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Live blog: LMCs Conference 2014

17.00 Time to wrap up the party. Thanks for logging on to Pulse’s coverage of the 2014 conference!

16.45 Time for LMCs to vote on a motion to deplore the Government’s decision to only fund GP occupational health services when there are performance concerns. It seems Pulse’s breaking news story – where we revealed that NHS England will fund services for all GPs but not their staff – has caused some confusion here, but it is decided that LMCs should vote on all parts of the motion instead of all points in isolation. This includes demanding that staff should also be provided with occupational health. It is carried in all parts.

16.25 Delegates vote in favour of introducing HPV vaccination for boys. Harrowing tales of adverse effects…

16.00 The following people have been elected/renewed onto GPC: Drs Katie Bramall-Stainer, Ivan Camphor, John Canning, Andrew Cowie, Chaand Nagpaul, Fay Wilson, Bruce Hughes and Grant Ingrams. Congratulations to Dr Hughes, who is new on the committee.

15:35 And conference decides to vote in favour of an opt-in only system, and that data should be anonymised before leaving the practice. That is a major new policy for GPC to take on.

15:30 We have a controversial motion now – whether should be opt in only. In advance of the motion, GPC negotiator Dr Beth McCarron-Nash announces that a pilot of 100-150 practices will be independently reviewed, and NHS England has said it will take on the findings of the review.

15:00 Big news – Pulse has learnt that the GPC has won concessions from NHS England for them to fund occupational health services. Read the story here and watch a video of Dr Chaand Nagpaul speaking about Pulse’s role in the campaign.

14:45 Dr John Canning, told the conference that LMCs should congratulate themselves and their staff for doing ‘additional vital work’ after the implementation of the 2013/14 contract.

But he said they should reject a motion to introduce a new national body for LMCs, saying that GPs needed it like they needed ‘a hole in the head’.

14:15 The conference voted unanimously to congratulate GPC on their success in their ‘reversal’ of some of the ‘damaging’ and ‘morale-busting’ part of the 2013/14 contract.

Delegates paid particular mention to the removal of tick box QOF points, but Dr Rami Eliad from Hertfordshire LMC did say that there were ‘white elephants in the room’ with the new contract.

Dr Eliad said that the new DESs being introduced were ‘complex’ and also involved lots of tick boxing. He suggested that future DESs should have a five year, rather than one year, time frame for completion so doctors didn’t have to ‘race’ to sign up all their patients before September.

14:00 A dispensing GP told conference that dispensing doctors don’t have a ‘level playing field’ by not having access to the electronic prescribing system.

Dr Alan McDevitt said Scotland has recognised this problems faced by rural dispensing practices, and is moving legislation to address this.
But he added that this has taken so long, and many dispensing practices would soon be forced to close.

Dr Peter Holden said we’re making sure that dispensing earnings will not be included in the final formula for publishing GP’s pay.

13:50 One delegate has expressed his anger at the CQC rating system he said he was ‘hopping mad’ about professor Steve Field introducing rating ps against the RCGPs advice.

Dr Dean Marshall, explained that GPC had explained to the CQC the system’s flaws but professor Field had been ‘adamant’ that they would be introduced.

Dr Marshall told conference: ‘It’s a case of making something stupid less stupid.’

13:30 Following a navel-gazing session on the LMCs Conference standing orders and lunch, we’re back, with a grilling of the negotiators.

11:45 A motion on QOF, calling on the GPC to remove the clinical indicators altogether. Don’t know which way it will go right now…

11:30 A debate on Your GP Cares now. A motion saying that the workload crisis that GPs face needs extra resources. Believe it or not, that one was passed unanimously.

11:15 It’s been a pretty uneventful beginning at conference today – perhaps to the relief of GPC negotiators.

11:10 Interventions from the Welsh and Scottish GPC chairs sees that the motion is lost, despite a call from the Scottish conference for separate negotiations. It’s now time for the soapbox.

11:05 Now that the fun and games are over, another important motion – on the future of the UK-wide GP contract.

10:42 A long rendition of Elvis on stage! Kent LMC representative calls for a little less conversation a little more action. It doesn’t help much – the whole motion is lost.

10:40 Dr Richard Vautrey, deputy chair of the GPC, warns of the ‘dangers’ of the motion. He says as there is no new money, a move to payment by results would carve up the existing money, as there is no new money. He also said it would lead to more micro-managing and salami slicing.

10:35 It’s a passionate debate. Former GPC chair Dr Laurence Buckman says patient list payments are not to blame for the increased workload. Dr Mark Durling from Sheffield says GPs are doing more work for the same money – he calls capitation a ‘hopeless’ funding formula.

10:30 Controversial motion now – calling for a move to payment-by-results instead of capitation. Judging by the speakers, it might be closer than you think.

10:20 That motion – saying the workforce crisis would be detrimental to patient care – was passed unanimously.

10:10 Dr John Grenville, secretary of the Derbyshire LMC, says this is a case of too many people leaving at retirement age, too few trainees coming through, which is squeezing the middle.

10:05 Dr Nigel Watson says this is not a crisis of this generation, it is a crisis of all generations. He quotes figures from a survey his Wessex LMC carried out that showed one-third of vacancies were not being filled.

10:00 We are discussing the workforce crisis now, and debating a motion in whether workload will harm patient care. \not surprisingly, the majority of the hall seems to want to talk about this.

Dr Krishna Karasaneni tells delegates that partners from his practice are leaving to go overseas.

9:35 Professor Chris Ham, of the King’s Fund, has just finished speaking. He once again called for GP contracts to be held by federations, based on population needs.

He also said the Government was too focussed on GPs as commissioners:


9:30 – 23/05/2014 Welcome to the live blog of the second day of the LMCs Conference, where delegates will be debating moving from a capitation basis of pay, the future of QOF and grilling the GPC negotiators.

18:00 And that is the excitement for the day over. Join us tomorrow for the second day of the conference.

16.20 Now time for GPC leaders for the devolved nations to speak.

Northern Ireland’s Dr Tom Black goes first, but Dr Charlotte Jones grabs the prize for quote of the day (in our humble opinion), in describing the plights of GPs in Wales: ‘I stand here today as a damsel in distress,’ she begins her speech.

Scotland’s Dr Alan McDevitt hails the Scottish Government’s decision to top up general practice funding.

15:40 And it is passed! The GCP will therefore explore whether to continue with the DDRB process. More on that to follow.

15:30 Uncontroversial motions about pensions and premises – highlighting the problems with changes to pensions and the need for new premises – are passed without fanfare. But now we are on to whether the DDRB is incompetent…

15:10 And here, pictured, is the extent of the winning margin on charging:


14:30 The main event for many – the vote on charging patients – has been lost. In a tense electronic vote (you could really hear a pin drop), 224 vote against, 59 in favour and four abstain. What will the Daily Mail have to say about this?

14.15 Now time for the much-publicised debate on charging patients for GP appointments.

Presenting the motion, Wiltshire GP Dr Helena McKeown says supporting the motion would at least force the Government to have an honest debate about general practice funding.

Next, Dr Laurence Buckman returns! And as per usual, doesn’t shred his words: ‘This is a dangerous and rotten motion.’

14.00 Dr Violaine Carpenter from Hertfordshire presents the annual motion on general practice funding… doubt there will be much opposition to this one.

GPs wants politicians to stop denying that general practice is underfunded, to recognise that GPs are the most cost effective part of the NHS and give GPs a bigger slice of the NHS budget.

This motion is unanimously carried.

‘This motion is toxic,’ adds GPC member and #savetheNHS campaigner Dr David Wrigley.

13:15 A dead heat in a vote! GPs are torn on the motion saying they will provide routine planned care if resources are provided to the satisfaction of the profession. The dead heat means it is ultimately lost – mainly because GPs feared it would give the Government a green light to press ahead.

Apologies for the lack of updates too. That’s what happens when 500 people are logging on to wifi that supports 400…

12:00 We’re now debating the CQC. Just when you thought it was safe to go in the practice…



11:46 Something you do not see every day: somebody wishing they went into general practice:


11.35 Dr Neil Thorman, from Rotherham LMC, argues that GPs are too often ‘chasing the QOF tail’ and not giving patients the care that they deserve. Again, the Government is the target of a motion that says its imposed reforms caused this situation. But Bedfordshire LMC’s Dr Una Duffy thinks this is a very negative motion: ‘Patients do get what they deserve from us and that is because of the dedication of GPs and the practice teams.’

11.26 Are the UK Government’s welfare reforms having a detrimental impact on the health of GPs’ most disadvantaged patients? According to the conference of LMCs, the answer is yes.

Further, Morgannwg LMC claims that Jeremy Hunt and David Cameron are ‘at war’ with the Welsh NHS. LMCs vote for them to stop using the NHS as a ‘political football’. No one is against this… oh hang on, apparently there was someone.

11:20 From earlier, unsurprisingly, motions about the workload GPs went through without too much opposition. They warned of the ‘unsustainable workload’, and the potential ‘collapse of services’, alongside demands that they are urgently addressed by Government.

One part of the motions was lost, however – a call for GPC to define what areas needed to be relinquished to maintain safety.


The phrase ‘poison chalice’ is much used as the conference debates CCGs co-commissioning of primary care.

‘I don’t like it even in its shadowy form,’ says Londonwide LMCs medical director Dr Tony Grewal.

Dr Beth McCarron-Nash, GPC negotiator says ‘the risks are there’.

The motion is carried in all parts. Looks like GPs will be opposing the handing of primary care budgets to CCGs.

11:00 It’s fair to say Dr Nagpaul’s speech went down well…



10.24 …and a renewed call for more funding: in tough financial times good business is to invest in the most cost-effective part of it. For the NHS, this is general practice, says Dr Nagpaul.

‘General practice is the solution, not the problem.’

Just an initial increase of funding of 2.5% would transform GPs’ ability to care for patients  and not be used to top up pay, despite what a ‘paranoid’ Treasury might think.

The real question is can the Government afford not to invest in general practice?, he concludes.

Standing ovations.

10.20. ‘We must fight for recognition… of UK general practice.’ Therefore the ‘Your GP Cares’ campaign, launched to influence all of the parties in Westminster ahead of next year’s general election.

Dr Nagpaul - online - LMCs

A renewed attack on seven-day working: ‘You can’t have it both ways with a skeleton GP workforce that is not even coping with current demand…’

10.19 111 is called a ‘disgrace’. People should get to speak to a clinician when they phone, Dr Nagpaul says. Not be asked questions in a computer algorithm on what they don’t suffer from. Applause from the hall.

10.15 Dr Nagpaul is speaking. He says immediate priority must be retaining GPs, stop people going off abroad to practice.

Dr Nagpaul - online

Moving on, both the Government’s Challenge Fund and Labour’s 48 hour guarantee gets a piece of Dr Nagpaul’s mind. ‘Gimmickery,’ he brands them.

9:30 Conference chair Dr Michael Ingram draws attention to the motion everyone is talking about:



9:00 Delegates are greeted with representatives from the NHA Party, compelling them to ‘keep our NHS public’. GPs will be voting on a motion calling on GPC to lobby for patient charges.

8:30 Welcome to Pulse’s Live Blog of the 2014 LMCs conference in York. We’ll be bringing you all the news as it happens. Before the conference kicks off at 9:30, we’ve got a taste of the keynote speech by Dr Chaand Nagpaul here