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LMC England conference: the main developments

17:50 It has been a busy day and now the hall is clearing. That is it from us, now time for a well deserved post-LMCs pint…

17:43 GPC executive member Dr Farah Jameel suggests that it is ‘within the gift of every GP practice to have this sort of service’. ‘Are we trying to suggest that this type of online service has no place?’ she asks adding that the GPC is still willing to ‘flex its muscles over this’. The hall is feeling riled up and votes for the motion to be adopted.

17:27 Derbyshire LMC  is proposing the GPC ‘seeks urgent legal advice regarding the options available and the potential for a judicial review’, to challenge the ‘GP at Hand’ service launched this week to patients across London. The scheme, run under an NHS contract by a west London GP practice and private provider Babylon, encourages patients to switch practices on the premise of receiving a video consultation within two hours of logging their symptoms online.

16:40 GP leaders vote for all ‘artificial intelligence’ GP systems to be ‘piloted and assessed’ before any further introduction. into the NHS.

16:25 Calls now for NHS England to take on the role of patient data protectors…

Vicky Weeks of Haringey LMC calls for NHS England to become the legally responsible body for patient data, not practices, because it’s NHSE who want it shared all over the place. #lmcconf

— LondonwideLMCs (@LondonwideLMCs) November 10, 2017

Dr Stephen Meech from Kent receives some applause when he points out how GPs have in the past fought to remain in control of patient data.

Cambridgeshire’s Dr Diana Hunter may have the winning argument? ‘As a patient, who would you want to be responsible for your data?’

According to GPC’s IT lead Dr Paul Cundy, GPs don’t really have a choice, under the Data Protection Act, whether they’re data controllers or not.

The motion on making NHS England data controller for primary care is clearly lost.

16:13 GPs vote in favour of a ‘guarantee that the “last man standing” in a partnership will have the building either bought back or the remaining lease taken over by the Government’.

But they vote down the suggestion to dissolve NHS PS and hand their responsibility to be GP landlord over to CCGs.

Unsurprisingly, a motion calling on the GPC to push NHS England to ensure promised premises funding urgently reaches practices is passed.

16:04 Dr Peter Gledhill from Bedfordshire proposes a motion which calls on the GPC to sort out NHS Property Services and/or dissolve the Government-owned company altogether.

He agrees they won’t be able to do both, but says the motion, which is in five parts, is aimed at giving the GPC a mandate to solve the problem however it sees fit.

‘Just sort it out,’ he says.

Dr Diana Hunter, Cambridgeshire LMC, says the suggestion to devolve premises to CCGs (after scrapping NHS PS) is a ‘dangerous suggestion’ and ‘risks making a bad situation even worse’.

It comes as we reported earlier today on the very bad news that talks between the BMA and NHS Property Services over sky-high service charges have completely broken down – while practices are continuing to be presented with six-figure bills.

15:57 Delegates vote through a motion which calls on GPC to work with RCGP to ‘develop the GP curriculum so that trainees are taught and assessed on relevant aspects of practice management’.

15:30 LMC leaders are now debating how hospitals should be held to account for dumping workload on GP practices.

The motion includes a suggestion to create a tariff allowing GPs to charge a fee when they do work hospitals should do.

This part isn’t going down well with everyone in the hall, including Lincolnshire LMC’s Dr Kieran Sharrock who says he doesn’t want to be paid for the work, hospitals should just do it.

But, despite his sentiment, an electronic vote declares that the motion is carried by 92 to 91 votes! Definitely the closest vote of the day so far.

14:55 Dorset  LMC’s Dr L-J Evans: ‘I don’t see why urgent care service GPs should fall on their swords. Let’s put this silly boycott nonsense to bed.’ The motion is rejected.

14:47 Dr Preeti Shukla from Lancashire and Cumbria LMC urges conference to support the motion, saying the recent announcement of a ‘state-backed indemnity scheme’ in England was as if ‘we had been given a lollipop and asked to stay quiet until 2020 while the adults talk. We need a solution here and now.’ 

14:41 Dr Bill Westwood, chair of Gateshead and South Tyneside LMC, introduces a controversial motion to survey GPs on withdrawing their out-of-hours committment ‘if direct reimbursement for their out-of-hours indemnity is not provided’. ‘This gives us more in ammunition by asking GPs what they think, although individual doctors are doing this already,’ he says.

14:30 Clearest sign yet that the GPC is not planning to ballot on mass list closures,despite over half questioned being in favour of the the move. ‘We don’t need to tell people to close their lists, they are doing it now,’ argues Dr Richard Vautrey.

14:05  We are back from lunch break and delegates are invited to put their questions to the GPC Executive team of negotiators. GPs are concerned that there is unfairness in the system for flu vaccinations. Why can pharmacies charge any patient that walks through the door for their flu jab when practices can only give the vaccine to patients on their list? Dr Richard Vautrey says ‘anomalies’ regarding vaccinations and charging patients forms ‘part of contract negotiations’. He said talks also include travel vaccines.

12:53 The motion is lost…

12:49 Dr Mark Sanford-Wood says: ‘It is important that we remember that what is being it is not calling for the charging of patients for NHS services.’ He accuses the media of the ‘deliberate misinterpretation of the media’ with regards to this vote and adds: ‘In view of the potential media interpreation I would ask you to vote against this motion.’

12:44 Dr Michael Ingram from Hertfordshire: ‘All GPs want to see a successful profession and we need to support GPC to do that. Please support this motion.’

12:39 Dr Alex Freeman from Hampshire and Isle of Wight LMC says: ‘If you don’t support this motion then you are saying that you don’t give a damn about your colleagues.’ Groans in the room.

12:36 The room has finally woken up. Dr Jackie Applebee from east London argues that ‘GPs should not ‘throw in the towel’ and should instead fight for a better funded NHS. ‘How will you look your patients in the eye next week if you vote for this?’

12:29 The big vote of the day. A motion urging the GPC to support practices ‘to operate within a private alternative model’ if they are struggling. Dr Christiane Harris from Bedfordshire LMC says that GPs feel like they are on a ‘hamster wheel’ every day.  ‘All this motion is asking is for GPC to support practices who want to explore a future outside the NHS’.

12:19 Dr Anne Birch from Cleveland LMC proposes a motion which looks at better financial support for surrounding practices and a new category of list closure to block patients from registering with another practice if their practice is in difficulty. ‘Clearly this cannot be a long-term solution as it goes against patient choice, but can be justified in the interests of patients safety and the stability of practices in the local area,’ she says. The motion is carried in full.

12:00 Arguing against the motion,Dr Michael Ingram from Herts LMC says that GP practices need to ‘harness’ ratings for their own good: ‘Let NHS Choices become the garlic and stake’ to stave off the ‘blood-sucking CQC’ he says. But GPC lead for regulation Dr Robert Morley says: ‘We all support feedback, but it should be professionally driven and not imposed.’ The motion is carried.

11:57 Dr Lee Salkeld from Avon LMC calls for the NHS Choices reporting system and the Friends and Family Test to be abolished. ‘We have no honest right of reply. We just want to protect ourselves from patients with an axe to grind,’ he says.

11:23 GPC not very happy about this vote. We are demanding another £3.7bn and ‘walking away from it will risk all the workstreams that we are working on’, warnsDr Chandra Kanneganti. But vote is carried. A real demonstration of how strong the feeling is about the inadequacies of the GP Forward View among grassroots GPs.

11:16 Oxfordshire LMCs Dr Prit Buttar proposes a motion for the GPC to ‘publicly disassociate itself from the GP Forward View’. It is not a lack of money that is killing us – it is a lack of political will,’ he says. ‘Better times are not coming unless we force the issue.’

11:13 As GPs move on to debate Capita’s support service contract, Dr Peter Gledhill, from Bedfordshire LMC, says apparently they have a stand at the conference. He adds: ‘I’m sure you’ll wish to tell them just how happy you are with their services.’ The motion, which wants the contract returned to the ‘public domain’, is passed in all parts.

11:00  LMC representatives have voted through a motion to say GPC England should ‘make clear to government and NHS England that GPs will not formally agree to begin online consulting until there is clear evidence that it is beneficial to the health of patients’. GPs said they were concerned it will ‘add to an already unmanageable GP workload’ and ‘decrease access to more vulnerable patients who may struggle to use the internet’.

10:30 Dr Vautrey’s speech got a standing ovation, as the conference moved on to the motions. We’re expecting a few big ones today, but we’re starting easy with calls for GPs to be involved in developing new care models, and locums being part of the future of general practice.

10:20 In a not very surprising twist, Dr Vautrey continues by asking for more funding for general practice. But did you know GPs only get 57p per patient per day?

GPs get 57p per day for each patient! Is that what government thinks Patients and GPs are worth asks

— Gaurav Gupta (@drguptagaurav) November 10, 2017

He also warns about the perils of going down the route of new care models without retaining the old faithful independent contractor status.

“We give up independent contractor status at our peril, the grass is not always greener… once in an MCP or ACO going back is very difficult” – @rvautrey#lmcconf

— LondonwideLMCs (@LondonwideLMCs) November 10, 2017

Dr Vautrey says: ‘I call on the Chancellor, at the budget in a few days’ time, to scrap the cap, and provide the funding needed to not only pay GPs, our staff and others in the NHS properly, but also to invest in NHS services as a whole.  Our staff and our patients deserve nothing less.’

10:00  Dr Vautrey has taken to the stage at the conference to welome GP leaders from across the country. He starts off his speech by going through the positives achieved in GPC negotiations with the Government.

He says he ‘often heard the question, “what has GPC ever done for us?” Well I’ll tell you what we’ve done. We’ve started to put right the problems of the last decade.

‘We’ve reversed much of an imposed contract, we scrapped the worst elements of QOF, we ended a whole series of micromanaging and bureaucratic DESs, not least the avoiding unplanned admissions DES which was the worst of the lot, we’ve secured non-discretionary maternity pay and guaranteed sickness pay, secured funding to cover in-year indemnity rises and we’ve even got full reimbursement of CQC fees.

‘And crucially, on top of all that, we’ve started to turn the tide on a decade of funding cuts and secured over £500m recurrent investment in to general practice in the last two years, investment that is vital for practices right across the country.  That’s what GPC has done for you and all the GPs we represent and that’s I’m proud to have achieved.’

But he goes onto say he knows it isn’t enough.

00.01 GPC chair Dr Richard Vautrey is kicking off the first-ever England LMCs Conference on Friday morning with a warning that GP workload levels are dangerous.

GP leaders have a long list of motions to go through, including regarding privatisation of services and boycotting out-of-hours services unless indemnity is paid.

Click here to see what Dr Vautrey will be talking about and keep following the liveblog for all the latest news throughout the day.