March 2023 Newsletter

Included in this edition:

  • GPC update on new contract changes 23-24 to LMCs
  • 2023/24 GP contract update webinars
  • New to Partnership Payment Scheme
  • GP workload pressures and safe working guidance
  • Junior doctors’ strike action – guidance for GP trainees and GP practices
  • Unnecessary GP workload
  • Court order medical requests
  • GP trainee visas
  • Working with Torture Survivors – an e-learning course for healthcare professionals
  • Claiming for Personal Independence Payment (PIP)
  • Practice Vacancies


Information, Guidance and News

GPC update on new contract changes 23-24 to LMCs

GPC exec team have recorded a video and it is live on social media.  It is intended to be short and snappy and outlines where we are now and next steps.  Video can be found

Also see the newly launched website page on the contract imposition here

The following communication has been received from GPC this week:

You will have by now seen that NHSE have chosen to implement the contract changes for 23/24 which GPCE voted to reject earlier in February.  Since we voted to reject the contract offer we have been working to secure an improved offer, but as we reported last week, this has not been forthcoming. 

We now must decide what action GPs want, and are prepared to take, to ensure that our profession is not further undermined by a government which has under-resourced and undervalued it for the last thirteen years. 

To further this discussion, we will be holding contract webinars in which we will discuss the contract, our proposals for the next steps towards action, and to hear the views of the profession.  Please encourage your constituents to attend these webinars so we hear the widest range of views.  These are open to BMA members and non-members. 

I would like to also offer for the officer team to attend your LMC meetings in the near future to be a resource to further these discussions.  If you want to hold joint meetings with other LMCs we will aim to attend many in-person, and hope that you make these meetings open to all constituents.  We may have to attend some meetings virtually given the geography of England, but hope that dropping in to meetings in this way will give you and our colleagues the  opportunity to share your thoughts and concerns. 

Please let us know when your LMC meetings are so we can get dates and times in our diaries. 

2023/24 GP contract update webinars

Those wishing to attend one of the GP contract update webinars in March can now register via the BMA website. The GPCE officers will deliver the same presentation at each webinar, meaning that attendees need only attend the event most convenient to them. The planned dates and times are:

Tuesday 21st March 19.00-20.30

Wednesday 22nd March 12.30-14.00

Wednesday 29th March 19.00-20.30

Thursday 30th March 12.30-14.00

Thursday 30th March 19.00-20.30

Register here

New to Partnership Payment Scheme 

The scheme comes to an end this month and it is looking increasingly likely that it is not going to be renewed going forward. 

GPC have raised the matter with NHSE repeatedly since the turn of the year but are still awaiting a response.  There is a slim chance something may be included in the imminent Primary Care Recovery Plan, but GPC are not holding out much hope.  Should NHSE confirm any more details GPC will post an update.

GP workload pressures and safe working guidance

GP practices continue to experience significant and growing strain with declining GP numbers and rising demand, as shown yet again by the latest GP workforce figures.

In January 2023, 88 GPs left the NHS and there is 2078 fewer fully qualified GPs than in 2015. At the same time, each GP now has 2283 patients to care for, which is 18% more than in 2015. It is no wonder patients are finding it difficult get appointments and years of neglect by this government has led to an NHS on its knees.

Practices are encouraged to continue to review their working practices in reference to the safe working guidance to prioritise care to manage the finite workforce and resources available. 

With GPs working under such great pressures the BMA is also there to support your wellbeing. You can also read about our work to improve the mental health of the profession, including new research and our wellbeing charter.

A range of wellbeing and support services are available to doctors, from our 24/7 confidential counselling and peer support services to networking groups and wellbeing hubs with peers, as well as the NHS practitioner health service and non-medical support services such as Samaritans.

The organisation Doctors in Distress also provides mental health support for health workers in the UK, providing confidential peer support group sessions.

See the poster with 10 tips to help maintain and support the wellbeing of you and your colleagues.

Visit the BMA’s dedicated wellbeing support services page for further information and resources.

NHS England is running a series of facilitated peer wellbeing sessions for the primary care workforce. Each peer wellbeing group will be made up of six-eight people that will meet fortnightly for four weeks. Register your interest here by Friday 10 March.

There will also be some further resources on practice workload and wellbeing in time for Stress Awareness month in April.

Junior doctors’ strike action – guidance for GP trainees and GP practices

Junior doctors (including GP trainees) will be taking industrial action from 13-16 March.  With this in mind, GPC have published comprehensive guidance for GP practices across England which can be read here  The guidance covers everything from managing the impact of strike action on practice work to GP trainee rotas and information on how GP practices can support GP trainees financially.  Practices are encouraged to familiarise themselves with all guidance before the strike days. 

The LMC England Conference also passed a motion in November 2022, offering public support to all junior doctors, including GP trainees, in their pursuit for pay restoration to 2008 levels. This support was further demonstrated by GPC England, where a motion was passed with no votes against, offering support to all junior doctors, particularly GP trainees, in their pursuit for full pay restoration.

A poster has been produced that you may want to display in your practice, a patient information leaflet, and an infographic that can be used on your website, which can be ordered online.

Unnecessary GP workload

DHSC want to work with GPC to remove workload from practices that should or could be done elsewhere.

There is clearly a lot of work passed inappropriately by hospital and community trusts, and GPC continue to work with NHSE, AoMRC, and DHSC to change this and locally the LMC is doing the same with trusts and ICBs.

On top of this there are various bureaucratic items which could be done by others and GPC want to share a list of these with DHSC.  GPC have produced a starter for ten list below:

  • Death certificates- could this be done by someone else, with the introduction of MEs why not them?  Nurses could do as they often know the patient better than a doctor.
  • Confirmation of death- not a legal or contractual requirement but still comes to GPs
  • Notifiable disease- why does a doctor have to do this, why not admin?
  • Medical examiners- needs to be properly resourced and funded
  • Sick notes- damages the doctor patient relationship, and we are mostly not occupational health trained
  • Prescribing end of life medication – why a GP? Could be a community nursing team or palliative doctor?
  • Medication administration recording sheets (MARS)- should not be coming to practice but still seems to
  • Pharmacy medication switches – community pharmacists not allowed to make a decision about changing the medication (10mg not available, so just give 2x5mg)
  • PIP forms 
  • DWP forms 
  • Community midwives/community providers – please prescribe…..they should have PGDs or prescribers so does not come to general practice 
  • Get a note from your doctor “culture” – GPs will not provide notes to indemnify you for an activity or to get out of something, eg gym membership, parachute jump
  • Housing requests- should not be a requirement for information from GPs


Items that are funded for privately but could be removed if practices would rather not have the workload

  • Cremation paperwork- may be lost anyway to Medical Examiners
  • DVLA forms
  • Airlines/travel companies wanting a list of medication, conditions etc

GPC want to build this list up, so please send items that may have been forgotten.  Please can constituent GPs  send us their suggestions to the LMC so these can be forwarded on to GPC so nothing is missed…

Court order medical requests

There have been a few instances of this happening in England and Wales.  Naturally, some contractors are choosing to reduce or stop this type of non-contractual work to focus on delivery of their NHS work.  This may be why some courts have decided to issue a summons to certain GP contractors.  They are demanding medical reports on behalf of bodies like probation and fostering services.

Consequently, the BMA legal team has recently obtained KC opinion at the request of GPC Wales and GPC England.  Essentially, a court ordering a GP contractor to produce a report forces them to undertake non-NHS work where they have no obligation to do so – potentially to the detriment of their NHS work.  Courts do therefore have this power, but it is clearly inappropriate given current NHS pressures and in the absence of a formally commissioned arrangement by ICBs.

Unfortunately, it is therefore not possible to ignore a court summons. GP contractors should be advised not to ignore or refuse the summons.

It is important to note, however, medical reports of this nature are not contractual, there is no obligation on GPs to provide them and, as others have already said, the contract allows the contractor to “demand or accept (directly or indirectly) a fee or other remuneration” (see page 170) if they choose to provide one.

Guidance summarising advice / practical suggestions for putting an end to this situation is currently being drafted. It should not be long at all before it can be disseminated. This should at least help GP contractors provide evidence that they have no obligation to provide a report if and when summoned by a court but they wish to object.

As the forthcoming GPC guidance will demonstrate, however, there is some national and regional lobbying to do to find a better practical solution to this emerging problem.

GP trainee visas

GPC has written to the immigration minister regarding the BMA’s ongoing concerns over barriers facing GP trainees to staying and working in the UK on completing their training. The letter followed the Minister’s commitment to ensuring officials in the Home Office are working with the DHSC and the BMA to consider umbrella sponsorship as a solution to the problem – something the BMA has repeatedly called for to help create a welcoming environment that ensures the UK attracts and retains talented doctors to help address the shrinking medical workforce in general practice.

Stressing the importance of measures being in place to facilitate smooth transition into full time employment ahead of the next cohort of GP trainees completing their training, the letter calls on the Minister to consider a six month grace period as a temporary measure whilst conversations on an umbrella route continue. A grace period would help alleviate some of the stress and anxiety felt by GP trainees coming to the end of their training by providing them with a six-month window to find a GP practice to employ them.

Working with Torture Survivors – an e-learning course for healthcare professionals 

Freedom from Torture, a charity providing therapeutic care to survivors of torture across the UK, have designed a course for doctors and healthcare professionals providing care for refugees and asylum seekers.  The course was established in response to requests for training from GPs who are treating increased numbers of asylum seekers.  A significant proportion of these patients will have experienced traumatic events, including torture, and have resulting complex health needs.  Doctors may feel that they lack the specialist knowledge required to support this group.

Backed with funding from BMA Giving, the BMA’s charitable arm, the 10-module course educates on the physical and psychological impact of torture, the unique treatment needs of survivors of sexual torture and how to document evidence of torture in medical records.  GPs and other healthcare professionals can access the course online and free of via the Freedom from Torture website

Claiming for Personal Independence Payment (PIP) 

If you have a conversation with an individual about PIP, please signpost them to the PIP information pages at GOV.UK/PIP so they can consider if they may be eligible prior to claiming.  The PIP pages include easy-read guides and links to YouTube videos about eligibility, evidence requirements and the claims process.  These will help individuals to understand what information they need to provide to support their claim and consider whether PIP is the right benefit for them.

Practice Vacancies

Can be found on the LMC Website

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