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Cornwall & Isles of Scilly

LMC Newsletter

February 2016

Indicators no longer in QOF

Practices in some areas have been asked again to accept requests within
the Calculating Quality Reporting Service (CQRS) for the extraction of
indicators no longer in QOF.
GPC advised LMCs in 2015 on this data extract, confirming our position
that that the decision to retire and amend these indicators was intended to
reduce bureaucracy and allow practices to focus on the needs of patients.
These indicators were successfully removed during negotiations as being
clinically inappropriate and unhelpful to practices. As such, there is no
expectation that practices should continue to focus on achieving these
targets, and GPs should instead continue to use professional judgment to
treat patients in accordance with best clinical practice guidelines. It is for
clinicians to decide how they record clinical consultations and what codes,
if any, to use.
Practices should be reassured that the previous GP contract agreement
still stands, and there is no contractual requirement for practices to record
codes for former QOF indicators. However, practices are also asked to
note the position outlined within the 2015/16 QOF guidance - that
practices are encouraged to facilitate data collection of these indicators.
The data is intended to inform commissioners and practices and provide
statistical information. It is not intended for any performance management
GPC anticipates a large fall in the recording of many of the retired codes,
particularly those that were previously imposed, as practices now work
more appropriately. In our view, allowing retired codes to be extracted
could help to demonstrate how inappropriate it was to impose contract
changes in the first place, as well as informing discussions between GPC
and government on the development of more appropriate future indicators
of quality care.

Inside this issue:

Your Chairman Writes
Zika Guidance for Primary
Care./Fetal Alcohol Spectrum
Disorders/Urgent Prescription
for General Practice/ Sessional
GPs enewsletter
Results of the LMC Triennial


GPC NewsChaand Nagpaul

GP Contract 2016/2017


Firearms Licensing/Brook 1-1/

NHS 111 Healthcare
Professional Feedback Form

LMC Buying Group Seasonal

Flu Offer 16/17.
NHSE PGD Update/
Hypertension survey

Post Coital Coil Fitting/Patient

Online Access to Records

Waiting Room Music

This company provide copyright free music so you do not
have to pay an annual licence
fee to PRS or PPL .
They also give you a certificate to prove you are in the
clear licence wise.
Their CDs are not cheap at
30 but it is a one off cost.



Items for the Newsletter should be

sent to the Editor, Dawn Molenkamp
at Victoria Beacon Place, Room
B314, Station Approach, Victoria,
Roche, St Austell, PL26 8LG
Tel :01726 210141




Dr Basil Bile


Your Chairman writes ..

We recently set up a series of meetings based on the following premise : These meetings are an opportunity for you to provide your personal and practices views and influence the Future of General Practice in Cornwall & Isles of Scilly. The meeting will also help the LMC and the CCG to gather 'intelligence' from GPs of all levels of experience including those in training and those approaching the end
of their careers to inform the Sustainability and Transformation Plan (required in June 2016) that includes clear
plans for the sustainability of general practice. The format will involve an introduction to include:

Current workforce provision

Workforce projections
Work of the Primary Care 2020 group
Five Year Forward View and strategic planning
Government intentions
Current and possible future contractual framework
An LMC view of the direction of travel for Primary Care

This part of the evening should take no more than 30-45 minutes because the second part of the evening will
be devoted to small group discussions on the above topics and will include discussions on:

Career intentions
Shape of Cornish General Practice
The future of GP partnership
Portfolio Careers
Workforce development

Two meetings were held. The first was at Lanhydrock and the second at Falmouth. Both meetings were extremely well attended and in fact well over the 60 participants anticipated were present on both evenings. The
demographic of the audience was slightly different at the two meetings being on average 10 years older or
more experienced at the first Lanhydrock meeting compared to the Falmouth audience. Each meeting opened
with a short preamble. At Lanhydrock this was firstly Laura Wheeler from the Academic Health Science Network presenting workforce data, Peter Stokes from the CIC presenting some of the challenges for providers
and finally myself (Peter Merrin) setting the local and national scene.
Peter Stokes talked about Place Based Care in the context of the Five Year Forward View
The audiences were challenged to do the following: Design a Primary Care System for Cornwall assuming no new money, no more GPs. They were asked to state
what it might look like, how patients might interact and what sort of practice structures might be involved. They
were also asked how Primary Care might interact with Secondary Care, KCCG and KernowHealth CIC. Finally
the groups were asked how we might transition from our current positions.
In reality we talked about the pressures on Primary Care and how it might meet some of the demands of the
Five Year Forward View and the governments 7 day, 8-8 agenda.
Its fair to say that the first evening meeting produced some more radical suggestions with the audience feeling
more comfortable shifting their working week to accommodate government wants if it was needed with the
thought that the CIC and Cornwall Health would be the vehicles to deliver these objectives. Five basic themes
emerged from the meetings and were common to both. They are as follows: 1.

IT - it was agreed by everyone that IT remains a huge barrier for most of us with an inability to share
even the most basic patient information. Whilst we talked of interoperability solutions, most people present wanted Cornwall to move to a single web based IT system. Whilst acknowledging the obstacles to
this problem and its solution, we all felt it merited concerted effort and funding and not IT fudges/

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Your Chairman writes contd/...

2. Visiting - with the exception of a few diehards, it was agreed that visiting is a burden on most practices. The
LMC and CIC have agreed to look at the possibility of a visiting service to cover afternoons essentially extending OOH cover
3. Access - whilst this is a problem from the perspective of some patients, there wasnt much appetite to extend
this but there was some discussion of a single/shared telephone access/triage point with extension of the working week in a limited fashion that could be potentially provided by the CIC.
4. Buildings - this provoked much debate but older partners on the whole felt that the worry of owning property
was becoming a burden to all but a few. Spreading risk by sharing ownership was discussed as a separate entity or as part of practice redesign
5. Practice Models - could we be one large Cornish partnership? There are many different models of partnership and contracting. It was agreed that the LMC would explore these models and present some information on
partnership models and buildings ownership to the profession at some point in the not too distant future. The
Area Team have agreed to help with this work.
We have already begun to develop some of these themes in our 2020 group and we hope to be able to progress some ideas shortly. We will of course keep you up to date with any developments but would welcome
any further comments/contributions.

Zika Guidance for Primary Care

Information and guidance can be found here from the BMA or here from Public Health England.

Preventing and Managing Fetal Alcohol Spectrum Disorders

The BMA Board of Science has published a report on
Alcohol and pregnancy: Preventing and managing fetal alcohol spectrum disorders

Urgent Prescription for General Practice

The BMAs Urgent Prescription for General Practice webpage is here (and practices and LMCs in England and Wales will soon receive their resource packs.

Sessional GPs subcommittee's February enewsletter

the latest copy of the sessional GPs subcommittee enewsletter, which can also be accessed here

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Results of the LMC Triennial Elections 2016

As returning officer I am pleased to announce the results of the Committee elections 2016.
I am delighted to say we have 5 new members, and would like to take this opportunity to welcome them. They are Dr Michael Trowbridge of Bude, Dr Sarah Keast of St Austell Health Care
Group, Dr Hugh Savage of Stennack, St Ives, Dr Sam Radford of Boscastle and Dr Harpreet
Jones-Pahdi of Pensilva.
Sadly three veteran stalwarts, Dr Phil Dommett, Dr Robert Harvey and Dr Angus McDonald have
decided to resign from the committee after many years of sterling service, and I am sure everyone will join with me in wishing them all the best for the future and thanking them for all their tireless work on behalf of the GPs of Cornwall.

Your representatives on the Local Medical Committee are as follows:

Dr Paul Abbott (Boscastle)
Dr Linda Barry (Three Spires, Truro and Occupational Health Representative)
Dr Jennifer Early (Tamar Valley Health)
Dr Sarah Gray (Locum)
Dr Will Hynds (Portscatho)
Dr Steve Jefferies (Oak Tree Surgery, Liskeard)
Dr Harpreet Jones Pahdi (Pensilva)
Dr Jonathan Katz (Penryn)
Dr Sarah Keast (St Austell Healthcare Group)
Dr Beth McCarron (Lander Medical Practice and GPC Representative)
Dr Peter Merrin (Perranporth Surgery)
Dr Martin Priest (Petroc Group Practice)
Dr Sam Radford (Boscastle)
Dr Justin Randell (Narrowcliffe Surgery, Newquay)
Dr Nick Rogers (Falmouth Health Centre)
Dr Hugh Savage (Stennack Surgery, St Ives)
Dr Francesco Scaglioni (Locum and Pastoral Care Lead)
Dr Matthew Stead (Locum)
Dr Phil Trevail (Carn To Coast)
Dr Michael Trowbridge (Bude)
Dr Victoria Olobia (Locum)
Practice Manager RepresentativeMrs Sally Poxon (Carnwater, Bodmin)

Dawn Molenkamp
Returning Officer
Cornwall & Isles of Scilly LMC

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General Practitioners Committee

Continuity of care under threat
Independent contractor status: a bargain for the NHS
This month marks 25 years since I qualified as a GP. It's hard to believe that for a quarter of a century I have
worked continuously in the same practice where I became a partner the day after completing my GP vocational
training. It was a completely different world then, with general practice a buoyant discipline and the most popular postgraduate medical specialty. There were no recruitment or retention problems; 80 GPs applied for the
partnership position I attained. I joined with 'three years to parity' - the norm then - whereby the privilege of
partnership overshadowed a graded increase in pay in the early years.
It was also customary to join a practice for life, such that I took out a mortgage for a property in the local area
before commencing my partnership. I also secured a loan to buy into and fund the development of the practice
premises. With high double-figure interest rates at the time, the rent reimbursement was far lower than our
mortgage outgoings. As partners, we invested in our surgery at a loss, coupled with negative equity that lasted
for 12 years. This is in stark contrast with the returns expected by the private financiers of GP estate today.
None of this was an obstacle, though, since, like other contemporary GPs, I was driven by the long-term commitment of ownership, a sense of vocation, the empowerment of autonomy and the reward of giving continuity
of care to patients and families I have now seen for over a generation.
On reflection, no commercial organisation would have touched the practice I joined. It would have made no
business sense to put in the time, energy, or financial resources for what clearly was not a quick 'profitable'
venture. This is why the independent contractor partnership model has been an absolute bargain for the NHS,
run as it is by GPs who are directly responsible for caring for their patients and who provide uncosted long-term
loyalty and dedication to local communities. Their commitment has also fuelled innovation and a spirit of professional entrepreneurialism. Compare this with England's short-term commercial APMS (alternative provider
medical services) model, whereby non-clinicians often run general practices via remote control and a balance
sheet, primarily driven by maximising profits within a limited timeframe.

Short-term contracts damage continuity

In light of this, it is extremely concerning that Pulse magazine recently reported that NHS England's London
area team has a blanket policy of only offering APMS contracts for the procurement of all new or replacement
GP contracts. This will destroy the fabric, ethos and success of general practice, creating instability and
change every few years, and is at odds with the government's own 'named GP' agenda. It will also put off
those doctors looking for a long-term commitment and exacerbate the recruitment crisis. Then there is the expense of short-term contracts requiring short-term profit, not least the costs of tendering and managing local
contracts. We already have evidence that many APMS providers have been unable to deliver on contract values or have left at the end of their tenure. In other cases, contracts have been decommissioned due to poor
value for money - and let's not forget that many APMS contracts are better funded than their GMS (general
medical services) or PMS (personal medical services) equivalents.
NHS England London has justified its policy on the basis of competition law in England, arguing that all contracts need to be opened up to private providers. However, BMA legal advice is that even current procurement
regulations allow for flexibility and require consideration of several factors before a decision can be made about
whether to open up competition and what contract to offer. There is therefore no obligation to solely offer
APMS contracts to the exclusion of GMS or PMS. In light of this, I have written a letter of rebuttal to NHS England London.
I fully support GPs receiving fair recognition and financial reward for their hard work, and I also emphatically
believe that GMS long-term contracts provide proven best value for money for the taxpayer and comprehensive
dependable quality for patients. NHS England's priority should be to provide stability and support for the independent contractor status model and GP partnership.
Ultimately, the root problem that must be addressed is competition legislation in England, brought in under the
previous Labour administration and cemented by the Health and Social Care Act. This is why the BMA is rightly calling for a repeal of the act, so we can rid the NHS in England of the wasteful and damaging ideology of
enforced competition.

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General Practitioners Committee

Continuity of care under threat
Independent contractor status: a bargain for the NHS
The future is flexible
I fully recognise we are in different times from when I qualified as a GP, with many in the current and future
workforce wanting greater flexibility, shorter tenures and diversity of contractual options. The BMA GPs committee very much supports these differing aspirations. Therefore, it is important that the independent contractor
model evolves to offer opportunities for all GPs - from those wishing to work as partners, in salaried positions
or as freelance locums, to those with portfolio careers incorporating management or clinical specialist roles.
Fundamentally, all GPs should be able to work in the rewarding environment of clinician-led, patient-centred
care that has underpinned the service most surgeries have been offering their patients for decades.

Share your views on the future

The GPC has also started examining GPs' aspirations and concerns for the future. As part of this process, we
are holding a free workshop for trainees, newly qualified and sessional GPs. The event, hosted by Leeds local
medical committee on 23 September, will cover:

spirations and career opportunities

the developing role of GPs, GP practices and primary care (and the role of both sessional and future qualified GPs in this) GP networks and federations
finding a balance between patient access and continuity of care.
Come and share your views at Weetwood Hall Conference Centre and Hotel, Leeds, from 6.45pm. Food will
be provided and travel expenses reimbursed. To attend, email
Finally, if you'd like to share your thoughts on the future of general practice, or any other area of concern, join
the debate in our dedicated online community The Practice.
Best wishes,
Chaand Nagpaul
Chair, BMA GPs committee

GP Contract 2016/2017

The GPC have said that the changes offer immediate financial support for practices, recognising the actual components of rising expenses, and is designed to deliver a net pay uplift rather than a pay cut. There
is no new clinical workload requirement or any change to QOF, but the deeply unpopular imposed dementia DES is being removed with funding transferred to core, and vaccination item of service payments
have increased 28% from 7.64 to 9.80.
Full details, including non-contractual areas of agreement, are covered in the attached letter to the profession and FAQs.
Full details can be found here

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New Referral System of Medical Suitability of Gun Owners

A safer system for firearms licensing is being introduced in April to improve information sharing between
GPs and police and to reduce the risk that medically unfit persons may have a firearm or shotgun certicicate. At present, the police usually only contact an individuals GP before the issue of the certificate if the
applicant has declared a relevant medical condition. After the certificate is granted there is no reminder
system to inform the GP that the patient they are seeing is a gun owner.
From 1st April 2016

Police will ask every forearm applicants GP if the patient suffers from specific health issues,
such as depression or dementia.

GPs will be asked to place a firearm reminder code on the patients record. This means that
the GP will know a person is a gun owner, and that they can inform the police licensing department if
the patients health deteriorates after the gun license is issued.

New Guidance will be published to help GPs and police to operate the new system. Responsibility for deciding if a person is suitable to hold a firearm certificate remains with the police.

The new system was developed after the BMA raised concerns about the weaknesses in the current process with the Home Office. It has been developed by the BMA, RCGP and the police, in conjunction with
shooting associations and the Information Commissioners Office.

Brook 1-1 (Early Intervention Project)

Brook 1 -1 is a project for young people aged 11-25 who are risk taking with their sexual health or identified as being vulnerable to, for example, exploitation, unplanned pregnancy, abusive relationships, or displaying inappropriate behaviour. This one-to-one intervention aims to improve relationships and sexual
health through a 6 week program which is tailored to each individual and looks at a series of subjects
such as: self-esteem, healthy relationships, body image, protective behaviours and consent, assertiveness and negotiation, and cyber safety.
Embedded within the intervention are strategies and tools to empower the client to take control of their
sexual health and relationship choices. Goals are identified during the course to increase aspirations for
the future, and a follow-up with the young person is carried out three months after completing the programme, during which goals and achievements can be re-visited.
For more information or to make a referral please contact:

NHS 111 Healthcare Professional Feedback Form

Since the NHS111 service was set up we have had a system to allow all healthcare professionals to feedback
concerns/compliments to the service. Over the years we have received lots of feedback from the Out Of Hours
Services but very little from the in hours GPs. All the feedback is checked by SWAST and by the Quality
Group which includes the Clinical Governance Leads from Devon and Cornwall CCGs. SWAST do reply to all
comments but this can take some time after receiving them.
The easiest way of feeding back is via the Healthcare Professional Feedback Form supplied by the NHS 111
service. So if you come across a patient you feel the NHS111 service has not managed well or has done superbly in hours or out of hours please let us know either by completing the HCP Feedback form by using the
link or emailing myself.
Dr Andy Haywood
NHS111 Clinical Governance Lead
NHS Kernow
Email Address:
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LMCs Buying group Seasonal Flu Offers 16/17

The LMC Buying Groups Federation has concluded negotiations with flu vaccine companies for the
2016/17 season and we can now announce that our joint first preferred suppliers for 2016/17 are Pfizer
and GlaxoSmithKline (GSK). Our second joint preferred suppliers are Mylan (formerly Abbott) and MASTA.
Full guidance and Pricing can be found here
There are lots of useful items from the buying group that can be purchased at very advantageous rates, if
you have not done so yet, have a look at their website and see what savings you can make from Medical
Consumables and Equipment, through Insurance and Online Training as well as other day to day items

NHSE PGD update

There are three new PGDs on the NHS England South region website Pediacel, Boostrix and Repevax.
Another two PGDs are currently being signed off (Menitorix and Prevenar 13) and should be available on
the website by the end of Feb. The new MMR PGD proforma is currently being finalised by PHE and
should be with us in March.
Check out the website for latest position,

Organisation of care in Hypertension 2016

Invitation to take a brief survey
If you have already received this through the PCRN and responded there is no need to read further.
As part of our ongoing programme of work around nurse-led and pharmacist-led hypertension care, we have
previously surveyed practices in the South West about their organisation of care. Our earlier findings showed a
trend to increasing sharing of care with healthcare assistants and practice nurses, and evidence of planning to
devolve increasing levels of hypertension management to practice nurses.
Our last survey was in 2010. New NICE guidance on diagnosis of hypertension was published in 2011, and
our work on nurse-led care was cited in the 2013 European Society for Hypertension guidelines. The introduction of ambulatory and home blood pressure monitoring appears to have generated educational needs, and
given these developments we are interested in seeing how the landscape has changed. We have updated our
survey and would be very grateful if one member of your practice, perhaps whoever leads in hypertension, for
example, could undertake to complete it for us.
We estimate that the survey should take no more than ten minutes to complete. We will be happy to circulate
a summary of our survey findings to you when the project is complete, and there is the opportunity within the
survey to express interest, without commitment, in future hypertension research projects.
The survey can be found here:
If you have any queries please feel free to contact me.
Dr Chris Clark NIHR Clinical Senior Lecturer in General Practice
Primary Care Research Group, Smeall Building, St Luke's Campus, Exeter, EX1 2LU
Tel: +44 (0)1392 722754 (research group); +44 (0)1884 860205 (surgery) Fax: +44 (0) 1392 722894
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Post Coital Coil Fitting Reminder

Post coital copper IUD fitting has a negligible failure rate and is much more effective that the oral methods. If a
patient requests an appointment for an emergency coil fitting that your practice is unable to facilitate within the
required time frame, please support her to follow this course of action. They can access either:
The Contraceptive Service - The Contraceptive service runs clinics throughout Cornwall and is generally able to provide a post exposure coil fitting appointment at one of their clinics within the timescale.
Central Booking Line: 01872 255044
An alternative primary care provider. Most practices in Cornwall have a LARC IUD/IUS contract with the
Local Authority. This allows provision to both registered and non-registered patients. A colleague may be able
to help. Please familiarise yourself with fellow local surgeries provision via
Brook can offer appointments Mon-Wes at their Pool Clinic to under 25s. Booking Line 01209 710088
If referring on please continue to provide the most appropriate oral product even if it is likely to have
limited effectiveness.

Patient Online Access to Records

We have been made aware that within SystmOne (TPP) it is possible for patients to identify the names of administrative staff who have entered codes onto their clinical record through the patient view. Whilst there is a
requirement that clinical staff are identifiable, for administrative staff this is more ambiguous as under the data
protection act such information should only be disclosed when reasonable to do so. I understand it would be
anticipated that the names of staff would be disclosed under a Subject Access Request unless there was a
specific risk surrounding doing so.
Whilst we have not experienced any incidents from sites that have enabled detail coded record access, some
practices have expressed concerns about how this is visible within SystmOne. At this stage, this does not prevent enabling the organisational settings and providing access to a couple of patients as it should be possible
for the practice to select a couple of patients where this is not a concern (e.g. PPG members of other members
of staff). This enables practices to meet their contractual obligations and begin experiencing the new functionality.
This issue is being escalated within NHS England and with the supplier. I will let you know if there is any further clarification and/or an official position statement generated.
This seems to be saying, its legitimate for practices not to allow access if the staff object, but in order to meet
the contractual requirement get the staff to agree to allow a friendly patient access to their records so the
practice shows up as having enabled the functionality. A bit of a fudge.
The GPC response when asked the question was:
The GMS regulations 2015-16 state that practices must promote and offer to patients the facility to view their
detailed coded online record by March 2016: A contractor must promote and offer to its registered patients, in
circumstances where the GP records of its registered patients are held on the contractors computerised clinical systems, the facility of any such patient to access online all information from the patients GP record which
is held in coded form unless:
The information includes a reference to any third party who has not consented to its disclosure.

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ST3 Finishers Day - Wednesday July 6th

This year Health Education Southwest are holding a Finishers Awards Day which is more in line with what happens in Severn.
It will be for both ST1 and ST3 year groups and includes presentation of CCT certificates and awards for different categories of excellence during their training.
We are looking to recruit a paid Keynote Speaker for this event. Ideally we would like someone who has been
in general practice for many years, manages to sustain themselves and feels an enthusiasm for the job, to talk
for 45 minutes about why they feel the way they do and share some anecodotes to illustrate this. The event is
planned to be somewhere on the Devon / Cornwall border. It will be paid.
If you are interested in being our speaker then please contact

RCGP Tamar Faculty Events

Thursday 21 April 2016 Flybe Training Academy, Exeter Airport, Exeter, EX5 2LJ Flying into the Future
Keynote Speaker President of the RCGP, Dr Terry Kemple General Practice 2022

To book a place please visit:

To view the full programme and prices please view the attached document
Identifying and Managing the Consequences of Cancer in General Practice Thursday 28 April 2016
Taunton Racecourse, Taunton, TA3 7BL
This free one day workshop will equip participants with the knowledge and resources to provide high quality
support to people living with and beyond cancer.

Booking form can be found on the attached flyer.

To view the full programme please visit:

Waking up to Epilepsy
Wednesday 20th April 2016 09:00-17:00
Medical School Building, Royal Devon and Exeter Hospital, Exeter
Keynote speakers: Prof Mark Richardson, Paul Getty III Chair of Epilepsy, Kings College, London
Prof John Terry, Professor of Biomedical Modelling, University of Exeter
Learn about the nature of epilepsy in adults and children, the disorders with which it can be confused, its investigation and treatment, its implications for mood and cognition, and the experience of patients during our one
day conference organised by Prof Adam Zeman and Tim Malone. Watch Prof Zeman discussing the conference. For more information and to book a place, please visit this link
CPD points applied through the Royal College of Physicians
10% early bird discount if delegates book before 19 th February 2016 Email: or Call 01392 722964

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British Society for the Study of Vulval Disease

Annual Meeting
9-11 March 2016 Headland Hotel, Newquay
Two day event including GP Study Day on Wednesday 9th March
CLICK HERE for details:

Public Health England, South (South West) Flu Evaluation &

Planning Event
The Screening and Immunisation team for Public Health England, South (South West) are holding an important planning event for the 2016/17 seasonal flu programme on Thursday 17th March at Taunton Racecourse
We aim to bring together experience and expertise from relevant local organisations to participate in the day
in order to plan for the 2016/17 flu season. The day will involve evaluating lessons from 2015/16 and looking
at ways to improve flu vaccine uptake amongst all eligible groups and preventing unnecessary A&E attendances and admissions next season. If you are involved in winter resilience or flu planning, this is a key local
event that we would encourage you to attend.
Please also forward to any key persons in your organisation who may not have received this invite. To register for this event go to Event Registration and complete the form.
If you or any of your colleagues would like further information regarding this event please email
We look forward to seeing you on 17th March

GP Engagement Event
Tuesday 15 March 2016 : 6pm - 9pm
St Cecilia's Lounge, St Michaels Hospital, Hayle, TR27 4JA
CLICK HERE for more information and to reserve your place.

Truro RCGP CPD meetings

Our next meeting is on 2nd Mar at Duchy Hospital at 7 pm for 7:30 start. Topics are Childhood Obesity by
Dr Alex Burns, GP in Cornwall and Physical Activity by Dr Emmeline Dean, GP from South Somerset.
April topic has been changed from ASSIST & Kidney disease to INFERTILITY and speaker is Mr Jonathan Lord from RCHT
ASSIST with AKI and CKD will be discussed at Renal workshop on 15th March in Arundel Arms,
Lifton, Devon, PL16 0AA at 1.00pm 4.00pm. To register for workshop please contact
Information on DOLS for GPs from Coroner Dr Emma Carlyon is attached, it follows on from her
talk to us in Oct 2015. Please direct any questions to her office.
Dormore information please contact

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We are looking for a committed and enthusiastic doctor with the energy to help develop our Practice. We
are a long established Practice based in the centre of Falmouth and can promise challenging but rewarding work. Flexibility and a sense of humour are essential!
Friendly and well respected Practice
Team of 6 GPs
List size of 8,000 patients
Minor Ops
Training of Medical Undergraduates
Full range of nursing services and Chronic Disease Clinics
Supported by excellent nursing and admin teams
Start date flexible for right candidate.
To apply, please send letter and CV to David Whitworth, Westover Surgery, Western Terrace, Falmouth,
Cornwall TR11 4QJ. For further information or informal discussion please contact David Whitworth,
01326 212 120,
Closing date: 31 March 2016

Camborne, Cornwall
Part-time partner required to join a friendly dynamic team with 4 partners based in a small town surrounded by
rural countryside and beautiful north coast beaches.
Undergraduate Teaching Practice
Training Practice With Two Registrars
Consistent High QOF achievement. EMISWeb
On site District Nurses, Macmillan Nurse, Speech Therapist, Dentist
& Community Matron.
We would welcome any informal enquiries or visits which will be kept confidential.
If wishing to apply please send your CV and covering letter to:
Tim Keech, Claire El-Borai, Ana Emberton and Rebecca Matthews
Phoenix Surgery, Rectory Road,
Camborne, Cornwall TR14 7DL
Tel. 01209 714876
Closing Date 14th April 2016
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Locum GPs RNAS Culdrose Vacancies

We have a vacancy available now, for a part time locum GP at Royal Marines Culdrose Barracks until 1st October 2016!
We offer superb opportunities to join the close-knit and highly motivated healthcare teams as a locum GP and
experience some of the best working conditions that can be found anywhere.
Duties will include running Primary care clinics for the service personnel, their families and any entitled civilian
staff on the base.
You will be working up to 20 hours per week depending on your preferred days and working pattern.
To find out more about these exciting and rewarding roles please call Rachel or Phil on 01792 224224 or
email or
We have a vacancy available now until 17th August for a GP with the diploma in Aviation Medicine to work at
RM Culdrose Barracks
We offer superb opportunities to join the close-knit and highly motivated healthcare teams as a locum GP and
experience some of the best working conditions that can be found anywhere.
Duties will include running Primary care clinics for the service personnel, their families and any entitled civilian
staff on the base. You will also be required to carry out aviation medicine type assessments/medicals meaning
the diploma in Aviation Medicine is essential.
You will be working 37 hours a week, Monday to Friday with the potential for an early finish on Fridays.
To find out more about these exciting and rewarding roles please call Rachel or Phil on 01792 224224 or
email or


Start date June 2016
We are a small but expanding practice on the beautiful North Cornish Coast. Our list size is approximately
4,750. In addition to the usual GP work we also care for the local Cottage Hospital at Stratton. We are
currently 2 partners with 2 part time salaried GPs. We have a lot to offer:

Superb, friendly and supportive team

Caring and compassionate
Training practice, with a very able ST3 currently
Rated as Outstanding by the CQC
Keen on innovation
Good work-life balance
High QOF achievers
Lovely rented premises
Skilled nursing and administrative team
Good schools locally

Informal enquiries and visits are welcome please telephone: 01288 270580
To apply to join our friendly team please send your CV to Dr Mike Dowling:

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Perranporth Surgery - GP Maternity Cover

Perranporth Surgery is a semi-rural practice, situated in a fantastic location overlooking the beach. We
are a forward thinking training practice, high QOF achievers, and partial dispensing. We offer high quality
patient care from our excellent facilities with our committed staff to a list of 7100 patients.
Maternity cover required for 4 GP Sessions from June 2016 for 9 12 months.
For further information please contact Lisa Fogg, Practice Manager or Sandra Batty, Assistant Practice
Manager on 01872 572255 or email or

Nurse Practitioner Wadebridge North Cornwall

We are looking to recruit a permanent Nurse Practitioner, with a prescribing qualification, to work as part of our
practice team. Experience in minor illness working within a GP practice setting would be an advantage.
25.5 hours per week over 3 days with additional hours to cover leave / sickness. Salary subject to qualifications and experience.
We are a GP practice serving patients in the Wadebridge and Rock area of North Cornwall. Our team includes
7 GPs, 1 Nurse Practitioner, 3 Practice Nurses, 2 Healthcare Assistants and full administrative support.
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as
CRB) to check for any previous criminal convictions.
For full details and an application form please see the practice website
(recruitment) or telephone 01208 812222.
Closing date 18th March 2016.
Applications to: Mrs Sonia Geach, Wadebridge & Camel Estuary Practice, Brooklyn, Wadebridge, Cornwall,
PL27 7BS.

Stratton Medical Centre

Exciting New Specialist Paramedic/ Nurse Practitioner post
We are a large, friendly, seaside practice in the beautiful countryside of North Cornwall. Our position offers excellent quality of life with stunning beaches on the door step.
We are looking for a Nurse Practitioner/Specialist Paramedic for an exciting new role that we are developing.
Exact job description would be dependent upon the successful applicants experience and interests but we envisage it would include regular surgery sessions, visits, administrative sessions, minor illness and chronic disease management.
We have recently been granted in principle NHS funding for a new purpose built surgery so we are looking for
an enthusiastic team player who has the vision and organisational skills to help us to develop this new role and
the care we give to our 11,000 patients.
Please apply with CV and letter to:
Miss Kathryn Pengelly (Practice Manager) ,Stratton Medical Centre, Hospital Road, Stratton, Bude
Cornwall EX23 9BP
Telephone no: 01288 352133

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I have never been one for sycophancy. Perish the thought that I should ever join the ranks of the
oleaginous complimentarians. My CBT Therapist, currently off work and enjoying a taste of her own medicine following my most recent torrid heart-to-heart session with her, kindly suggested my reason for not
being a sycophant is that I have never done anything praiseworthy in the whole of my life, and hence never qualified to be the recipient of verbal bouquets myself. According to her, it is just sour grapes on my
Bearing her bon mots in mind (which I ought to do as I am paying for them, although admittedly
by using my winter fuel allowance) I tried my very best not to be irritated by a laval flow of congratulationary guff oozing in the direction of a General Practice in Hertfordshire. I have never been to that inauspicious part of the UK, mainly due to a fear of vanishing without trace in the Watford Gap, which sounds
suspiciously similar to the Bermuda Triangle.
Congratulations, an excellent piece of work, an excellent scheme , very well done. Will
somebody please pass me a metoclopramide tablet before I throw up all over my Cornish Pirates rugby
So what on earth could the motley crew have done to earn such praise? Undertaken a moon walk?
Invented a cure for male pattern baldness? Kidnapped Jeremy Hunt?
The truth is out there. Apparently they have won an NHS Innovation Prize for a C-reactive protein
(CRP to you and me) testing scheme that cut antibiotic prescribing by 25% and dramatically reduced the
number of punters re-attending for coughs, freeing up oodles of appointments. The West Hertford Docs
undertook a finger prick blood test for CRP, a key marker for infection, and only prescribed antibiotics if
the level was raised.

In return they received something called The Acorn prize. Hardly an Oscar. However dear readers, my eyes lit up and the old antennae started twitching when I discovered there was a cash prize of ten
thousand smackeroos attached to the award.
Suddenly this all seemed so much more worthwhile. Not least because according to a recent article in the
Plymouth Herald patient care is deteriorating at more than half of GP practices across the South West.
This shocking revelation was the result of a survey of nearly three thousand practices across the country
carried out by the BMA. Cornwalls very own BMA GP executive member, Dr Beth McCarrot, opined this
was clearly the result of a rising workload.
I have therefore been devising my own five-star scheme to reduce patient demand. Inspired by
events in Hertfordshire, it will be known as the CRAP (Cunning Removal of Awful Patients) test. It also involves a finger prick test, but using a needle so large and blunt that the malingering so-and-sos will never
darken the doors of the Abandonhope Surgery ever again. The blood obtained can then be safely disposed of in your nearest sharps bin. No laboratory costs involved at all. Eureka!
All I have to do now is to sit back and await the accolades, and the loot. Please feel free to be as sycophantic as you like

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