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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