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

“ “ 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

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

IndependenceIndependence

Fully independentFully independent

Self financingSelf financing

LMCs are NOT trade unionsLMCs are NOT trade unions

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

OfficersOfficers

Chief ExecutiveChief Executive

Director of Finance & ITDirector of Finance & IT

Director of Liaison & PlanningDirector of Liaison & Planning

Medical DirectorsMedical Directors

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

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

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

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

MeetingsMeetings

Monthly - eitherMonthly - either

– FullFull

– LMC / PCT liaison meetingsLMC / PCT liaison meetings

– HonorariumHonorarium

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

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

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

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

GPCGPC

NegotiatorsNegotiators

Meets monthlyMeets monthly

ReportsReports– Regional representatives to LMCRegional representatives to LMC– Published on www.bma.org.ukPublished on www.bma.org.uk

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

The NHSThe NHS

The GovernmentThe Government

Department of HealthDepartment of Health

Strategic Health AuthoritiesStrategic Health Authorities

Primary care TrustsPrimary care Trusts

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

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

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

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

……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

Surrey and Sussex LMCsSurrey and Sussex LMCs

www.lmcs.infowww.lmcs.info