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NHS managers exclude LMCs in management of performers list



NHS managers plan to exclude LMCs from the management of the new national GP performers list in a move criticised by GP leaders.

NHS England has proposed that each of its local area teams establish a ‘performers list decision-making panel’ (PLDP), which will make decisions on removing GPs from the list, thereby preventing them from practising, and whether to refer them to the GMC.

However, although the panels will have a ‘discipline-specific practitioner’, there is no requirement for LMC representation. GP leaders warn this will lead to a loss of credibility.

This follows a move by the DH to develop a national performers list, to replace the separate local lists help by PCTs.

If the proposals go through, GPs will also be charged a fee of £850 when returning to the performers list.

The PLDP will take overall responsibility for the management of performance and decide the outcome of performance review cases or, for example, if a GP’s case should be referred to the GMC.

Each area team will also have one performance advisory group (PAG) each, responsible for giving expert advice in performance review cases relating to the list. NHS England is consulting on whether these groups should have one LMC member or alternatively a senior manager or patient representative in their place.

The consultation document, which was published on 17 February and runs until 20 March, said: The role of the PAG is different to that of the PLDP. The PAG’s role is investigative and advisory; the role of the PLDP is to make decisions under the performers lists regulations.’

In the section on membership of the PDLP, it said: ‘The PLDP will take overall responsibility for the management of performance, to decide on actions required on individual performance cases, in line with statutory regulations, and to make referrals to other regulatory bodies where appropriate.’

‘Membership of the PLDP should be competence-based and comprise the following people: a lay member who will act as the patient / public advocate; a discipline-specific practitioner; a senior manager / director with responsibility for patient safety/experience; the medical director for an area team or their nominated deputy.’

However, GPC deputy chair Dr Richard Vautrey said: ‘We do have major concerns about the absence of LMC representatives in the performance management groups. LMC representatives play an essential role in both the PAG and the PLDP and they should be core members in the future to ensure these groups are both effective and have local credibility.’

Other GPC concerns included demands to take a child protection training course to get on the list, as this is already a core part of GP training, and Dr Vautrey also criticised plans to charge a fee of GP returners to the list amid ongoing recruitment concerns.

He said: ‘Whilst child safeguarding is important, it is unclear why training for this should be signalled out as being necessary to be on the performers lists. It should be and is a core part of GP training, and whilst critically important, there are also many other equally important and essential elements of training that GPs should have done before qualifying. There is a real danger of diplomatosis developing with more and more additional elements being added on when the key focus should be to ensure that GP training is comprehensive.’

‘Finally we have some concern about the proposal to charge each GP returner £850 for induction. We need to remove as many unnecessary barriers are possible that put off GPs returning to the workforce, not add new ones.’

However, Dr Vautrey welcomed NHS England scrapping proposals for GP trainees to pay for an occupational health assessment in order to get on the performers list.

He said: ‘We’re pleased that NHS England have listened to our concerns relating to charging GP trainees for an occupational health assessment in order to get on to the performers list. We’d argued that if they were already working in an NHS hospital this was unnecessary and they appear to have accepted that position in the consultation document.’

The GPC is still fighting for the right to free occupational health care for all GPs, not just when there are performance concerns. This followed similar demands made by Pulse in the Battling Burnout campaign.