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February 2017 LMC Buying Group

Cornwall and Isles of Scilly LMC has been a member of the LMC
Buying Groups Federation since 2014. This means that all practices
can access the discounts the Buying Group has negotiated on a
wide range of products and services.

If you're not sure what the Buying Group is all about then this short
video explains what they do:
Cornwall & Isles of Scilly

By registering with the Buying Group's website:, you can view all the
suppliers' pricing, contact details and request quotes. The Buying
Group also offers any member practice a free cost analysis which
demonstrates how much money your practice could save just by
swapping to buying group suppliers.

And if your practice is part of a GP Federation group then the

Buying Group Plus initiative could help you save additional money
as a group. This short video explains what Buying Group Plus does:
LMC Newsletter

Inside this issue:

Sessionals Newsletter
Your Chairman writes 2
This month, amongst other im-
portant issues, includes updates
Your Chairman writes contd. 3 on changes to funding for indem-
nity arising from changes in the
GMC 4 2017/18 GP contract, and pro-
#NHSbreakingpoint gress on pensions issues follow-
ing a further meeting with NHS
2017/18 GMS Contract 5 England and Capita.
Antivirals & Care Homes
Social Prescribing in Cornwall Read it here.
Events 6

Vacancies 7-9 Items for the Newsletter should be

sent to the Editor, Dawn Molenkamp
at Victoria Beacon Place, Room
B314, Station Approach, Victoria,
Dr Basil Bile 10 Roche, St Austell, PL26 8LG
Tel :01726 210141
Your Chairman writes ..
I was at a conference recently and Sir Simon Stevens said something along the following lines: - .
We need to standardise urgent and emergency care. We need to better connect urgent care and ooh.
111 dispositions need to change. We need a more standardised offer all around the country. The public
need clarity about the NHS offer.......


I have been thinking about the NHS offer for some time both to patients and practices. In many ways and
in many places that offer is uneven. Patients have to adapt to differing modes of delivery of services, dif-
ferent access models and often risk being told that there are in the wrong place at the wrong time. Practic-
es have to deliver the martini contract (anytime, anyplace, anywhere) and are often confused about the
limitations, if any, of such a contract.

This has led me to think about holidaying in France with my children. Why ? When the children were
younger we used to tow a caravan to France (a GP colleague recently confessed to me in hushed tones
that they too owned one as if it was something to be ashamed of). If you have ever towed a caravan an in
a foreign country with four children, you will understand how stressful this can be at times. Long journeys
in a foreign land with children need planning to alleviate the boredom and regular stops are necessary.
Anyone who has travelled in France will know that they don't have motorway service stations of the sort
are used to in the U.K. In many ways they are much better, more civilised. However, feeding children who
are tired, bored and at the end of a holiday is not straightforward in such an environment. What the French
motorway networks lack in service stations, however, is made up for in their out of town 'developments' of
Mr Bricolage and sundry other awful looking buildings. There is, however, an oasis in this desert, one
where you know exactly what you are getting and that will (probably) satisfy the children even if it is only
for a short time, MacDonalds.

Save for the famous Royale with Cheese (a Pulp Fiction reference), when you walk through the door you
know exactly what to expect. It's French of course but in every respect it's exactly the same as MacDon-
alds everywhere else in the world. You know exactly what you are getting. So for a short time, it provides
temporary relief and happiness for hungry bored children (provided they like eating processed fast food).

What on earth has this got to do with General Practice ? Well I wonder how many of you know that Mac-
Donalds is actually a franchise ?

It got me thinking about how we operate our (GP) franchise and I have now evolved the concept of

For too long GP has become an all you can eat buffet where customers can satiate their health appetite
by repeated attendances and feast on an unlimited menu. If you have ever been to Pizza Hut you will
know exactly what I mean. The thing about MacDonalds is that the menus are consistent everywhere in
the world, you know what you are getting and it is always of the same quality.
What would McGP look like ?

The menu would be fixed and strictly defined by the commissioners and agreed by franchisee representatives (GPC and LMCs). You
don't go to MacDonalds for a curry or a pizza, that's a different Provider and commissioned differently.

NO . 3 0 5 Page 2
Your Chairman writes ..
It's fee for item of service provision (thus limiting over spending and over provision)

You wouldn't do home visits (it's not Dominos this is separately commissioned)
Special menu weeks could be commissioned for flu vaccination etc (think Mexican themed weeks in Mac-
Donalds' terms)
The buildings would all of the same standard and have the same levels of equipment, accessibility, clean-
liness etc. (inspected by Ofmac or some such body)
Staff would be guaranteed career development and progression (you've seen the stars) which would be
transparent and open to all (people might even aspire to become franchise holders, think partners)
Online access and prescription request (digital menus)
Phone consultation (drive through)

In other words patients would know how to access the service in differing ways and would absolutely
know what they were getting wherever they went. We know that patients will travel miles at night if and
when they get hungry (MacDonalds at Fraddon on Hamburger Hill) so I think the parallels exist for all of
our services (out Of Hours.
Is it good for health? It could be but would depend on the menu.
Is it economically sound? I guess this depends on the menu choices but it should avoid a postcode lot-
It would be, however, be consistent, transparent and the offer would be clear for both patients and provid-

Would you want to be a McGP ? You might need a McMRCGP first !

The Firearms Task & Finish (T&F) Group has previously made the commitment to inform LMCs of our new
augmented advice before launch so that LMCs have an opportunity to review their own guidance in its light.
This is the fulfilment of that commitment and I ask you to respect the embargo.

In reaching this new guidance the T&F group has debated all aspects of licensing exhaustively and we are
happy that our advice falls within all ethical and legal opinion we have received. We expect that external or-
ganisations may challenge or question the validity of our position but I am minded that the T&F group has giv-
en unanimous support for this guidance which we hope will provide much needed clarity and safety for profes-
sionals and LMCs alike.

The T&F group was set up with the remit of producing safe, ethical and legal guidance relating to the current
system and at publication we will have discharged that responsibility. However, both GPC and the Profession-
al Fees Committee (PFC) will continue to engage with the Home Office to press for improvements to a system
that I know causes grave anxieties for many of us.

I would like to express my thanks to the members of the T&F Group, BMA staff and to members of PFC who
have input into this process. I am grateful to Dr Peter Holden, Chair of PFC, for his support and look forward to
taking this issue forward with him on behalf of both GPC and PFC.
Dr Mark Sanford-Wood
*Guidance is attached to this Newsletter, Guidance and sample template letters have also been sent to
all Practice Managers*

NO . 3 0 5 Page 3
The General Medical Council (GMC) has published revised, expanded and reorganised guidance on con-
fidentiality for all doctors practising in the UK. The guidance Confidentiality: good practice in han-
dling patient information comes into effect from Tuesday 25 April 2017.

Revisions have been made to the guidance, last published in 2009, following an extensive consultation
exercise. While the principles of the current GMC guidance remain unchanged, it now clarifies:

The public protection responsibilities of doctors, including when to make disclosures in the public inter-

The importance of sharing information for direct care, recognising the multi-disciplinary and multi-
agency context doctors work in.

The circumstances in which doctors can rely on implied consent to share patient information for direct

The significant role that those close to a patient can play in providing support and care, and the im-
portance of acknowledging that role.

The new guidance can be found at:

The GMC has also published a decision making flow chart, and revised explanatory guidance to show
how the core guidance applies in situations doctors often encounter, or find hard to deal with including:

Patients' fitness to drive and reporting concerns to the DVLA or DVA

Disclosing information about serious communicable diseases

Disclosing information for employment, insurance and similar purposes

Disclosing information for education and training

Reporting gunshot and knife wounds

Responding to criticism in the media


As many of you will have seen, the BMA has published a new report into the state of the health system,
with particular focus on bed usage across the four nations. The report has received wide coverage in the
media including the front page of the Daily Mail this morning.

Much of the coverage has focused on our messaging that the NHS is at breaking point. We have today
launched the hashtag #NHSbreakingpoint to badge this and other relevant content, as part of a wider
approach to pull together various strands of work on the state of the health service in England under a
single, overarching message: NHS at breaking point. This is to ensure that the BMAs message is heard
loud and clear by our members, decision makers and the public at a time when a number of other stake-
holders, politicians and interested parties are talking about the enormous pressures impacting on our-
selves and our patients.


2017/18 GMS Contract Announcement

With apologies for the short notice, the 2017/18 GMS contract has now received final sign-off by the gov-
ernment, and weve been informed that an announcement will be made imminently. Please find the at-
tached letter from Chaand outlining the final agreement. This will also be sent out to members individual-

Full details of the agreement will be available via the website. There will also be a set of FAQs available
and further guidance will follow in due course.

Antivirals for the prophylaxis of influenza in care homes.

Please find attached a letter from Dr Richard Vautrey to Professor Paul Cosford, Medical Director of Pub-
lic Health regarding continued PHE requests for GPs to prescribe antivirals for the prophylaxis of influen-
za in care homes.

Social Prescribing in Cornwall

The aim of this survey is to assess the understanding of, and interest in, social prescribing across Corn-
wall. This information will be used to influence the designing of potential social prescribing projects in the

We all know that general practice is under increasing pressures and with this increased strain there are
calls for the development of alternative approaches to meet local health needs. It has been estimated that
around 20% of patients consult their GP for what is primarily a social problem. Social prescribing can oc-
cur in a number of different guises but broadly speaking it is a means of enabling GPs and other front-line
healthcare professionals to support people with social, emotional or practical needs to find solutions which
will improve their health and well-being, often using services provided by the voluntary and community

What do you think of social prescribing?

I would really like to hear your views, and would be grateful if you would spend a couple of minutes com-
pleting this survey.

Many Thanks


Dr Bethany Dick

Fill out the survey


GMC Workshops

Keeping out of trouble: A day in the life of a GP


New Confidentiality Guidance

Tuesday 9th May 2017

6.30pm - 9.00pm

Carn Brea Leisure Centre, Station Road, Pool, Redruth, TR15 3QS

GMC Workshop

Keeping out of trouble: A day in the life of a GP


New Confidentiality Guidance

Wednesday 10th May 2017

6.30pm - 9.00pm

Lanhydrock Hotel and Golf Club, Bodmin, PL30 5AQ

Bookings in the first instance for GPs due to room space, but a reserve list will be held for Practice
Managers should they wish to attend.

A sandwich supper will be served from 6.30pm

Entrance is FREE, but BOOKING is ESSENTIAL

Please complete the booking form attached to this newsletter and return to


The Falmouth Health Centre Practice,
GP Vacancy

We are a 6 Doctor partnership in Falmouth, Cornwall with a retirement vacancy.

Were a teaching practice with high QOF score and superb patient satisfaction measures and a
CQC good and outstanding report.
We like the equality of partnership and the control of our own working environment.
We can offer the right candidate somewhere between 6-8 sessions a week in a fabulous practice
and in a fabulous area.
Health centre premises, so no capital commitment.
The partnership is proud to be financially robust and well organised.

We are looking for someone who enjoys general practice and shares our hope for a bright future.

If you want to know more please call our Practice Manager, Geoff Dennis, on 01326 310160 or
07921 240856 or email
The Falmouth Health Centre Practice, Trevaylor Road, Falmouth, TR11 2LH.

Mullion & Constantine Group Practice

2 x Practice Nurse Positions (1 x Permanent & 1 x Maternity Cover)

We are a rural GP practice with 7800 patients. Due to retirement and maternity leave we are looking to
appoint two motivated and experienced Practice Nurses to join our nursing team. Both positions are for
22.5 hours per week over 3 days commencing May 2017.

Duties include the full range of Practice Nurse duties including Chronic Disease Management, Cervical
cytology, Dressings, Vaccinations, Phlebotomy, ECGs.

Please apply in writing with CV to: Mr Neil Stevens , Practice Manager, Mullion Health Centre, Mullion,
Helston TR12 7DQ or email For more information or details regarding either posi-
tion please telephone 01326 242104

Closing date for applications: 20th March 2017

NO . 3 0 5 Page 7
Mevagissey Surgery
8 Session GP Partner Vacancy at Mevagissey Surgery
Part time also considered

Enthusiastic, flexible Partner(s) required to join a friendly, dedicated practice team.

We are looking to cover 8 sessions per week, we welcome part time or full time interest. You will be join-
ing a GMS dispensing Practice which is located in the picturesque fishing village of Mevagissey close to
the beautiful Lost Gardens of Heligan with a branch surgery operating in the nearby seaside village of
Gorran Haven.

Mevagissey is in easy reach of Truro, a cathedral city with an excellent choice of state and private

The surgery has a high QOF, enhanced services and prescribing achievements, supported by highly ex-
perienced nursing and administration teams.
We are actively involved in a wide range of activities as well as providing placements for medical students
and are keen to be involved in GP training in the future.

We have a long established very active Friends of The Surgery group who fund raise on behalf of the sur-
gery and also our Mevagissey Patient Participation Group which actively delivers patient views on how the
practice meets the needs of our rural healthcare community.

Informal enquiries/Practice visits are welcome: Contact Nikki Deakin ( or Dr Kathy
James (

Apply in writing with CV and covering letter, marked Private and Confidential, to Nikki Deakin, Practice
Manager, Mevagissey Surgery, River Street, Mevagissey, St Austell, Cornwall, PL26 6UE

Tel: 01726 843701

View from our branch surgery at Gorran Haven

NO . 3 0 5 Page 8
Due to retirement, we are now looking for a forward thinking and energetic GP to work between 6 8 ses-
sions per week, ideally starting in the summer 2017. The main role will be to provide clinical leadership to
our same-day urgent care centre, but could include an educational component.

St Austell Healthcare formed in May 2015 comprising the four former St Austell Practices with a list size of
over 32,000 patients. We have a dedicated urgent care centre 8am-8pm Monday to Friday.

Primary Care is changing and we are the future. At SAH, by increasing the skill mix within our planned
care site and urgent care centre and encouraging a team-based approach, we allow GPs to be GPs. We
believe in strong clinical leadership and in looking after our people to enable them to deliver our vision of
the future. We will support GPs keen to build a portfolio career with flexible working and those wishing to
pursue any specialist interests. We have been described as an impressive team and believe in a strong
partnership ethos.

We offer highly competitive salaries (GP partner level) with NHS pension, 6 weeks annual leave and 1
weeks study leave. In addition:

Integrated working with voluntary sector and community services

One of 15 sites nationally undertaking Primary Care Home (new care model as in FYFV)
A mixed work-force with flexible shifts and opportunities to suit young parents, part time, job share or port-
folio career
A clinical pharmacist prescriber, ECP, nurse consultant and minor illness nurses are valuable members of
the team
Longer appointment times and improved continuity of care for patients with complex needs
Social prescribing and virtual ward concept embraced and established
Participating in Investors in People
Established training practice with medical students, registrars (ST and FY2), student nurses, HCAs and
Business Administration Apprentices.
Integrated SystmOne IT system across all sites and community services
Annual medical defence costs are paid by the practice.
Open and honest work ethos with a commitment to personal development with innovative, developed edu-
cation programme to include community teams, locums, other NHS providers and voluntary sector.

The successful applicant will be involved in the rota for on-call and extended hours surgery
For further information contact:
Bridget Sampson Managing Partner on 01726 626842 or

Please see job description attached to this newsletter.

NO . 3 0 5 Page 9

There is nothing that gets my gander up as much as folk claiming to have come up with
something wonderfully innovative, when in reality all they have gone and done is reinvented the
wheel, having hurled the original flaming wheel on to the scrap heap in the first place.

For example, take the fanfare surrounding the launch of a free health service for Family
Doctors to help them cope with the severe stress and burnout caused by the unreasonable and
ever increasing demands of their work. A GP Occupational Health Service perchance? Funny
you should call it that, because until recently Cornwall and Devon possessed one, and had done
for very many years. It was overseen by the estimable Dr Ben Chardonnay and his altruistic
team, a highly valued service run as the result of close liaison between the LMCs and PCTs of
both counties. Once Peeceetees had bitten the dust to be replaced by Ceeceegees (in the latest
in a long line of pointless and misguided money-burning NHS reorganisations) Ben and his team
of good eggs were consigned to the dustbin of history, without so much as a by-your-leave or
thank you. This was in spite of 1 in 10 Cornish GPs receiving the services support at one stage,
both to the obvious benefit of patients and the docs themselves. Sick doctors are not generally
safe doctors. The reason for disbanding the service? Loot. Lucre. Dosh. Greenbacks. Smacke-

Now we are told a 19.5 million quid nationwide NHS GP Health Service has been
launched to do exactly what Bens brigade were not only doing, but doing extremely well until the
plug was pulled. Doesnt it make you want to weep? At least there is once more a service availa-
ble to offer me a hankie. I dont suppose theres any chance of getting the original wheel back?

I sincerely hope robots will also be offered some sort of counselling and support service. I
say this in the knowledge that the wonderfully reliable and much revered 111 helpline scheme is
to utilise artificial intelligence to ease pressures on Accident and Emergency Units. At least, that
is the cunning plan according to Laura Donnelly, Health Correspondent of the Daily Torygraph.
As part of a pilot scheme patients will be given access to an app that will enable them to consult
with a chatbot instead of a human being. I fondly believe this latter category of human being
includes myself and my non-artificially intelligent colleagues at the Abandonhope Surgery, with
the possible exception of one or two of our receptionists who are affectionately known to the rest
of us as sodoffbots.

If you ask my ever humble opinion Dear Readers it sounds like a kamikaze pilot scheme to
me, but naturally health officials cannot see risks in any of this. Concerns raised by leading doc-
tors and patients groups that serious conditions could be missed by automated systems are be-
ing treated with contempt, and dismissed as the ramblings of the self-interested. Well yes, pa-
tients are interested in staying alive. And the dire warning dished out to us members of the medi-
cal community who have the temerity to profess genuine alarm? The inane scribblers that cobble
together the Daily Torygraph editorials have served us with this pernicious pearl of wisdom.

Doctors resisting the governments efforts to produce a seven-day NHS should beware
the rise of the machines before they take over their jobs entirely.
Please take a seat Mrs Pascoe. The Docbot will see you in a minute