G.

My hope is that the PCT will accredit only the best and not all those who come up to a minimum standard.

Recommendation 12: The GP contract to be modified to allow devolved responsibility for OOH to an accredited organisation, but where that organisation fails to meet appropriate standards the HA should, in the last resort, return the 24 hour responsibility to the GP.

This has caused great confusion. It does NOT suggest we abandon 24 hr responsibility. It actually restates the status quo. However, it does raise the spectre of Banquo at the feast. What has he got to do with it, you ask?. I’ll tell you, and ignore me at your peril. Cast Banquo in the role of 24 hour responsibility and yourself in the role of Macbeth. You don’t like him much so you have the BMA put him down. Where does that leave you? Devoid of your previous power. Banquo will haunt you when you are feasting on spam and chips because you can’t afford the langoustine. The Government will have you by the wot-nots and there will be no way back. You will be as assertive as a chicken in a boneless chicken farm. Don’t assume that you will be able to tell the nice friendly Government that you work very hard in the week and are too tired. Or that you have a young family, or that you are too senior, or whatever is the current “out”. Hospital doctors can’t do that and soon there are to be CONSULTANT operating sessions on Saturday and Sunday at Stepping Hill. Imagine warning about that 10 years ago—you would have been thought mad.

It is anticipated that 13 GPs will stand for the 7 available places on the PCT Executive Committee. Each candidate will prepare a brief personal statement which will be circulated to all GPs along with the official ballot papers during week commencing 8th May 2001.

Completed ballot papers will be collected from each practice between 12 and 12.30 pm on Monday 21st May and subsequently counted in the Seminar Room at Springwood House at 2.30 pm. To ensure your vote is counted please arrange for the completed ballot papers to be available for collection from reception. It is understood Professor Sam Moore, Dr David Bostock and Mr James Dunlop (PCT non-executive member) will supervise proceedings.

It is understood that other PCT Executive Committee appointments are following a similar process across the same timescales and it is anticipated that the PCT Executive Committee will be able to meet for the first time by the end of May.

Your LMC has also been informed that the first round of interviews for the post of PCT Chief Executive were unsuccessful. As a result the post has been reassessed and, we understand, re-advertised at a salary in the region of £85,000 - £90,000, considerably greater than that previously advertised (c£60,000). 

We must consider this encouraging. Your LMC has long been advocating the fact that leading possibly the largest PCT in the country is a task for a high profile experienced chief executive, and it is hoped that the new salary scale will attract a candidate of the right calibre. The next round of interviews will take place on 10th May.

During the interim period, in line with National Guidance, the (acting) Chief Executive of the Health Authority, Mrs. Jan Hewitt will also act as caretaker PCT Chief Executive. Dr Stephen Watkins, Director of Public Health will act up as Health Authority Chief Executive during this period.

The BMA's General Practitioners Committee issued the following statement on 5/4/01:

GMS GPs who choose to follow this advice are not in breach of their terms of service, but PMS GPs should check the terms of their contract.

In an attempt to resolve the issues which have stalled negotiations on the introduction of annual appraisal for family doctors, GP leaders are to meet Minister of Health John Denham. Dr John Chisholm, chairman of the GPC and representatives from the GPC negotiating team will meet with John Denham in an attempt to make progress on appraisal issues. A sticking point in negotiations to date has been the GPC's insistence that annual appraisals must be fully resourced and funded. There are also disagreements over the independence and quality assurance of the process.

The time scale for introduction of appraisals for GPs has already slipped. In the NHS Plan launched in July last year it was announced that annual appraisals would start in April 2001. The appraisal scheme is now scheduled to be introduced during the coming 12 months.

Dr Hamish Meldrum, joint Deputy Chairman of the GPC said: "We are relieved that the Minister has belatedly recognised GPC concerns that progress in appraisal discussions had got bogged down." Appraisal is seen by the Government as a quality of service issue. Dr Meldrum said: "We share the public's concern that they want to be treated by well qualified up to date GPs. But the Government cannot expect that family doctors who are already overworked should take on the additional burden of appraisal without the necessary protected time and proper resourcing to do it."

The GPC in a joint discussion document with the RCGP has calculated that to cover the work necessary for annual appraisal, an extra 3000 family doctors will be needed if the present level of patient care is to be maintained.

Dr Meldrum said: "GPs are happy to prove to patients that they are offering a high quality service, but while they are doing this patient care has to be maintained. That is why GPs must have protected time and adequate resources for the appraisal process."

For those of you who are tempted to work till 65 for Mr. Milburn’s £10,000

Actuarial figures show that if a GP retires at 60 he can expect to live to 77, thus he or she will draw a total pension of £595,000 at present day values. If he or she retires at 65, life expectancy is reduced to 68 and the pension is therefore drawn for an average of 3 years (or £105,000)

According to our calculations, allowing for Milburn’s £10K, the government is making a gain of £480,000 per GP.

Is this a form of stealth tax?

The need to provide GMS services, in a secure environment, to patients who have a history of adopting threatening or vexatious behaviour towards GPs and their staff has resulted in the establishment of a Local Development Scheme for Stockport. Working alongside the Health Authority your LMC is pleased to announce that the first phase of the scheme will be operational from April 2001.

Initially, one practice (maximum 10 patients at anyone time) has been identified as the recipient of the first patients removed from a practice list as a result of violent or vexatious behaviour towards a GP or his/her staff. Security issues at the practice have been addressed and recommendations are now being implemented. Since the extent of patients of this nature can not be clearly identified from current statistics a fairly tight definition of violent / vexatious will need to be operational. It is hoped that further practices will be recruited, preferably one in each PCG area, as time passes and demand dictates.

Full details of the scheme will be sent to all practices in the very near future .

Are you one of the 41 Stockport Practices yet to spend all their Prescribing Incentive Scheme monies??

The monies can be spent on anything that will improve patient care. Examples include vaccine fridges, examination lamps, drugs cabinets or practice computer equipment.

To see if you have unclaimed monies call Sue Chambers on (419 5432) or Paul Stevens at the LMC office.

Your LMC has been advised that the new non—obstetric Ultrasound Service, provided by Ultrasound Now!, available to all Stockport practices has enjoyed an excellent first month. Over 120 patient appointments have taken place.

With a waiting list of less than 3 weeks the service is sure to prove popular. For further information contact your old PCG leads or Paul Stevens at your LMC office.

I am pleased to have received numerous enquiries from practices regarding our Zoladex consortium.

To participate practices should call Farillon on 01708 330202. All Stockport practices have been flagged on Farillon’s database to ensure all practices benefit form the specially negotiated terms and conditions.

For further information regarding how your practice can make money from self administering Zoladex please call Paul Stevens at the LMC Office (Old Telephone Number)