LMC(NI) 1
2017
ANNUAL CONFERENCE OF LOCAL MEDICAL COMMITTEES (NI) 2017
SATURDAY 4 MARCH 2017 AT THE MERCHANT HOTEL, BELFAST
AGENDA FROM 10.30 AM
1APOLOGIES
Receive: Apologies for absence.
2STANDING ORDERS
The Chair (on behalf of the Agenda Committee): That the standing orders – LMC(NI) 2 2017 -be adopted as the standing orders of the meeting.
3RESOLUTIONS OF CONFERENCE 2016
Receive: Resolutions of the 2016 Annual Conference of Local Medical Committees (NI) – LMC(NI) 3 2017
4STATEMENT OF ACCOUNTS
The Treasurer of NIGPC: That the annual statement of accounts for year-end 30.6.16 be received – LMC(NI) 4 2017
5INTRODUCTION FROM CHAIR NIGPC
Receive: Introduction to conference from Dr Tom Black, chair NIGPC.
MOTIONS FOR DEBATE
Workforce 10.50 – 11.15
1ELMC – That this conference calls for a coordinated and planned approach by DoH, NIMDTA,QUB and UU to address the current workforce crisis in NI.
2ELMC – That this conference calls for an extension to the GP specialty training scheme in NI to four years in order to fully prepare GP trainees in the complexities of working in primary care.
3ELMC – That this conference calls for a significant and adequate increase in the funding available for the GP returner scheme.
4SLMC – That this conference calls on NIGPC to work with DoH and the HSCB to develop a returners scheme that encourages candidates to return to Northern Ireland.
5NLMC – That this conference commends the vision of the University of Ulster in its plans for a medical school with a curriculum based in primary care.
6WLMC- Thatthis conference calls on Queens University medical school to modernise its undergraduate medical curriculum to allow medical students to spend more time in general practice.
7ELMC – That this conference calls for an urgent enquiry of the reasons not to implement the 3 previous workforce plans which, if implemented, would have resulted in over 150 more GPs in NI and averted the current crisis.
Negotiations11.15 – 11.30
8ELMC – That this conference thanks Dr Tom Black for his unwavering leadershipand support of the profession during these challenging times ofcrisis.
9SLMC – That this conference insists that all our political representatives implement the Bengoa report as per their commitment in 2016.
10NLMC – That this conference condemns the actions/inactions of local political representatives that have put the health and welfare of the most vulnerable in our society at risk.
Undated resignations (themed debate)11.30 – 12 noon
Question: Should NIGPC proceed to action practice undated resignations?
11*SLMC – That this conference calls on GPs to move ahead with practice URs as this is the only way to save general practice in NI from the destruction of the service by our department of health.
12NLMC - That this conference demands that the strategy of undated resignations and development of “Plan B” be continued until either it is no longer required or it is the only option left to ensure the survival of general practice in Northern Ireland.
13ELMC – That this conference calls for the release of more detail of plan B from NIGPC so that a fully informed decision can be made by practices.
14ELMC – That this conference calls for the development of a Plan C to enable practices that wish to remain within the NHS but not continue with the current contract to be able to make an orderly transition to a contract held by another body.
15WLMC - That this conference instructs NIGPC to commission a public relations campaign to demonstrate the efficiency, the effectiveness and the value of general practice to the public.
Practice collapses 12 noon – 12.30
16*SLMC – That this conference reminds HSCB, that as holders of GP contracts, they have a duty of care to their contract holders especially in struggling practices.
17SLMC – That this conference insists that when HSCB is informed that a practice is struggling to maintain services, that it responds with urgent help and not simply remind the practice of their contractual obligations.
18SLMC - That this conference believes that with the real prospect of GPs going bankrupt if their practice collapses and without jeopardising independent contractor status, NIGPC will look at how to protect GPs in the increasingly common "last man standing" scenario.
19SLMC – That this conference calls on the DOH/HSCB to facilitate and finance practice mergers in an attempt to stabilise practices.
20NLMC – That this conference calls upon NIGPC to remind the health and social care board that as commissioners they are responsible to provide general medical services for all patients in Northern Ireland and that their contractual requirements in ensuring this does not put other patients at risk by threatening collapses of neighbouring practices.
21ELMC – That this conference advises DoH that their inaction has directly resulted to the current and continuing collapse of general practice.
22ELMC – That this conference instructs NIGPC to develop a plan to identify resources to support struggling practitioners and put inplace mentoring support where necessary.
23ELMC – That this conference instructs NIGPC to work with the department and health board to develop a contingency plan that can be put into action to stabilise general practice within a locality in the event that a practice is on the brink of collapse.
Indemnity 12.30 – 12.40
24*SLMC – That this conference demands funding of GPs indemnity costsin view of the fact that NHSE has agreed a scheme in England.
25A ELMC–That this conference calls for urgent negotiation by NIGPC with the department of health to ensure full costs of GP indemnity are met both in and out of hours and to include the whole practice team.
26A WLMC - That this conference instructs NIGPC to negotiate reimbursement of general practitioners' medical indemnity costs.
27NLMC–That this conference demands that the increasing indemnity costs to general practitioners, principals, and sessionals resulting from working in out of hours are addressed by the health and social care board, so working there is not deemed a financial “penalty”.
OOH 12.40 – 12.50
28ELMC–That this conference calls for an urgent injection of funding forGPOOH to stabilize and secure its future. Failure to do so may result in implosion across the province.
29SLMC–That this conference calls on an end to reward schemes in the OOH and demands negotiation of a regional rate of pay.
Prescribing 12.50 – 1 PM
30NLMC – That this conference demands that the HSCB remove “over the counter “preparations from NHS prescriptions.
L U N C H 1 – 2 PM
ANNUAL GENERAL MEETING OF THE NI LOCAL MEDICAL COMMITTEES CO LTD – LMC(NI) 5 2017
Rescue plan (themed debate)2.10 – 2.50
Question: What will it take to save general practice?
Update by Dr Richard Vautrey on the English perspective
31*ELMC – That this conference instructs NIGPC to continue to urgently lobby and collaborate with HSCB, DoH and elected representatives to ensure implementation and full funding for the GP rescue plan.
32NLMC - That this conference demands the department of health implements a fully funded rescue package for general practice in Northern Ireland, and if there is a political hiatus an interim package implemented immediately to ensure its existence and to enhance and support its infrastructure.
33SLMC - That this conference insists that, despite that whatever is going on at Stormont, a fully funded rescue package for general practice needs to go ahead without undue delay.
34SLMC – That this conference demands that our minister of health or in absence of a minister that the department of health, implements an immediate rescue package for general practice in NI before there is no GPs left to rescue.
35NLMC – That this conference demands that the next minister of health does not “consult” further but “implements” a structured rescue package for general practice in Northern Ireland.
36WLMC - That this conference calls on the department of health and RHSCB to urgently develop and deliver a credible, funded rescue plan for rural general practice.
37ELMC – That this conference seeks to put on record the support for all general practice teams at this time of crisis; in particular our receptionists, practice managers, and nursing staff who are alsoburdened with extreme volumes of work at this time.
38ELMC – That this conference instructs NIGPC to negotiate the urgent development of proper primary care teams so that any work that can be performed by a healthcare professional other than a GP should be offered to that professional in order to preserve the scarce resource that is GPs.
39SLMC – That this conference calls for an end to the increasing unnecessary administrative burden on general practice.
40SLMC – That this conference demands a fully funded GP sickness scheme in line with that agreed by NHS England.
Demand 2.50 – 3.00
41ELMC – That this conference instructs NIGPC to ensure that any changes to the GP contract will include measures to manage demand such as co-payments.
Contract/ salaried service 3.00 – 3.20
42*ELMC – That this conference instructs NIGPC to call on GPC UK to renegotiatethe GP contract in order to preserve a safe and effective general practice service within the NHS.
43SLMC – That this conference insists that the current GP contract is no longer fit for purpose, and that an alternative arrangement for providing primary care needs to be found as a matter of urgency.
44SLMC – That this conference demands that whilst they remain independent contractors, a variation to the contract should be sought, entitling GPs to reasonable annual leave, facilitated by HSCB.
45ELMC – That this conference believes the GP partnership model has served the profession well, but it has had its day. Conference instructs NIGPC to investigate other employment models for GPs.
46ELMC –That this conference opposes the idea of a salaried gp service held by trusts.
47ELMC – That this conference believes that for primary care general practice to continue to provide a safe, effective and sustainable service it needs to become a salaried service with the running of practices administration and estates handed over to a primary care provider.
48ELMC – That this conference instructs NIGPC and the LMCs not to agree LESs which are for less than 5 years as this creates instability in practices.
Funding 3.20 – 3.40
49NLMC – That this conference commends the approach taken by NIGPC chair Dr Tom Black and NIGPC in highlighting the derisory funding for general medical services in Northern Ireland in light of the increasing workload and decreasing workforce, to enable general practice to continue to exist in some recognisable format.
50A NLMC – That this conference demands the HSCB ring fences funding for primary care to at least 11% of the Northern Ireland healthcare budget.
51NLMC – That this conference demands that the department of health highlights to the population of Northern Ireland who they are not prepared to fund healthcare provision for through general medical services in light of the failure to fund the expanding population of Northern Ireland.
52SLMC - That this conference demands that winter pressures funding be allocated to practices directly on the basis of patient list size and not dependent on the availability of locum support.
Federations 3.40 – 3.50
53NLMC – That this conference demands the HSCB commission the development of community based teams around the practices that provide general medical services with named and responsible professionals liaising with GPs and their budgets devolved to GP federations.
54ELMC – That this conference thanks the GP federations for the development ofpractice based pharmacy provision and also for their development and innovation in a time of crisis.
Business improvement districts 3.50 - 4.00
55*SLMC – That this conference insists that practices located in business improvement districts should have reimbursement of the compulsory levy by HSCB, and that this should be funded by the department of health.
56 NLMC – That this conference demands that the HSCB fund increased rate liabilities to practices generated from the implementation of business improvement districts.
PHA/ HSCB 4.00 – 4.15
57ELMC – That this conference instructs NIGPC to inform GPs to reject any unresourced non GMS work from PHA.
58ELMC - That this conference instructs NIGPC to set up a working group to workwith the HSCB, DHSSPS NIMDTA and BMA consultants committee to tackle the issue unresourced work, non GMS work being passed from trusts to general practice.
59ELMC – That this conference instructs NIGPC to negotiate with the departmenta public health agenda and delivery based on local populations.
Sessional GPs 4.15 – 4.20
60NLMC: That this conference calls on NIGPC to work with the sessionals group to explore and resolve any problems that sessional doctors are having with reference to the superannuation scheme.
Research 4.20 – 4.25
61WLMC -That this conference calls for investment and development in the provision of research opportunities in general practice.
IT 4.25 – 4.30
62ELMC – That this conference instructs NIGPC to work with the board to expedite ICT solutions that will assist in the provision of 21st century general practice including electronic prescribing and the electronic transfer of GP records.
NIAS 4.30 – 4.35
63SLMC - That this conference notes with concern the increasing tendency of NIAS staff to assess and leave patients, often with instruction for immediate review with their GP, and instructs NIGPC to liaise with NIAS to ensure safer and more acceptable pathways for patient care.
AND FINALLY ......
64ELMC – That this conference instructs the last GP practice holding a contract to please switch off the boilers.