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At the heart of general practice since 1960

GPs to vote on introducing a 'fully salaried service'

GP leaders are set to vote on whether general practice should become a fully salaried service at the LMCs Conference later this month.

It is one of a number of potentially controversial motions to be debated at the conference on 21-22 May in London, including suggestions get rid of the QOF in its entirety, abolish the CQC and bring in a new ‘staff grade’ GP.

However, the salaried model motion from the Liverpool conference region is likely to be the most controversial.

It proposes that ‘conference believes that the model of the self-employed independent practitioner has been so eroded by the current contract and regulatory regime, that the GPC should be exploring the establishment of a fully costed and salaried GP service’.

The motion follows similar calls by former RCGP chair Professor Clare Gerada and NHS England (London), while NHS Hull CCG has also looked into developing a fully salaried model.

Other motions call on the GPC to include in the GP contract the potential of practices offering ‘top up’ private services to their NHS patients, with the motion from Gloucestershire stating that this would improve patient care.

Elsewhere, one motion calls for practices to be allowed to ‘declare major incidents and capacity shutdowns in a similar manner to A&E’, at the same time as calling for enough resources to ensure they can offer standard appointment lengths of 15 minutes.

The agenda is dominated by issues relating to workload and recruitment. One of the suggestions to improve GP recruitment is to introduce a ‘staff grade’ of GP, who are able to practise safely independently, but who have not reached the standard of the MRCGP exam.

It follows a row over the MRCGP exam, which international doctors’ groups said were discriminating against international medical graduates, leaving many GPs unable to continue practising.

The CQC - which has recently apologised for rolling out its ‘intelligent monitoring’ risk ratings, which unfairly branded practices as a risk to patients - is the subject of a number of motions, with the main motion to be debated demanding for it to be decommissioned.

GPs will also debate the abolition of a number of other bodies and services, including NHS 111, the unplanned admissions DES, QOF and co-commissioning.

Read the agenda in full here

Highlight motions in brief:

LIVERPOOL That conference believes that the model of the self-employed independent practitioner has been so eroded by the current contract and regulatory regime, that the GPC should be exploring the establishment of a fully costed and salaried GP service.

 

GLOUCESTERSHIRE That conference believes patient care would be improved were practices to be allowed to offer ‘top up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations.

 

HAMPSHIRE AND ISLE OF WIGHT: That conference supports the creation of an intermediate grade qualification for GPs, similar to staff grade in hospitals, to allow a career path for GP registrars whose practice is safe but does not reach the standard required for the MRCGP qualification, to avoid the loss of this potentially useful workforce to the profession.

 

AGENDA COMMITTEE to be proposed by DEVON: That, in the interests of the safety of patients and the health of GPs, conference demands that practices should:

(i) be resourced to limit the maximum list size to no more than 1500 patients per whole time equivalent GP

(ii) receive increased funding to be able to offer standard consultation times of 15 minutes

(iii) be able to declare major incidents and capacity shutdowns in a similar manner to A&E, supported by equal access to emergency resources at times of system stress

(iv) have the right to close their list when they alone decide it is unsafe to take on more patients

(v) be enabled to ensure GPs do not work beyond the legislated hours of the European Working Time Directive.

 

AGENDA COMMITTEE to be proposed by the GP Trainees Subcommittee: That conference calls on GPC to work with the RCGP to ensure the GP training curriculum encompasses:

(i) commissioning, management and clinical leadership skills

(ii) finance, business management and business skills

(iii) IT

(iv) health and justice

(v) resilience.

 

COVENTRY: That conference deplores the bureaucratic and incompetent nightmare of the CQC, and demands that it is

decommissioned forthwith and that the funding is reinvested in frontline services.

 

AVON: That conference calls on the government to abolish the unplanned admissions enhanced service for 2016/17 as it:

(i) lacks evidence as a policy

(ii) has not achieved its intended aims, as A&Es are inundated with patients and hospitals struggle to cope with demand

(iii) has meant clinicians have had to focus on processes and paperwork rather than on patients

(iv) puts GPs in medico legal danger

(v) was always destined to fail.

 

 

Source: LMCs Conference agenda

Readers' comments (77)

  • This is not GPs voting,this is LMC members voting.I for one do not feel that people who are in the LMC locally represent my views at all,they seem to belong to the establishment that are hanging us all out to dry.Thanks.

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  • No.

    End of.

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  • if it were salaried, then we would all have to work shifts (weekends and evenings), take a pay cut and have no say in how we run the business. This is all again not suggestive of grass roots GPs. I would welcome the loss of the quangos (CQC and the others who are cropping up left right and centre) and also lose CCG;'s so GP's can get on with their work of seeing patients and providing access.

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  • Nice day out it will be. Put the vote out to all GPs on the GMC register...that's democracy. By the way - all GPs are leaders, this is not an exclusive bunch.

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  • Turkeys - Christmas

    This is exactly what HMG want.

    If that is passed better to give up.

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  • That conference believes patient care would be improved were practices to be allowed to offer ‘top up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations.

    Or to put it another way, offer a two tier service to patients and top up their generous salaries. And where would the bandwidth for this extra work come from if they are all so overworked already? Whats that I can smell?

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  • independent contractor model works - full stop.

    its the terms and conditions, political stupidity that doesnt.

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  • This would be disastrous for General Practice as being fully salaried would erode the possibilities for local initiatives and innovation that is the main attraction of General Practice. The bureaucracy would increase massively and make any changes for local practices slow to implement. Of course Clare Gerada is in support she is a director of the Hurley Group, a slight conflict of interest!

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  • Are salaried GPs allowed to vote or is it just a fake vote ?

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  • Depends on what the salary is.What are the terms and conditions? Who`s going to buy the premeses and at what price? I`m not interested in working weekends , but for £500,000 I might think again - but even for that, not while Bristol City are playing ( especially after the season we`ve just had.) There are some things even money can`t buy !

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