ࡱ> ]_\#` 5bjbj\.\. 8Z>D>D- t68%J^:> $$$$$$$$'h)${{{$${.${$rT R [/ "s$D%08% ** * 8l$$ 8%{{{{   NEGOTIATORS REPORT FOR GPC NEWS DDRB In advance of publication of the DDRB stories in Pulse and General Practitioner on 23 November (Government set to ignore review body on GP pay), the GPC provided the following comment - "We totally reject the idea that the government, by refusing to submit evidence to the DDRB, can exclude a group of doctors from access to the independent body set up to determine their pay in a fair and non-political way. It has never been our understanding that should negotiations fail there would be no recourse to the Review Body. That is precisely what it is there for, "It has always been understood that the DDRB was there for GPs just as much as for hospital or other doctors working for the NHS. To try to remove us, unilaterally, from the independent review system the government is supposed to back is discriminatory and grossly unfair." The negotiating team subsequently gave oral evidence to the DDRB on 18 December 2006 Patient Experience Survey The Department of Health published details of the Patient Experience Survey on 27 November. The BMA issued a press release stating that the GPC believes the survey is discredited because of the governments insistence on adding biased questions to the original survey. Although the imposed questions will not directly affect practice income, they have the potential to bias responses to all the other questions which will and that they will falsely raise patient expectations. Patient Experience Survey Choice A further meeting of the Patient Experience Survey Board has since been held. Discussions are now underway about how the choice component of the choice and booking DES can be measured. It is anticipated that this will be an in-practice survey of all relevant patients. The question that will be used is currently being reviewed and assessed by Ipsos MORI. Discussions about how this will be implemented will continue to be discussed with NHS Employers. Formula Review The report from the Formula Review Group has now been finalised and this was presented at Decembers plenary meeting. Whilst, as anticipated earlier in the year, the report finds that the original formula may have been more robust than perhaps was perceived it is still intended that the report will be issued for wider consultation to all GPs, hopefully sometime in January. Plans for how this consultation will be undertaken will be announced very shortly. PMS contracts threat of termination There have been a few more cases of PCTs threatening PMS practices which they believe are not providing 'value for money'. This includes PCTs seeking to renegotiate aspects of PMS contracts to extract sums from the baseline and setting out new targets and expectations. If practices do not comply with these changes, PCTs are threatening to terminate contracts and proposing to offer new contacts (either APMS or a return to GMS). Whether contracts can be terminated will depend on the terms of individual contracts thought it is possible, under the PMS regulations, that this threat could be implemented. Additionally, as you know, there is no guarantee of an MPIG, though the GPC strongly advises that all LMCs seek to make financial arrangements with the PCT to allow for this if a return to GMS does occur. Further advice on both these issues is available in the following guidance:  HYPERLINK "http://www.bma.org.uk/ap.nsf/Content/pmscont0406" http://www.bma.org.uk/ap.nsf/Content/pmscont0406 The point that needs to be stressed to PCTs is that by going down this road they are destabilising the one thing that might help them get out of their financial mess. It would be helpful if all LMCs could keep the office informed, via regional liaison officers, of any further moves in this direction to enable the GPC to review and refine our approach and policy on this issue as appropriate. New PBC guidance from the Department of Health New guidance was published on 28 November by the Department of Health titled 'PBC: practical implementation' and 'PBC: practical implementation - what does this mean for practices?'. This can be found at the following web address:  HYPERLINK "http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4140709&chk=IcmUWc" http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4140709&chk=IcmUWc Whilst this offers some clarification, there is general feeling that firmer agreements are needed to fund practice engagement adequately and to ensure suitable incentive scheme payments. The commissioning and service development subcommittee will go through these documents and prepare guidance for LMCs on any changes to existing PBC policy in due course. GP pay On 30 November, an announcement of average GP earnings for 2004-5 was released by the Information Centre. The report can be found at the following link:  HYPERLINK "http://www.ic.nhs.uk/pubs/gpearnex0405" http://www.ic.nhs.uk/pubs/gpearnex0405 Through PADiv, the GPC worked to put forward the view that general practitioners have well and truly earned their pay rise. In defending these figures it was noted that prior to the introduction of the new contract, there were serious recruitment problems and GPs pay had fallen behind a fact which was officially recognised during negotiations and is reflected in pay increases under the new contract. Additionally, it is important to realise that GP practices worked extremely hard to deliver the Quality and Outcomes Framework targets in the new contract and that, despite inflation, GPs received no cost-of-living increases whatsoever in 2006/07. This was also an opportunity to put forward the GPCs consistent message that general practice is appreciated by patients who trust their family doctor and view it as a lifelong partnership. Moreover, general practice is highly cost-effective, delivers high-quality care, all this despite the fact that we still have fewer GPs per head of population than most of our European counterparts. Whilst, as expected, there was some negative press about these earning figures it seems that in most cases at least our balanced view has got through. The GPC also questioned the comparative validity of the figures. It has since come to light that the average GP earnings figures for 2004-5 announced by the Information Centre are misleading. The Technical Steering Committee (TSC) have identified that an error which means that the quoted figures are pitched at too high a level. The 14% employers pension contribution has been included in the income figures. This means the comparable average GP pay for 2004-05 will be below 100,000+, which was reported. This also means that the percentage rise in pay is substantially below the 30% claimed by the government. Clarification of the problem, and the impact of it, is being sought by the TSC. Annual Certificate of Pensionable Earnings The revised version of the certificate of pensionable earnings for England and Wales is currently being drawn up by the BSA Pensions Division with Institute of Chartered Accountants and the Association of Independent Specialist Medical Accountants (AISMA) and is expected to be available shortly. The certificate will only be released once DH and the BMA have approved any changes. The Pensions Agencies in Scotland and Northern Ireland have been kept informed during the development of the certificate and it is anticipated that the respective Pensions Agencies will be issuing similar arrangements in Scotland and Northern Ireland. Flu Vaccine The Times published a story on the flu programme based in part on a Pulse survey on 23 November. In response, the Department of Health has reinforced that GPs are continuing to work very hard to ensure that those who need flu vaccine receive it as soon as possible. Surveillance of coverage in the over 65s shows that we are two weeks behind last years figures, exactly in line with the delayed distribution, and that by the end of December over 1m more doses of vaccine will be distributed than were used last year. The GPC also sought to counter the rather sensationalist reporting but also to highlight the sterling work of GPs and their practice staff to deliver flu immunisation under difficult circumstances. Pandemic Flu planning In written correspondence from both Rob Webster and Professor Lindsey Davies, the GPC has been assured by the Department of Health that, in the event of a flu pandemic, GP income will be secured in the event that the QOF and other routine work will have to be suspended. It was suggested that the details of such an agreement should be discussed between NHS Employers and the GPC. The negotiating team had plenary on 14 December where NHS Employers agreed to write a firm letter of confirmation that they are committed to this approach and it has also been agreed that a small sub-group of plenary would be set up to discuss the practicalities. The GPC recognise that it is most important to ensure that plans are in place to ensure continued GP remuneration in the event of a flu pandemic, and that these are understood by all PCOs. It is hoped that a firm agreement on this issue may help to facilitate PCOs in developing operational plans in conjunction with local practices and LMCs once this aspect has been nationally agreed. Also on this subject, Peter Holden and Hamish Meldrum, together with Chris Spencer-Jones, the chairman of the BMAs Public Health committee, met with Lindsay Davies on 15 December to discuss some of the potential operational problems and to raise the GPCs concerns about the lack of PCO planning in this area. It was quite a productive meeting and we came away from it with a greater degree of confidence that most of these difficult issues are being addressed. Obviously, there can never be perfect planning for something as unpredictable and potentially serious as a flu pandemic, but identifying the potential problems, the key personnel and trying to come up with possible solutions and clear guidance is crucial to any planning process. LMC Secretaries Conference Many of the LMC secretaries from across the UK came to BMA House on 30 November for the annual conference of LMCs. As well as an opening address and a Q&A session from Hamish Meldrum, there was a further Q&A with the negotiating team and a very useful presentation from Jonathan Fielden, chairman of CCSCC. Workshops were held on a range of issues including practice based commissioning, pensions, business planning in primary care, employing GPs, and APMS. These workshops allow the opportunity for LMC secretaries to get together and share ideas and information from a local perspective. It is also helpful for the GPC to be made aware of any concerns or ideas that LMCs have that can then be fed into our overall strategy. A summary of the workshop discussions will be circulated to the LMC listserver once these have been collated. Strategy planning The negotiators, together with staff members, spent two days at the beginning of December on a residential meeting to discuss wider strategy and a plan of action for the GPC in light of changing policy in the NHS. Discussions focussed quite heavily on the paper discussed at GPC about the future of general practice and the negotiators hopefully are now in a position to produce a more comprehensive plan of action that can be refined by the GPC subcommittees and negotiators at their January meeting.   !"'@DHT^wz|}ȻxePx:+hn0 he6B*CJOJQJ]^Jph(hshsB*CJH*OJQJ^Jph%hshsB*CJOJQJ^JphhsB*CJOJQJ^JphheB*CJOJQJ^Jph%hn0 heB*CJOJQJ^Jphh*he5CJOJQJ^Jhs5CJOJQJ^Jh<(5OJQJ^JaJh+ 5OJQJ^JaJh3[5OJQJ^JaJhv`Gh3[5OJQJ^JaJ!"'\ ] o p de4 7$8$H$gd 7$8$H$gdiM 7$8$H$gdegdx_5 Z \ n o t + ; < L [ ̹̩scPcscs=%h"hHhiMB*CJOJQJ^Jph%hiMhiMB*CJOJQJ^JphhiMB*CJOJQJ^Jph%h"hHhiMB*CJOJQJ^Jph$h"hHhiM5B*CJOJQJphhFB*CJOJQJ^JphhiMB*CJOJQJ^Jph%hn0 heB*CJOJQJ^Jph%hn0 heB*CJOJQJ^JphheB*CJOJQJ^Jphh+ B*CJOJQJ^Jph /h!(0n  G̹|l]Q]Q]Q]EQE]Q]h }CJOJQJ^JhCJOJQJ^JhIhCJOJQJ^JhIh5CJOJQJ^JhB*CJOJQJphhiMB*CJOJQJph!hfhiMB*CJOJQJphhiM5B*CJOJQJph$hfhiM5B*CJOJQJphhiMB*CJOJQJ^Jph%h"hHhiMB*CJOJQJ^JphhiMB*CJOJQJ^JphG:Y`pq%./0<lnop"M]ɺɮɮɢɢɗq` hqh0JCJOJQJ^J+jhqhCJOJQJU^JjhCJOJQJU^JhIhOJQJhVCJOJQJ^Jh'8CJOJQJ^JhIhCJOJQJ^JhIhCJOJQJ^JhCJOJQJ^JhIh5CJOJQJ^JhCJOJQJ^J#]458gOPʾ|dId8d h"hHh0JCJOJQJ^J4j9h"hHhB*CJOJQJU^Jph.jh"hHhB*CJOJQJU^JphhB*CJOJQJ^Jph%h"hHhB*CJOJQJ^Jph$h"hHh5B*CJOJQJphh0irCJOJQJ^JheCJOJQJ^JhIhCJOJQJ^Jh }CJOJQJ^JhIhCJOJQJ^Jh+ CJOJQJ^J45678gO ~###$&%&1&( 7$8$H$gdZgdZgde 7$8$H$gd 7$8$H$gde &1di()8\^ŶݛvcScSc;c.jh"hHhB*CJOJQJU^JphhFB*CJOJQJ^Jph%h"hHhB*CJOJQJ^JphhB*CJOJQJ^Jph(h"hHh5B*CJOJQJ^Jphh"hHhCJOJQJ^JhCJOJQJ^Jh"hHhCJOJQJ^JhCJOJQJ^JhFCJOJQJ^Jh"hHhCJOJQJ^J%h"hHhB*CJOJQJ^Jph!"#*AD=ͼͬvfVC3hhgB*CJOJQJ^Jph%h"hHhB*CJOJQJ^JphhCB*CJOJQJ^Jphh }B*CJOJQJ^JphhFB*CJOJQJ^Jph%h"hHhB*CJOJQJ^Jph%h~[khB*CJOJQJ^JphhB*CJOJQJ^Jph h"hHh0JCJOJQJ^J.jh"hHhB*CJOJQJU^Jph4j:h"hHhB*CJOJQJU^JphINHKd+ j !! !!%!(!1!O!a!s!!""ܹ繁vvi_iv_iUh }CJOJQJhCJOJQJhfhCJOJQJ%hfhB*CJOJQJ^Jphh|B*CJOJQJ^JphhFB*CJOJQJ^Jphh }B*CJOJQJ^JphhgziB*CJOJQJ^Jph%h"hHhB*CJOJQJ^Jph%h"hHhB*CJOJQJ^JphhB*CJOJQJ^Jph!"I"`"a"e"p"{""""""""#3#J#}#~###$$$$'%%Űm]Mh5{B*CJOJQJ^JphheB*CJOJQJ^Jph%hiMheB*CJOJQJ^JphhiMB*CJOJQJ^Jph%h*heB*CJOJQJ^Jphhe5CJOJQJ^J(h"hHh5B*CJOJQJ^JphhB*CJOJQJ^JphhFCJOJQJhgziCJOJQJhCJOJQJhfhCJOJQJ%&#&$&%&0&1&&&&:'<'C'b'y'z'''''''((&(6(7(>(C(ɹwwwwwwwwiw[J!h'th'tB*CJOJQJphhgziB*CJOJQJphh|B*CJOJQJph!hXhZB*CJOJQJphhZB*CJOJQJph$h~MkhZ5B*CJOJQJphhZ5B*CJOJQJphh5B*CJOJQJph%hh5{B*CJOJQJ^Jphh5{B*CJOJQJ^Jph%h5{h5{B*CJOJQJ^JphC(J((((()W)a)b){))))))**t*******3+J+K+++++,.,8,ô}qeY}}}hCCJOJQJ^JhWXCJOJQJ^JhsCJOJQJ^JhgziCJOJQJ^JhsCJOJQJ^JhIhsCJOJQJ^JhIhs5CJOJQJ^JhIh'8CJOJQJ^JhsCJOJQJ^JhZB*CJOJQJph!h'thZB*CJOJQJph!h'thFB*CJOJQJph"((()++&-'-00+0t3u335gdZ 7$8$H$gdZ 7$8$H$gds8,X,\,g,,,,,%---;-<-C-J-N-\------...'./.0._.00+0l0z00000pp`phq)B*CJOJQJ^JphhZB*CJOJQJ^Jph%h"hHhZB*CJOJQJ^Jph(h"hHhZ5B*CJOJQJ^Jphh"hHhZCJOJQJhD=CJOJQJ^JhsCJOJQJ^JhiCJOJQJ^JhgziCJOJQJ^JhIhsCJOJQJ^JhsCJOJQJ^J$00`111s3t3u33333333444^4i444455<5̹ooooo_oOo?hiB*CJOJQJ^Jphh7B*CJOJQJ^JphhWXB*CJOJQJ^Jph%hfhZB*CJOJQJ^JphhZB*CJOJQJ^Jph(hfhZ5B*CJOJQJ^Jph"hZ5B*CJOJQJ^Jph%hshZB*CJOJQJ^Jph%h"hHhZB*CJOJQJ^JphhZB*CJOJQJ^JphhD=B*CJOJQJ^Jph<5I5e5~555ܹ%hZhsB*CJOJQJ^JphhiB*CJOJQJ^JphhZB*CJOJQJ^Jph%hfhZB*CJOJQJ^Jph6&P 1h:phq. A!"#$% 9DyK 1http://www.bma.org.uk/ap.nsf/Content/pmscont0406yK bhttp://www.bma.org.uk/ap.nsf/Content/pmscont0406DyK http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4140709&chk=IcmUWcyK Fhttp://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4140709&chk=IcmUWcDyK 'http://www.ic.nhs.uk/pubs/gpearnex0405yK Nhttp://www.ic.nhs.uk/pubs/gpearnex0405F@F hqNormal$a$CJ_HaJmH sH tH DA@D Default Paragraph FontRiR  Table Normal4 l4a (k(No List6U@6 3[ Hyperlink >*B*phHH  Balloon TextCJOJQJ^JaJB'B Comment ReferenceCJaJ<"<  Comment TextCJaJ@j!"@ Comment Subject5\pCp L+ Table Grid7:V0$a$FV@QF F8FollowedHyperlink >*B* ph-Z!"'\]op d e 45678gO~$%1 !##&%'%((+(t+u++-h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h0h00000000000000 G]"%C(8,0<55 !#$%&'(*+,4(5")5/ o O-XXX _Hlt154215484 _Hlt154215485-@@- tERtEqtEQtEH@tEg@tEF@tE|G@tEL?tE?tEtEetE;#tE==JANW(W(-    F__I^ ""Y(Y(- =*urn:schemas-microsoft-com:office:smarttags PlaceName= *urn:schemas-microsoft-com:office:smarttags PlaceTypeB *urn:schemas-microsoft-com:office:smarttagscountry-region8 *urn:schemas-microsoft-com:office:smarttagsdate9 *urn:schemas-microsoft-com:office:smarttagsplace  12182006DayMonthYear   >C!C)J)-8 @ -33 t88Y ` p q  % {478888^^#*AD`a}}'#7 C J J a!b!j!j!""""3#J###\$g$&'&((^,i,,,<-<---=.br)AiWlR {fbh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh ^`hH.h ^`hH.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh ^`hH.h ^`hH.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.r)AiWlR {=.                                    >?ub 3i<E+ + G(,Kcn@\B%ERhf;(GXu"Y u##mn$dN)q)L+@2\=3D4Da56F8'8.8%9!:D: ;nV;m;<X?C?J@|[A5BC*D(FVbFHUI*[IpJ K`KTyKiM3NT#PqP0Sj4T\TVV(]W~~WWXxXY3[o_|j`#elefhg4khgzifjGqjhq(.r&`+9)C^M +'8wMbQl #Q)&CQiM|V A&xCcr< J\C=Nu=esK:x_#35{ &q }4V <(C1DJ>V|*c brFb7`5cq2Z?BBHBD=UQ6"RF& 4Ow>wQZ1uKgn_o vC\ISV} ?7NhY_t%<!'\~$J#-!n@ -`@Unknown Gz Times New Roman5Symbol3& z ArialK"Frutiger 45 Light=" HelvArialWTms RmnTimes New Roman?5 z Courier New5& zaTahoma;Wingdings"qhXf֓&&R&R!924di-i- 2q HX+ ?hq2'NEGOTIATORS REPORT FOR THE GPC MEETINGStephanie Ashmore Dr Anne Hicks    Oh+'0$ <H h t  (NEGOTIATORS REPORT FOR THE GPC MEETINGStephanie Ashmore Normal.dotDr Anne Hicks3Microsoft Office Word@F#@1C"@ȣ%@/&՜.+,D՜.+,T hp|  BMARi- (NEGOTIATORS REPORT FOR THE GPC MEETING Title 8@ _PID_HLINKSAgz'http://www.ic.nhs.uk/pubs/gpearnex0405( lhttp://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4140709&chk=IcmUWc(  1http://www.bma.org.uk/ap.nsf/Content/pmscont0406(   !"#$%&'()*+,-/012345789:;<=>?@ABCDEFGHIJKMNOPQRSUVWXYZ[^Root Entry Fj/`Data .1Table6*WordDocument8ZSummaryInformation(LDocumentSummaryInformation8TCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q