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Somerset LMC Weekly Update Friday 27th January 2023

Date sent: Friday 27 January 2023

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

MD Soundbites!
Dedication and teamwork order of the day! This has been one of those weeks when I have fallen back in love with being a GP. Do you remember those days when you were excited about discussing clinical cases and making a real difference to patients. On Monday I was working as a duty GP alongside two very able paramedics and the day was really enjoyable. There was a real feeling of collaboration and working together as a small team to manage the daily calls. We talked! They asked relevant clinical questions and helped me find time to work through some of the ‘GP to sort’ queries. Later in the week I spoke with an inspirational GP who shared their thoughts on the future of general practice. GPs managing a clinical team and really tacking those clinical problems that needed a GP and how they sought solace from speaking to colleagues and making time to teach and talk to colleagues. During a practice visit this week I witnessed how a clinical team was adapting to use secondary care clinicians to support and provide clinical leadership. Creating inspirational solutions to overcome challenges and free their GPs up to have time to manage complexity, make difficult decisions, lead their teams while at the same time enjoying their days. I appreciate that some of you will be reading this thinking your working patterns are far more pressured and chaotic but be assured that some are managing to make changes and feeling better for it…. Having time to think is critical to providing safe care and we need to do more of this. At a meeting with NHS resolutions this week the LMC were updated on some of the main reasons why clinicians are becoming unwell and I could not help but think that a large part of this is because we have historically been doing too much with too little for too long. So please make some time this week to think, meet your colleagues and share ideas.

So while we look at managing change to keep ourselves and our patients safe, we must listen to political debate as to what the future of the independent contractor model will be. The LMC received an update email from the GPC on this subject this week - click this link for full details. Rather reassuringly the GPC are fully supportive of the independent contractor model and thankfully sensible conversations seem to be happening. An interesting article from the BMA providing comment on Wes Streeting narrative is worth a quick look. Continuity of care that GPs provide is critical to safe, effective care – this can also only help mitigate the widening inequalities of care that we are seeing. However, we need the resources to deliver this and this is where we have to articulate our pressures to central government. The GPAS data this week shows once again extremely high pressures with practices being at Opel 4 overall and the indicative number of patient contacts being almost 120,000, with an amazing return of 79% - thank you again so very much. However, the LMC want the pressure in every part of our county to be recognised so please help us in getting this to as close to 100% as possible - it really matters. There is a national programme for GPAS in every county to be reported to central government so please help us to show accurate data and put Somerset on the map. Daily Mail headlines hardly help! The ICB comms team has offered support if this generates any queries from patients, full detail here.

Your LMC wants every practice in the county to flourish and everyone in them to have a manageable workload. If things are tough and we can help please reach out. Sources for GP Support. For those that would like to see what support is available online there is ‘Practitioner Health’ (this was new to me).

Take care everyone and perhaps like me you have found some hope this week.


GP-Secondary Care Collaboration Group (from Dr Andrea Trill SFT): The first meeting starts on Teams on 31st January 1-2 pm. Click here to join the meeting. We will hold it regularly on the last Tuesday of the month at 1-2pm and would love to welcome all members of the practice team. We are aiming for an informal, non-intimidating space. This month we will be concentrating on womens health and neuro-rehabilitation pathways and the agenda will look like this:
1:00 – 1:25 Womens Health
1:25 - 1:40 Neuro-rehabilitation – A case for change
1:40 – 2:00 Drop in session
If you can’t attend but would like access to the recording afterwards, please email and you will also be able to send comments back if you would like. Please come and put faces to some of the people working in secondary care.

Statutory Requirements for Doctors Completing the MCCD: Somerset’s Senior Coroner, Samantha Marsh would like to highlight that doctors completing an MCCD must have seen the deceased in life AND in last illness AND within 28 days prior to death or after death if outside of the 28 days regardless of whether the patient was referred to the coroner or after receipt of a form 100A.
A recent local addition to this is that viewing of patients after death for MCCD purposes (not verification) can be done by video. Samantha Marsh clarifies: For the avoidance of any doubt, the Dr viewing after death must be the one who saw in life and so is capable of issuing the MCCD. The legal requirements for completion of an MCCD cannot be met by joining together the actions of various doctors (i.e. if Dr A saw in life and in last illness but in excess of 28 days before death, Dr B cannot see after death).

Update on the Digital Firearms Flag: The digital firearms flag will soon be relaunched on SystmOne (TPP) and EMIS Web (EMIS) systems, and is scheduled for deployment on Cegedim/Vision systems in March 2023. GPC anticipate the relaunch to take place towards the end of January. The digital marker and flag have been tested and brought before the Joint GP IT Committee since being taken down in July 2022. GPs should add the appropriate Snomed code to a patient's record when they receive notification of a firearms certificate application or when a certificate is granted, and this will automatically add a marker to the patient’s record. If a potentially relevant condition of concern is added to their medical record during the application process or after a certificate has been issued, an alert will pop up. Further information will be announced in due course via the BMA and NHS Digital.

21/22 GP Pensions End of Year Assessments: It's that dreaded time of year again for all GPs that have an NHS pension! Deadline for submission 28/2/23. More information click here.

Health Education England Education Contract (from GPC): The GPC have had some queries regarding the HEE (Health Education England) education contract that some practices have been asked to sign. Following discussions with HEE they continue to advise that practices do not need to sign this contract if they are not happy to do so. The contract was introduced in some locations to formalise the payment mechanism for practices to be paid for training and supervision, however the contract was not general practice specific and included much which applied to hospitals. They will now be working with HEE and NHS England towards a more suitable contract for general practices and will update you when there are any developments. Somerset Training hub are currently piloting this new approach in one of the PCNs, the outcome of which we will feed back to HEE and the GPC.

Somerset New to Practice General Practice Fellowship Programme for Newly Qualified GPs: Are you or do you know a GP that has qualified since April 2022 and is/will be working in Somerset? If so this funded fellowship programme may be of interest. It is a 2 year programme designed to provide personalised support to newly qualified GPs to help gain confidence and to develop enjoyable, fulfilling and sustainable careers in general practice. NHSEI is aiming for a 100% uptake and nearly all of our Somerset GPs have joined. We started in April 21 and have had up to 47 fellows, so you may already have one of our fellows working in your practice! We have had great feedback, and one of the highlights is the benefit of the mentoring, appreciation of paid time (£10,000 pro rata per annum) to undertake chosen CPD or interests and the online monthly Thursday lunchtime 30 minutes session with various speakers. Example topics include: knowing about appraisals; PCN overview; lifestyle medicine; managing difficult blood results on a Friday afternoon and time management. This programme continues to evolve according to the needs and aspirations of our fellows. Our next cohort will start in April 23 and the closing date is 16th March. See programme, application form and needs analysis for more information. If you would like to find out more or apply, please contact Dr Catherine Ievers

Shortage of Medical Student Placements: Due to a last minute cancellation there is a shortage in GP host placements for 4th Year Peninsula Medical Students. Peninsula are urgently looking for a practice to host a single year 4 student for a two-week period (Monday-Thursday not including Wednesday afternoons) from 6th February 2023. This will be funded at a rate of £1327.50. Anyone able to help or who would like further information please contact or

Library Services for Everyone Working in Primary Care: Veronica Price, Knowledge and Evidence Specialist from Somerset NHS Foundation Trust is a guest star on their recent podcast Accessing Trusted Health Information and Knowledge Matters.

Kind regards


Jill Hellens

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

Tel: (01823) 331 428            
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