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GPs go forth

LMC issues 'black alert' and commits resources to GPs after CCG cuts funding

An LMC in the East of England has issued a ‘black alert’ for GP practices after the local CCG cut its general practice funding. 

Cambridgeshire LMC said cuts to financial resources for practices and 'unprecedented' pressure on GPs had led to the alert.

The LMC said it will ‘proactively’ help practices to manage their workload and safety provisions by accessing its emergency resources, including emergency guidance for inappropriate GP workload, posters and template letters for patients and consultants. 

It comes after NHS Cambridgeshire and Peterborough CCG cut nearly a third of its discretionary general practice budget in July. 

In a statement on the LMC website, GP leaders said the move was to ‘protect’ practices and prioritise patient safety.

The statement said: 'In this climate, it is crucial that the safe provision of core services to patients remains GPs’ overriding core priority.

'Our GPs have a duty of care to provide quality and safe care to their patients. Despite cuts to their practices, against ever-increasing pressures, our GPs’ prime responsibility must always be to fulfil their contractual and GMC professional duty of care to patients seeking their services.

'As CQC registered providers, our practices are also under a specific obligation to review and take appropriate measures if workload is putting patient safety or quality in jeopardy.'

Chief executive of Cambridgeshire LMC Dr Katie Bramall-Stainer said disinvestment by commissioners has resulted in practices receiving 38p per patient 'above their core contract.'

She said: 'We have many practices who have merged to bring resilience, almost twenty within 5 years, but scale doesn’t always equal security and we have a system deficit that dominates the commissioning environment which has led to real cuts in discretionary spend, that to an average-sized practice equates to a full-time salary of a member of the admin team.

She added: 'Our local system pressures mean active disinvestment in our quality enhanced framework has resulted in practices receiving only 38p per patient above their core contract - this will affect the quality of patient care our practices are able to afford and it’s against this context that we are launching our black alert campaign for Cambridgeshire practices.'

Dr Bramall-Stainer added that the LMC was also creating a pastoral support team, adding to the emergency resources available to struggling GPs in the area.

The BMA voted in favour of a hospital-style black alert reporting system in 2017, for practices struggling with problems affecting patient safety.

Resources provided by the LMC include emergency guidance for inappropriate GP workload such as implementing practice policies for DNA (did not attend) appointments, patients presenting with dental problems and prescribing.

Other resources consist of posters informing patients of chargeable GP services, and template letters to send to consultants and patients.

The LMC is also encouraging practices in the areas to complete a black alert practice action tool – for practices to undertake its own financial review - and submit by the end of the year for the LMC to present to commissioners in 2020.

A Cambridgeshire and Peterborough CCG spokesperson: 'Primary care is an important part of our local healthcare system, and the CCG appreciates the vital role our primary care colleagues have in delivering good quality healthcare to patients. We are therefore working closely with partners to ensure resilience in this area.

'Our Primary Care Commissioning Committee has agreed this funding and we will continue our discussions with the LMC around communications and how best to use primary care network development funding.

'The overall budget for primary care has increased from £139 million to £147 million this year, an increase of 5.5%.'

Last year, the BMA suggested guidance of capping routine consultations to 25-35 a day under the ‘black alert’ system.

GPs in Cambridgeshire have previously felt the consequences of the hospital 'black alert' system, when a hospital asked GPs to refrain from referring patients in 2017.

Readers' comments (13)

  • Come on BMA what are you going to do about this.If they get away with this it will be tried else where as the system collapses.Bet you sit on your hands as usual.

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  • Why are hospital's allowed to do "BLack alerts"/diverts? Safety reasons. So why can't we?

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  • Joke....38 pence per patient..... a label 'black alert' will fix nothing........pastoral support team.... that will really help...... as will the posters and letters...not.
    A black alert should indicate to the GPs that now is the time to resign thats its gone too far.... then people across the country will take notice the next time one is issued....... and perhaps more resources will follow.... until then.... just a joke.

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  • Vinci Ho

    Treachery and travesty of justice
    What is the story of this CCG then ?

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  • @ curious I agree only coordinated mass resignations will change things

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  • The CCG is a membership organisations. The LMC should be organising a no confidence vote by constituent practices in the CCG, and oust the current leadership...

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  • Even Sisyphus would have ‘thrown in the towel’ by now!

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  • GPs need a plan B for when you the NHS stops paying enough to meet the bills. The dentists have Denplan, and it works.
    The BMA are long overdue in looking at alternatives to the NHS for their members to earn a living.

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  • Play the safety card. CQC can only back you up on this. The only other option for them would be to put you into special measures. Should go down a treat

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  • ‘Black Alert’ with the measures described above is a toothless gesture that offer no practical solution for practices.
    It should carry some threat of withdrawal or resignation if it’s to have any meaningful impact. The ccg spokesman is poking fun at the whole affair by reiterating how they value(or not) colleagues in primary care .
    We’ve got to get the public on board so they understand what this means In terms of reduced services , access etc
    Time to stop posturing and do something meaningful .

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