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‘We need to help GPs secure their future position as providers. We are in a minority view in believing that commissioning is outside of our remit.’

Chris Locke, secretary of Nottingham LMC

What have been your most memorable achievements for GPs?

We were the first LMC in the country to introduce the forerunner of local enhanced services. In 1996 we negotiated the first local development scheme under which GPs were paid to do INR monitoring and negotiated a few of £120 per patient. When they brought the new contract in eight years later and there was a national enhanced service for INR – that was the figure they were using. Shortly afterwards  we had near patient testing, and another local development scheme for supporting patients in nursing homes. All of these things featured in the new contract but as far as I know we were among the first in Nottingham. We pride ourselves on being very forward looking. We were among the first in the country to secure access to occupational health services for GPs, plus a formal pastoral network to support GPs in crisis in our area.

What have been its most significant moments?

We are also very proud of another added value service, a buying group which we negotiated discounts. We started in Nottinghamshire in 1997, extended to our neighbouring areas in 2001 and then about 2008, we exported the model and helped them set up. We then set up the federation of LMC buying groups. It has now got 64 LMCs I think that are part of it, and about 4,400 practices – and it is increasing. We’ve got two LMCs joining us this month. We can prove through price comparison analyses that procurement consultants have done for us, that if practices switch to the suppliers we identified, they are actually saving thousands per annum, anything from a few thousand to say 20k a year could be saved  An LMC is not just there to be a sounding board.

What are your biggest challenges at the moment?

We need to help GPs secure their future position as providers. We are in a minority view in believing that the commissioning side of things is outside of our remit. Our job is to represent GPs as providers of services – dealing with the threats posed by added competition, to help practices organise themselves into federations and provider organisations over and above the level of the ordinary practices, to enable them to compete for contracts, and provide services at scale that they couldn’t as smaller practices.

Are LMCs being involved enough in the NHS reforms?

As LMCs we shouldn’t be spending all our time insisting that there an LMC rep on the local CCG executive. My question is, what added value are we going tor bring to that? Is it that we don’t trust our own GP constituents on those boards to do what they’ve got to do? There are going to be areas where there are tensions and crossovers between what the CCGs do and our core business which is negotiating the contracts and such like, but in the main, they’ve got to get on with this commissioning lark. It may or may not be a success, but in a few years time, with a change of Government, that could all change, that responsibility could be taken away and we’re still back to – ‘how do we support general practice?’ There are lots of other LMC secretaries who believe we need to be involved in commissioning and they are unhappy that their own colleagues are saying this has got nothing to with the LMC. I’m saying, where does it ever say that we were involved in commissioning health services for the NHS?

What do you think the future holds for LMCs?

When I started over 16 years ago, LMCs were representative bodies but they were not proactive.  They were just a group of GPs that met round a committee table and considered correspondence and made representations in a leisurely fashion. Over that period, we have sort to transfer the organisation into a service based organisation. We’re not just representing views, we are also providing services to GPs – the pastoral network , organising training events, anything to do with the contract, CQC, pensions, premises concerns, issuing guidance.

Do you have any plans to celebrate the 100 year anniversary?

We are contemplating an event next year. We decided we started in 1912, so next year is our anniversary year. Halfway through next year we may have another.  We might do a contrary version of our awards that we run for GP practices which we do every two years.