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General Practice in Birmingham Part 5


The 2016 Annual Report of the Birmingham Local Medical Committee was published in March 2017. It was a year that had seen further massive change and unprecedented challenges for Birmingham GPs, their practices and no doubt reflecting issues in other regions in the UK. During the year the LMCs’ constituents sought advice and support more than ever before, reflecting the huge and diverse problems now facing general practice and the wider NHS. The report has been divided into a series of blogs covering:


A special conference of Local Medical Committees took place in January 2016, following pressure from a number of LMCs, including Birmingham, to hold such an event to recognise the extent of the crisis in general practice. The key motion which was passed at the conference called on GPC to ensure that should negotiations with government for a rescue package for general practice not to be concluded successfully within six months then further actions must be taken. The outcome of this was the GPC document entitled “Urgent Prescription for General Practice” (UPGP), detailing the measures, including additional investment, it believed should be taken, in order to deal with the massive crisis facing the profession.

Shortly after this NHS England produced its own document the ”General Practice Forward View” (GPFV) recognising at last that there was a crisis, belatedly admitting the underfunding that had taken place for many years and putting forward its own proposals for investment and initiatives to support general practice. It was clear however that the various piecemeal measures in the GPFV, and the additional investment offered therein, were a woefully inadequate response which simply did not recognise the scale of the catastrophe engulfing general practice, and would go nowhere near to providing the solutions required.

The usual annual UK conference of Local Medical Committees took place in May 2016. Birmingham LMC was allocated five representatives to the conference who attended in addition to the LMC secretary and two other LMC members who attended the conference in their roles as members of GPC. Three motions were submitted by Birmingham for consideration for inclusion in the conference agenda on the themes of working at scale, increase practice funding and the management of workload by controlling practice list size. Sadly none of these motions was chosen for debate by the conference agenda committee.

A key motion passed at the conference called for the government to accept the urgent prescription document in full and that if it did not do so the profession would be surveyed on its willingness to take industrial action (by means which would not breach contracts or statute) and on its willingness to submit undated resignations. The LMC’s position on this was that whilst the UPGP went a little further than the GPFV, even in the likely event that the urgent prescription demands were met in full, the additional funding it called for was still nowhere near adequate to address the catastrophic crisis facing the profession.

Subsequent discussions between GPC and NHS England led to an agreement by the latter to continue discussions with GPC over those demands in its UPGP document which were not covered in the GPFV. As a result of this the GPC’s view was that the requirements of the conference motion had been met, a position however with which Birmingham LMC did not accept.

The action which the GPC did take in respect of the conference motion was to survey the profession at the end of the year on the problems that GPs and practices were currently facing and to canvas views on what actions practices might take to resolve them. Sadly only about 5000 GPs responded to the survey and of note the survey omitted the key question as called for in the conference motion, in respect of willingness to submit undated resignations. Overall the results of the survey were not particularly enlightening and did not appear to suggest a clear and agreed way forward for the profession to deal with the crisis.


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