ࡱ> bda @ &bjbj5*5* 8>W@W@j'2 2 2 2  8<2 JZ:"IIIIIII$LROI jjjI2 2 ;Ij2 8 IjI>Oj  AN dC?"eI$I0 J!@OODA 2 2 2 2 AO B|dII $Lj Appendix 1 Negotiators' report - December 2007 Northumberland PMS contracts Northumberland PCT is pressurising its PMS practices into accepting a micro-managed back-to-GMS contract. Their alternative is to offer an unacceptable PMS contract. The GPC secretariat has been advising the LMC from the beginning, as have PADiv on publicity and GPC members have also been supportive. The PCT is threatening to close down all PMS practices and allow the county to have no primary care other than the few GMS practices that remain. All this echoes Suffolk and will need the same tactics: unity of all Northumberland GPs in only accepting the right deal for all of them, involving MPs, informing patients about the implications and keeping up a local (and later a national) press campaign. Laurence Buckman and Richard Vautrey, together with Jonathan Fielden (Chairman of CCSC), met Ben Bradshaw and some of his advisers to discuss PMS contract reviews and a return to GMS deal for those who wished to. The GPC made it clear that we believed that several PCTs are acting dishonourably by trying to pressurise practices and LMCs into accepting new deals with little regard for patient services. In particular, by issuing termination notices before anything has been agreed, they are substituting threat for negotiation. The Minister was troubled to hear that in certain areas, including Suffolk and Northumberland, patients had raised their very significant concerns in the press about losing their local practices and the possible reduction in services. The negotiators made little progress in agreeing a return to GMS deal for PMS practices but will keep on pushing. It would seem that the civil servants might be prepared to clarify their interpretation of reasonableness for PCTs so that they would be willing to create a sort of MPIG for PMS practices. New practices and health centres under Darzi's next stage review The negotiators have seen some information from both the East and West Midlands area detailing how the Department is planning to procure new practices and health centres as part of the NHS next stage review. It is unclear whether one of the papers sent to us has been produced by West Midlands SHA or the Department itself, but it contains some "high level assumptions" that are worrying. In particular it appears that all investment will go towards new primary care services and with the explicit statement that investment will not be directed towards expanding existing GP surgeries. There are also concerns that the funding available for these new health centres is nowhere near sufficient to provide the level of service that is assumed including seven days a week, 8am 8pm opening hours. Given that the new health centres will also have implications for local secondary care services, the GPC will be liaising with CCSC on how to approach this BMA-wide. Londonwide LMC is currently in the late development stages of a campaign plan to help patients, GPs, MPs and the media understand and respond to the Darzi changes in London and we will gather ideas from this work and learn lessons from their approach. The negotiators will also be asking the newly established GPC communications group to input into this. For a summary of the interim report of the NHS next stage review, refer to appendix 2 of the October edition of GPC news:  HYPERLINK "http://www.bma.org.uk/ap.nsf/Content/news3oct2007" www.bma.org.uk/ap.nsf/Content/news3oct2007 If other LMCs receive any further information about local developments as part of Darzis review, please send them to the appropriate regional liaison officer in the GPC secretariat. GP Patient Survey The DH has released new guidance on the GP Patient Survey. The document provides guidance on this year's GP patient survey which will be launched in January 2008. It includes changes in arrangements following lessons learned from 2006/07. GP surgeries should receive questionnaire packs in the week commencing 14 January 2008. The new guidance can be accessed here:  HYPERLINK "http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081112" www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081112 Partnership agreements Most of the partnership problems on which the BMAs help is sought arise either from the fact that there is no written agreement or from inadequately drawn up agreements. The BMA strongly recommends that GPs enter into a written partnership agreement. Partnerships at will are an unstable basis for a business relationship and few GP partners would dispute the importance of having a comprehensive partnership agreement in place. Even if a practice already has an agreement in place, it may well be outdated, or no longer meet its needs. An up-to-date formal partnership agreement will help to reduce the risks both financial and non-financial for all partners, while clarifying the basis on which the practice is to be run. If partners are concerned about partnership finances, profit sharing, maternity leave or even termination, it is essential that their practice has a robust agreement in place to protect all partners. LMCs may wish to emphasise to practices of the risks of not having a partnership agreement in place and alert them to the partnership agreement drafting service that the BMA now offers. At least one partner in a practice must be a BMA member in order to take advantage of the service. For further information contact BMA Law on 020 7383 6128 or email  HYPERLINK "mailto:info.pds@bma.org.uk" info.pds@bma.org.uk National Framework - Pandemic Flu The GPC has been involved in a lot of work with the Department of Health in relation to this, including sitting on a number of primary care work groups dealing with overall planning, surge capacity, roles and responsibilities, and pharmacy and drug supply. The current updated framework is not complete in many ways however it should enable LMCs and GPs locally to engage with the issues. The GPC has made it clear to the Department of Health that there are three issues which are still key to GPs and which will need further work to enable LMCs and GPs to respond to the best of their abilities in the event. 1. Income protection LMCs will want to be aware that income protection has been guaranteed in principle, although the details are still being discussed. The GPC will make the agreement available when complete. 2. Command and control The GPC believes it is essential that LMC officers are involved in key command and control roles in the event of a pandemic, in order to gain professional acceptance of the decisions that are made throughout this time, and also to engage GPs in difficult circumstances. Equally LMCs should engage with PCTs sooner rather than later to ensure they are involved in key local decision making. 3. Deployment of community staff The HR guidance has been published. It does not deal in detail with general practice. The GPC will be involved in the production of primary care specific guidance. GP practices should be involved in any decision on deployment of community staff to ensure the most effective use of this resource. Throughout the GPCs work with the Department of Health, the negotiators have done their best to feed back concerns where necessary. However, we are also aware, that with the huge number of stakeholders being engaged, no plan could ever fully satisfy any one stakeholder group. This is a complex, cross sector piece of work and we welcome feedback on what is happening locally and what else the GPC can do to help LMCs in flu pandemic planning. More information will follow in due course.     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