Welsh LMCs round up: Enhanced services, unresourced work and secondary follow-ups

Round up from Welsh LMCs conference

Enhanced services

Welsh GPs said they are ‘appalled’ by health boards removing enhanced services due to GP over performance in the QOF when primary care budgets are exceeded.

LMC representatives raised the issue in a motion at their annual conference in Newport on Saturday.

Bro Taff LMC’s Dr Sarah Morgan said practices in Cardiff had been told they had ‘overspent’ their LES budget. 

'What this means is we have seen more people with chronic disease, brought them to the accepted, evidence-based targets, or given them the appropriate public health information…  And we are being penalised for this’, she said.

‘We expect that our staff and ourselves are appropriately resourced for doing the work we do so well rather than being penalised for seeing more patients.’

Where there are overspends, said Dr Morgan, it was because GPs were doing their job properly. ‘What other profession is told off for for doing its job so well?’

Unresourced work 

LMC representatives voted to demand the Welsh government increase resources to general practice to fund work moved from secondary care.

GPs agreed that the government’s stated policy of shifting increasing amounts of work into primary and community care meant the NHS was reaching the point where general practice is full.

Morgannwg LMC’s Dr Andrew Bradley said with the considerable transfer of unresourced work it was ‘hardly surprising the workforce in general practice is starting to think about walking away’.

North Wales’ Dr Phil White said there had been a ‘drip drip feed’ of additional district nurse work from secondary care such as suture removals and post-op work.

‘We have to be in a position now where we can’t really take any more work until someone seriously reviews the funding issues.’

Secondary follow-ups

General practice should not become the normal place for secondary care follow ups, LMC representatives said.

Plans should be drawn up to deal with patients on health boards’ follow up not booked appointments who may not be given appointments within a reasonable time, according to a motion passed.

North Wales LMC’s Dr Eamonn Jessup said there had a been a ‘scandal’ in his region, where nearly 12% of the entire population, 48,000 people, were on a follow-up backlog list. ‘That is horrendous’, he said. ‘We think it is occurring throughout Wales.’

GPs in North Wales, he said, were refusing to do unpaid follow up work for patients on the backlog list.

Dr Jonathan Jones, also from North Wales, said the ‘follow up scandal of North Wales is shocking’.

‘Fourty seven thousand patients are meant to see specialists for follow up, but nothing is happening’, he said.

‘The only solution the Local Health Board could come up with is that primary car5e might find the capacity to, might find the ability to take on additional work.’

Dr Jones said the Board had proposed to fund the work with LES money which should fund general practice.

GPs had agreed that the money on offer was too little, and the workload to great and refused to take it on, he added.

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