LMCs 2018: All the key votes

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GP leaders overwhelmingly give a vote of no confidence in the #GMC at the #LMCConfpic.twitter.com/iY07G88ClS

— Mena-Mark Mikhail (@MenaMarkMikhail) March 9, 2018

15:08  Now a motion of no confidence in the GMC. GPC sessionals lead Dr Zoe Norris presents the motion saying that despite reassurances, the GMC’s actions over the case involving Dr Hadiza Bawa-Garba mean that doctors have lost faith in the regulator and that doctors should be advised to ‘disengage from written reflections’ until new safeguards are put in place. She asks: ‘When you make a mistake are you confident that the GMC will be objective and fair in its assessment of you?’

The mood in the hall is very sombre. Dr Alicia Watts from Kent says: ‘In its present state the regulatory process may actually harm doctors’. GPC’s Dr David Bailey says that ‘it is no longer safe to make a written reflection over errors that you have made’ as they can be requested by judges and shared by Royal Colleges with the GMC, but urges the conference not to pass a vote of no confidence in the GMC. Despite this, the motion is carried in full.

GPC’s @dr_zo urges #lmcconf to back a vote of no confidence in @gmcuk#BawaGarba#iamhadizapic.twitter.com/ccs08Io7RX

— Sofia Lind (@sofialind_Pulse) March 9, 2018

14:40  So, coming up this afternoon. Votes highlighting concern over the number of doctors convicted of gross negligence manslaughter, alarm over plans to restrict OTC medicines on prescription and that the survival of the GP profession should take precedence over the survival of the NHS.

14:15 The afternoon session kicks off with questions for the GPC Executive. Asked when the 2018/19 GP contract – due to kick into force in mere weeks – will be announced, GPC chair Dr Richard Vautrey apologises for the late-running of negotiations. He adds that there will be a special meeting of the GPC next week about the contract, after which hopefully more can be revealed! For more on the contract, read our what-we-know-so-far preview here.

12:50 The workload debate ends with LMC representatives voting to strongly support the GPC’s workload plan. We are breaking for lunch.

12:15 In the first ‘themed debate’ of the day, LMC delegates discuss GP workload.

This comes as BMA unveiled new guidance on GP ‘black alerts’ earlier this week, suggesting a limit per GP of 25-35 routine consultations – or 15 complex consultations – as a recommended ‘safe’ limit before agreeing with CCGs to send patients on to ‘overspill’ clinics.

The RCGP said it supported GP black alerts, but not caps on appointments, while NHS England said caps would be non-contractual.

In 60-second slots, delegates relay tales of stress leading to ‘honest mistakes’ and early retirements, with the message clear that the situation ‘cannot continue’.

Dr Mary McCarthy from Shropshire LMC says UK GPs are not alone. European GPs also want to cap consultations to 25 a day.

GPs: We’re practicing like we’re drink driving. We know its unsafe and we can probably get a certain distance before we crash says #LMCconf

— Derbyshire LMC (@DerbyLMC) March 9, 2018

12:00 Dr Matt Best, from Plymouth LMC, spoke about practice closures.

11:45 ‘Cherry-picking is not for us as health professionals… we do not select the patients we want to see,’ says Dr Simon Parton, from Lewisham LMC, as delegates debate new online providers of GP services.

Dr Lynette Peterson, from Thames Valley LMC, who works for online provider GP at Hand said GPs should show patients thety were a ‘progressive and forward looking profession’.

She added that she would like to correct the ‘misconception’ that online services do ‘cherry pick’ patients, and they also see patients with multiple complex conditions and ‘heart-sink’ patients that ‘previously have taken up a lot of time within the NHS’.

The motion, to demand a stop to ‘cherry picking of patients by private companies’, is passed.

The vote comes as Pulse reports today that NHS Hammersmith and Fulham CCG – which hosts the practice from which GP at Hand operates across London – has launched a £250 bid for an independent evaluation of the service.

Babylon has consistently denied that its GP at Hand service is cherry picking patients.

11:00 Avon LMC’s Dr Shaba Nabi: ‘Public has no idea how vulnerable their GP practice is.’

11:18 GPC Wales chair Dr Charlotte Jones is giving an update on the Welsh GP contract for 2018/19. Dr Jones says it is ‘close to ministerial sign-off’ – with improved indemnity arrangements and ‘positive changes to QOF’. 

10:38 Dr Alan McDevitt gives a presentation on the new Scottish contract: ‘It is not a big bang – the world won’t suddenly change. It is going to take time to shift general practice to a better place.’ Click here to find out more about the new contrac t. His speech is followed by a vote on whether to look at including elements of the Scottish contract in the English contract negotiations. Motion carried.

Honest, it’s not another @TEDTalks from @AMcDevitt2 as our @BMAScotland GP Committee Chair shares Scotland’s recent #GPContract developments and aspirations with our UK GP colleagues#LMCconf@BMA_GP@scotgovhealth@AndrewBuist17@HighlandLMCpic.twitter.com/lpQH0SQAMg

— Iain Kennedy (@DrIainKennedy) March 9, 2018

10:22 Dr Shaba Nabi from Avon LMC proposes a motion urging GPC to take ‘urgent action to ensure the protection of last-man standing GPs from any additional costs of resignation or retirement resulting from practice closure’. She delivers a powerful speech about the stresses of being a GP partner in a struggling practice: ‘My husband would often find me sobbing in the middle fo the night. Would I have to sell my house? Would I have to take a bank loan?’ Dr Nabi has written a powerful blog on a similar subject – click here to read it. Motion carried unanimously.

09:50 First motion to be debated is looking at whether to back a demand for an ‘incentive scheme to encourage GPs into permanent roles’ and encouraging non-GPs to become partners. Some strong speeches against this idea, with Dr Zishan Syed from Kent LMC calling for changes to working conditions and the medicolegal risk on GPs saying: ‘Address these issues and you will have stiff competition for partnerships.’ But proposer Dr Alex Freeman from Hampshire and Isle of Wight argues that ‘just because someone is not a GP does not mean they don’t have specific skills to offer partnerships’. This part of the motion is lost.

09:20 GPC chair Dr Richard Vautrey starts his speech strongly. ‘Doctors today are being exploited by a system that relies on their goodwill’. Dr Vautrey on the Bawa-Garba case: ‘You could end up in the dock … it is not only unfair it is unjust and the system must change’. He also calls for a pharmacist for every practice, ‘equity with our colleagues in hospital’ on indemnity fees and ends with an Obama-esque flourish of: ‘Together we can make things better’. Click here for more from the speech.

GPs deserve a pay rise and it is time the UK Government provided for it #applause@rvautrey#LMCconf

— Nigel Praities (@nigelpraities) March 9, 2018

09:15 The hall is filling up with LMC representatives. If you want a preview of what is happening today, then click here.