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Name: SHAUN FIRTH
Date: 18 Oct 2000
Time: 14:10:41
GPC INSIGHT News from your GPC Representative Issue: 20 October 2000
Dr.Shaun Firth
CONTENTS (1) An Apology
(2) GPC Committee Elections
(3) The Doctor Patient Partnership
(4) PMS Schemes
(5) Electronic Patient Records
(5) Modernising the GMS Contract
(1) An Apology
During last month’s meeting of the North Essex Primary Care Support Group, I was too firm in my chairing the meeting and quite unintentionally upset my colleague Dr.Valerie Brook. This was clearly quite unacceptable and I have apologised to her personally. I would like to take this opportunity to repeat this apology in a public forum. I have the utmost respect for Valerie as a friend and colleague and was horrified by her reaction to my conduct. I am happy to say that she has accepted my apology and I hope this matter is now concluded (2) GPC Committee Elections
Elections to the various GPC subcommittees now take place each year by transferable vote system and members are limited to serving on two committees. This change of policy took place to try to ensure fairer representation of ordinary members on these important committees.
This year’s elections took place in August and I was again elected to the Information Management & Technology Committee. I think this will have particular relevance this year with the introduction of the improved NHS Net, the recent change in our Terms of Service “legalizing” electronic records and changes in the Data Protection Act. I am not by any means a computer nerd but I will try to pass on any information or guidance I receive in this important area of our working lives (3) The Doctor Patient Partnership
The Doctor Patient Partnership is an important organisation which was established to encourage better communications between patients and health care professionals. It aims to promote the responsible use of NHS services and offers practical advice to the public on self-medication.
Much of the NHS Plan is unachievable unless the Government devotes significant effort and resources into persuading the public to use the health service more responsibly. Sadly, this is unlikely in a pre-election period so the work of the DPP will have increasing importance.
The DPP produces excellent literature and targets particular subject areas as part of a planned programme of campaigning. Issues to be covered this winter are Colds and Flu, Flu Vaccinations, Polypharmacy and the Elderly and Antibiotics. You will have seen the recent campaign about missed GP appointments which received good general media coverage: it is said that £185 million worth of appointment time each year is lost to the NHS by patients failing to turn up for their GP appointments. (4) PMS Schemes
Enclosed with the agendas of both LMCs this month is some very valuable guidance to inform colleagues who are considering joining a PMS scheme. The publication of the national core contract for PMS doctors has changed the climate completely and GPs are advised to consider this step more carefully than ever.
Already, there are clear indications that the Government is going to bypass the Review Body when it comes to doctors’ pay in PMS schemes and LMCs will have a vital role to play at the local level to protect the interests of their constituents.
The GPC is working with other GP organizations to produce timely guidance to ensure that family doctors consider all the necessary questions before deciding finally whether to opt for the new PMS contract. Formal proposals had to be submitted by 1 October from those GPs who want to switch next April but the final decision does not have to be made until next February for PMS contracts starting in April 2001 and until August for those starting in October 2001.
The national PMS contract has had the effect of making many colleagues think again and up and down the country initial expressions of interest are being withdrawn.
The joint guidance from the GPC, RCGP and the National Association of Primary Care will be sent to every family doctor in the country and will be published on the BMA website at www.bma.org.uk
(5) Electronic Patient Records
For many years, the GPC has been pressing for a change to the Terms of Service to legitimize computerized medical records. From October 1st, this has finally happened. The reason this has all taken so long to negotiate is because it was not just a matter of changing the wording of the regulations. There are also important principles that go together with the Terms of Service alteration which have been achieved by negotiation.
It is important to stress that the electronic option is now there for those who want it but there is no need for the individual practice to rush into the change. The amended Terms allow GPs to keep manual records, computerized records or combined records. It will be left to individual practices to decide how to implement electronic record keeping locally, but the GPC and RCGP have developed guidelines. The DOH has recognized that practices moving to paperless status will need help preparing records, training staff, funding extra time to translate records into electronic format and providing any necessary computer upgrades. It is important to stress that the agreement means that the pace of change is under the control of GPs (for a change!) and cannot be hijacked by the health authority or PCG.
(6) Modernising the GMS Contract
Following motions at the LMC conference in June, the GPC negotiators have begun the task of trying to update our existing GMS contract. Many people are considering PMS because they feel that this is the only way of achieving flexibility and innovation. In fact, most of the things that are claimed as successes of PMS can already be achieved under GMS but a modernized contract might produce a much more obvious level playing field
The GPC is looking for greater flexibility, maintenance of the cost-plus principle (which is lost in PMS), family-friendly work patterns, the ability to provide high quality care with sufficient time for patients and simplification of the mechanisms for Fees and Allowances.
One major change being considered is that basic practice allowance should form a greater proportion of income with a reduced emphasis on capitation. It should be possible to have corporate practice contracts rather than individual practitioner contracts. Item of Service and Target payments should be grouped together under national service level agreements. The need for clinical quality could be delivered through this route.
( I am anxious to reflect your views and concerns on the GPC : Please contact me as follows:
Dr Shaun Firth, Nuffield House, The Stow, Harlow, Essex, CM20 3AX
Phone: 01279 425661 (work) Fax: 01279 427116 (work)
Phone: 01279 731396 (home) Mobile: 07957 207442 Email: shaun.firth@lineone.net
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