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Somerset LMC Weekly Update Friday 17th January 2020

Date sent: Friday 17 January 2020

Sent to all Somerset GPs and Practice Managers          This and previous updates are available here

PCN Draft Specifications: BMA GPC negotiators met NHSE on Thursday and were offered significant and welcome changes to the draft PCN DES specifications after universal criticism from the profession. Nevertheless after a debate yesterday GPC decided to reject these pending more details. Negotiations with NHSE will continue but a special LMCs conference has been called, probably for the second half of March, for the profession to discuss the final offer. You can read Richard Vautrey’s press release here.

Safeguarding Audit: The LMC had a productive meeting with the CCG yesterday and further meetings are planned. we have agreed that the deadline date will be extended until these are concluded and sufficient notice has been given. We would therefore advise that practices do not complete the audit survey until the discussions are complete.

LARC contract: For those practices who received your LARC contract and were concerned by the wording in section 4.1 of the service specification “ An appropriately trained nurse should be present to assist the fitter and support the patient during the procedure”, you will be pleased to learn our County Council colleagues once made aware of this have quickly changed the words to “trained Healthcare Assistant” as in previous contracts. So you can now all breathe a sigh of relief and sleep well knowing it’s not yet another role for our nurses to fulfill.

Digital Medical Record Access for Patients: Colleagues have asked about this contractual requirement. “A five-year framework for the GP contract reform to implement The NHS Long Term Plan” (BMA & NHSE: 31 January 2019) contained this commitment: 5.10 (ii) all patients will have online access to their full record, including the ability to add their own information, as the default position from April 2020, with new registrants having full online access to prospective data from April 2019, subject to existing safeguards for vulnerable groups and third party confidentiality and system functionality investment and evolution (our emphasis). The work involved in looking for and redacting information that could cause patient harm and risk breaching the statutory protection of third party information could be enormous. Simply not recording such information in future to avoid the pitfalls could compromise patient or third party safety. This is why the “subject to…” clause was agreed. GPC is still discussing with NHSD the implementation of the on-line access programme. Practices can be advised in the meantime that they need not take any action. The digitisation of remaining paper records (to ensure full access to the whole record) is another vast enterprise which NHSE may well have not thought through fully. It has sponsored some pilot projects around the country to “scope” the size of the problem. An interim paper has been published but, again, we are far from a solution for which national guidance and funding must be available. So, again, the advice is to wait and see.

SMI Miquest searches: We have received a number of queries regarding the SMI Miquest searches that Mark Dalley sent out before Christmas. These searches are not linked to the PCIS contract and the SMI extraction has been happening quarterly for the past 6 quarters. It picks up SMI data for the period of 1, 2 or 5 years prior to the latest quarter end.

Placement urgently sought for a Return to Practice Nurse (RtP) preferably in Central or East Somerset: Somerset Training Hub are happy to offer increased funding (£500) in addition to the £500 currently offered by Health Education England to practices that will offer placements for RtP Nurses.
We currently have an excellent candidate currently looking to complete the Return to Nursing programme at either Plymouth of Bristol University this spring who requires a practice to host and support her. She is not looking to be employed for anything other than as a RtP nurse to do more than the required 450 hours supernumery placement. If you can help please email or
We need to retain and recruit nurses into Primary Care and encourage experienced nurses to re join the workforce. Offering a placement will not only help to increase the workforce but will provide an exciting opportunity for existing nurse assessors and supervisors to use their teaching and supervisory skills and enhance their role, increasing job satisfaction.
For more information see the FAQs or information on the RtP Programme here.

From the Appraisal Newsletter: “Appraisals should usually take place in a professional place of work. However, if both parties agree and the doctor’s home is preferred then this can be approved. We need to remind you of the need to remain professional, to conduct the appraisal in a space where neither of you will be interrupted or overheard, and to ensure that you both feel comfortable having an appraisal in a home environment can be met. Appraisals in an Appraiser’s home should only occur in exceptional circumstance, at the doctor’s request (with the Appraiser's agreement) and with approval for this being sought prior to the appraisal from the Appraisal Team. Your Appraiser should have public liability insurance in place to cover both themselves and their Appraisee if this is to occur and the need for a suitable space remains the same.”
LMC understands that this guidance follows some interesting cases. In one case an Appraiser complained about domestic interruptions during an appraisal at a GP’s home. Despite this remonstration the same thing happened the following year. On at least one other occasion an appraisal at the Appraiser’s home was thought to distort the power dynamic and the Appraisee complained. Finally, it appears that another Appraisee tripped going into an Appraiser’s house which was undergoing building work.

LMC Monthly Training Morning: Please could we remind everyone that the LMC have a training morning on the last Tuesday of each month and as such the office closed, if you do have a query please do leave a message on the answer machine and we will return your call from 1pm when we reopen.

And Finally...

Having recently read in an NHS policy document about “How we can do more, better with less” the LMC was reminded once again about the BBC policy in the comedy (or documentary?) W1A. “The fact is, this is about establishing what we do most of best and finding fewer ways of doing more of it less.”


Kind Regards



Jill Hellens

Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY

Tel: (01823) 331 428            
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