MOTIONS PASSED WEDNESDAY AT ARM

GENERAL PRACTICE

Motion 67 proposed by Richard Vautrey YORKSHIRE REGIONAL COUNCIL:

That this meeting believes the current workload pressure in general practice is unsafe and unsustainable, that a rapid expansion in the general practice workforce is required to deal with this and therefore calls for sustained investment above the commitments made in the GP Forward View to be made available as a matter of urgency.

Motion 68 proposed by EDGWARE & HENDON DIVISION:

That this meeting applauds NHS England for the changes to the primary and secondary care interface within the standard hospital contract which came into effect on 1st of April 2016, with subsequent additional requirements in 2017. However it is dismayed to note that despite the national levers, there are trusts and CCGs that do not appear to acknowledge or enforce these changes. We call on the BMA to create a communications work stream which is focussed on reaching out to trusts, CCGs, different branches of practice to communicate the interface changes.

Motion 69 proposed by Peter Holden EAST MIDLANDS REGIONAL COUNCIL:

That this meeting notes the regular declarations of “black alert” by hospitals and demands that a similar reporting system be created for general practice to indicate that maximum safe capacity has been reached and conference instructs BMA council and the GPC to construct such a system with or without government cooperation.

Motion 70 proposed by Guy Watkins SOUTH EAST COAST REGIONAL COUNCIL:

That this meeting feels that the Multispecialty Community Provider contract framework does not go far enough in:- i)   protecting the liability of individual contract holders from the implications of pooled budgets; ii)  preserving the tenure of GMS and PMS contracts; iii) protecting GPs from further unfunded work being transferred from secondary care.

Motion 65  proposed by Ryan Devlin  JUNIOR MEMBERS FORUM:

That this meeting believes that parity between physical and mental health will only be achieved if the stigma against mental health problems among medical professionals is addressed. We call on the BMA to create a national campaign to eliminate mental health stigma among medical professionals.

 

HEALTH INFORMATION MANAGEMENT AND IT                       

Motion 71 proposed by Jackie Appleby TOWER HAMLETS DIVISION:

That this meeting notes and deplores the recently signed memorandum of understanding between the UK Department of Health, NHS Digital and the Home Office, which agrees to the transfer of patient administrative details including address for the purposes of immigration enforcement, without the consent of the patient and the knowledge of the GP. This meeting believes:- i)   this is a breach of patient confidentiality that undermines trust between patient and doctor; ii)  this Is not justified by the public interest; iii) that this may result in patients not coming forward for treatment with consequences for public health; iv) and calls on council to call on the Department of Health to cease this practice.

Motion 72 proposed by Farah Jameel EDGWARE & HENDON DIVISION:

That this meeting believes that there is an urgent need for the development of an electronic prescription service for hospitals, to enable hospital clinicians to prescribe remotely for patients to collect their prescription from a nominated community pharmacist, thereby enabling clinical responsibility to rest with the prescribing clinician, as well as reducing inappropriate demands on GPs to prescribe outside their competence.

Motion 75 proposed by Pradeep Sanghi LINCOLN DIVISION: That this meeting welcomes the working party report “Every breath we take: the lifelong impact of air pollution” produced by the Royal College of Physicians [London] and Royal College of Paediatrics and Child Health, and we call for:- i)   further research into the economic impact of air pollution; ii)  clearer information for consumers on emissions produced by new vehicles, including information on ultrafine particles and oxides of nitrogen; iii) effective monitoring of air quality and pollution; iv) the NHS to become an exemplar for clean air and safe workplaces; v) empowerment of local authorities to take remedial action when air pollution levels are high

Motion 76 proposed by Mark Pickering YORKSHIRE REGIONAL COUNCIL:

That this meeting:- i)   notes the widespread problems of abuse and addiction with pregabalin amongst users of illicit drugs; ii)  notes the contribution of pregabalin to bullying and violence in prison populations; iii) calls for the BMA to lobby the appropriate authorities to make pregabalin a controlled drug.

Motion 77 proposed by Farah Jameel EDGWARE & HENDON DIVISION:

That this meeting in the wake of the measles outbreak that swept Europe in March 2017:- i)  condemns anti-vaxxers who deny immunisations to their children (as a reference); ii) calls upon the BMA to present a position paper to the government on the potential advantages and disadvantages of childhood immunisation being made mandatory under the law. (as a reference);

Motion 81 proposed by Gillian Beck

proposed by BUCKINGHAMSHIRE DIVISION: That this meeting extends its full support to the GPs of Northern Ireland for their robust defence of the provision of safe care to their patients.

Motion 83 proposed by Anne Carson NORTHERN IRELAND COUNCIL:

That this meeting believes that reconfiguration of services in Northern Ireland must::- i)   be evidence based and result in better outcomes for patients; ii)  be carried out in an integrated way, taking patients’ primary, secondary and social care needs into account and not confined to local HSC trust level;  iii) include full and meaningful clinical engagement with doctors at all levels.

Motion 84 proposed by Sara Hedderwick NORTHERN IRELAND COUNCIL:

That this meeting recognises that the lack of full implementation of the recommendations from numerous workforce planning reviews has contributed directly to the current shortage of doctors in Northern Ireland. This meeting believes that the Department of Health in Northern Ireland:- i)  must be held accountable for ensuring there is the appropriate medical workforce to deliver care to the population of Northern Ireland; ii) must recognise that increased investment in the medical workforce is required to ensure that Northern Ireland is an attractive place to work.

WALES                                                                                               

Motion 86 proposed by David Bailey WELSH COUNCIL:

That this meeting notes the observations of the OECD in its 2016 report comparing health systems of the four UK nations that:- i)  Welsh health boards do not have sufficient institutional and technical capabilities and capacities to drive meaningful change; ii) a stronger central guiding hand may be needed.  This meeting therefore calls upon the Welsh government to take what steps are necessary to provide such a central guiding role, thereby ensuring that health boards and NHS trusts are subject to greater direction, scrutiny and accountability so they are clearer and better able to deliver what is expected of them.

SCOTLAND

Motion 88 proposed by Bethany Threlfall SAS CONFERENCE:

That this meeting:-  i)  commends BMA Scotland for setting up a ‘respect at work’ helpline to offer support and advice to members with problems relating to bullying, harassment, discrimination and dignity at work; ii) calls on the rest of the BMA to follow this example.

Useful link

BMA Work life support, your wellbeing

SCIENCE HEATH SOCIETY

Motion 78 by Sara Hedderwick CONSULTANTS CONFERENCE:

That this meeting acknowledges the global threat to human health posed by antimicrobial resistance and the firm linkage to inappropriate usage both in human health and in agriculture.  As such we call on the BMA:- i)   to continue supporting the vision of the UK 5-Year Antimicrobial Strategy (20132018); ii)  to support stakeholders in making sure that there is a subsequent strategy following on from 2018; iii) to support the One Health approach to antimicrobials, recognising that usage in human health only accounts for 50% of usage worldwide and encouraging responsible use in agriculture, engineering and other industries aside from human health; iv) to recognise their own part to play by ensuring, where possible, that subcontracted catering suppliers used for BMA meetings use antimicrobial-free produce by preference.  (as a reference)

FINANCES OF THE ASSOCIATION        

Motion 92 proposed by TREASURER: That the annual report of the directors, treasurer’s report and financial statements for the year ended 31 December 2016 as published on the website be approved.

Motion 93 proposed by TREASURER: That the subscriptions outlined in document ARM1A (appendix IV) be approved from 1 October 2017.

Motion 94 by Dino Motti THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE JUNIOR DOCTORS CONFERENCE):

That this meeting believes that the expenses, reimbursements and honoraria of all BMA committee and council members should be made available to:- i)   individual members on personal request;

DOCTORS’ PAY, PENSIONS AND CONTRACTS     

Motion 97 proposed by  Emma Runswick MANCHESTER & SALFORD DIVISION):

That this meeting:- i)   recognises the significant contributions and personal sacrifices made by medical students and junior doctors during the course of their degree and further medical education; ii)  recommends that the government should seek to understand why junior doctors might leave the NHS; iii) rejects the secretary of state’s proposal that doctors should be required to work for the NHS for 4 years after registration or pay back the “cost of their training”; iv) opposes any move to impose a minimum period of NHS employment.   

 Motion 98 proposed by Samira Anane NORTH WEST REGIONAL COUNCIL:

That this meeting notes the on-going gender pay gap and consistent under-representation of women in leadership positions and:- i)   insists that employment contracts do not contain clauses which discriminate against women; ii)  insists that equality impact assessments have equal status to other documents when considering contracts; iii) calls for the BMA to encourage improved diversity in representation locally, regionally and nationally.

Motion 99 proposed by Ian Hume EASTERN REGIONAL COUNCIL:

That this meeting is appalled by the delays that are being reported by practitioners, in payment of doctors’ pension lump sum and even delays of payments of regular pension payments and calls on the BMA to:- i) undertake a full inquiry into the size of the problem and reasons for these delays; ii) ensure that doctors are awarded full financial compensation for any loss as a result of any delay; iii)ensure that the NHS Pensions Agency pays interest on delayed pension lump sums.

Motion 100 proposed by Selwyn D’Costa DARTFORD GRAVESEND & MEDWAY DIVISION:

That this meeting recommends that members who are forced to withdraw from the NHS pension scheme on breaching their Life-Time Allowance should be refunded future NHS employer contributions

Motion 101 proposed by Gordon Mathews CONSULTANTS CONFERENCE:

That this meeting believes the NHS funding crisis cannot continue to be managed by pay restriction.

STAFF, ASSOCIATE SPECIALISTS AND SPECIALTY DOCTORS  

Motion 103 proposed by Ham Mekhael SOUTH WEST REGIONAL COUNCIL:

That this meeting warmly welcomes the publication of the document “SAS Doctor Development” in partnership with the Academy of Medical Royal Colleges, Health Education England and NHS Employers and calls upon all these agencies to use their collective best endeavours to ensure that the principles outlined in the document are fully realised such that the disadvantaging of SAS doctors in terms of career development and leadership opportunities becomes a thing of the past.

Related information

2017 NHSE SAS doctor development workshops and survey

2017 SAS development guide.

Motion 104 proposed by Reshma  Khopkar SOUTH CENTRAL REGIONAL COUNCIL:

That this meeting has concerns that currently there is a lack of SAS representation on the Local Education and Training Boards and the appointments of Associate Deans for SAS doctors are not being continued. It therefore calls on Health Education England to ensure that:- i) there is appropriate SAS representation on the Local Education and Training Boards and; ii)the appointments of Associate Deans for SAS doctors continue and that they are appointed from within the SAS grades.

 MEDICO-LEGAL AFFAIRS  

Motion 107 proposed by Chandra Kannrganti NORTH & MID STAFFORDSHIRE DIVISION:

That this meeting, in the light of increasing personal injury awards and rapidly increasing medical indemnity costs:- i) supports the introduction of a system of no-fault compensation for medical injuries; ii) supports the principle of annual care payments to the injured, rather than lump sum payments; iii)seeks the direct reimbursement by government of medical indemnity costs relating to NHS treatment.

Motion 55 Proposed by  Gorden Mathews  BUCKINGHAMSHIRE DIVISION:

That this meeting believes, in respect of eligibility for NHS treatment of overseas visitors:- i)   government publicity about the cost of treating overseas visitors is a distraction from the under resourcing of the NHS;  iii) urgent clinical care should not be delayed or prevented by eligibility checks; iv) medical staff should not be involved in ascertaining eligibility of patients for NHS treatment.

MEDICO-LEGAL AFFAIRS  

Motion 108 proposed by CARDIFF AND VALE OF GLAMORGAN DIVISION:

That this meeting welcomes the Law Commission proposals to simplify the Deprivation of Liberty Safeguards procedures and urges the government to make legislative time for such primary legislation despite Brexit.

 

 FORENSIC MEDICINE 

Motion 110 proposed by Nick Swift FORENSIC MEDICINE COMMITTEE:

That this meeting regarding the mental state examination of children under arrest in police custody suites:- i) is concerned at the lack of forensic physicians possessing membership of the Faculty of Forensic and Legal Medicine; ii) considers that it is non-equivalent compared with the care given to non-detained children; iii)calls for increased out of hours provision of child and adolescent mental health service (CAMHS) and youth offending teams to facilitate prompt liaison and diversion.

Motion 111 proposed by Nick Swift FORENSIC MEDICINE COMMITTEE:

That this meeting supports the Royal College of Psychiatrists’ urging of the government to amend the Prison and Courts Bill to include a statutory requirement of prisons to protect the mental and physical health of offenders.  (as a reference)

MEDICAL STUDENTS    

Motion 113 proposed by LOTHIAN DIVISION:

That this meeting calls on the BMA to improve awareness of student mental health in medical schools. The BMA should do this by:- i) utilising its growing local networks to host mental health talks and events for local medical students; ii) calling upon medical schools to improve support for student with symptoms of mental health illness Iv) reporting back on progress and responses from medical schools.

Motion 114 proposed by Grant Ingrams LEICESTERSHIRE & RUTLAND DIVISION:

That this meeting, in light of the NHS medical recruitment crisis, is appalled by the decrease in medical student applications and calls for:- i) places to be given on merit without financial barriers; ii) the cost of a 5-year medical degree to be realigned to meet the cost of an average undergraduate degree in a comparable subject; iii)the government to increase medical student numbers and resource universities appropriately.

Motion 115 proposed by DARTFORD GRAVESEND & MEDWAY DIVISION:

That this meeting condemns the proposed increase in tuition fees and calls on the BMA to:– i) support other organisations campaigning against the proposals; ii) oppose excessive rates of interest charged on student loans and lobby for any interest charges to be in line with the governments’ long-term borrowing costs

JUNIOR DOCTORS    

Motion 118 proposed by Daniel Redfern CONSULTANTS CONFERENCE:

That this meeting continues to support junior doctors, and:- i) calls upon consultant members of the BMA to endorse exception reporting as a tool for the improvement of terms and conditions of trainee doctors; ii)asks its members not to suppress in any way the fair use of the exception reporting mechanism by junior colleagues.

Motion 119 proposed by Jonathan Fenwick MANCHESTER & SALFORD DIVISION:

That this meeting calls for a mandatory nationally agreed minimal period of protected administrative time (relevant to the level of training and duties) built into junior doctors work schedules. This would be above and beyond that protected for teaching and training and intended for the purpose of completing paperwork tasks, mandatory training, portfolio tasks, audit, guideline reviews and other required educational, teaching or management tasks currently having to be completed in that doctors own time without recognition or pay.

 

OCCUPATIONAL MEDICINE   

Motion 122 proposed by Alex Freeman SOUTH CENTRAL REGIONAL COUNCIL:

That this meeting notes the publication of the green paper ‘Improving Working Lives’ and:- i) regrets the short timescale for consultation; ii)supports initiatives which encourage occupational health support and workplace assessments for employers designed to keep people in employment through periods of ill health or to enter the workplace where possible; iii) believes that any additional burden of workload and costs with respect to implementation of the recommendations should fall to the DWP and not the NHS.

 

BMA TREASURER’S QUESTION AND ANSWER SESSION

There was an opportunity for representatives to ask questions of the BMA treasurer.

 

Received reports from

BMA general practitioners committee chair (Chaand Nagpaul).

BMA board of science chair (Parveen Kumar).

BMA Northern Ireland council chair (John D Woods).

BMA Welsh council chair (Philip Banfield).

BMA Scottish council chair (Peter Bennie).

BMA private practice committee chair (Derek Machin).

BMA civil and public services committee chair (Alan Mitchell)

BMA charities committee chair (Andrew Mowat)

BMA staff, associate specialists and specialty doctors committee chair (Amit Kochhar).

BMA medico-legal committee chair (Jan Wise).

BMA forensic medicine committee chair (Rachael Pickering).

BMA medical students committee co-chairs (Charlie Bell and Harrison Carter).

BMA junior doctors committee chair (Jeeves Wijesuriya).

BMA occupational medicine committee chair (Nigel Wilson).

BMA treasurer (Andrew Dearden).

 

Victor Horsley Scientific lunch time meeting III

Given by Tom Rapanakis  ‎Service Coordinator at British Medical Association and Dr Clare Gerada

Useful links         Doctors wellbeing back from the brink

Young doctors seek more help

Bullet points of Dr Gerada’s talk

  • Doctors are taught to be invincible
  • Doctors are 3x as likely to die from suicide and a greater risk of mental illness
  • They have a high divorce rate
  • There is often a triad of doubt guilt and responsibility
  • Associated factors include bullying at work and exposure to dangerous drugs, anxiety and unrealistic views of patients
  • Doctors suffer a heavy psychological burden
  • Doctors are poor attenders, present late or in a crisis or not at all and may be blind to their own distress and often treat themselves
  • Doctors as a group create behavioural norms – doctors don’t get ill !
  • Confidentiality or lack of it is an issue as doctors often report personal details shared
  • She discussed PHP a bespoke mental health service established in 2008 it contrasts with physician health programs in the US which has since become more a probation service. There is a noticeable increase in suicide rate in US Doctors . PHP UK is the largest in the world,  treating whole person and working as a single team. PHP saves money as well as lives
  • The electronic record is not linked to the NHS. They provide prescription and alcohol de-toxification . Allow doctors space and time in confidence. Service is now national. Doctors can self-refer and through facebook and twitter. About 3000 doctors have used the service as example for anxiety, depression NHSitis, practice meltdown

Addicition disorders (with the latter only 6% relapse rate)

  • All age groups but especially 30 – 39 age group are affected
  • She asked why is there an increase in mental health problems in doctors
    • The need for the right support
    • Doctors thrive in adversity but everyone has a breaking point
    • Patient live longer and are more active participants
    • Medical authority is disappearing and doctors are less confident in their role in society
    • Lack of shared spaces eg the doctors mess, the firm, groups that needs belonging
    • Industrialisation of craft

How to deal with this she said

  • “I do” –  create a balance and reduce stress,
  • Taking holidays, time with friends , know your limits , seek help
  • “We do” :-  teams , reduce stress were possible , attend to each other , meet learn and respect

She ended by discussing the legacy of Victor Horsley

Tom Rapanakis (BMA)  discussed BMA counselling staffed by counsellors with 300 calls a month and a doctors advisory service with peer support.

 

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