Bulletin 24.01.2012
Commissioning News
The GPC discussed recent developments affecting Clinical Commissioning Groups (CCGs), in particular the need to CCGs to develop clear and comprehensive constitutions. It was strongly reiterated that local medical committee (LMC) involvement and engagement would be imperative to the success of successful clinical commissioning. The authorisation process will require CCGs to demonstrate that they have good relationships and engagement with member practices and local GPs (principal and sessional). CCGs will be accountable to member practices for the decisions that the CCG takes on their behalf. LMCs, as statutory representatives of the profession, should work with their CCGs to ensure that the local profession is consulted in the development of their CCG. The GPC has published this guidance which highlights essential elements that should be included in a CCG constitution. Further to the recent messages, the GPC have been pleased to hear examples of GPs feeling empowered to resist pressure locally for their CCG to reach rapid and unacceptable agreement on commissioning support or CCGs ‘clustering’. They hope other GPs will take heart from this and feel similarly empowered to resist such pressure.
Remediation/Revalidation
The DH steering group on remediation has published this report which sets out the following recommendations:
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performance problems, including clinical competence and capability issues, should normally be managed locally wherever possible;
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local processes need to be strengthened to avoid performance problems whenever possible, and to reduce their severity at the point of identification;
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the capacity of staff within organisations to deal with performance concerns needs to be increased with access to necessary external expertise as required;
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a single organisation is required to advise and, when necessary, to co-ordinate the remediation process and case management so as to improve consistency across the service;
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the medical royal colleges should produce guidance and also provide assessment and specialist input into remediation programmes;
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postgraduate deaneries and all those involved in training and assessment need to assure their assessment processes so that any problems arising during training are fully addressed.
Although the issue of funding fell outwith the remit of the group, a range of options were developed on the assumption that there was unlikely to be any additional money in the system. The BMA’s view is that remediation must be fully funded to ensure equality across the different branches of practice, and they will continue to lobby the Department of Health for this to occur.
Extending GP Training
GP trainees and trainers may recently have seen a document produced by the Committee of General Practice Education Directors (COGPED) outlining proposals for extending GP training to four years. The GPC is urgently seeking to discuss this with the relevant parties to establish a suitable way forward as the GPC does not believe that these proposals are sufficiently focused on educational benefit for GP trainees, nor do they outline a suitable implementation process, particularly sufficient funding.
NHS 111
The GPC has concerns that the new NHS 111 service has not been properly piloted or evaluated and shadow CCGs are already being asked to make procurement decisions, despite the fact they have not been properly established themselves. Procurement decisions are also being driven at excessive speed and influenced by the Stocktake, Stabilise and Shift project that PCTs have been asked to undertake in preparation for the handover to CCGs. It appears that the exercise may be being used to bring forward reviews of or renegotiate existing out of hours provider contracts. There is a serious risk of a potentially costly, ill-conceived and unalterable urgent, emergency and unscheduled care solution being imposed upon / inherited by CCGs, with consequent detriment to GPs and their practices. GPC representatives are taking forward these concerns with those responsible for the project.
Sessional GPs Newsletter
The Sessional GPs newsletter draws together information about new and ongoing issues affecting sessional GPs and this issue covers pensions reform, NHS reforms update, guidance on setting up and developing sessional GP groups, locum agreement guidance, devolved administration updates, information cascades, revalidation, retainer and returned schemes and sessional GP conferences. We encourage members to forward this newsletter to any locum and salaried GP colleagues.