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.
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.