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Your Chairman writes.

No. 269

Cornwall & Isles of Scilly

LMC Newsletter

February 2014

Development of our Cornwall wide provider company is proceeding.

Kernow CIC AGM is coming up shortly and it is important that your
practice is represented at this meeting or at least transfers a proxy vote to
either myself or another representative so that the process of evolving
Kernow CIC into our provider company proceeds without delay. A group
of interested managerial and GP colleagues will meet shortly to start the
work needed to develop Kernow CIC into a business. I am still keen to
hear from those of you who would be prepared to devote some time,
energy and expertise to this project. Please don't assume that you have
nothing to offer or that someone else will do the work on your behalf. We
will need people with a wide variety of skills to deliver this project.
Meanwhile, GP life plods on. As we approach the end of the QOF year I
would urge you to maximise your QOF returns so that we can evidence
our commitment to the QOF agreement that we negotiated with the Area
Team. We will shortly be sharing the forms required to evidence your
work towards 2014-15 QOF which was part of our deal with the AT.
Finally, we need your views on matters that you would like us to raise
nationally at LMC conference in May. We will shortly be submitting
motions that we hope will be debated. If motions are passed at
conference they become policy of the General Practitioners Committee
(GPC) so this is a great opportunity to exercise your democratic rights in a
medical context.

Inside this issue:

CFPT End of Life Care Project
Update from the GPC.

N3 Connection

RCGP Meeting - Truro

Free GP Trainers nMRCGP
revision resource.

GP Champions Supporting
Carers in General Practice.

At the LMC we have been

made aware of two practices
who have problems with their
N3 connection.
If you also have problems
please contact Dawn at the
LMC office and we will take the
issues forward for you.

Seniority Factors



Items for the Newsletter should be

sent to the Editor, Dawn Molenkamp
at Sedgemoor Centre, Priory Road,
St Austell PL25 5AS
Tel :01726 627978,

CFPT End of Life Care Project

On the 1st May 2013, the second phase of the CFPT End of Life Care Project commenced.
In 2012 CFT Complex Care and Dementia Services ran an End of Life Care Pilot Project in the east of Cornwall (Phase 1). The End of Life Care Pilot Project developed and implemented a series of steps/measures and
approved documentation to improve the care and quality of life for people in the end stages of dementia in
Care Homes. The project is specifically aimed at residents who lack mental capacity to make decisions about
their care and focused mainly on residential homes and as such fits well into the Gold Standards Framework
The project also provides 2 training packages. The first seeks to improve assessment and monitoring skills for
unqualified staff to assist in early detection and treatment of health problems with the aim of preventing admission to hospital. The second gives staff knowledge and skills to monitor and where possible reduce antipsychotic medication prescribed to residents with dementia.
The Care Homes that participated in the End of Life Care Pilot Project last year found the process an extremely
helpful and positive experience. The project has won an HSJ Excellence in Health Care award in 2013 and has
been approved as best practice by:
KCCG (then CIOS PCT) Information Governance & Clinical Governance Committees - Via the Comms dept.;
Patient Safety Committee; SWAST (Kevin Roberts); SERCO - medical director; LMC; Cornwall Coroner (Emma
Carlisle); DOLS (Paul Wilkins)
Peer reviewed and approved by DoH; National Council for Palliative Care - have approved the project as best
The project team are collaborating closely with SERCO and SWAST to improve out of hours knowledge and
communication, as well as collaborating with Julia Oxenbury, GP Dean from SW Deanery who has made ST3
& 4 input available to the project.
Funding for Phase 2 has come from a successful bid to the Prime Ministers Dementia Challenge Fund and will
roll out the project to a further 44 Care Homes across the county as well as maintaining the original pilot sites
over the next 12 months. The second phase of the project is being led by Lynn Dunne, Clinical Project Manager and a team of 3.5 wte End of Life Practitioners. Lynn is a qualified nurse and nurse teacher who holds a
M.A. in Law & Medical Ethics and has many years experience in NHS organisational development and implementing special projects. She also has a keen interest in improving patient experience and worked for The Patients Association before joining the Trust.
At the end of the year, the project will be handed over to staff within the Complex Care & Dementia Services at
CFT, who will continue to roll this project out to the remaining 200+ Care Homes across Cornwall.
The End of Life Practitioner posts have now been filled, with appointed staff in post from the beginning of September 2013.
A list of the participating Care Homes for phase 2 is below:
Tregenna House NH, Tremethick House, Pine Trees, Kenwyn, St. Martin's House, The Brake Manor, Trecarrel
CH, Ponsandane CH, St. Breock, St. Mary's Haven RH, Athelstan House, Blackwood House, Kernow House
inc. Millaton Court, Rosehill House RH, Trefula House NH, St. Margaret's NH, King Charles Court NH, Poldhu
CH, Elmsleigh, Tregertha Court, The White CH, Trevern, Trevarna, Garsewednack RH, Fairholme NH, The
Grove, Pendruccombe House , Trengrouse House, The Green, Trevaylor Manor CH, Pengover House, Trewiston Lodge, Fore Dore NH, Courtlands, Torpoint Nursing Centre (AKA Torcare), Chypons, Harbour House, Cedar Grange, Clinton House NH, Hillcrest House NH, Collamere CH, Tamara, Trewartha House, Eventide
Home, St. Anne's, Beech Lawn , Tamar House, Asheborough House, Coombe House, Sheldon House, Crossroads, Atlantis, Restgarth, The Old Manor

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Update from the GPC

Halt to programme
I am pleased to say that GPC was instrumental in securing a six-month delay to the implementation of the government's scheme following several weeks of urgent talks with NHS England regarding GPs' significant concerns about a lack of awareness among patients of the scheme. In our call for action we urged the
government to halt any uploading of patient data until a properly informed public awareness campaign was put
in place.
Now that NHS England has acted on our concerns it is vital we use the delay productively. We have already
opened dialogue with NHS England on the next steps, including having their National Director for Patients and
Information, Tim Kelsey, attend last week's GPC meeting.
Today, I spoke at the All-Party Parliamentary Health Group meeting and, yesterday, I appeared before the
Health Select Committee to present GPs' views on I emphasised that we are custodians of sensitive
and confidential patient information and any fears patients have about the security of their data will damage the
trust they place in us as GPs. The system must engender the confidence of GPs and patients alike
and their ability to make informed choices about the use of their data.
Given the degree of publicity, some of your patients may have questions about what is happening with their
personal data. Please advise them that this scheme has been put on hold until the autumn, pending an adequate public information programme and assurances that data will be properly protected and used only to improve healthcare.
5 per head funding for practices to improve care for vulnerable older adults
It is welcome that NHS England's recent planning guidance, Everyone Counts, recognises the need for practices to be given additional resources to provide improved quality of care for patients over the age of 75, over and
above the avoiding unplanned admissions enhanced service that will be coming into effect in April. CCGs are
expected to fund practices at around 5 pounds per head of practice population.
I would therefore urge practices to contact their CCG Board now with regards to making these funds available,
and also to contact their LMC for any additional advice. For more information see paragraphs 36 and 37 in this
NHS guidance
Funding redistribution for GMS practices
You will be aware that from April 1, there will be funding changes for GMS practices as part of last year's government's contract imposition, which will see the phasing out of MPIG over a seven-year period. There will be
redistribution of the correction factor across all GMS practices, with each ending with an equivalent weighted
per head funding in seven years.
This will mean that about half of GMS practices will lose funding, while the other half will gain. Our biggest concern is for those practices which will lose significant sums of money and the impact this could have on service
provision or even practice viability.
NHS England has identified 98 practices as outliers'; those who will suffer the greatest losses. They have assured us these practices will be offered appropriate financial protection. However, in late December, Area
Teams were somewhat belatedly told that these arrangements would be left to local discretion. We have not
been advised of the identity of these practices, with NHS England stating this information is commercially sensitive.
We have expressed our dismay at this being a local process instead of being nationally directed, and that it is
unacceptable to leave practices at the mercy of local negotiations just weeks before these funding cuts take
We strongly encourage outlying and any other significantly adversely affected practices to contact their LMC so
that they can work with Area Teams to find an acceptable way forward.

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Update from the GPC contd/..

PMS practices
NHS England has also announced funding changes for PMS practices. It has identified 235m of premium'
PMS expenditure as the amount by which PMS funding exceeds total GMS expenditure of global sum plus
Correction factor
It is proposed that this 235m premium funding will be redeployed for new GP services, with equal opportunity
across GMS and PMS practices, according to criteria set by NHS England. Area Teams will have up to two
years from April this year to review their local PMS contracts, with the pace of change on the redeployment of
premium funding following the reviews being left to local judgement.
We have firmly advised NHS England that this is an inappropriate approach at a time when GP practices are
overstretched, and that it would be better to redistribute this premium funding across all GMS and PMS practices to provide improved core services to patients. We will be issuing guidance shortly on this matter.
NHS England also recently agreed to pay PMS practices belatedly their proportion of the historic resource for
employer locum superannuation. This funding should be added to PMS budgets.
Other engagements
On 12 February, I attended and delivered a keynote speech to an excellent and well attended Londonwide
LMC conference on The Power of Collaboration. It comprised presentations and workshops allowing GPs to
explore and learn about how best to work together to maximise cost-efficiencies and productivity.
I attended the Welsh LMC conference over the weekend of 15 and 16 February. I would like to thank Charlotte
Jones, GPC Wales Chair, and Eammon Jessup, Chair of Conference, for wonderful Welsh hospitality mixed
with excellent debate. It was illuminating to observe the common themes affecting GPs across the border. A
particular highlight for me was the evening entertainment from a band made up of highly talented GPC members.
This week I was one of a senior BMA team that met with the Labour health team, as part of the BMA periodically meeting all the major political parties. I use every opportunity of advising politicians from all parties of the remarkable success of UK general practice, and the benefits to be reaped by supporting and investing in general
practice as a means to delivering future sustainability in the NHS.
Best wishes,
Chaand Nagpaul
Chair GPC

RCGP meetings in Truro

Our next meeting is at the Duchy Hospital on the 5th March at 7 pm. We have the RCH Neonatal Unit's Dynamic
Duo - Dr Paul Munyard and Ms Judith Clegg. If I start listing their experience and knowledge then this email will be
too big to send through GroupWise! Their immense patience and enthusiasm for teaching for countless years, has
left many trainees with vastly improved confidence in dealing with Neonatal issues. I will not be uploading their
presentation on the faculty website so please don't miss this only chance to enjoy a great educational session.
Please arrive early as food and drinks are available from 6:30 pm and talk will start promptly at 7:30 pm. Staff Car
Park behind the Duchy Hospital is free.
I am in the process of reshuffling the April and May meetings so please watch the space or contact me if in doubt....
Dr S Rao
Mob: 07861390708
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Free GP Trainers nMRCGP revision resource

We are 3 GPs in Cornwall who have recently set up an online education website for doctors
As part of the nMRCGP revision section we have designed a free resource that GP trainers can utilise as a training
tool to help GP ST trainees prepare for the AKT and CSA.
dotMedics AKT training resource:
provides 100 free questions from the dotMedic AKT revision bank, including revision notes and explanations
these questions are automatically marked and include peer-group benchmarking of your scores.
dotMedics CSA training resource:
includes 10 free cases presented in exam format, with case marking schemes and further explanations
also includes additional revision guidelines and tips
has been developed by fully qualified GPs for registrars preparing for the CSA
all cases are based on real-life scenarios
provides GP Trainers with a free resource to practice CSA role-plays with their GP ST trainees and use the explanations for further discussion and development
If you wish to take advantage of this training tool please email with your details name,
GMC number and which practice you are a registered trainer. dotMedic will contact you directly with your account
details. Your information will not be passed on to any third party,
Kind regards
The dotMedic Team
Dr Noor Hamad - Perranporth Surgery
Dr Sam Radford - Boscastle Surgery
Dr Stephen Seale - GP Cornwall

Applications now open for GP Champions

Supporting Carers in General Practice programme
The Clinical Innovation and Research Centre (CIRC) of the RCGP is seeking to appoint GP Champions for the Supporting Carers in General Practice programme in South West England, among other areas. This position requires a
commitment of at least 1 session/half a day per week and is initially offered for 6 months. Applications are welcomed
from RCGP Members or Fellows with an interest in the supporting carers agenda and who are able to translate the
vision for the supporting carers clinical area into effective local strategic and operational plans.
Deadline: 09:00, 10th March 2014
Please see our website for more information on this role -

Seniority Factors
The Final Seniority Factors for England and Wales for 2010/11 have been published today by the Health and Social
Care Information Centre, following agreement by the Technical Steering Committee. The figures are 94,080 for
England and 82,237 for Wales.
Further details and the report explaining the calculations may be viewed on the HSCIC website at
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Salaried GP required (6 Sessions)

Probus Surgery
Due to retirement we are looking for an enthusiastic GP who is caring, highly motivated team player, who
can demonstrate high standards of clinical excellence to join our friendly team at Probus Surgery. We are
a rural practice operating a number of branch sites delivering excellent care within the community.

6 partner practice

List size of 8500

Special Interests encouraged

DFFP desirable

Consistently high QoF achievers

Teaching Practice with support from a highly skilled Nursing team.

Active in areas of commissioning

Attached Surgical Centre

Informal visits are welcomed

Closing date for applications: Friday 21st March 2014

For an application form please contact:

Mrs Debbie Barnicoat, Practice Manager, Probus Surgery, Probus, Truro, Cornwall. TR2 4JZ

Telephone: 01726 882745

Salaried GP (with a view to partnership)

Harris Memorial Surgery, Illogan, Redruth
Due to retirement of our senior partner we are seeking a full-time (8 sessions) salaried GP with view to
partnership (part-time will be considered).
Our practice would welcome an enthusiastic and motivated GP committed to providing a full range of
medical services based on patient-centred care. We are looking for someone to bring new ideas and develop new services for patients. An interest Women's Health Care would be an advantage.
We are a long-established, well-regarded, part-dispensing, GMS Practice, with a stable list of 5340 between 3 full-time partners. We operate from modern, purpose-built premises, including a thriving branch
surgery at Lanner. We value our loyal and highly skilled nursing, dispensing and administrative team, who
are friendly and dedicated. We use Microtest Evolution clinical system, are consistently high QOF achievers and hold weekly clinical/business meetings.
Post available from 1st May 2014 but will wait for right applicant. Informal visits and enquiries are welcome. Closing date for applications Friday 7th March 2014, interviews to be in the following 2 weeks. Apply with handwritten letter and a current CV to Bob Boyce, Executive Partner, Harris Memorial Surgery,
Robartes Terrace, Illogan, Redruth, TR16 4RX, Tel 01209 842515.
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We are looking for Salaried GP/s, Partnership potential, to fill up to 10 sessions per week. We have a
flexible approach and will consider full-time or job share.

High achieving rural dispensing practice

GMS practice list of 17,500 patients (8,000 dispensing)

Practice owned purpose built premises

Undergraduate teaching

Full PHC Team, including Nurse Practitioners, Respiratory Nurse

High QOF achievement and patient satisfaction rating

SystmOne clinical system

Close to the moors and beautiful Cornish coastline

Applications are welcomed from newly qualified as well as experienced GPs

Informal visits and telephone enquiries welcome. Visit our Website at
Applications to
Mr P Harper, Business Manager, Launceston Medical Centre, Landlake Road, Launceston, Cornwall
PL15 9HH
Direct Line 01566 771060


suggested 20 hours per week

Salary: negotiable depending on experience

We are seeking a Practice Manager to join our friendly, supportive team. We are a small practice with a
list size of 2600, split over two sites.
The Practice Manager must have the strategic skills to lead and develop the practice in the evolving
changes within General Practice, as well as good people management and financial acumen.
Hours will be negotiable in order to attract the right person and meet the practice needs. Pre-arranged
informal visits welcome.
Closing date: 5pm Friday 7th March 2014
For further details about the post and an application pack please email current practice manager Jo Lloyd

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PART-TIME PARTNERSHIP -Veor Surgery, Camborne

An opportunity has arisen for a Part-Time GP Partner, to join our friendly and progressive PMS training practice with
8,700 patients, 4 sessions per week. We are looking for flexibility, enthusiasm and commitment to providing high
standards of clinical excellence.
Modern purpose built premises.

Consistently high QOF Achievement

Emis Web Clinical Systems

Nurse Led Chronic Disease Management clinics

GPs and nurses with special interests

Training Practice

Active members of our local commissioning group

NHS Pension Scheme

Please send expressions of interest and a copy of your current CV to our Practice Manager:
Teresa Kemp, Veor Surgery, South Terrace, Camborne, Cornwall. TR14 8SN 01209 611171 or e-mail to


Do you want to work in Cornwall, have an opportunity to use your talents in a forward looking team, and have a good
life in a flourishing seaside town with excellent facilities?
If so contact Mr Yorick ONyons, Practice Manager for details of a Partnership Opportunity at TRESCOBEAS SURGERY, FALMOUTH.
E-mail: or ring 01326 315615 / 07807768437
For information on the surgery see our website

Tamar Valley Health, Cornwall

GP maternity cover for 12 months from 21 June 2014
One of our associate GPs is going on maternity leave and we need to cover 4 sessions at Gunnislake Health Centre. These are currently Tuesdays and Fridays although we may be able to accommodate other days.
Our rural practice is situated in beautiful east Cornwall, within easy reach of Plymouth and the Cornish coastline.
We care for over 16,700 patients at the Callington & Gunnislake Health Centres, both purpose-built and practice
owned. Each health centre has a dispensary and we also have our own pharmacy and primary-care pharmacists.
We offer a wide range of services, including minor injuries; have high QOF scores; are extensively computerised
with Vision; and are actively involved in commissioning. We also enjoy what we do and value our terrific team!
For further information, please contact Kathie Applebee, Strategic Management Partner at or Gunnislake Health Centre, The Orchard, Gunnislake, Cornwall, PL18 9JZ. 01822 832641
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