Notes of the meeting of North West Forum of Sessional GPs
20th January 2015
Attending: Dr S Baier - Chair
Dr T Ahmad Dr R Avasthi
Dr S Clarkson Dr C Coyle
Dr G Dean Dr U Desai
Dr M C Fernandes Dr R Glen
Dr G Jagan Dr C Jones
Dr I Juozaitiene Dr M Kaur
Dr M Lupton Dr R Mathews
S Mirza Dr E Pimlott
Dr C Shah Dr E Tsouma
Dr S Velusamy Dr S Wong
Dr R Yerra
Dr S Shackleton
Mr D McGrath, Lead Executive, LMC
Apologies: Dr F Apaloo, Dr S Ashraf, Dr A Greenwood, Dr G Phillips, Dr L Sears, Dr S Glendinning, Dr C Carradus
1. Presentation; Dr S Shackleton
Members welcomed Dr Shackleton to the meeting who proceeded to give a presentation on ‘The successful transition from children’s services to adult services’.
A successful transition from children’s services to adult services will make a difference to the care of young adults who have life limiting conditions. This applies to education, social care, psychological and mental health services as well as medical services. This would involve work with young people who have capacity and their families from the age of 14.
The following points were highlighted:
- Reference was made to the STEPP project which is a 3 year project looking at the transition from paediatric care to adult care for young people with life limiting conditions.
- Early days in an adult clinic are scary, intimidating and overwhelming.
- What are the issues for GPs and the practice team?
o Do young adults under GPs care have free will and control over how much their parents are involved?
o Does the practice reflect on and respond to the reality of involvement of parents in young adult lives?
o Does the practice provide opportunities for patients to speak with the practice team?
o This applies to contraceptive care and safeguarding issues
- What GPs can do when young patients are experiencing worrying symptoms or ill-health?
o Work with the families using their preferred methods of decision making
o Share difficult news gradually
o Avoid decision making in a crisis
o Make a record of discussions and issues that need further discussion
o Make a record of the young person’s wishes regarding their parents role in decision making.
- GPs need to consider from a CQC point of view needs of a young patient moving into adult care. These would include – social needs, employment, housing, education, sexual health, psychological and emotional health.
- Areas Primary Care need to consider are:
o Promoting safeguarding and have policies for children and vulnerable adults
o Some children with complex health care needs can become vulnerable adults
o Children have individual care packages and have responsibility for their own care once they move to adult care and are often open to financial exploits.
o The Liverpool Care Pathway is not in use anymore and many Trusts have their own pathways for end of life.
Members thanked Dr Shackleton for a very useful presentation.
2. Welcome to new members
Members welcomed new members to the meeting.
3. Notes of meeting held on 4th November 2014
The notes of the meeting held on 4th November 2014 were agreed as a correct record.
4. Matters Arising
(i) Deprivation of Liberty (DOLS)
Members were urged to familiarise themselves with the Deprivation of liberty safeguards (DOLS)
5. GP Support Scheme
Dr Baier made reference to the LMC GP Support Scheme which is available to all GPs across Cumbria & Lancashire. Information is available on the LMC website - GP Support Scheme. A paper highlighting the benefits of the scheme had been circulated with the agenda for information.
6. Local Medical Committee Elections
Reference was made to the forthcoming LMC elections. Each of the three LMCs in Lancashire have vacancies for a sessional/locum GP. Nominations forms would be sent to all GPs in the next couple of weeks.
7. BMA Sessional GP Subcommittee
Dr Lupton reported that she had attended a GP Sessional Subcommittee meeting on the 13th November 2014. Areas of discussion were as follows;
- Over 75s named GP. There had been concerns that salaried GPs would have increased unpaid work. In some areas salaried GPs were being paid and admin session to do the work for over 75s care plans. GPC was working to protect all GPs from increased workload.
- Publication of earnings. Publication of earnings will be based on the average of all GPs (contractor and salaried) working in a practice and not WTE proportions so any figures will be meaningless.
- Dr Lupton reported that newly qualified GPs still want to be partners.
- There had been discussions on a paper ‘The role of Sessional GPs within the Future of General Practice’.
- Various statistics had been presented. These included;
o In 2013 female Drs made up 44% of licensed Drs and 49% of GPs
o Of those female Drs on the register 58% were aged 30-50
o In total (male and female) 38% of the workforce were aged 50+
o Borne out by the last BMA Cohort Study where 47% of those cohort GPs were salaried and 26% were freelance/locum GPs. With this in mind they should be listened to and have a voice.
- NHS 5 Year Forward – Care Models. These were discussed at length. Concerns had been expressed that the reforms were happening within general practice with 40% of GPs being left out of the negotiations i.e. locums & sessional GPs.
- Appraisal. It was reported that Scottish sessional GPs had been granted £350 for appraisal but they had to complete a non-compulsory workforce survey. GPC were still negotiating payment for sessional GPs in England. Reference was made to SOAR the Scottish online Appraisal Resources which has a specific area for Sessional GPs.
Dr Lupton reported that the following day she had attended a Sessional GPs Conference – future proofing your career.
Quality Improvement
Dr Lupton referred to "a tip from another committee member for an easy quick Quality Improvement Activity – looking at the notes for the last 5-10 children <5 you have seen to see if you have documented P, CRT, Temp & RR as per NICE Guidelines and then recording 5 or so subsequent ones to show an improvement." (P=pulse, CRT=capillary refill time, Temp=temperature, RR= respiratory rate)
8. Views on demand for locums – general discussion
Locum GPs present reported that they were in big demand at present. Members referred to issues around negotiating fees and calculating their Superannuation when working in practices. Reference was made to two very useful documents on the BMA website which would help both the GP and practice.
survival guide for locum-superannuation and survival guide for locum superannuation
It was noted that most areas had recruitment problems and practices had to use locums. Members discussed issues around whistle blowing.
Mr McGrath made reference to the Prime Ministers Challenge Fund. The following points were highlighted;
- The government were looking at different ways of delivering care to patients
- There was a potential for locums to be employed in the new services being set up
- There was a worry that there would be a shortage of GPs in general practice particularly if salaried GPs migrate to these schemes
- Reference was made to Preston Urgent Care Centre, Blackpool, Heysham and Morecambe.
9. Standing items
(i) Revalidation & Appraisal
Reference was made to the appointment of Dr Raj Patel, new Responsible Officer and Medical Director. This follows the merge of the Lancashire Area Team with Manchester Area Team.
(ii) CCG update
Reference was made to Co-Commissioning and 7 out of 9 CCGs across Cumbria and Lancashire have applied for full Co-Commissioning status level 3. West Lancashire and North Lancashire have applied for level 1 but it was felt that they might be pressured in to level 3. Co-Commissioning guidance
(iii) QOF Issues for Locums
Members were urged to familiarise themselves of QOF changes.
10. Any other business
(i) GPC Negotiators Roadshow.
Reference was made to the regional GPC Negotiators Roadshow which was to be held on Wednesday 4th March 2015. Dr Richard Vautrey, GPC Deputy Chair will be giving a presentation at the Preston Marriott Hotel. All GPs are welcome to attend.
11. Correspondence
A list of correspondence e-mailed to members since the last meeting had been circulated with the agenda for information.
12. Date & time of next meeting
It was agreed that the next meeting of the Sessional GPs should take place on Tuesday 24th March 2015.
It was agreed to ask Dr Kumar, Consultant in Cardiology to give a presentation on ‘New Developments in Cardiology’
Future meetings would start at 7.00 p.m.
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