Collective Action
81% of Humber area practices are taking one or more of the actions from the menu of actions. None of them breach your contract, but they will help you manage your workload and keep you safe. You can use the BMA safe working guidance handbook to support your practice team’s transition to providing safer, higher quality care for the patients you see. 

The BMA weekly action tracker surveys are now being sent monthly - please respond to let them know what action your practice is taking.

Please notify any actions you plan to take to the ICB via email:
hnyicb-ny.primarycarecontracts@nhs.net. Please CC the LMC if possible: humberside.lmcgroup@nhs.net.
 
Referrals: email addresses to send referrals if opting not to use referral documents/proformas:
HUTH: hyp-tr.huthreferrals@nhs.net
NLAG: nlg-tr.referrals@nhs.net
 
If you need any support with collective action please contact the LMC.

BMA Safe Working Handbook for General Practice
The BMA’s GPs committee England (GPCE) has updated its safe working guidance, to support and enable practices to prioritise their delivery of safe, high-quality patient care, within the regulatory and professional expectations of the Primary Medical Services (GMS/PMS) Contract.

The guide is designed to help GP practices make decisions that will allow them to prioritise their limited capacity to deliver safe, high-quality care. GPC England recommends you can do this by reviewing your currently offered services.  Decisions will need to be individualised to the needs of your patients and practice. This approach recognises practices are operating within limited resources, but also the need to stay within the requirements of the GMS/PMS contract. Visit the BMA’s Safe Working in General Practice.

Death Certificate Reforms and the Medical Examiner System
From 9 September 2024, all deaths not investigated by a coroner must be reviewed by NHS medical examiners.

As part of the reforms, a medical practitioner will be eligible to be an attending practitioner and complete an MCCD, if they have attended the deceased in their lifetime, even if they did not see the patient in person after death. The requirement for a cremation form ceased on 9 September 2024.

More information on the death certification reforms which apply from 9 September can be found on our website. 

DDRB 2024/25 LMC FAQs
The LMC has published a new set of FAQs on the DDRB announcement for 2024/25 and the impact on general practice. This summary provides information from the LMC and BMA to support your discussions around the announcement, and provides links to further information and advice. Download the 2024/25 DDRB LMC FAQs. Further background is available in GPCE's new DDRB 2024/25 analysis. 

Sessional Guidance on Collective Action
New guidance has been produced by the BMA Sessional GP Committee for both locum and salaried GPs to support them in navigating phase one of the general practice collective action.

Guidance from Senior Coroner - Hull and East Riding
Professor Paul Marks, HM Senior Coroner for Hull and the East Riding, has written to the LMC with an updated protocol letter for all organisations dealing with the Coroners court. This includes instructions on referrals, Cause of Death (COD) statements at inquest, correspondence, and attending court. Download the Coroner's letter. 

GPMplus Mentoring for GPs and Practice Staff
GPMplus mentoring is available for GPs, Practice Managers, Nurses and other members of the practice team with leadership or decision-making responsibilities. The service includes up to 8 hours of mentoring from a trained mentor and thanks to funding from NHS England, this is available free of charge.
 
The service is provided by trained mentors who all have experience of working in frontline General Practice. There is a team of GP, practice manager and nurse mentors who can help you to:

• Move forward with personal and career goals
• Work through a problem
• Consider opportunities
• Manage transitions positively
• Build confidence
• Improve your work life balance
• Build your resilience
• Achieve your aspirations

There has been excellent feedback from staff accessing the mentoring programme, here is a selection below:

• I was incredibly unhappy in my job and my sessions with my mentor really turned that around and inspired me to look at how I can make the job work for me. I think I would have quit by now if it wasn't for this programme
• 18 months after the sessions I'm still thriving on the improved work-life balance that resulted from the career change made after the mentoring sessions. Feel blessed to have had that opportunity
• I can't put into words how much of an impact the mentor sessions have had on me. They are very inspiring, motivational and have opened my eyes to a whole new world of Primary Care! 

There’s more information about mentoring on the GPMplus website https://gpmplus.co.uk/general-prcatice-mentoring-2/ including profiles of all our mentors https://gpmplus.co.uk/general-practice-mentors/.

GP Forum Study Days
GP Forum are hosting the following primary care programmes. Certificates of Attendance will be issued and the sessions are free to attend. Full details including how to book your place can be found on the GP Forum study days flyer.
 
Musculoskeletal - Thursday 14 November 2024, 11:45-16:00
The Pelham Suite, Cambridge Road, Grimsby DN34 5SZ
 
Contraception and Sexual Health - Wednesday 4 December 2024, 11:45-16:00
Mercure Grange Park Hotel, Willerby HU10 6EA 

Spire Primary Care Events
Spire Hull and East Riding have the following free events coming up:

Hand Surgery, Skin conditions and What to Refer
Wednesday 2 October, 12:00 – 13:00, Online 
Join consultant plastic and reconstructive surgeons Alastair Platt and Ashutosh Kotwal for a lunchtime virtual talk and Q&A regarding hand surgery, skin cancer and skin conditions, as well as what to refer. Sign up for this event: https://shorturl.at/Wkmiy
 
Headache and Migraine Management in Primary Care
Saturday, 16th November 09:30 – 13:00, Spire Hesslewood Clinic
Learn about the different varieties of headaches and migraines, red flags for treatment, and the whens and whats to refer for with Prof Ahmed, Dr Dorsey and Dr Khalil. A joint Q&A session will be available for presenting any queries and case studies you might have. Sign up for this event: https://shorturl.at/7KGGP

Cloud Based Telephony Data - GPCE View
As part of the 2024/25 contract imposed on the profession in April, NHSE have sought directions from the Secretary of State to extract data from clinical systems on Cloud Based Telephony (CBT) usage. An email has been sent by NHSE outlining the instructions to comply with this data extraction under section 259 (1) (a) of the Health and Social Care Act 2012, stating:
 
‘All general practices are therefore mandated to comply with this invitation and approve the collection.’
 
The legal basis for the collection is explained in the Data Provision Notice, which will enable your call data to be extracted on a monthly basis. 
 
The BMA has taken its own legal advice: 
 
Practices cannot decline the instructions, as doing so will risk breaching their contract. 
 
The BMA have made it clear to NHSE that the data must not be used to performance manage practices or single them out for criticism. 
 
The PCN DES includes three components of the Capacity and Access Improvement Payment (CAIP). This data extraction is the component pertaining to the existing use of CBT and the relevant metrics. GPCE advice is that should a practice fail to sign up ahead of the October 1^st deadline, there may be a risk of a breach notice being imposed as well as contravening the Health and Social Care Act 2012. 
 
There is another component which relates to ask No 9 in the collective action campaign. There are significant concerns around online consultation software being available to patients from 08:00-18:30 given practices’ lack of capacity, and their responsibilities for ensuing patient safety.
 
GPCE advice continues to apply here: CDs and PCNs are advised not to sign this particular declaration presently, but to await further guidance closer to the financial year end. 
 
Read the full update here and if you have any queries, please email us at info.gpc@bma.org.uk

Zero Racism and Discrimination Poster
This is a new poster you can download to display which reiterates the zero tolerance message that racism and discrimination will not be tolerated. Download the poster. 

LMC Jobs Page - Post Your Vacancies
Practices can post their GP and practice manager vacancies on the Humberside LMCs Jobs page. Complete the online form with details of the vacancy and we will upload it free of charge.

Interface Update
This month's interface update presentation gives an overview of our work to support practices with interface queries. Contact us with your interface queries via humberside.lmcgroup@nhs.net. 

Mental Health ARRS Community of Practice
As implementation of the roles under the Additional Role Reimbursement Scheme (ARRS) are realised across England, NHS England North East and Yorkshire (NEY) are supporting this for Mental Health  ARRS. Following system level requests, the ICB has established a region wide MH ARRS Community of Practice (CoP). This CoP provides a safe place for all those involved to come together to share experiences of these new roles, including good practice, challenges, and to work through pertinent issues and improvement opportunities.

The next meeting is on Tuesday 8 October 2024, 12:30-13:30 via MS Teams. Further information on the CoP and joining link for the meeting can be found here. 

Microbiology Team and Service Update - South Bank
Following the appointment of a new Microbiology locum Consultant and help from supporting colleagues, there has been a resumption to Microbiology services across NLAG/ULHT as was previously in place.

Clinical and urgent advice can be sought by contacting the on-call microbiology consultant via the switchboard. Calls can be made from Registrar colleagues and above, General practitioners and ACP staff. Wherever safe and possible, please defer calls to in-hours.
 
There are no changes to the laboratory aspect of the service. Colleagues are encouraged to use the trust intranet to access the antimicrobial guidelines.

New Standard GMS, PMS and APMS Contracts Published
NHS England has published new standard General Medical Services (GMS), Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts, along with their contract variation notices. The documentation incorporates changes made to the contract Regulations in May 2024 including the requirements for practices to share digital telephony data from 1 October and to register patients either through the online registration service or a new paper form from 30 October 2024. These documents have been sent to commissioners for onward cascade to GP practices, to formally notify them of changes to their contracts.

Free Breast / Chest Cancer Awareness Sessions 
To mark Breast Cancer Awareness Month in October, the HNY Cancer Alliance is holding a set of 20-minute breast / chest cancer awareness sessions for all colleagues working in health and care across our system. It’s important to check your breasts or chest regularly (around once a month) and both trans men and trans women, as well as gender diverse people, can experience this type of cancer.

The ‘Get in touch with yourself’ sessions are taking place virtually and there are multiple dates and times for each session. 

You can book your place using the links below:

• Get in touch with yourself - awareness sessions for women
• Get in touch with yourself - awareness sessions for men
• Get in touch with yourself - awareness sessions for the LGBT+ community

The alliance also holds regular general cancer awareness sessions which you can book onto online.

HNY Primary Care Workforce and Training Hub 
All the latest opportunities available via the hub can be viewed on their news feed. Opportunities available this month include:

• Physician Associates Preceptorship funding offer 2024/25
• CPD Funding Update
• Introduction to Clinical and Educational Supervision - Fully Funded Courses
• Qualified Advanced Practitioner Masterclasses - Fully Funded, Northumbria University
• HNY AHP Faculty FuturesNHS Platform
• Apprenticeship News and Resources
• Non-Medical Prescribing Funded Places

GPMPlus - Fully Funded Courses Available
GPMPlus have a full set of courses now available, with dates running up to December 2024. Courses are fully funded and are designed to help strengthen your practice, as a whole. They are all delivered via Zoom and by highly experienced GPs and practice managers. 

9 October - Successful Complaints Management 2pm-3.30pm HERE
11 October - Team Wellbeing: Huddles & Civility 9.30am-11am HERE
15 October - Personal Wellbeing 9.30am-11am HERE
17 October - Conflict on the Frontline 2pm-3.30pm HERE
22 October - Effective Appraisals 9.30am-11am HERE
23 October - Burnout: Prevention & Repair 12.30pm-2pm HERE
24 October - Financial & Business Resilience 9.30am-11am HERE
29 October - Team Leadership & Engagement 2pm-4pm HERE

More courses are available - for a comprehensive overview, please click HERE
If you need further information or help, please contact Tim Bennett on tim.bennett@yorlmclaw.co.uk or call 01423 879922.

General Practice Nurse Leadership Fundamentals 
GPN Leadership Fundamentals is a set of 3 interactive modules, developed exclusively for General Practice Nurses and Nurse Practitioners. The modules are accessible at no cost to all GPNs via the NHS Leadership Learning Zone (LLZ) and are mapped against the Primary Care and General Practice Nursing Career and Core Capabilities Framework  

For an overview of the content and to access the modules download the GPN Leadership Fundamentals flyer. 

Domestic Abuse Awareness Month October 2024
The Domestic Violence Abuse Partnership is hosting a programme of free webinars in October. This year the focus is ‘Domestic Abuse through the Lifespan’ looking at the impact from pregnancy through to older survivors. Download the programme for details and joining instructions.  

GPC Update
The GPC publish regular updates for LMCs, covering contractual issues, policy, news updates and more. Read the latest updates, published fortnightly by the GPC. 

Nephrotic Syndrome in Children
Idiopathic nephrotic syndrome is the most common paediatric glomerular disease, characterised by heavy proteinuria, low plasma albumin (leading to oedema) and increased risk of infection. This Red Whale article looks at how 
the condition might present, and also the long-term care children need to help prevent relapses and reduce the risk of serious complications.

Recurrent UTIs in Women
Recurrent UTIs are a significant source of problems and distress for patients, and a similar source of repeated appointments for us in general practice. This NB Medical article explores recent research on a condition that is very common and can easily be missed due to a combination of patient under-reporting, self-treatment, and the increased number of places patients can now present for treatment of UTI symptoms.

Management of Older People with Type 2 Diabetes and Frailty
This recorded session from Medscape discusses how to appropriately manage older people with type 2 diabetes, with a focus on increasing quality of life and preventing functional decline. Includes useful case studies to aid understanding.