1. West Midlands Nuts and Bolts Dr Dean Marshall GPC Negotiator

2. Current issues GMS Contract Appraisal and Revalidation HSCA Other issues

3. GMS contract Current state of “negotiations” How did we get here? What does it all mean? What can we do next?

4. Current position DH have threatened to consult on imposition of changes to the GMS contract unless we return to negotiations

5. How did we get here? 5 months of “negotiation” Mandate from DH – further “efficiencies” GPC position –workload saturation

6. What does it all mean? 1.5% “contractual uplift” if we agree “fairer funding” between GMS and PMS Implementing NICE QOF changes Increasing QOF thresholds Removing organisational points

7. What does it all mean? Changing time limits on some QOF indicators from 15 to 12 months Changes to Carr- Hill - CPI and deprivation

8. What can we do next Return to negotiating table? Disengage from commissioning Maximise income and minimise expenses

9. Appraisal and Revalidation Introduction of revalidation in 2013 “Leaders of the profession” go first 5 appraisals + MSF Appraisal does not equal Revalidation

10. Appraisal and Revalidation Sessional GPs Consistency of appraisal across England Peer appraisal RO conflict of interest Failure to revalidate

11. Health and Social Care Act CCG constitution Authorisation process Conflict of interest Quality premium Performance Management

12. Health and Social Care Act NHSCB LATS LETBs/Clinical senates Health and Well Being Boards

13. Other issues Pensions Premises Extended GP training Recruitment and Retention