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LMCs, the GPC, LMCs, the GPC, the NHS and All that Jazzthe NHS and All that Jazz
Dr James GillgrassDr James Gillgrass
Chief ExecutiveChief Executive
Surrey and Sussex LMCsSurrey and Sussex LMCs
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“ “ Local Medical Committees (LMCs) Local Medical Committees (LMCs) are unique. They alone amongst are unique. They alone amongst health service institutions have health service institutions have remained largely unchanged in their remained largely unchanged in their functions and structure since 1911. functions and structure since 1911. Therein lies both their strength and Therein lies both their strength and weaknesses.”weaknesses.”
ScHARR report ScHARR report 20032003
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What is a Local Medical What is a Local Medical Committee?Committee?
Statutory bodyStatutory body
Recognised by successive NHS actsRecognised by successive NHS acts
Recognised by PCTs as the GPs’ Recognised by PCTs as the GPs’ representative organisationrepresentative organisation
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IndependenceIndependence
Fully independentFully independent
Self financingSelf financing
LMCs are NOT trade unionsLMCs are NOT trade unions
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Surrey & Sussex LMCsSurrey & Sussex LMCs
Provides support and information to Provides support and information to the LMCs and GPs ofthe LMCs and GPs of
CroydonCroydonKingston & RichmondKingston & RichmondEast SurreyEast SurreyWest SurreyWest SurreyEast SussexEast SussexWest SussexWest Sussex
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OfficersOfficers
Chief ExecutiveChief Executive
Director of Finance & ITDirector of Finance & IT
Director of Liaison & PlanningDirector of Liaison & Planning
Medical DirectorsMedical Directors
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Funding the LMCFunding the LMC
GMS GPsGMS GPs– Statutory levyStatutory levy– Voluntary levyVoluntary levy
PMS GPs – both levies are voluntaryPMS GPs – both levies are voluntary– Administrative levyAdministrative levy– Voluntary levyVoluntary levy
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Statutory / administrative levy Statutory / administrative levy
Set as:Set as:– Pence per patient Pence per patient
Used forUsed for– Funds costs related toFunds costs related to
Running of the officeRunning of the officeStaff salariesStaff salariesHonoraria to membersHonoraria to membersCosts of meetingsCosts of meetingsWebsite and newslettersWebsite and newsletters
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Voluntary levyVoluntary levy
Set as:Set as:– Pence per patient oPence per patient o– At a different level from Statutory LevyAt a different level from Statutory Levy
Used forUsed for– Payment to the GP Defence FundPayment to the GP Defence Fund
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ElectionsElections
Process detailed in the ConstitutionProcess detailed in the Constitution
Held every 4 yearsHeld every 4 years
Electors must be on the Primary Care Electors must be on the Primary Care Performers list (from April 1st 2004)Performers list (from April 1st 2004)
Co-optionsCo-options
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MeetingsMeetings
Monthly - eitherMonthly - either
– FullFull
– LMC / PCT liaison meetingsLMC / PCT liaison meetings
– HonorariumHonorarium
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Functions and dutiesFunctions and duties
GPs’ contractsGPs’ contracts
Representation of GPsRepresentation of GPs
Advisory roleAdvisory role
Support for GPs and practicesSupport for GPs and practices
ResourceResource
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Representation of GPsRepresentation of GPs- the medico-political axis- the medico-political axis
LocalLocal– LMCsLMCs– Annual conference of LMCsAnnual conference of LMCs
NationalNational– General Practitioners CommitteeGeneral Practitioners Committee
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Annual Conference of LMCsAnnual Conference of LMCs
Representatives from all LMCsRepresentatives from all LMCs– EnglandEngland - Wales- Wales– ScotlandScotland - Northern Ireland- Northern Ireland
Motions proposed by LMCsMotions proposed by LMCs 2 days of intense debate2 days of intense debate Results dictate national policyResults dictate national policy Conference dinnerConference dinner
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General Practitioners General Practitioners CommitteeCommittee
Craft committee of the BMA Craft committee of the BMA
Recognised by Department of Health as Recognised by Department of Health as GMS GPs’ sole negotiating bodyGMS GPs’ sole negotiating body
Representatives elected byRepresentatives elected by– Region Region
– Annual Conference of LMCsAnnual Conference of LMCs
– Annual Representative Meeting of BMAAnnual Representative Meeting of BMA
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GPCGPC
NegotiatorsNegotiators
Meets monthlyMeets monthly
ReportsReports– Regional representatives to LMCRegional representatives to LMC– Published on www.bma.org.ukPublished on www.bma.org.uk
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The NHS - historyThe NHS - history
Set up on July 5Set up on July 5thth 1948 1948
Funded by the taxpayerFunded by the taxpayer
Organisational changesOrganisational changes
Largest employer in EuropeLargest employer in Europe
Budget 2007/08 - £92.6billionBudget 2007/08 - £92.6billion
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The NHSThe NHS
The GovernmentThe Government
Department of HealthDepartment of Health
Strategic Health AuthoritiesStrategic Health Authorities
Primary care TrustsPrimary care Trusts
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Department of HealthDepartment of Health
““Provides strategic leadership to the NHS Provides strategic leadership to the NHS and Social Care organisations in England”and Social Care organisations in England”
Monitors spendingMonitors spending
Monitors standards and safety of servicesMonitors standards and safety of services
Collaborative development of policiesCollaborative development of policies
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Strategic Health AuthoritiesStrategic Health Authorities
Develop plans for improving health Develop plans for improving health services in their local area services in their local area
Monitor local health services Monitor local health services
Increase the capacity of local health Increase the capacity of local health services services
Meeting national priorities locally Meeting national priorities locally
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Primary Care TrustsPrimary Care Trusts
Responsible for provision of services Responsible for provision of services locallylocally
Integration of health and social care Integration of health and social care systemssystems
Administration of Primary Care Administration of Primary Care
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PCTS commissionPCTS commission Primary carePrimary care
– General PracticeGeneral Practice
– DentistsDentists
– OptometristsOptometrists
– PharmacistsPharmacists
– NHS Direct NHS Direct
– Walk-in CentresWalk-in Centres
Secondary CareSecondary Care– HospitalsHospitals
– Ambulance servicesAmbulance services
– Care servicesCare services
– Mental health servicesMental health services
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……and All that Jazzand All that Jazz BMABMA
– The doctors’ trade unionThe doctors’ trade union
NHS EmployersNHS Employers– Responsible for workforce and employment issues in the Responsible for workforce and employment issues in the
NHSNHS
NHS ConfederationNHS Confederation– Works with members to improve health and health Works with members to improve health and health
servicesservices
NHS AllianceNHS Alliance– Representational organisation of primary careRepresentational organisation of primary care
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Surrey and Sussex LMCsSurrey and Sussex LMCs
www.lmcs.infowww.lmcs.info