No.

274
July 2014

Your Chairman writes ..

There is so much that I could but cant tell you. I am subject to a plethora
of non-disclosure agreements as well as on-going professional
confidentiality. Sometime I am so uncertain what I can say and to whom
that I find it easier to shut up altogether a concept that many of you will
find difficult to believe and will have my parents rotating at high speed in
their grave. So, rather than put my foot in it, I will say only one thing prior
to going on holiday. Some of what I cannot say will become obvious by
the time I come back, so I will leave you with this thought that was given
to me by one of my repeat attenders who also happens to have bipolar
disorder. It was written on a piece of paper and I now keep it on my desk
below the computer screen: -

Cornwall & Isles of Scilly

LMC Newsletter

Check in with yourself. Catch up on your own news. Listen to your heart
and how you really feel. Give yourself some of your best attention. You
cannot neglect yourself and find happiness
So, dont forget that the LMC provides pastoral care in addition to work
related advice. Please contact the office if you have concerns about
yourself or a colleague. This is a difficult time to be working in the health
service make sure that you continue to be a provider rather than a
consumer of its resources and make time for yourself and your family.

Inside this issue:

STREAM
Workforce crisis

Employment Law Update

Seminar

Are you retiring?

Guidance on implementing
Family and Friends test.
CQC requirements.
Notional 5 per patient via
CCGs

Thursday 25th September

Lanhydrock Golf Club

LMC Buying Group

News on Controlled Drugs

Gastro Rapid Access Clinic

Vacancies

Vacancies

We have only 2 places left on this

seminar, if you would like to
attend please contact the LMC
office as soon as possible.

Items for the Newsletter should be

sent to the Editor, Dawn Molenkamp
at Sedgemoor Centre, Priory Road,
St Austell PL25 5AS
Tel :01726 627978,
e-mail dawn@kernowlmc.org.uk

STREAM is helping to enhance patient care

NHS Kernow's GP feedback reporting system, STREAM, launched in May last year, is proving to be very successful meeting its aim to improve patient care.
This is thanks to the GPs who have taken STREAM on board over 520 concerns have been flagged up over
poor and inappropriate patient care being delivered by providers. Some have also submitted suggestions on
how to improve services. It does not, however, replace the official complaints system.
The system automatically flags up repeated comments and concerns on specific services and can reveal patterns which have previously not been identified. All concerns are checked and actioned via the contract manager for that service. We are looking at a feedback mechanism so that the individual who raised the concern
receives a response, but have not rolled this out yet. Theme reports are circulated via the GP bulletin or on
request. One of the key themes has been poor discharges from the acute hospitals.
No log in is required. If you have not already done so, please put this link on your desktop as a shortcut: http://
app.cornwall.nhs.uk/streamfeedback/sendfeedback.aspx.
If you have any queries please contact the engagement team by email kccg.engagement@nhs.net . Your Locality Data Quality Support Managers are also on hand to help.

Government commissioned report shows GP services

facing workforce crisis, warns BMA
Ministers must act urgently to address the crisis facing the GP workforce in England following a new report
commissioned by the government, the BMA warned today.
The new report from the GP Taskforce - Securing the Future GP Workforce1 - concludes that the GP workforce
is now shrinking rather than growing and that there is an unequal distribution of GPs across the country with
areas of high deprivation having fewer GPs per head than the UK average.
It also notes that large number of GPs are planning to retire in the next five years and that these workforce issues are coinciding with patients facing increasing problems accessing GP services.
Responding to the report, Dr Richard Vautrey, Deputy Chair of the BMAs GP committee, said:
Following persistent pressure from the BMA, we are pleased that at long last the GP taskforce report that was
finalised in March has been published. It not only provides a valuable summary of the serious challenges facing
the GP workforce that the BMA has been highlighting for a number of years but also puts forward many of the
solutions that we too have been calling for.
We have reached a serious crisis point where not enough GPs are being recruited and too many are retiring
early. Recent GP trainee recruitment figures showed hundreds of vacancies across the UK2. A BMA survey in
March suggested that six out of ten GP were considering early retirement, with a third actively planning for this
decision3.
There is no longer any time to waste and the government needs to implement the findings of this report in full
and begin a programme of sustained, long term investment in the GP workforce as the BMA has called for in
the Your GP Cares campaign.
1.

The full report from the GP Taskforce can be accessed here

2.

Recruitment figures released in June 2013 suggested there were 451 GP trainee vacancies across the
UK. Full report here

3.

The BMAs survey of the GP workforce can be accessed here

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For GPs - Are you retiring?

Many doctors make the decision to retire and notify the GMC that they wish to voluntarily leave the register and surrender their licensc to practice, but they dont automatically think to notify the Area Team or
Shared Business Services (SBS). The General Medical Council (GMC) contacts the Medical Directorate to
let us know, but often we have no official record of the GPs retirement. This can lead to unnecessary letters being sent to the doctor trying to ascertain their status on the Performers List.
If you are retiring permanently from practice, please can you write to the Medical Director, Devon, Cornwall and the Isles of Scilly Area Team of NHS England, Kingsmill House, Tamar View Industrial Estate,
Saltash, Cornwall PL12 6LE or Dr Graham Lockerbie: graham.lockerbie@nhs.net informing him that you
wish to be voluntarily removed, at the same time as cancelling your indemnity and GMS licence to practice, so the process can be completed without warning letters about compulsory removal being dispatched?
If you contact SBS directly, please remember to copy the Medical Directorate into the email:
SBS-I.ContractsSW@nhs.net This will smooth the process and be very much appreciated.

Guidance on implementing the Friends and Family Test

The NHS Friends and Family Test (FFT) becomes a contractual requirement for GP practices from 1 December 2014. NHS England, NHS Employers and the BMA General Practitioners Committee have jointly
published guidance that sets out how GP practices should implement it.
Guidance can be found here

CQC requirements
By law you must give CQC advance notice if you think members of your partnership will change (including
a new partner joining or an existing partner leaving). If more than one partner is either joining or leaving,
you must fill in and submit a separate form for each. Once you have submitted the notification, you must
then apply to make the changes.
Details of how to do this are on the CQC website here
If the partner leaving is also the Registered Manager, you will also have to follow the process for changing
the Registered Manager. It is the responsibility of the existing Registered Manager to inform CQC that
they are leaving. If they dont do this, the existing Registered Manager will remain legally responsible for

Notional 5 per patient via CCGs

The LMC would encourage practices or groups of practices to bid for this money to help them support GMS work to
over 75s.
Examples include:
Community matron time
Extra district nurse
GP time for regular reviews of vulnerable patients
Nursing home work
Pharmacist to work with practice on 4+ medicines complex patients
Care coordinator/practice navigator
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How to use the new LMC Buying Group website

www.lmcbuyinggroups.co.uk
The LMC Buying Groups Federation has recently launched its new website. The site has a new design
and layout and the log-in process has also been streamlined.
Any visitor to the website can still view basic information about the Buying Group and its suppliers without
having to log-in to the Members section.
However since the special prices on offer through the Buying Group are only available to members, we
keep the details of our deals within the password protected part of our website.
So the first time you visit the new website youll need to fill in the registration form to get your log-in details: www.lmcbuyinggroups.co.uk/members/register
After youve received a confirmation email you can simply log-in as follows:
Go to www.lmcbuyinggroups.co.uk/members/login
Enter the email address and password youve just registered with then click Go.
Go to the Suppliers page to see a list of the commodity areas. Click on whichever one is of interest to you
e.g. staff uniforms to view that page.
To order you need to contact the suppliers directly. All their contact details can be found on their individual
pages.
If you ever forget your password you can reset it yourself by visiting the Reset page:
www.lmcbuyinggroups.co.uk/members/reset This will only work if youve previously registered with the
site.
Contact the LMC Buying Group
Tel: 0115 979 6910
Email: info@lmcbuyinggroups.co.uk

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Controlled Drugs for Doctors Bags

We have received a communication which clarifies the information given in an article in last months LMC
News on Controlled Drugs for Doctors Bags
In the article it says controlled drugs can only be supplied by a pharmacy with a wholesale licence, which
means that if you carry CDs or hold a stock in the practice you can no longer replenish this at a local
pharmacy
Following the DH letter regarding the repeal of Section 10(7) of the 1968 Medicines Act , the Devon,
Cornwall and Isles of Scilly Controlled Drug Local Intelligence Network ( to which Cornwall LMC is invited) wrote to Dr Keith Ridge, Chief Pharmaceutical Officer, and the MHRA asking for clarification and expressing our view that his change in legislation could negatively impact on community pharmacy supplies, even though this consequence may be unintended.
The replies that we have received have been clear to point out that the MHRA is still keen to ensure that
normal health service supply of medicines is not compromised as a result of the revocation of the exemption.
The MHRA takes the view that the supply of medicines by community pharmacies to other healthcare professionals in the UK who need to hold small quantities of medicines for treatment of, or onward supply to
their patients represents an important and appropriate part of the professional practice of community
pharmacy. Also community pharmacies may need to obtain small quantities of a medicine from other
pharmacies to meet a patients individual needs. Both these activities are considered by the MHRA to fall
within the definition of provision of healthcare services. In such circumstances, provided the transaction
meets all of the following criteria the MHRA will not deem such transactions as commercial dealing and
pharmacies will not be required to hold a Wholesale Dealers Licence:

It takes place on an occasional basis

tient

The quantity of medicines supplied is small and intended to meet the needs of an individual pa-

The supply is made on a not for profit basis.

Due to the fact community pharmacy supplies to GPs for the purpose of replenishing doctors bags generally meets the above criteria , it is not the intention that this current change in legislation should affect this
chain of supply.
Darren Barnett
Deputy Accountable Officer for Controlled Drugs,
Devon, Cornwall and Isles of Scilly, Area Team
NHS England

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Gastro Rapid Access Clinic Brief to GPs

Introduction
A gastroenterology rapid access clinic (gRAC) is being trialled to determine whether patient outcomes are improved
and urgent admissions are saved.

Why gRAC
It is anticipated that this pilot will demonstrate:
Improvement in clinical outcomes and patient experience due improved access to GI services and avoidance
of urgent admissions.
Reduction in urgent admissions resulting in a net financial saving for NHS Kernow.
Reduction in demand for inpatient beds.

What
Clinic accessible by telephone referral via Acute GP.
Rapid assessment and diagnostic intervention including CT, ultrasound and endoscopy slots available same
day if necessary.
Correspondence from clinic will be e-mailed out within 24 hrs.
Pilot to measure impact.

When
Clinic start Wed 4 June, pilot initially set for 4 months but if successful clinics will be available 52 week per year.
Clinics Wed and Fri, 0900-1030 (3 patient slots) in Medical Day Unit, 2 nd Floor Tower Block.

How
Check criteria for clinic. See below. Guidance will be available on the Acute GP website.
Call Acute GP service 01872 226263. 0830-1800 M-F, 0900-1800 Saturday &Sunday.
Acute GP will have sight of available clinic slots and be able to book patients in.

Who
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

When considering admission for patient with:

Suspected new diagnosis inflammatory bowel disease
New onset diarrhoea more than 2 weeks
Oesophageal obstruction
Displaced feeding tube/PEG
Suspected blocked common bile duct stent
Exclusions:
Patients with jaundice should be referred to the Jaundice Hot Line.
Patients with acute deterioration with chronic abdominal pain should be referred to the responsible consultant.
Low risk GI bleeds should use the established GI bleed pathway.
Dysphagia (no known diagnosis and not thought to be food bolus obstruction) should be referred to the Dyspha
gia Hot Line.

2WW patients should be referred via the 2 WW service.

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GP PARTNER / SALARIED GP
WESTOVER SUGERY, FALMOUTH
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 8,500 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 21 21 20,
david.whitworth@westover.cornwall.nhs.uk
Closing date: 22 August 2014

Helston Medical Centre & Porthleven Surgery

Salaried GP 6-8 Sessions per week
Helston Medical Centre is an innovative 8 partner practice with 5 salaried GPs based at Helston,
Porthleven and the Isles of Scilly. We look after just over 13000 patients on the mainland as well as the
residents and visitors of the Isles of Scilly. We are passionate about providing services locally to our patients in the South Kerrier locality as well as improving the range of services on the Isles of Scilly.

Purpose built premises recently extended

Registrar/F2 and medical student training
Supportive multidisciplinary team
Part dispensing practice
Specialist services provided including Sexual Health, Drug Misuse etc
Active role care provision at Helston Community Hospital
Highly involved with local CCG

We are looking for an enthusiastic, proactive, team player with a strong patient
care focus who will share our supportive, hardworking ethos and commitment to high quality care.
Initial enquiries to Dr Lin Davies 01326 572637 or Alison Butterill, Practice Manager a.butterill@nhs.net
CV with covering letter to Alison Butterill, Helston Medical Centre, Trelawney Road, Helston TR13 0PU
Closing date for applications: 15 August 2014

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JOB SHARE GP PARTNER

LANDER MEDICAL PRACTICE, Truro, Cornwall
Lander Medical Practice is a friendly 9 partner (7 WTE) PMS practice, with 2 salaried part time GPs. We
are based in purpose-built modern premises (opened 2010), and with a practice-owned branch surgery
serve a patient population of 16,000 in the City of Truro and immediate surrounding countryside. Due to
retirement, we are looking for a dynamic, forward thinking job share partner to provide a full complement
of services to our patients, and to assist the practice in its plans for the provision of new services. We
would anticipate the successful candidate will be able to take up the role from 1 January 2015.
VISION clinical system
Electronic Prescribing
Supportive multidisciplinary team including in-house physiotherapy.
Dedicated minor surgery suite
High QOF achievement
Website: www.landermedicalpractice.co.uk
Working collaboratively with Kernow Clinical Commissioning Group
The City of Truro is located in the centre of Cornwall, but only 15 minutes drive from both the South and
North Coasts, has excellent leisure, retail and education facilities.
Initial enquiries to Dr Beth McCarron-Nash (07968341309/bethmccarronnash@hotmail.com).
Informal visits welcome, contact Liz Wilson, Practice Manager (01872 246810/liz.wilson16@nhs.net)
CV and application in writing to Liz Wilson, Practice Manager, Lander Medical Practice, Truro Health Park,
Infirmary Hill, Truro TR1 2JA
Closing date for applications: 29 August 2014
Interview to be held on: Week beginning 15 September 2014.

Ambulance Clinical Hub Sessional General Practitioners

An exciting opportunity
South Western Ambulance Service NHS Foundation Trust is recruiting General Practitioners with an aptitude for Urgent and Emergency Care telephone triage. The role will be based in our 999 Clinical Hubs in
Bristol, Exeter and Dorset. You will be working alongside our clinical team to provide primary care support
to hub clinicians, clinical staff on the road and telephone contact with patients. The role will suit experienced GPs who are comfortable with managing clinical risk in the context of telephone triage, experience
of OOH working will be beneficial.
You will be supported by clinical hub staff who include experienced paramedics, emergency care practitioners and nurses as well as emergency ambulance crews. A period of induction and training will be arranged which can be tailored to your requirement.
We plan to cover shifts in the North (Bristol) and South (Exeter/Dorset) hubs over weekends and the occasional Fridays and Mondays at times of peak demand.
Rates Comparable with local OOH providers however medical indemnity is included.
For further more information please contact Adam Wiles (Adam.Wiles@swast.nhs.uk)
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