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DDLMC Weekly Update - 4.12.2020


You will all be aware that the COVID ES was released on Tuesday night.  Both documents contain information that practices need to be aware of as you consider whether or not you are prepared to deliver the ES.  Attached to this briefing is a detailed analysis of the ES for you to consider.  This has been prepared in conjunction with other LMC’s and we would like to thank them for their input.  We also include a summary and concluding advice at the end of the analysis.

As a precursor to you studying that analysis it is worthy of note that we all clearly want to get engaged in the process of getting a vaccine into our patients, as soon and as safely as possible.  There is no question that we all want a return to normality as quickly as is possible.  We recognise that the majority of our vulnerable (and other) patients would prefer to receive a potentially life-saving vaccine close to home.  Somewhere they know, from a team they can trust – their GP practice.

But we recognise that there is an expectation on general practice to achieve the impossible here: continue business as usual; immunise all 50 to 64 year olds against flu; prioritise our most vulnerable patients; manage the work transfer from trusts and the ongoing needs of those waiting for interventions and diagnostics - when we know our capacity is non-existent as our workload transfer survey illustrated.

We recognize that the current position is not the fault of anybody or any organisation in Derby and Derbyshire.  Instead, the ES represents an opportunistic strategy by some in NHS England to prematurely force a collaborative contractual agenda onto practices, which we fear will have a destabilising effect on those same nascent networks they are so keen to establish.  To that end, we cannot, in all good faith, recommend that you sign it.

What if we say YES to playing our part in vaccinating, but NO to the CVP ES?

What if as an area, Derby and Derbyshire practices said that this was a red line they felt they could not cross.

That this enhanced service poses too great a risk in allowing NHSEI unilateral changes to payments; notice periods; hours; wastage; scope; extent; where your own liability is predicated on how able the surgery down the road is able to fulfil its side of the deal – irrespective of whether they are in the midst of significant difficulties of which you may be unaware (this being the same NHSEI that castigated us for being ‘closed’ whilst delivering hundreds of thousands of appointments every single month according to their own data).

Discussions have taken place and have today been ramped up as to what a Plan B may look like involving DCHS as a lead provider subcontracting delivery (as appropriate) to GP practices. News in this regard will be shared with you as soon as we are in receipt of anything more concrete.

Whilst we cannot recommend the CVP ES to you, we will support all practices, irrespective of what decision you make.

We remain, as always, available for individual practice level advice on any aspect of this, or indeed any issue.

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