No.

312

September 2017 GPFV 2017/18 schemes

The GPFV has committed to increasing

investment and resources to general practice.
Whilst GPC recognise that additional investment to
these GPFV commitments is needed to address
the current crisis in general practice, any funding
or support for general practice is welcome.
Cornwall & Isles of Scilly

It can be incredibly difficult to keep track of the

GPFV schemes and what is available. Therefore,
we have provided the information (attached to this
newsletter) on funding and support that should be
available in 2017/18. Please use this information
to ensure that your local area and clinical
commissioning group is adhering to their
commitments and practices are aware of the
support available.
LMC Newsletter

Deadline for the October issue is

Wednesday 25th October.

Inside this issue:

Sessional GP Newsletter
Your Chairman writes 2/3

Here is the link for the Septem-

Cornwall Infant Hip Ultrasound 4 ber issue of the Sessional GP
Screening Service Newsletter.

Training 5
CHP and NHSPS premises

Vacancies 6-9
Dr Basil Bile 10
Items for the Newsletter should be
sent to the Editor, Dawn Molenkamp
at Victoria Beacon Place, Room
B314, Station Approach, Victoria,
Roche, St Austell, PL26 8LG
Tel :01726 210141
e-mail dawn@kernowlmc.co.uk
Your Chairman writes ..
Some months ago we published the LMC myth buster. If you havent read it yet, please try and read it as it
may enable you to make some sense of what I have to say this month. It is available here (https://
kernowlmc.co.uk/wp-content/uploads/2017/03/LMC-Myth-buster-Final.pdf).
However, just to recap we said the following: -

ACS
Fact
Accountable Care System - a process where all NHS organisations in an area commissioners
and providers sign up to a formal agreement to work as a system. In essence it is the team of
organisations evolving and having responsibility for delivering the STP.
Opinion
ACSs will probably evolve into ACOs

ACO
Fact
Accountable Care Organisation - An ACO brings together a number of providers to take
responsibility for the cost and quality of care for a defined population within an agreed budget. In
some senses, they are the natural evolution of an ACS.
Opinion
ACOs sound powerful, scary and American. It is difficult to see where General Practice can fit into
a healthcare landscape with these behemoths. However, it is also clear that ACOs need a sound
and vibrant GP landscape to deliver their aspirations. If GP is going to operate in the environment
of ACOs it needs strong representation (i.e. functioning and dynamic LMCs)

We also wrote: -
CCGs
Fact
Clinical Commissioning Groups - Clinical commissioning groups (CCGs) are NHS organisations set up by
the Health and Social Care Act 2012 to organise the delivery of NHS services in England.
Opinion
It is likely that the future of CCGs is time limited if Accountable Care Organisations (ACOs) evolve.

The new few months will see some seismic shifts in the local healthcare landscape. An ACS will be set up
with RCHT (Royal Cornwall Hospital, Treliske) and CPFT (Cornwall Partnership Foundation Trust) at the
heart of the new organisation in conjunction with Cornwall Council. CPFT and RCHT are developing a
committees in common structure and this process has now developed a momentum that will be unstop-
pable unless we have another election, Labour win and enact changes

NO . 3 1 2 Page 2
Your Chairman writes ..

And this of Kernow CIC: -

Here to stay and will be an important part of the transforming GP landscape in Cornwall. The CIC can do
as much or as little as we want. In future, it may be desirable for KHCIC to take a greater role in, for exam-
ple, a super-practice contract.

The time is rapidly approaching when the events, as envisaged above and spoken about over the past
few years by us both at meetings and on these pages, are going to explode onto the GP landscape. I think
we are reaching a fork in the road and we need to make a decision about our direction of travel. We can
continue to bimble along and wait to be run over by the vehicle that is the ACO or we can supercharge our
provider organisation and plough the road in the direction of travel that we feel is best for General Prac-
tice.
What does this mean ? It means doing some of the things that we have been resisting and also doing
some of the things we have been doing a bit better: -

Working effectively in collaboration through and with our CIC

Taking control of those CCG provided functions that we can shape and utilise
Thinking the unthinkable - getting bigger/larger/more corporate
As a shareholder in the CIC making your voice heard

Sound scary ?
Absolutely.
The alternative - do nothing and accept that ultimately the end game is a salaried GP workforce with little
control over how you work.

So what do you want ?

NO . 3 1 2 Page 3
 CORNWALL INFANT HIP ULTRASOUND SCREENING
SERVICE

Guidelines for referral:

Urgent - Scan within 2 weeks

- Any infant you suspect has a dislocated/unstable hip.

- Infants with positive Barlow or Ortolani tests.
- All infants presenting with unequal leg lengths, unequal/tight hip abduction or asymmetric skin
creases.

Routine/At Risk - Scan at 6 weeks of age (corrected age for pre-term babies)

- Family history of hip dysplasia or instability.

- Breech deliveries.
- Caesarean Section delivery for breech or transverse lie.
- Pregnancy complicated by oligohydramnios.
- Babies with foot abnormality especially talipes.
- Infants with torticollis or sternomastoid tumour.
- Infants with plagiocephaly.
- Infants with any other signs of intra-uterine compression ie moulded babies.
- Infants with birth weight below the 3rd centile for gestational age.
- Infants with other congenital skeletal abnormalities.
- Any infant with clicky hips
- Twins (both)
- Parental concern

Notes

All infants with suspected DDH below the age of 18 months should be referred for ultrasound of
the hips in the first instance.

Babies requiring the application of a Pavlik harness are referred to the Paediatric Orthopaedic Physiother-
apy Team and progress monitored with regular ultrasound scans. Those not responding to harness treat-
ment will be referred to the next available Paediatric Orthopaedic Surgical Clinic.

Infants with positional talipes, plagiocephaly or torticollis are referred to the paediatric orthopaedic physio-
therapists. Any other leg abnormality noted on examination will be referred to the paediatric orthopaedic
surgeons.

Referral

Routine referrals should be made by letter providing full clinical details including reason for referral.
Urgent referral by phone.

Orthopaedic Booking Centre Contact No: 01736 758892

St Michaels Hospital
Trelissick Road
Hayle
TR27 4JA

For further advice, contact Carol Scott (Infant Hip Sonographer) - carol.scott18@nhs.net

NO . 3 1 2 Page 4
 Training More Delegates please!!
I still have places going begging on the following courses:

Read Coding 15th November 2017 (All day)

Clinical Notes Summarising 29th November 2917 (All day)
Succeeding with Difficult People 6th December 2017 (All day)
Managing Change in General Practice 7th February 2018 (All day)
Exceptional Customer Service 21st February 2018 (All day)
Fine Tune your Appraisal Skills 7th March 2018 (All day)

I would really like to try and fill these bargain days so please try your best and help me out here!

If you need any info on the content please just drop an email to admin@kernowlmc.co.uk.

Letter for practices in CHP and NHSPS premises

Please find attached a letter for practices in CHP premises, and a separate letter for practices in NHSPS premises.
There is also created a webpage for practices with useful guidance, please follow this link:

NO . 3 1 2 Page 5
 St. Marys Health Centre, Isles of Scilly
Salaried GP Post
An exciting opportunity has arisen for a full time GP to join a team of three doctors to enjoy a challenging expe-
rience and unique life style on these beautiful sub-tropical islands, which is also an ideal location for families.
The purpose built main Health Centre is situated on St. Marys covering 2,500 registered patients with a Com-
munity Hospital and minor injuries. Branch surgeries exist on the off-islands, reached by a purpose built mod-
ern launch.
The surgery holds an APMS contract together with optometry and pharmacy contracts. The Doctors cover out
of hours on a rota.
The Health Centre is backed up by a larger Health Centre of 13,800 patients, based on the mainland consisting
of 7 partners, 5 Salaried Doctors, some of whom help to cover work on the islands. Education courses are of-
fered to help Doctors to be safely equipped to work in this environment. Salary TBN reflects the commitment
needed.

Contact Dr. John Garman, GP Partner/Alison Jenkins, Practice Manager

St. Marys Health Centre, King Edwards Lane, St. Marys, Isles of Scilly, TR21 0HE
01720 422628 for further information.
Please apply in writing/email with a copy of your CV
Email john.garman@nhs.net
alison.jenkins9@nhs.net

Helston Medical Centre & Porthleven Surgery

Salaried GP with a view to Partnership to work in Porthleven Surgery 4 sessions per week
This is a unique opportunity to work at Porthleven Surgery with the autonomy of a small practice and consistent
continuity of care, whilst having the support and benefits of the larger practice team.
Helston Medical Centre & Porthleven Surgery is an innovative 7 partner practice with 8 salaried GPs based at
Helston, Porthleven and the Isles of Scilly. We care for almost 14000 patients on the mainland as well as the
residents and visitors of the Isles of Scilly. We are passionate about providing services locally to our patients
in the South Kerrier locality as well as improving the range of services on the Isles of Scilly.
Purpose built premises at Helston
Registrar/F2 and medical student training
Supportive multidisciplinary team
Part dispensing practice
Specialist services provided including Level 2 Sexual Health, Drug Misuse
Active role care provision at Helston Community Hospital
Highly involved with local CCG
CQC good rating at Helston/Porthleven and Outstanding on St Marys
We are looking for enthusiastic, proactive, team players with a strong patient care focus who will share our
supportive, hardworking ethos and commitment to high quality care.

Initial enquiries to Dr Richard Drummond 01326 562204 or Alison Butterill, Managing Partner 01326 572637
a.butterill@nhs.net
CV with covering letter to Alison Butterill, Helston Medical Centre, Trelawney Road, Helston TR13 8AU
Closing date for applications: 16 October 2017

NO . 3 1 2 Page 6
 Are you a General Practitioner who is keen to develop a special interest
in the management of breast disease?
If so, we are looking for you to join our enthusiastic, dynamic and forward thinking breast team at the Mermaid Cen-
tre, Royal Cornwall NHS Trust. We are aiming to find 2 more GP's to complement our multidisciplinary team, working
up to 2 flexible sessions a week, principally in our triple assessment new patient clinics.
The successful appointees will be offered a period of training in all aspects of the assessment and diagnosis of be-
nign and malignant breast conditions. This will incorporate initial shadowing of established clinicians and gradual
clinical exposure leading to independent, but supervised practice. You will be working alongside surgical consultants
and junior doctors in a multidisciplinary setting with our team of Radiologists, Radiographers, and supported by our
Breast Care Nurses.
ur new patient clinics assess over 4500 2WW patients a year with a range of symptoms from breast pain, benign
breast disease, gynaecomastia and developmental breast problems as well as cancer. In addition our oncoplastic
breast surgical service is at the forefront of innovation and surgical research and offers the latest techniques combin-
ing plastic surgery and evidence-based cancer surgery. Our 5 consultant oncoplastic and reconstructive breast sur-
geons also share special interests in revisional breast reconstruction as well as risk reducing surgery, mammoplasty
techniques and gender re-assignment surgery.
You would be joining a surgical department supported by a first class radiology service, providing new patients with
immediate access to digital mammography and ultrasound with additional breast MRI, PET and Nuclear Medicine
scanning as necessary.
The two successful candidates will be expected to work two sessions a week, either in the morning or the afternoon,
with their exact schedules being negotiable and mutually agreed. This has been a very successful new initiative with
the appointment of 2 GPSIs last year who have enhanced our team enormously. In developing this collaborative
and progressive approach to joint working and training in the management of breast disease, we hope to further pro-
mote ever closer working relations and strengthened links between specialty services and primary care.
Interviews are likely to be in October.
If you require further information please contact Miss Polly King Consultant Surgeon on 01872255075 or
email polly.king1@nhs.net

ST AGNES SURGERY
Partner wanted for four sessions due to Retirement

Chances are if you are a Cornish GP you already know about St. Agnes because you probably live in the village.
But even if you dont, you might want to (https://www.thetimes.co.uk/article/st-agnes-best-places-to-live-2017-
wwj3q8bv3). This is your opportunity to come and join our local friendly and dedicated team as a GP partner with
amazing views on your visits.

What we are:
A partnership of five WTE GPs
St Agnes is a semi-rural dispensing practice with a branch surgery in Mount Hawke.
List size of approx 8000 patients.
We offer all the usual routine services and others including research, GP training, aural micro-suction and mi-
nor ops.
Microtest Evolution computer system.
Committed Patient Participation and Friends of St. Agnes Surgery groups.
Active member of the Coastal Cluster and Kernow CCG.
Good CQC rating (though we obviously consider ourselves to be Outstanding).
5 star rating on Google reviews!
Forward thinking, dynamic supportive friendly

Applicants should have interest and experience in Womens Health including IUD fitting, contraceptive implants.

Start date January 2018

For further information and/or to submit your CV please do not hesitate to contact:
Liz Thierens, Practice Manager, St Agnes Surgery, Pengarth Road, St Agnes, TR5 0TN Email: liz.thierens@nhs.net
Closing Date 27.10.2017

NO . 3 1 2 Page 7
 Phoenix Surgery
Emergency Care Practitioner (ECP)
Phoenix Surgery are looking for an enthusiastic, motivated and forward thinking Emergency Care Practi-
tioner (ECP) to join our committed and friendly team at Phoenix Surgery in Camborne, Cornwall.

We are especially looking for a someone with enhanced skills in medical assessment and extra clinical
skills in urgent care medicine who will support the GPs in seeing the urgent on the day cases and assist with
home visiting.

The post-holder must share our aims of delivering personalized, patient-centered care, whilst providing a
happy and healthy working atmosphere for our team. We are supportive of career development and wel-
come opportunities to support all our staff in their career choices

Practice Summary:-
List size of 5851 patients
Team consisting of 5 GP partners (4 WTE), 2 GP Registrars, 3 practice nurses, 2 HCA, 1 phleboto-
mist and associated administration and reception staff
Clinical system used EmisWeb
High QOF achieving and recent CQC overall rating of good
Medical student teaching and VTS Training Practice, with three approved trainers including one of
the local Training Programme Directors
Very well supported by skilled on-site district nursing team, community matron, palliative care nurse
and health visitors

Prospective candidates are very welcome to visit the practice on an informal basis, and/or to speak to a
member of the medical team. Please call 01209 714876 to arrange.

Please send a CV and covering letter to: Alison Henley, Practice Manager - ahenley@nhs.net

Port View Surgery

Lead Practice Nurse
Port View Surgery is looking for an experienced Practice Nurse to become the lead for our existing team
of 2 practice nurses and 3 HCAs. Ideally you will have Chronic Disease management training and be able
to provide the full range of general practice nursing care.

We are a small friendly team and we pride ourselves in the continuity of personal care we are able to pro-
vide for our 6500 patients.

The post is initially for 20 hours per week, days and hours to be agreed; however there will be a require-
ment to cover the absence of your nursing colleagues so flexibility is a key requirement.

Rate of pay will depend upon experience.

Expected Start date: ASAP

Application forms and a job description can be downloaded from our website:
www.portview.surgery.co.uk

Closing date: Sunday, December 31, 2017

NO . 3 1 2 Page 8
 HCA VACANCY ST AUSTELL HEALTHCARE

We require a full time reliable, competent HCA to join our busy primary care team at St Austell Healthcare.
The post-holder will be part of our healthcare team providing high quality, forward thinking nursing care to meet
the holistic needs of our practice population of 32,000 patients.

The post holder must have good communication and IT skills, be able to work under pressure, and work within
a large team.

Training to NVQ level 2 / 3 desirable as is previous experience in venepuncture, wound care, blood pressure
and ECGs .

There will be a requirement to move between sites, all of which are located within a 1 mile radius of the town
centre. Hours to be arranged between 8.00 and and 8.00 pm Monday to Friday. Rate of pay is 8.30 per
hour.

Further information available from Mrs J Arrowsmith, Planned Care Matron email: j.arrowsmith@nhs.net

Applications to Mrs J Arrowsmith, Planned Care Matron, St Austell Healthcare, 1 Wheal Northey, St Austell,
PL25 3EF. CLOSING DATE 20th October 2017

PHLEBOTOMIST VACANCY ST AUSTELL HEALTHCARE

We require a full time reliable, competent Phlebotomist to join our busy primary care team at St Austell
Healthcare. The post-holder will be part of our healthcare team providing high quality, forward thinking nursing
care to meet the holistic needs of our practice population of 32,000 patients.

The post holder must have good communication and IT skills, be able to work under pressure, and work within
a large team.

Training to NVQ level 2 desirable as is previous experience in venepuncture, blood pressure and ECGs .

There will be a requirement to move between sites, all of which are located within a 1 mile radius of the town
centre. Hours to be arranged between 8.00 and and 8.00 pm Monday to Friday. Rate of pay is 7.90 per
hour.

Further information available from Mrs J Arrowsmith, Planned Care Matron email: j.arrowsmith@nhs.net

Applications to Mrs J Arrowsmith, Planned Care Matron, St Austell Healthcare, 1 Wheal Northey, St Austell,
PL25 3EF. CLOSING DATE 20th October 2017

Carnewater & Stillmoor Practices, Bodmin

Experienced Project Manager - 30 month fixed term part-time appointment

Clinical Care Co-ordinator, 2 x part-time 0.6 FTE posts, fixed term contract of 18 months

For further details on both of these posts please see documents attached to this newsletter or they can be
seen online here.

NO . 3 1 2 Page 9
Dr Basil Bile

So, its official. Small isnt beautiful. At least not anymore when it comes to the noble art of Family
Doctory. 7 million patients are urged to leave unsafe GP Surgeries quoth the front page headline of The
Thunderer this week. Similar sentiments were regurgitated in The Daily Torygraph. They were referring to
the sage opinion of the CQC. Sage and onion might be more apposite as my first instinct is to tell them to
get stuffed.

The Care Quality Codswallop outfit has just finished inspecting 7,365 GP Practices, though not, I
hesitate to point out, my own Abandonhope Exemplar Practice at St Salive. We were closed for staff train-
ing the day they arrived on our doorstep complete with their sniffer dogs and thumbscrews. Fate decreed
we were otherwise engaged on a Yoga and self-discovery session in the back room of our local hostelry,
The Crooked Speculum.

The CQC inspectorate found that nine out of ten general practices were either good or outstand-
ing, a significantly better score line than that to be found in care homes or hospitals in these troubled
times. The pockets of persistent poor care they claim to have uncovered were more likely to be linked with
smaller surgeries, with the worst practices being half the size of the best. As I frequently reassure my wor-
ried male customers, size isnt everything. My own practice is a splendid example of what can be achieved
with economies of scale. I myself am barely five foot seven inches in height while Dr Hilda Bunnytunnel is
a mere five foot wide.

I hear you ask Dear Readers, not unreasonably, what were the mortal sins that came to light fol-
lowing the CQCs irritating prodding? Out-of-date medicines for one. This would frankly be impossible in
our set up at Abandonhope as we check all drugs routinely every five years, with the admitted exception of
leap years so perhaps we should revisit our methodology by way of a forelock tug in the direction of Pro-
fessor Fields Spanish Inquisition. They also had a moan about refrigerators being at the wrong tempera-
tures. I can assure you that there is no way I would countenance my cans of Tribute Ale being anything
other than properly chilled, so vaccines are hardly at risk.

The average inadequate practice had 5,770 patients compared with 10,126 punters at the average
outstanding one. Well that reassures me hugely as we have a mere 5,769 patients which moves us adroit-
ly off the CQC naughty step.

But before any of you feel you fall below the high standards set by myself and my team in St
Salive, please take a moment to reflect that there is no need to go into panic mode. That venerable institu-
tion, the BMA, has taken issue with Prof Field by suggesting that his inspections were not fit for purpose.
According to Chris Smyth, Health Editor of The Times, our very own Dr Richard Vautrey of the GPC has
noted that in his humble opinion the process remains overly bureaucratic with hard pressed GPs wasting
time filling in oodles of forms when they could be better employed treating patients.

Even Jeremiah Stunt is remarkably upbeat about the whole bangshoot, being quoted as saying
Nearly 90 percent of GP Surgeries in England have been rated as good or outstanding, and that is a
huge achievement for GPs given the pressures on the front line.

I note our esteemed Secretary of State said England rather than Cornwall, where the figure is
likely to be nearer to one hundred percent, if not greater. Nonetheless, I fear I must be getting soft in my
old age. I find myself inclined to agree with the blighter

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