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GPs write to CCG to say they are stopping all 'unfunded' work

Exclusive GPs in Lincolnshire will stop offering non-essential services they not commissioned to provide unless they are given the cash to do so under a new LMC-led campaign, Pulse can reveal.

Around 100 practices in the area have drafted letters to CCGs notifying them of their intention to stop offering unfunded services, which could see them stop providing treatments such as ear care, ECGs and 24 hour blood pressure monitoring.

It comes as Dr Chaand Nagpaul identified the withdrawal of non-contractual work as a potential legal form of action that practices can take to reduce their workload in an email to practices, as Pulse exclusively revealed. 

Lincolnshire LMC's move represents the first reported example of an LMC going ahead with this organised form of action.

The LMC told Pulse it was currently in discussions with the CCGs in the county about the proposals, and hoped to resolve the issue by March 2017.

The LMC's members originally voted in favour of taking the action in February. It came in response to the Special LMCs Conference in January, which first mooted the possibility of GPs signing undated resignationsa move recently shot down by the GPC.

GPs in the region indicated they would not be willing to submit resignations, so the LMC proposed for members to stop doing unfunded work as a means of highlighting the pressure GPs were under.

Dr Kieran Sharrock, medical director of Lincolnshire LMC, told Pulse: ‘Our practices were feeling the pinch. We arranged a meeting in February to find out what sort of industrial action they wanted to take.

‘They didn’t want to strike or sign a mass resignation letter because they didn’t want to take any action which could harm patient care so they decided that they would look to stop offering non funded extra services.’

He added: ‘Staff felt that they shouldn’t be offering these services if they haven’t been commissioned to do so and wanted to ask commissioners to find alternatives. They don’t want to withdraw services but they cannot do everything.’

Dr Sharrock said that these services were already being commissioned elsewhere in the county, but that some GPs had been offering the services to benefit patients without being commissioned.

He added: ‘The ideal situation would be that the practices get commissioned to provide the services themselves because that would be better for patients. The GPC has been pushing for practices to refuse to do unfunded work. Most of the stuff which we are not being funded for should be funded – it is in other areas. These services should be standard across the country.’

Gary James, accountable officer of NHS Lincolnshire East CCG, said: ‘As CCGs we are talking with our member practices and the LMC in an effort to address practices’ concerns and find suitable solutions.

‘This may take time to work through, however, patient safety is always our first priority and we want our GPs to be able to continue to offer Lincolnshire patients a safe and high quality service.’

CGs with large deficits have been looking to cut local enhanced services offered by GPs in a bid to save cash.

Pulse found that three CCGs rated ‘inadequate’, NHS Kernow, NHS Walsall and NHS Shropshire were reviewing enhanced services in order to save extra cash this year.

Readers' comments (36)

  • I think many in LBGTQ community would be disappointed to hear comments from GPs belittling this issue and saying it is meaningless.

    It is not irrelevant for the patients who are missing out on vital care because someone has not considered it.

    If you don't want to ask 90 year old Maude or a night club bouncer that's fine. If you want to check your boiler and it is cold, I won't stop you.

    You may think patients would just volunteer everything; we know in reality this doesn't always happen in a lot of other contexts. How do you know if it is relevant and yet they don't feel comfortable telling you? It might give you a clue to some maladptive behaviours - eg depression, risk taking, substance misuse, etc. How would you know if you don't consider it?

    I refuse to believe Dr Cobblers treats all their patients in the same way and not give special attention to some vulnerable groups. I am sure Dr Cobblers also recognises that not all vulnerable people are "ill" either.

    Perhaps I have not made it clear, we are talking about sexual orientation, not gender identity. While they are not the same things, there are clearly some overlaps.

    I have heard enough complaints about their care from LGBTQ community to know it is important. What we need to work out is how to get this information - whether routinely eg on registration which means it is there already, or opportunistically which, like many new things, could be an awkward conversation until you have done it a few times.

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  • Groan

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  • CQC fees are high. How do they explain charging a practice for extra inspections that they describe themselves as for their own (CQC) 'control/ audit' purposes?

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  • The number of weird, counter intuitive findings of the ombudsman worries me. Nice to hear someone is trying to review them, but they seem dissociated from reality and less interested in facts than in conciliation. Not reassuring what standard of care are being set though.

    One recent example: £15k recommended to be awarded to a mum who let her 5 year old wander out of the consultation and out of the practice?!? Are we really to provide proactive emergency child care now?!?

    Ombudsman get your act together. And stop recommending financial awards for heavens sake!

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  • This is why Britain is full of foreign doctors. Medicine has lost it's attraction for home grown students who have better opportunities in other fields.
    The sad thing is Britain will always be able to find doctors from the nearly 3 millions doctors available elsewhere in the world.

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  • The trajectory seems clear. But what will the CCG or NHSE reaction be I wonder?

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