National Insurance Contributions 
The BMA continues to put pressure on the Government regarding concerns over the national insurance increases. Please use the BMA online calculator to estimate the impact of the increases to employer National Insurance contributions and the national minimum/living wage on general practice in England. Practices are being urged to write to your local MP, using the BMA online tool to tell them about the impact that ENICS increases will have on your practice and patients.

 

Data from the online calculator submissions so far indicates that the average additional cost pressure runs to around £33,000 for each practice. This means practices are at risk of closure or, as a minimum, reducing staff and services as a result if these additional costs are not covered. 

Collective Action 
Thank you to all those taking part in collective action to protect patients and practices. These nine actions will continue to make a difference: they are safe, sustainable, and do not breach your contract. For all General Practitioners to collectively participate continues to put pressure on the Government to do the right thing for patients and general practice.

We recently updated our workload rejection template letter following feedback from practices that they continue to receive inappropriate prescribing requests. The letter now explicitly states that if the provider lacks adequate prescribing infrastructure (e.g. electronic prescribing, or qualified prescribers) they should raise this within their own organisation, not with the GP. 

 

At the Conference of LMCs in England last month, the GPC England Chair, Dr Katie Bramall-Stainer explained why collective action is needed NOW, as grassroots GPs are telling us that "this is going to break us". Watch the speech: GPs are having to take collective action

The BMA’s ‘Protect your Patients and Protect your Practice‘ campaign webpage has information about all of the actions. Please also refer to other useful links such as:

The LMCs collective action resources page also has a number of useful resources. 

Interface Update: 2024 - A Year in Review
Interface Officer Simon Nichols presents an overview of this year’s activity to support practices with interface issues.

As we approach the end of the year, we present a summary of key areas of work undertaken in 2024. Many of the areas we have been working on have been directed and shaped by the 750 queries you’ve sent over the last few months, whilst other areas relate to stakeholder engagement and consultation. In this end of year roundup (summarised below) we discuss a small selection of reports, key areas of success, and ongoing difficulties we have supported you with.

Click below to read the full version of this Interface Update: 2024 - A Year in Review. Contact us with your interface queries via humberside.lmcgroup@nhs.net. 

BMA GP Opinion Survey 
The BMA GP Opinion Survey is still open. This annual survey gathers GPs’ views on current issues facing General Practice and is helping to influence and inform this year’s contract negotiations, inn addition to the longer-term strategy of promoting and protecting the future of General Practice.

It is open to GPs in England working in all settings and practices, including partners, salaried GPs, locums, and GP registrars at ST3 and above. Participants do not need to be a member of the BMA to participate but need to enter a GMC number to ensure that responses are coming from eligible GPs based in England. All responses will be anonymised.

Take the survey here: https://www.research.net/r/FP9JLQJ

Changes to the GP Pension Type 1 & 2 Forms for 2023-24 
GPs should have received an email from NHS England detailing how you must submit your type 1 or type 2 form for the year ending 31 March 2024 to PCSE. Previously you could submit your forms either through your PCSE online account or the 'Contact us' section on the PCSE website. Instead, you or your accountant, will now need to submit the form via the ‘Contact us’ section on the PCSE website. This will not impact your pension record, just how you submit your forms.

All of the necessary forms, including the Type 1 form for GP partners, and guidance are linked on the BMA webpage. The forms must be completed by those who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024, and should be submitted by 28 February 2025.

Updated GP Training Guide 
After a year of negotiation with COGPED (Committee of GP Education Directors), the BMA GP Registrars committee has launched an updated guide for GP registrar sessions, bringing practical improvements to training. It supports flexible working patterns, allowing registrars to follow either session or hour-based schedules as per their contract. Appointment times are now adjustable based on training stage and consultation complexity, with a goal of reaching 15-minute face-to-face consultations by the end of training. The guide promotes both flexibility and tailored support, reflecting the evolving needs of GP registrars. For full details, read the document on the BMA website.

This primary care study day will focus on neurology, with the agenda including:

This is a free event and certificates of attendance (3 hours CPD) will be awarded. Light lunch included. Download the event flyer for full details including how to book your place. 

A free webinar from the Huntingdon's Disease Association; certificates of attendance will be available. As Huntington's disease is a relatively rare condition many GPs may not have come across a family where there is Huntington's before, so when they do it can present many challenges. As Huntington's disease is progressive, patients' needs change over time and can be complex due to not only the impact of physical symptoms but those of a cognitive and psychiatric nature.  As it is a genetic condition family members may also approach their GP with questions about testing to see if they carry the gene or about having children. 

Speakers: 

Dr Nayana Lahiri, Consultant Clinical Geneticist, St Georges University Hospital - how to support Huntington's disease family members around questions of genetic testing and having children.

Dr Marianne Novak, Consultant Neurologist, St Georges University Hospital - supporting your Huntington's disease patients to manage their symptoms.

More information and online booking: Huntington's Disease Association - Supporting people in Huntington's disease families: a webinar for GPs

Cameron Fund Christmas Appeal 
The Cameron Fund is the only medical benevolent fund that solely supports GPs and their dependants in times of financial need, whether through ill-health, disability, bereavement, relationship breakdown or loss of employment. Each year the Cameron Fund runs a Christmas Appeal to raise extra funds for their beneficiaries. If you would like to make a donation, please find further details here.

Research - Cauda Equina Syndrome Guidelines in Primary Care
The National Institute for Health and Care Research is inviting primary care clinicians to complete a national survey into the awareness and use of cauda equina syndrome guidelines in primary care. Please follow this link for further details: https://forms.office.com/e/pSjHUp55h4. 

Rebuild General Practice - Patient Awareness Videos
The Rebuild General Practice campaign has created a series of videos featuring real GPs speaking about the reality of working in general practice. These videos:

Subjects include:

Practices are invited to share the videos through social media channels. Videos can be accessed here.  

Pharmacy Bank Holiday Rota Christmas and New Year 2024/25
Community Pharmacy Humber have published the rota covering bank holiday opening hours for pharmacies in the Humber and North Yorkshire area. Download the rota. 

New Talent Programmes for 2025
HNY ICB have shared information on three new system leadership development programmes due to launch in January 2025. These programmes are specifically tailored to develop system leaders – so if you’re interested in working across the system, this is the programme for you.  

 

These programmes are intended to encourage colleagues from across Humber and North Yorkshire to discover their own strengths and fulfil their ambitions of becoming future system leaders, with a key focus on addressing the lack of diversity we see from middle to senior management. Each programme is designed to prepare participants for the next step of their career journey, equipping them with the skills to truly transform health and care across our system. 

There are three programmes: 

Programme 3: Advancing international talent 

All three programmes are available to colleagues across the system in all health and care organisations in Humber and North Yorkshire. Applications from minoritised colleagues are strongly encouraged. Find out more and express an interest by completing the expression of interest form.

The ICB would also like to hear from you if you can get involved in the following ways: 

GPMplus 2025 Courses
GPMplus wellbeing courses for early 2025 are now available to book. All the courses are on the GPMplus website up until March 2025 including five courses taking place in January – please use the links below to book your place:

 

Tuesday 14 January, 12.30-14.30 – New to General Practice Partnership

Wednesday 15 January, 09.30-11.30 – Team Leadership and Engagement

Thursday 16 January, 09.30-11.00 – Contingency Planning for Crisis Aversion

Tuesday 21 January, 14.00-15.30 – Financial and Business Resilience 

Tuesday 28 January, 13.30-15.00 – Recovery From Adverse Events

 

You will see that there is now a charge attached to GPMplus courses for colleagues attending from Humber and North Yorkshire (HNY). Unfortunately, due to financial pressures felt in many areas, HNY ICB have not been in a position to continue to commission GPMplus services for General Practice in 2024/25, which is the reason for the new charge. GPMplus will subsidise the cost for HNY GPs and practice staff, and are offering courses at a discounted rate. The courses are still delivered by facilitators with frontline practice experience and they hope you will continue to find them a helpful part of your training and wellbeing programmes. 

Details of the new prices are below and you will see these when booking a course:

 

Charge for HNY (subsidised):

Course duration up to 2 hours = £25

Course duration up to 4 hours = £40

Course duration up to 8 hours - £75

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:

Government Review of Physician Associates
The government has launched an independent review of physician associates (PAs) and anaesthesia associates (AAs). In response to this, the BMA Chair of Council, Dr Phil Banfield, welcomed that the government has acknowledged the concerns of doctors and accepted there is a safety issue with the employment of physician associates. Read the full statement here. 

Read the BMA guidance: PAs in general practice: making it safe for patients and GPs. 

GPs continue to treat many more patients than they have done in the past. The latest data from NHS Digital shows a record 63.66 million patients registered with practices in England, while there are over 1,300 fewer fully qualified full-time GPs compared to 2015. 

As a result, each full-time equivalent GP is now responsible for an average of 2,271 patients, an increase of 333 patients per GP (or 17%) since 2015, and appointments level at an average of almost 1.5 million per working day. Since September 2015, there has also been a decrease of 1,387 GP practices.  

This fall in both GP numbers and practices coincides with a rise in patient numbers, which is putting staff at GP surgeries under immense strain, with knock-on effects for patient care. Learn more about the pressures on general practice. 

New Humber and North Yorkshire Cancer Alliance Website
As well as changing appearance, the new website features new functions, sections and pages. The homepage now includes a quick-search function to guide the user to the specific section or page they are looking for as quickly as possible.

 

Elsewhere on the website there is an A to Z of cancer information repository; as well as a new, upgraded events section, where you can find all the Cancer Alliance’s events and educational sections, including its well-established Cancer Champions sessions. There are also and refreshed sections detailing the Cancer Alliance’s different workstreams:

Visit the website: hnycanceralliance.org.uk.

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. 

PSA Testing in Asymptomatic Men
This subject has been in the news in recent weeks, and there will have been many requests for PSA testing. This Red Whale article looks at deciding whether to have a PSA test; shared decision-making and the evidence behind it; how to do the test well; and what to do with the results. 

Kidney Stones
This NB Medical article summarises new research which highlights that as well as all the myriad of benefits currently discovered for SGLT2 inhibitors, they may also have a role in the prevention of recurrent renal stones.

Diverticular Disease
‘Diverticular disease’ is a term that encompasses the spectrum of presentations and complications of diverticulosis. This Medscape article looks at signs,  symptoms, and management.