No.

306 LMC Non-Clinical Staff

March 2017 Training
The LMC office has secured funding to provide a
series of non-clinical staff training.

The training will include:

Medical Terminology,
Read Coding.
Cornwall & Isles of Scilly

Note Summarising.
Dealing with Difficult People
Employment Law
Data Sharing & Governance (to comply with the
new European legislation coming into force in
2018).
As well as other courses.
There will be a nominal charge of 25 per person
for a full day training.
LMC Newsletter

Dates to be announced shortly.

Inside this issue:

Your Chairman writes
DOLSLegislative changes
LMC Myth Busters
QOF/GPES & Enhanced
service payments
Update records please
A free, confidential NHS
service for GPs..
Safe Caseloads in DN Service
HPV Vaccinations for boys
Sessional GPs Newsletter
2 Please see this months edi-
tion of the Sessionals e-
3 newsletter below.
http://bma-mail.org.uk/t/JVX
4
-4TA86-1BJCJOU46E/
cr.aspx

Events 5-6 Items for the Newsletter should be

sent to the Editor, Dawn Molenkamp
Vacancies 7-10 at Victoria Beacon Place, Room
B314, Station Approach, Victoria,
Dr Basil Bile 11 Roche, St Austell, PL26 8LG
Tel :01726 210141
e-mail dawn@kernowlmc.co.uk
Your Chairman writes ..
The end of March always brings a mad scramble to finesse QOF data and always throws up the odd sur-
prise eg where a new diagnosis in a domain completely changes the numerator data and the last minute
eating to a loss of a disproportionate amount of points. Once again we have a summary of the changes to
our contract but no business rules. Changes are outlined here . Effectively we will be operating in the dark
for three months or so. One thing is for certain the dreaded avoiding unplanned admissions DES will be
gone and, with it, the need for Multi Disciplinary Team Meetings. This is called throwing the baby out with
the bathwater. Never has there been a greater need to work collaboratively with colleagues. The following
is from the FAQs around the contract: -

In place of the AUA DES, practices should focus on providing clinically appropriate care to a much more
limited group of patients of 65 years and over who are living with severe frailty. Practices will need to use
an appropriate tool of their choosing, for example the Electronic Frailty Index (eFI) to identify patients who
are living with moderate or severe frailty. For those patients identified as living with severe frailty, the prac-
tice will deliver a clinical review providing an annual medication review and where clinically appropriate
discuss whether the patient has fallen in the last 12 months and provide any other clinically relevant inter-
ventions.

Our District Nursing colleagues already perform frailty assessments on their patients so working in parallel
lines would probably not be a great idea. This is an area where joint working would be mutually beneficial
and although we are yet to see the detail of this contractual change (which will not start immediately) it
would be wise to start thinking about how as practices you might achieve this. Whether this particular
change will provide meaningful improvements for patients is debatable but it is an opportunity to improve
our working relationships. The LMC has been involved with ongoing discussions with Cornwall Partner-
ship Foundation Trust (CPFT) and a joint communication will be sent to practices soon.

Finally, changes to QOF can be found here . It is likely that this will be the last year of QOF as it appears
to have outlived its usefulness. It was innovative and seemed like a good idea at the time (2004) and ele-
ments may live on from April 2018 but it has produced some perverse incentives. Lets hope we dont all
clamour to have it back !

DoLS - legislative change

This is a legislative change that will come into effect on Monday.

Patients who die while subject to an authorisation under the Deprivation of Liberty Safeguards
(DoLS) no longer require automatic referral to the coroners

From the 3rd of April 2017, it will no longer be necessary to refer all patients who die while subject to an
authorisation under the Deprivation of Liberty Safeguards (DoLS) to the coroner.

Before that date, patients who died subject to DoLS were regarded as dying while in state detention, trig-
gering an automatic requirement for an inquest. From Monday the 3rd of April the Coroners and Justice
Act 2009 will be amended so that coroners will no longer be under a duty to investigate a death solely be-
cause the individual was subject to the DoLS at the time. These deaths will only require reporting to the
coroner if the cause of death was unknown, or where the cause of death was violent or unnatural.

All deaths while subject to a DoLS authorisation that occur prior to the 3rd of April will still need to be re-
ported to the Coroner.

NO . 3 0 6 Page 2
 'LMC Mythbuster'
Please find attached to this newsletter a document entitled 'LMC Mythbuster'. It has been designed to ex-
plain some of the changes currently happening in the NHS and to give our opinions on those changes. We
are hoping that it will become the basis for a series of meetings for practices to discuss the STP process
and the CCG Primary Care plans. This is a challenging time for General Practice but we believe that GPs
will be pivotal in any putative system redesigns and as such our voice is extremely important.'

QOF / GPES and enhanced service payments

We are writing to make you are aware of the timings of GPES contract extractions this year. NHS England
have informed us that due to when the Easter bank holiday falls this year, there is a delay in timing of the ex-
tracts for enhanced services which has the potential to affect the payments run.

Since 2013, QOF extraction has been separate from the other enhanced services so as not to overload the
system. This normally hasnt impacted significantly on the timings of payments for the enhanced services,
however, due to the timing of Easter this year and the rules around giving practices time to review and validate
data collections, there is a risk that for some practices there is the possibility that their enhanced service pay-
ments might be delayed. This is due to timing issues between the achievement calculation and the payment
run dates.

NHS E are trying to minimise the impact that this has on practice cash flow, so are looking to time payment run
to ensure those with the highest value are done first. The exception is the AUA as the work to validate has al-
ways taken some time and it is likely this will get paid later.

The current timetable is the following;

The process will start on the 27 March, with all the messages going out to system providers.
The data collection will start at 1 minute past midnight of 31 march/ 1st April.

After QOF the extractions will be prioritised in the order described below:

Group 1: Men B, Pneumococcal, Seasonal Flu (all March 2017 payment) all starting 8 April
(earliest possible date, 5 working days into the month)
Group 2: AUA (component 3 payment), LD (Quarter 4 payment), Rotavirus (March 2017 pay-
ment), Pertussis (March 2017 payment) all starting 12 April after completion of Group 1)
Group 3: Shingles R, Shingles CU, Men ACWY, Childhood Flu (all March 2017 payments) all
starting 16 April (after completion of Group 2)
Group 4: Alcohol, Named GP and INLIQ (all March 2017 achievement dates but no direct pay-
ment calculations) all starting 20 April (after completion of Group 3)

NHSE is not able to advise on when each run will occur as it is different for each area.

Page 3 C O R NW A LL & I S LE S O F S C I LL Y LM C NE W S LE T TE R
 Please update your records

As from Monday 3rd April Dawn will be moving from office B310 to B313, email address and phone num-
ber will remain the same.

A free, confidential NHS service for GPs

Advice, assessment and treatment for mental health concerns and addiction problems particularly those
that may be affecting work. Local and national treatment locations are available.
Tel:0300 0303 300 email gp.health@nhs.net

Also available is a free, confidential local service offered by the LMC. Our pastoral care team is highly ex-
perienced in dealing with range of issues and can offer help, support and guidance at short notice.
To access the service all you need to do is contact the LMC Office on 01726 210140/1 or email
dawn@kernowlmc.co.uk

Safe Caseloads in District Nursing Service

NHS Improvement has launched new draft guidance on Safe, sustainable and productive staffing in dis-
trict nursing services and is asking for comments on it before the official resource goes live later this year.
If you are involved in district nursing services and would like to contribute to the production of this guid-
ance, please check out the details on this webpage.

HPV Vaccination for boys

We recently met with HPV Action who are campaigning to get all boys vaccinated against HPV, which is in line with
LMC Conference and BMA ARM policy. If you're uncertain as to the importance of this please cast your minds back
to the LMC conference in York, if you were there, and the most moving speech I have ever heard made at that
event.

As part of HPV Action's work, they are running a very brief survey of GPs and dentists, seeking their views. This
takes only a few seconds to complete.

I would be very grateful if you could pass this link on to GPs in your area, and encourage them to complete.

https://www.surveymonkey.co.uk/r/XG935K3

Page 4 C O R NW A LL & I S LE S O F S C I LL Y LM C NE W S LE T TE R
 New Doctors!!
Meet and Greet Evening

You are invited to a Meet & Greet evening at the Seiners Arms, Perranporth on the evening of Thursday
22nd June 2017 from 6.30pm until around 9.30pm with a buffet being served from 6.30pm

The invite is cordially given to all new GPs and registrars (in practice for 5 years or less) come and
have a social evening and meet your fellows. The evening is free including the buffet.

For the sake of numbers and any dietary requirements, please can you complete the attached booking
form and return it as per details on the booking form.

Cornwall Dermatology Group

Are you a GP with a special interest in dermatology?

We have started an evening group for GPs with the Dermatology Diploma looking to keep up to date with
dermatology and fellow colleagues. Next meeting (all welcome):

Lanhydrock Hotel, Lostwithiel Road, Bodmin, PL30 5AQ

Thursday 20th April 2017
Chaired by: Dr Clare Tyler, Wadebridge and Camel Estuary Practice

Agenda
Dermatology Update to include Vulval Health
Company Stands will be present with prescribing information available.

7.00pm-7:30pm Registration & Hot Buffet

7.30pm-8:15pm Introduction & Photo quiz

Dr Liz Venner, Dermatology Associate Specialist, RCHT

8.15pm-8:30pm Coffee & Pudding

8:30pm-9:15pm Discussion of Case studies

Dr Liz Venner, Dermatology Associate Specialist, RCHT

If you would like more information or to attend this event please RSVP:
Katrina Lyons Email: Katrina.lyons@leo-pharma.com Mobile: 07500944913

Confirmation is essential for catering purposes

This Educational Event is kindly organised and supported by Leo Pharma, Dermal Labs and Galderma UK to cover
the costs of speakers & catering.

NO . 3 0 6 Page 5
 NB Education and Devon Doctors
Hot TopicsUrgent Care
In and Out of Hours

CORNWALL RCGP CPD MEETINGS

RCGP Tamar Faculty has been organising educational events in Cornwall since 2009.

The events are aimed at Sessional and Principal GPs, Locums, First5s, AiTs, trainees in Primary care and multi-
disciplinary teams, Secondary and Social Care staff.

These meetings educate, update and provide a platform for peer group networking and mentorship.

Evening meetings are free for everyone, there is no need to book. Workshops rquire payment through RCGP web-
site http://www.rcgp.org.uk/tamar

Time: 7 pm for 7:30 start. Hot Buffet and drinks are available from 6:30 pm.

Venue: Duchy Hospital, Truro, TR1 3UP.

Parking: Staff car park behind the Duchy Hospital.

Conference room: opposite the Staff car park, please press the PUSH PAD to enter

5 Apr Wed 201 Hearing Loss: Dr. Ted Leverton. GP, Volunteer with Action on Hearing Loss, and NICE guideline
committee member, Devon

3 May Wed 2017 Dermatology Update- Cancer: Dr. Tom Lucke . Consultant Dermatologist, RCHT

7 Jun Wed 2017 Pain Management Programs in Cornwall: Ms. Barbara Sharp. Lead Specialist Physiotherapist,
Pain clinic, RCHT

5 Jul Wed 2017 NO EVENING MEETING

7 Jul Friday 2017 Allergy Workshop by Dr Andrew Whyte: Consultant Immunologist, Plymouth, To register your
interest email Natalie.Bastone@rcgp.org.uk

2 Aug Wed 2017 NO EVENING MEETING

Page 6 C O R NWA LL & I S LE S O F S C I LL Y LM C NE WS LE T TE R

 Falmouth Health Centre

We are a 5 Doctor partnership in Falmouth with a retirement vacancy.

Were a teaching practice with maximum QOF score and superb patient satisfaction measures and a CQC
good and outstanding report.
We like the equality of partnership and the control of our own working environment.
We can offer the right candidate somewhere between 6-8 sessions a week in a fabulous practice and in a
fabulous area.
We are in health centre premises, so no buy in to the premises.
The partnership is proud to be financially robust and well organised.

We are looking for someone who enjoys general practice and shares our hope for a bright future.

If you would like to know more please call our Practice Manager, Geoff Dennis, on 01326 310160 or
07921 240856 or email geoff.dennis@nhs.net
The Falmouth Health Centre Practice, Trevaylor Road, Falmouth, TR11 2LH. www.faldoc.co.uk

Pensilva Health Centre

We are a growing, rural practice with a current list size of 4,980

In addition to our dedicated staff we have supportive patients who value our care.

Recent retirements have led to a younger workforce and we are now looking for a new person to join us
so we can continue to provide good quality patient care.

Minimum of four sessions required to join two existing partners and four salaried doctors.

We work in a spacious, purpose built health centre, in a pleasant, surrounding area.

Our dispensary is profitable and efficient.

Work-life balance and opportunities for developing outside interests are encouraged.

Do you have strategies / ideas for primary care in the future NHS?

Please contact Catherine Pickstone on 01579 362249,

Catherine.pickstone@nhs.net, our Practice Manager to learn more or see our Practice.

NO . 3 0 6 Page 7
 TRESCOBEAS SURGERY Falmouth, Cornwall
SALARIED GP
Due to a rapidly expanding list size, an opportunity has arisen for an enthusiastic and proactive 4-8 Ses-
sion salaried GP with a view to a partnership.

Located within central Falmouth, which has just been been listed as the best place to live in the south
west in the prestigious Sunday Times Best Places To Live Guide

Highly regarded and fast growing practice with a modern, purpose built surgery

GMS with 10,000 patients and 8 partners

Part dispensing, Semi-rural with 2 branch surgeries
Training and teaching practice
Total triage.
High QOF and clinical achievement,

Happy and healthy work atmosphere for our team. Generous holiday and study leave allowance to sup-
port a positive work/life balance.
Start date and salary negotiable.

For more details of Trescobeas Surgery please see www.trescobeas-surgery.co.uk

Informal enquiries/Practice visits are welcome: Contact Practice Manager, Yorick ONyons
Yorick.onyons@nhs.net or 01326 315615) or Dr Carol Clark carol.clark14@nhs.net

The Three Spires Medical Practice

Salaried GP (2 posts) - 4 sessions permanent and 4 sessions maternity cover - Truro,

We are a highly regarded training and research practice, looking for enthusiastic and dedicated GPs to
join our forward-thinking, supportive and friendly team. The Practice is located in new purpose-built prem-
ises at the Health Park in Truro, Cornwall. Our list size is approximately 15,000 with a clinical team of 8
partners, 4 salaried GPs, 4 practice nurses and 8 phlebotomists/HCAs.
We require two salaried GPs for four sessions each per week. One on a permanent basis and one to pro-
vide maternity cover for up to one year.
Together with our existing Salaried GPs, you will be responsible for a shared patient list and provide cover
accordingly. The post will involve managing your own workload, completing paperwork, home visits, and
being part of the duty rota. Experience in Womens Health will be advantageous.
Informal enquires are welcome; please contact Katy Roussel, Operations Manager on 01872 272272 or
email katy.roussel@nhs.net

NO . 3 0 6 Page 8
 Salaried GP Chacewater & Devoran Surgeries

3 Sessions per week: Monday, Tuesday and Friday mornings

An opportunity has arisen for a salaried GP to join our forward-thinking, supportive and friendly team.

We are a four partner semi-rural dispensing, GP Training, GMS practice with 5,800 registered patients. We provide
high quality, personal primary care in beautiful central Cornwall. We are a highly motivated practice and perform well
across a variety of outcome measures including QOF, CQC and patient surveys and we are an active member of
NHS Kernow CCG.
We are looking for an enthusiastic and dedicated GP who is patient centred and enjoys working as part of a small
and caring team of doctors, nurses, HCAs, dispensers and administrative staff.

We offer a highly competitive salary with NHS pension.

For further information or to arrange an informal visit please contact:

Debbie Berryman d.berryman@nhs.net
or
Susan Gunn susangunn@nhs.net
Telephone: 01872 562200

Closing date: 30th April, 2017

ADVANCED NURSE PRACTITIONER ST AUSTELL HEALTHCARE

We are looking for a forward-thinking Advanced Nurse Practitioner(s) to join our award winning Team. The post
holder should be an independent Nurse Prescriber with Primary Care experience.

4-10 sessions available. Flexible working considered. Competitive rates of pay dependent on experience and quali-
fications.

SAH has 32,000 patients. We are nationally recognised as being at the forefront of innovative Primary Care. We
are committed to MDT working, development and education. We will support you clinically, plus development of
your portfolio career/specialist interests.

Our MDT includes:

Clinical Pharmacist:
ANPs dedicated visiting service
Community Integration Nurse
Minor Illness/Practice Nurses
HCAs
Occupational Health Drs
Ophthalmology Service.
Specialist Diabetic Service
Social Prescribing
Research Nurse.

We are working towards integration with community teams and local voluntary sector organisations.

For more information about the post and to request an informal visit please contact:

Bridget Sampson Managing Partner 01726 626842 email: bridget.sampson@nhs.net

NO . 3 0 6 Page 9
 Stratton Medical CentreNurse Practitioner

We are a large, friendly, forward thinking seaside practice in the beautiful countryside of North Cornwall. Our posi-
tion offers excellent quality of life with stunning beaches on the doorstep.

We are looking for a dynamic Nurse Practitioner who values a supportive team environment to work alongside com-
mitted and dedicated partners who will be able to develop and progress your clinical skills whilst providing a high
level of patient care.

Our ideal candidate would be an independent prescriber, have knowledge of long term conditions and be confident
in triaging, minor illness and willing to undertake home visits on behalf of the GPs. They will demonstrate safe clini-
cal decision-making and expert care, including assessment and diagnostic skills.

If you are an enthusiastic, progressive thinking, committed Nurse Practitioner who has the vision and organisational
skills to help us to develop this role and improve the care we give to our 11,000 patients we would welcome your
application.
Please apply with CV and letter to:

Miss Kathryn Pengelly (Practice Manager)

Stratton Medical Centre
Hospital Road
Stratton
Bude
Cornwall EX23 9BP

Telephone no: 01288 352133

Email: kathryn.pengelly@nhs.net Website: www.strattondocs.co.uk

NO . 3 0 6 Page 10
DR BASIL BILE

What is it with TV remote control units and the fairer sex? Belinda keeps stubbornly selecting non-
HD channels in spite if the fact we have had a High Def television set for simply ages. Freeview channels
101, 102, 103 bloody etcetera seems to be beyond her ken. I suppose I should be grateful she hasnt worked
out how to select the black and white picture option or we would be back in the 1950s with Champion The
Wonderhorse, Muffin The Mule, and The Lone Ranger.
Mind you, the mehmsab is a trifle distracted at the mo due to the impending wedding of our dear
daughter Basilica. Whopping quantities of spondoodles are making their way on a frighteningly regular ba-
sis from our all-too-easy-to-access Bodmin and Sticker Building Society account in the direction of the vo-
racious and appropriately named Wedding Industry. The horribly pretentious venue is gobbling up what
little remains of my dispensing profits. We are off to a meeting with someone called Fenella, a Wedding
Organiser no less, who makes the average Harley Street nip-and-tuck merchant look economically priced
by comparison. Trying to work out which ghastly relatives and dipsomaniac chums to invite to the ruddy
affair pales into insignificance when compared with deciding who sits where. There seem to be so many
warring factions in both families that unless we get the seating plan absolutely bang-on there is likely to be
a blood bath of Mafia vendetta proportions.
Basilicas intended victim, the bewhiskered Hamish, recently came to stay in St Salive with his fu-
ture in-laws. He insisted on wearing his kilt whilst cycling round the Cornish lanes, inflaming passions in
elderly ladies shopping for marmalade in Fore Street that frankly were best left dormant. Needless to say,
Belinda is bewitched. Im not quite so sold on the young blighter, not least because he has made rather
short work of polishing off several years worth of single malts donated by justifiably grateful patients over
the last few Yuletides.
Still, thats enough of my problems. The latest dictat-from-on-high declares that Family Docs who
shut their surgeries for half a day a week will lose their share of eighty-eight million smackeroos handed
out by NHS Fruitcake for evening and weekend appointments. The National Audit Office unearthed the
tantalising tit-bit that 46 percent of Englands 8,000 GP surgeries closed during the working day, even
though most of them were getting extra loot for offering out-of-hours access. Jeremy-I-couldnt-organise-a-
piss-up-in-a-brewery Hunt, who it is alleged is our Secretary of State for Health, intends to take stern
measures to deal with the miscreants. I must say to my errant colleagues that closing for half a day a week
is disappointing conduct, and is bound to leave patients confused. Closing every day would be much more
sensible, merely opening briefly to qualify for the out-of-hours backhanders, finishing in time to listen to
The Archers.

just about pay for the canapes to be served to the various misfits attending Basilicas nuptials, a fin-
ger feast which Belinda fondly believes will prevent the buggers getting pissed on the El Plonko sparkling
white we are serving by the thimble-full.
Meanwhile, Helen Stokes-Lampoon, venerable Queen Bee and Chairwomanperson of the Royal
College of Garrulous Practitioners, has given the two-fingered salute to NHS Fruitcakes proposals for
more old codgers and those with long-term conditions to be treated in GP surgeries, on the grounds that
existing appointments were already too rushed. We have the shortest consultations in Europe. Its a crazy
situation, she pointed out. Unfortunately, Jeremy H had his fingers jammed firmly in his ears at the time
so may not have heard her.
As for long term conditions, I have often wondered what a short-term condition is. Sadly I have
been taking so many half-days off recently I may never find out

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