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GPs go forth

In full: the letter that staved off GP mass resignation

The GPC has called off plans to ballot the profession on taking industrial action, after NHS England agreed to negotiate on a series of GPC demands. Read the letter in full

Sent by email

Date: 16th August 2016


Dear Chaand

General Practice Forward View and Urgent Prescription

Further to my letter of 20th July and our continuing discussions, I am writing to follow up on a number of issues.

As previously outlined, NHS England accepts the BMA’s Urgent Prescription as a good basis for further discussion and work on supporting general practice pressures, also noting that some of the proposals need greater detail. We have continued to discuss the areas that are included in the Urgent Prescription but not in the General Practice Forward View, set out in your Annex 2 which you shared with me. I would like to suggest that we discuss formally each of these 15 areas at the next LMC Reference Group so that we can consider and agree how each should be taken forward. I also suggest that relevant Urgent Prescription proposals are considered at the newly formed Primary-Secondary care Interface group, in which GPC will play a key role.

I would also like to update you that the NHS England Board had a discussion at its meeting on 28th July about general practice and the progress made to date and key next steps in implementing the General Practice Forward View. The Board clearly heard the comments made by Sir Bruce Keogh regarding the need to value and invest in general practice. The Board agreed to a package of immediate actions, that I had mentioned in my earlier letter, to strengthen general practice, ease the pressure on GPs and improve services for patients. This included:

  • the release of the first £16 million of the new £40 million Practice Resilience Programme;
  • the first phase of the three year £30 million general practice development programme;
  • proposals to reform indemnity arrangements, and
  • increases in the allowance payable under the Retained Doctors Scheme

In keeping with the Urgent Prescription proposals, and following the helpful discussion with the LMC Reference Group, on 28th July, NHS England, together with NHS Improvement, also wrote to all NHS Trusts, Foundation Trusts and CCGs to remind them of the six new standards for outpatient appointments and interactions between hospitals and practices now in force as part of the NHS Standard Contract. For example, hospitals will not be able to adopt blanket policies under which patients who do not attend an outpatient clinic appointment are automatically discharged, and hospitals will be responsible for communicating investigations results directly to patients.

We have also continued to discuss the STP process. As I mentioned in my previous letter, we will be enforcing the message that LMCs need to be engaged in local STP planning processes. As we have done with the plans for the practice resilience programme, I am committed to ensuring the valuable role and input of LMCs in STP processes and would be happy to receive feedback of any instances where this is not happening.

Further guidance on primary medical care finance input into STP planning requirements was also sent out last week. As well as setting out the key financial planning assumptions from now until 2020/21, this reiterated the crucial role of primary care services and that STPs should translate the aims and key elements of the General Practice Forward View into local plans.

I hope this provides a further helpful update.

Best wishes,

Rosamond Roughton

Director of NHS Commissioning


copy: Simon Stevens

Arvind Madan

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Readers' comments (7)

  • Not worth the appetite is written on. More action less words please

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  • That letter promises the square root of nothing. Read it carefully and tell me in hard detail what real things it promises will happen to relieve workload and financial pressures for all practices within the next 12 months.

    Thought so, you can't find it can you?

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  • Do GPs really know why they wanted to resign? Also, do they have the daring to do so? This shows GPs are not yet ready to put their money where their mouth is. This was the case in the past also when I was working.
    The stage has not yet arrived. Maybe, there will be a day when GPs will be desperate enough to go on strike. Till then, grin and bear it. Best wishes to all.
    Retired GP 6years.

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  • to Anonymous | Sessional/Locum GP03 Aug 2016 12:39pm

    think you're right, except its not training that is detrimental, its the way RCGP orchestrates it.

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  • All lies. My practice is going to the wall with one partner for 10k patients. NHSE have supportive words but no action. If we cant act because of various legal issues then what is the point to the GPC. Ultimately this whole mess will require action at an individual GP level. Are we all ready for that?

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  • So only £70M extra resources promised 'some time' in the future, and almost certainly not direct to GP practices, but to GP Federations.

    £70M is only 0.07% of NHS funding

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  • I attended the roadshow yesterday in London and despite keeping us from 7pm until 21:45 and asking many many times politely if they could provide detail, there was absolutely no concrete detail.

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