GPC England's LMC Update: 6 June 2022
Important information on the GP pension scheme – new CPI modeller
The recent soaring rate of inflation will have significant tax implications for some GPs’ pensions. This applies to those who are active members of the scheme contributing at any point of the current 2022/23 tax year, as you could have very large Annual Allowance charges, when such charges become due, depending on your accounting / pensions administration.
The BMA Pensions Committee have launched a new CPI modeller for the GP pension scheme for GPs to look at their pension growth in 2022/23 and 2023/24 tax years, and to explain the problems with poor design of the Annual Allowance and how it will interact with the 1995 / 2015 GP pension scheme, and Annual Allowance taxation. It is important that you urgently take steps to at least understand your position and the potential impact this may have on future Annual Allowance charges. Entering your own data and numbers in the tool will only take a few minutes and will enable you to see how this might affect you personally – for many members they may need to estimate the value of their current pension based on their most recently available pension savings statements, subsequent contribution history and pensionable earnings.
The Pensions Committee continue to lobby Government on this significant issue and encourage members to raise this with their local MPs, and help increase awareness with fellow GPs. Thanks to the Pensions Committee for their hard work on this, particularly the chair Vish Sharma, and the deputy co-chairs, Tony Goldstone and Krishan Aggarwal.
Fuller Stocktake report on the next steps for integrating primary care
Last week, NHSE/I published the ‘Fuller Stocktake report’ on the next steps for integrating primary care in England.
General practice’s strength and value lies in its ability to provide good quality care from within communities, offering continuity and reassurance for patients. It is therefore positive to see this report and the accompanying King’s Fund analysis recognise and champion the invaluable part that practices play in the health of their local areas, and why it is so vital that general practice is given a leading voice and role when it comes to overhauling health systems locally.
Throughout the pandemic, practices seized the opportunity they were given through increased flexibility to quickly adapt for the better under the most difficult circumstances, and it’s particularly positive that this report recognises that this autonomy is far more valuable in improving outcomes for patients than top-down directives and micro-management.
While the report highlights pockets where good collaboration is happening successfully already, we will continue to advocate on behalf of and call for more support for those areas that are struggling.
Read the full BMA statement here
Extending fit note certification
From 1 July, legislation is changing which will allow more healthcare professionals to certify fit notes to patients.
Currently only doctors can legally certify fit notes. DWP are now changing the legislation which will allow a further four professions to do this. These professions are nurses, occupational therapists, physiotherapists, and pharmacists.
Not everybody working within these professions should issue fit notes. Professionals should be working in a suitable environment and have the necessary skills and training to have work and health conversations with patients. This task needs to be within their professional ‘scope of practice’, therefore new guidance and training has been developed which will help professionals to identify if this task is suitable for them.
This legislation change applies across England, Scotland, and Wales.
This change follows legislation changes in April which removed the need for fit notes to be signed in ink. This change made it possible for doctors to certify fit notes digitally and also for patients to receive their fit note via digital channels (where GP IT systems support this).
Working conditions of independent contractor GPs
GPC England met last week in our first face-to-face meeting since before the pandemic. In that meeting, the committee debated and passed a motion regarding the working conditions of independent contractor GPs. This motion reaffirms GPC England’s commitment to defending the independent contractor model, whilst highlighting the committee’s concerns about the pressures GP contractors are under, and its recognition of how undervalued they are by the current Government. Representatives also firmly believe the interests of independent contractors, and defence of the model, are also best served by one united committee for all GPs in England.
Commenting on the motion, I said:
“General practice has evolved over many years, changing to meet the needs of communities, but with the independent contractor model sustaining as the core on which it is built. We know that patients appear to benefit from continuity of care, with the quality, strength and consistency of their relationship with their family doctor having a significant impact on their health outcomes. All of this and more is possible through the independent contractor model.
The outcome of this motion reaffirms the committee’s wholehearted support and commitment to this model that allows for high-quality, cost effective and timely care, despite it being poorly valued by policymakers. And it further demonstrates how important it is that the profession stands together with strong representation for all GPs, regardless of career path, at a time when general practice and the whole of the NHS and care system are facing unprecedented challenges.
With the NHS undergoing significant reorganisation, it is vital that a strong, high quality general practice is able to thrive as part of the wider system and meet the needs of patients.”
GP workforce and appointment data
The latest GP data from NHS Digital once again shows a decline in GP numbers. Compared with this time a year ago, England has the equivalent of 396 fewer full-time, fully qualified GPs – having lost a further 26 in the most recent month alone. To this end, 1,622, fully-qualified full-time equivalent GPs have been lost from the workforce since 2015 (when the current collection method began). Meanwhile, the total appointments booked have reduced to 24.0 million in April 2022 from 29.7 million in the previous month – this is potentially due to there being fewer working weekdays in April compared to March.
Doctors have undercharged for private and non-NHS fee-based work for years, effectively subsidising the system and taking the hit on their take-home pay. In response to this issue which was highlighted during ARM last year, we recently launched the Fees calculator and feedback has been extremely positive. Many doctors told us that they rarely reviewed their fees, some looked to their peers to gauge what to charge, and others used guidelines that were years out of date. The Fees calculator helps doctors decide how much to charge for their services based on their own circumstances. Find out more
The Fees calculator uses your overheads to calculate a fee range for the time it takes to complete a piece of work. The calculations are specific to you, and you can see what rates you would need to charge to make sure your costs are covered. You can find out more about how the tool can help you save money and save time.
Rebuild General Practice: support the campaign
The Rebuild general practice campaign continues to tackle the crisis facing general practice. The campaign has been building awareness of the key issues in the media, with the public and with politicians. We need your support to amplify the message and make the campaign a success.
Invite your MP to the parliamentary event
We are hosting a parliamentary drop-in event on Wednesday 15 June. The aim is to engage politicians from all parties, and raise awareness of the challenges facing general practice. This is a real opportunity to influence policymakers, and we are encouraging you to write to your MP and ask them to attend. Write to your MP
Have you signed the ‘Letter to my patients’?
The campaign is asking GPs across the nation to sign an open letter to our patients - showing them that GPs are on their side. Over 250 GPs have already signed. To add your signature, simply email email@example.com with your full name. You can read the letter on the campaign website.
An increasing number of monkeypox infections are being identified with some spread in the community.
Whilst the risk is currently low, an increase in numbers is expected, and the UK Health Security Agency (UKHSA) is asking people to be alert to any new rashes or lesions on any part of their body.
Although this advice applies to everyone, initial infections are currently mainly in urban areas with a particular focus on gay communities and men having sex with men. Practices should remain vigilant as anyone in close contact with a case, including household contacts, will be at risk.
If you are concerned that a patient may have contracted the disease, use appropriate PPE, including mask and gloves. Isolate the person whilst seeking advice on next steps from the local sexual health clinic for urgent advice or your local health protection team, and ensure the consultation room is cleaned appropriately afterwards based on UKHPA advice.
We have raised concerns with NHS England that specific guidance for primary care has not been provided.
If you have any specific concerns, please get in touch and we can raise these with UKHSA.
Read more, including guidance for healthcare professionals, on the UKHSA website.
Safe surgeries survey
Doctors of the World (DOTW) is working with UCL and the NHS to better understand issues facing underserved groups when accessing GP services. They want to hear from general practice staff (including reception staff, managers, clinical staff) to find better ways to support staff and patients to ensure that everyone can register with a GP. Part of this work will involve evaluating and redesigning the DOTW UK Safe Surgeries Initiative, a BMA-endorsed programme and toolkit that supports GP practices to become more accessible to socially excluded groups.
This project ‘Right to Care’ aims to identify barriers and facilitators to support socially excluded groups such as people experiencing homelessness, people with irregular or insecure immigration status, people who sell sex, and members of the Roma, Gypsy, and Traveller communities who may experience unique challenges to access primary care and to register with a GP.
GP staff perspectives will be highly valued and will help better support the needs of your GP practice and community. Please complete a 5 minute survey by 20 June 2022.
If you’re interested in participating in a short online interview, please contact Kerrie at
NHS Digital survey on the future of GP data sharing
Following discussions last year around the proposed GP Data for Research and Planning programme, and ultimately the indefinite delay to the programme. NHS Digital is now seeking views from the profession to shape their thinking in this area and more broadly in terms of data sharing across general practice. They have produced a 5-minute survey with a view to garnering feedback from all practice staff, so please forward on where appropriate. The survey will close on Friday 10 June 2022.
Primary care wellbeing survey
NHSE/I has commissioned the Institute of Employment Studies to carry out a survey of the wellbeing and resilience levels of staff in primary care. The findings provide valuable insight into the wellbeing of primary care staff and help national and regional teams to respond to the needs of the workforce.
The survey takes 10 minutes to complete, and will close at the end of June. Take the survey here
NHSE/I health and wellbeing support is available on the FutureNHS space. This includes a coaching programme, support for managing patients and promotional resources to share with teams.
Annual health checks to patients aged 14 years or over on the learning disabilities register
Under the LDHC (Learning Disability Health Check Scheme) DES, GP practices are required to offer an annual health check to each patient aged 14 years or over on the learning disabilities register. The requirements are set out in the DES Directions 2022. During the pandemic, NHSE/I advised GP practices that the LDHC could be undertaken with a blend of remote and in person appointments.
However, recent feedback of patient experience gather by NHSE/I has indicated a preference to return to face-to-face checks, so NHSE/I request that GP practices ensure at least part of the check is face to face unless there is a strong clinical and/or patient preference for not doing so. Where the LDHC has already been delivered virtually this financial year, this will still be counted. More information can be found here.
LMC UK conference 2022
BMA annual representative meeting 2022
27–29 June | The ARM is a hybrid event this year, taking place online and in Brighton, with the theme ‘Fighting for our rights, fighting for our future’. See the agenda and find out more
GPC ARM elections
We are seeking nominations for 10 seats on GPC UK for a one-session term. At least one seat will have their principal place of work in England, one in Northern Ireland, one in Scotland and one in Wales, and be elected by the RB as a whole. Find out what you can expect as a committee member
To stand in this election, you must be a BMA member and have a BMA online account.
Nominations will close at 10am on Monday, 27 June. Nominate yourself at elections.bma.org.uk
Voting will take place during the ARM on 27–29 June. Voting is open to delegates of the ARM only.
Read the latest GP bulletin (England) here