National Insurance rise

“With employer National Insurance contributions rising together with the rise in staff costs, which have not been adequately funded, it could mean practices really struggle to keep their head above water. “There is no way that Labour will meet it’s manifesto commitment to ‘bring back the family doctor’ unless it funds GP practices properly to recruit, retain, and grow capacity, particularly GPs, many of whom are underemployed or unemployed. “General practice has been delivering five million more appointments a month which puts the extra 40,000 a week promised in context. “Patients want and need to see doctors.”

General practice

Now DAUK is supporting GPCE calls for GPs and patients to write to their MPs to express concern at the potential impact National Insurance rises will have on practices. GPCE has produced a letter template for people to copy and paste and send to their MP. The letter is reproduced below. You can support the work of DAUK by becoming a member or donating to our Go Fund Me. Find your MP’s email at: https://members.parliament.uk/members/Commons ———————-

GPCE letter template

Dear <insert MP> I am writing to flag a profound concern around NHS GP Practices and the Autumn Statement announcements on Employers’ NICs. We have lost over 1000 NHS GP practices in the past decade. If Darren Jones’ comments on BBC QT are correct, we shall see many more hand back their contracts overnight. NHS GP Practices are excluded from employer support for small businesses – and previous Conservative governments have offered full recovery for NICs rises. GPs are very clearly defined in the past 25 years of law as “public authorities”. The assertion by Darren Jones above flies in the face of various legislation, including: – Freedom of Information Act – The Equalities Act – GDPR – IR35 Presumably Treasury do not intend to amend hundreds of pieces of major legislation in order to claim an extra 1.2%? Such poorly thought through comments are sending us into a tailspin. This needs absolute clarity as soon as possible. Likewise, the methodology for recent uplifts is out of date and has failed to deliver. Any repeat of a Global Sum % uplift will not work with the NICs change proposed, because of the ‘fixed per employee’ element. The Association of Specialist Medical Accountants has flagged this concern too. Treasury and DHSC need to take immediate steps to correct Mr Jones’ comments and assure the profession that they have no intention of threatening the viability of thousands of NHS GP Practices, lest Labour kills the family doctor. Yours <Insert name>

Dr Nicholl is encouraging Doctors’ Association UK (DAUK) members and supporters, as well as MPs and those with an interest in whistleblowing to attend events in Westminster as part of Whistleblower Awareness Week.

Whistleblowers UK has organised two events which may be of specific interest to DAUK members.

The first is titled Meet the whistleblowers: Exploring the issues and agreeing the solutions. It takes place from 1pm to 2.30pm on Wednesday 23 October.

The second is called Duty of candour and whistleblowing, and is being held from 10am to 11.30am on Thursday 24 October. Both events are in House of Lords Committee Room 4A.

These events will be an opportunity to meet people who have blown the whistle and hear how their experience changed their lives.

Lord Berkeley, vice chair of the All Party Parliamentary Group (APPG) for Whistleblowing, will chair a discussion on the problems with existing legislation and why it does not work, what needs to change and why they support the Whistleblowing Bill.

Dr Nicholl said: “Being able to highlight concerns and wrongdoings in the NHS on matters of public interest is absolutely crucial to the service.

“Failings can affect patient care, staff safety, and cost the NHS huge sums of money in claims.

“The freedom to speak up for staff and patient safety is vital to achieving a just culture in the NHS.

“But despite the clear benefits of whistleblowing, all too often those who speak out do so in spite of the fear of reprisal from employers.

Independent Office for the Whistleblower

“This is why we need an Independent Office for the Whistleblower and reform of the law with the new Whistleblowing Bill.”

For more information about these events and to book a free place, click here.

Finally we would encourage DAUK members and supporters to contact their Members of Parliament to attend via https://www.writetothem.com

Support the work of DAUK by donating to our Go Fund Me.

Anaesthetists United (AU) has announced it has filed its claim against the GMC in the High Court.

The challenge is regarding the regulation of PAs and AAs by the GMC, which the Doctors’ Association UK (DAUK) believes puts patient safety at risk.

DAUK has been an early and consistent supporter of this crucial legal action, and contributed £30,000 to AU’s crowdfunding efforts.

AU has received financial support from medical professionals and the public, and last week the British Medical Association (BMA) agreed to provide indemnity support for the case.

It has also received the support of the parents of Emily Chesterton, Marion and Brendon. Emily was aged 30 when she died after two appointments with a PA she believed was a GP.

Legal challenge

Ms Fernandes said: “It’s heartening to see doctors from all specialities standing together to support this legal challenge.

“We thank AU for taking on this vital action and everyone who has contributed towards funding it.

“It’s clear that doctors feel very strongly about the regulation of PAs and AAs by the GMC and the blurring of lines which is putting patients at risk.

“It’s really quite incredible the GMC is being taken to court by doctors over concerns it is not regulating strongly enough and is encouraging the blurring of those lines.”

For more information on how to support the legal challenge, please visit the Anaesthetists United website.

Become a member of DAUK and support our work.

Meanwhile, GMC chief executive Charlie Massey has issued an update on its preparation for the regulation of PAs and AAs.

DAUK submitted its response to the consultation held by the Marine Biodiversity Department of the Scottish Government alongside Green Scrubs Wales.

Writing to the consultation, Dr Matthew Lee, DAUK’s sustainability lead, Dr Maneha Sethi, chair of Green Scrubs Wales and DAUK committee member, highlighted the public health implications of failing to tackle the biodiversity crisis.

They wrote: “The concept of one health relates to the interlocked relationship between the health of the environment, animals and people; humanity cannot survive without a healthy natural world.”

They added: “We are deeply concerned to learn that in offshore Marine Protected Areas (MPAs) all around the UK, the environmentally destructive practice of bottom trawling has been allowed to continue, as Oceana data analysis has revealed.

“Given the urgent and imminent nature of the climate and biodiversity crisis, and its threat to human health, we feel it is crucial that bottom trawling activities are fully excluded from MPAs, for the sake of public health.

“Bottom trawling can decimate huge swathes of seabed with very high rates of bycatch, and can release large quantities of blue carbon.

“As one of the most nature deplete countries in the world, the UK must cease such destructive practices in supposedly protected areas to allow nature to recover.

Read the submission in full below.

You can support the work of DAUK by donating to our crowdfunder.

The BMA has agreed to provide indemnity support for the case brought by Anaesthetists United (AU) and the Chesterton family against the General Medical Council (GMC).

The challenge is regarding the regulation of PAs and AAs, which the Doctors’ Association UK (DAUK) believes puts patient safety at risk.

DAUK has been an early and consistent supporter of this crucial legal action, and has contributed £30,000 to AU’s crowdfunding efforts.

We believe this case is vital for patient safety and the maintenance of high standards in UK healthcare.

Dr Matt Kneale, DAUK committee member, said: “We are pleased to see the BMA joining this important cause.

Physician associates

“DAUK recognised the significance of this issue early on, which is why we provided substantial financial backing.

“This legal challenge addresses critical concerns about patient safety and the appropriate regulation of physician associates and anaesthesia associates.

A spokesperson for Anaesthetists United said: “The BMA’s decision to support this case is generous, rare and highly significant.

“It does not typically fund legal actions brought by others; this move highlights the enormous gravity of the situation. We are deeply grateful for their help and recognition of how vital this is to healthcare in the UK.”

Now DAUK has renewed its call for healthcare professionals to support this legal action.

We are also urging royal colleges and other medical organisations to join us and the BMA in backing this case, which has far-reaching implications for the future of healthcare delivery in the UK.

For more information on how to support the legal challenge, please visit the Anaesthetists United website.

Become a member of DAUK and support our work.

DAUK’s GP Committee stands ready to work with Wes Streeting on cutting bureaucracy and addressing issues with primary and secondary care communication.

It follows a speech by the Health Secretary at the Royal College of GPs conference in which the Government launched a so-called Red Tape Challenge with NHSE to cut down on bureaucracy and free up GPs’ time to spend with patients.

DAUK’s GP Committee welcomed his focus on primary care but said the solutions needed input from GPs.

The committee also called on Mr Streeting to tone down the ‘negative rhetoric’ around general practice which was ‘encouraging resentment towards GPs’.

Urgent attention

Dr Lizzie Toberty, DAUK GP lead, said: “The interface between primary and secondary care is problematic and needs urgent attention.

“While Mr Streeting has understood the diagnosis, the treatment is wide of the mark and would benefit from input from GPs on the ground rather than managers in Whitehall.

“Negative rhetoric from Mr Streeting is not helpful and encourages public resentment towards GPs, who are desperately trying to do their best for their patients in a failing system.

“It also compounds the low staff morale highlighted in Lord Darzi’s recent report.”

Dr Ellen Welch, DAUK vice-chair, said proper funding for general practice to meet demand, which is at an all-time high, to retain and recruit GPs, and stop the closing down of practices should be the priority for the Government when it comes to primary care.

She said: “In England, the number of medical staff working in hospitals has increased by thousands – 163 per cent more consultants over the past 25 years – while general practices have closed in their hundreds, and the primary care workforce is shrinking with almost 2,000 fewer GPs than we had in 2015.

Demand

“Despite this, demand is high, and an average of 1.4 million GP appointments per working day were delivered between March 2023 and February 2024.

“On top of this, GPs are being expected by hospital teams to perform additional work for free. Every day, general practices across the UK receive letters asking GPs to kindly complete an array of unfunded tasks.

“Referral forms are a small part of our daily red tape but much more time is spent dealing with unfunded requests from secondary care such as ordering and chasing blood tests and investigations; providing fit notes or prescriptions for patients who have been seen in hospital; referring patients to another specialist; and chasing relatively small pots of money from ICBs.

“For the past decade, funding for hospitals has grown twice as fast as funding for general practice.

“Getting rid of a few referral forms will not revolutionise primary care, and on the whole GPs have taken the initiative to do this already.”

Collective action

The GP Committee also responded to Mr Streeting’s call for GPs in England to end collective action, with the Health Secretary saying he understood why doctors ‘wanted to give the previous government a kicking’.

GP spokesperson Dr Rosie Shire said: “Collective action is not about giving anyone a ‘kicking’. It is about doing what we are contracted and paid to do.

“No other section of society expects public or private sector workers to do work for free, and NHS general practice can no longer allow the service to run on goodwill when they are at risk of closing under the pressures.”

GP spokesperson Dr Sarah Jacques said investment was also needed in IT and estates to improve efficiency. Indeed, the Darzi review of the NHS found that ‘crumbling buildings hit productivity’ as well as impacted staff morale.

Dr Jacques said: “Primary care needs a fully-funded model with the promise of a long-term uplift to core funding.

“Buildings which are not fit for purpose and IT belonging somewhere in the last decade also need urgent attention.

“Only then will we see some meaningful change.”

Become a member of DAUK and support our work.

The Doctors’ Association UK’s (DAUK) GP Committee says the shortages of GPs is because practices are not being funded to retain, employ, or increase their capacity.

The committee was responding to BBC analysis which found that the average GP in England has to care for 17 per cent more patients than nine years ago.

According to the BBC online report, for every permanent GP there are more than 2,300 patients, a rise of nearly 350 since 2015, with some areas exceeding 3,000 patients. The widely recognised safe limit is one GP to 1,800 patients.

Dr Steve Taylor, DAUK’s GP spokesperson, said the figures do not tell the whole story.

Shortage of GPs

He said: “Although there are fewer GPs working, and it’s often worse in areas of deprivation, the cold reality is that there is a shortage of funding not general practitioners.

“Many GPs are now finding it increasingly difficult to get work and some are even taking on roles outside of medicine to pay the bills.

“NHS England has cut funding to GP practices by 20 per cent per patient in the past eight years alone.

“GPs themselves are earning 20 per cent less in real terms and practices don’t have the funds to retain, recruit, or expand their GP roles.

“Instead NHS England has moved funding into other roles via the Additional Roles Reimbursement Scheme (ARRS) at the expense of GPs.”

Dr Ellen Welch, DAUK’s vice chair and a GP in Cumbria, said: “We currently have GPs who are unemployed and on benefits who cannot get the work they have been trained to do.

“I lost work as a locum at the start of the year as the practice was given Government funding to employ a pharmacist instead of a locum GP.”

Unemployed

Dr Lizzie Toberty, DAUK’s GP lead said a ‘fundamental shift in thinking towards retention’ was needed.

“We have full training schemes, we have unemployed GPs, and we need meaningful jobs for them to go into,” said Dr Toberty.

“The addition of GPs to the ARRS up to March is too little, too late and is only for newly-qualified GPs.

“There are GPs with 20 to 30 years’ experience who can’t get jobs or are being made redundant by some companies who are taking over practices and trying to run them with nurses, paramedics, and physician associates with just a GP to oversee them.

“We need achievable, worthwhile and meaningful careers for GPs to aid retention, and ultimately continuity of care which has the potential to save the NHS a fortune.”

Become a member of DAUK and support our work.

Today marks one of the most pivotal moments in modern public health; the closure of the last coal-fired power station in the UK.

Coal was instrumental in giving the UK an economic headstart with the industrial revolution and for over 140 years has contributed to powering our homes and public services.

It has contributed to the living standards we expect today, but this has come with a heavy price of climate catastrophe through the release of greenhouse gas emissions.

The heatwaves, floods, crop failures and spread of disease from climate change have come about because of the warming effect caused by the greenhouse gases released from coal, oil and gas.

The effects on health have been seen across the globe, though the UK continues to be somewhat sheltered from catastrophes on the scale of the floods in mainland Europe or the wildfires in Canada.

Nevertheless, we are becoming more exposed to the wrath of the environment. While this year has made itself known for being one of the wettest on record, it is a record that will inevitably become the norm.

People often say ‘China, Russia and the US are all much higher carbon emitters, anything the UK does is negligible’.

However, carbon emissions are cumulative. Some of the gases we released 140 years ago will still be in our atmosphere today.

For the first 50 years of the industrial revolution, the UK was responsible for approximately 100 per cent of global greenhouse gas emissions, predominantly because of coal.

Morally, the UK has a duty to lead the way to a decarbonised future running on cleaner energy. The current Government has announced plans to phase out gas from our energy grid by 2030.

This must be an absolute deadline and we encourage the Government to increase their ambition and meet the target comfortably before the next election – all our lives depend on it.

We all have the power to bring this change sooner. Moving your money away from banks that invest in fossil fuels and switching your energy supplier to a renewable one will accelerate change.

If you are a GP partner, make this change on a much bigger scale and move your whole practice away from fossil fuels. Crucially, tell your current supplier and bank the reasons why you are leaving.

And what better day to do so, than the day that coal is phased out of our power grid and confined to the history books, exactly where a fossil fuel should remain.

Visit ourhealthourplanet.co.uk to find out more about decarbonising your home and workplace and about how climate change is affecting our health in the UK.

CATA chair Dr Barry Jones gave evidence for 90 minutes at the UK Covid-19 Inquiry.

Support the work of the Doctors’ Association UK by becoming a member.

Ms Helen Fernandes said it was ‘really good news’ that NHS Practitioner Health had secured funding until March 2026.

She said: “This is really good news and most welcome.

“The work of NHS Practitioner Health is greatly needed at a time when the medical profession is on its knees and healthcare professionals are under huge pressure.

“The service is so important in supporting doctors while we support our patients. It’s needed more than ever.”

DAUK broke the news in April that Practitioner Health had been due to have its funding cut while a review into the service was carried out.

It led to a social media storm and widespread criticism before NHS England announced the service would be extended by 12 months while a wider review was carried out.

Announcing that funding was in place until March 2026, Lucy Warner, NHS Practitioner Health chief executive, said: “Earlier this year we were hugely grateful to those individuals and stakeholders who spoke out in support for the service, highlighting the impact of NHS Practitioner Health on their lives and those of friends and colleagues.

“As a result, we saw agreement from NHS England to fund the service for a further 12 months to March 2025, while they carried out a review into staff mental health support.

“Over the last six months we have been engaging with our commissioners and inputting into the review.

“We have now been reassured that our funding is secure for a further 12 months through to March 2026, to enable time for the review to be completed and for a clearer picture to emerge on long term support for all staff.

“We really believe we have been able to demonstrate the value and impact of the service and hope that by the end of this review NHS England will have identified a long term future for NHS Practitioner Health.”

Support the work of DAUK by signing up as a member.