LMCs represent local area GPs who form part of a PCN (Primary Care Network).  Local Doctors and Practice Staff reside on the LMC - they are elected by their local peers every 2-4 years.  For NHS Local Medical Committees (UK), March 31st marks the end of the standard UK financial and contracting year for most GP surgeries and Local Medical Committees (LMCs). They are entirely funded by the GPs themselves (self-serving) through a statutory levy deducted from practice incomes.  Sadly, Salaried, locums and sessional GPs are heavily under-represented on the committees.  GP partners are primarily responsible for decision making on the LMC, which is a contentious issue.  Nobody manages their day to day operations however the law mandates that the LMC must consult with the ICB and NHS England with all issues within GP.  NHS England and The Secretary of State for Health hold balancing power as they control the NHS Perfomers List and National GP contracts - a LMC must adhere to the legal definitions of GP set out by these health authorities.

I am deeply concerned about the actions and priorities of 1 Local Medical Committee (LMC), which, rather than serving in the best interests of patients, has allowed:

• a Doctor on their committee (who was under several existing serious complaints), to misuse their position as a LMC member, which helped the said Doctor to evade accountability for misconduct, with no apology, or rectification for the complainant;
• the Doctor on the LMC, to be promoted on said Committee, during ongoing unresolved patient complaints which to this day (and at the time of promotion), lay formally uninvestigated/addressed by 1 official channel/grossly misunderstood by some/deliberately brushed aside by others), despite the Chair having been presented with factual, ongoing evidence/complaints prior to this new role appointment.

Background

• Several existing long-standing serious complaints from patients about 1 specific Doctor in a GP surgery were ongoing;
• The GP surgery knowingly put forward the Doctor as a LMC nominee whilst these existing patient complaints from very upset patients were ongoing/not looked at properly; unaddressed and lay unresolved - that is underhanded, immoral and unethical.  They should have been doing their utmost to resolve the complaints for their longstanding patients as a priority; exhibit a duty of candour; consider their pyschological/emotional well-being and resolve the issues within the Doctor as there were clear prior repeated patterns of poor behaviour and unprofessional conduct from the Doctor - instead they chose to ignore the issues/patient concerns and worsen an already bad situation;
• The Doctor did not cite a 'reason' for wanting to join the LMC in the nomination paper, which is dubious in itself;
• The GP was appointed on the Local Medical Committee that year, despite serious ongoing patient complaints

The surgery, using the LMC as a weapon, later that same year on 1st election of the Doctor under complaint, served an underhanded, unfair warning letter on a poor vulnerable, upset recipient with genuine ongoing, unaddressed complaints/concerns and concerns for other patients (broached), rather than the said Doctor face accountability/consequences for their actions towards said complainant (and others) and apologise - a silencing DARVO technique.  I am sure most people would recoil at such abhorrent behaviour towards a NHS patient.  This could happen again with future patients/complainants, should further complaints arise about the same Doctor/surgery - this is a disgusting, underhanded way to deal with complaints within GP.   I would strongly urge anyone on receipt of any correspondence from a GP surgery with LMC/MDU mentioned in the content to obtain immediate legal counsel - you must.

It also demonstrates poor oversight/scrutiny on nominees by the LMC and how easy it is to be elected - clearly a gap.

As Time Progressed...

• The LMC were later made aware of the complaints about the Doctor out of concern, (once it was discovered they resided on the Committee);
• The Chair of the Committee, on receipt of the complaints/evidence, 'ignored' the written evidence/complaints about the Doctor;
• The LMC, using an election process, subsequently then promoted the Doctor on the committee to a higher representational, regional rank (despite ongoing unaddressed/unresolved complaints/concerns) - that's corruption at its' finest, underhanded and most unfair on patients/complainants with outstanding complaints/concerns and tensions - naturally, this would fuel further animosity.  Not to mention, unfairness and a lack of transparency in terms of suspected non disclosure to members over said patient complaints/concerns.

Elections of higher ranking LMC Members

Higher ranking executive LMC members (Chair/Vice Chair) are typically elected by and from the newly elected committee members during their first official meeting or AGM following regular election cycles - it is highly probable that other members of the LMC would have been unaware of the pre-existing complaints so elected the candidate without proper due course of consideration.

Constitution of the LMC

All LMCs form constitutions.  In the LMC constitution (available online), under the Suspension clause; a member who:

• Commits any act that, in the opinion of the committee, is of such nature or seriousness that it prejudices the standing as a Committee member;
• In the opinion of the Committee brings the committee into disrepute or acts in a manner that is contrary to the interests of the Committee, for the avoidance of doubt this clause shall also apply to the removal or suspension of Chair, Vice Chair and Secretary of the Committee.

This should be strictly adhered to - it would appear this is a matter for this LMC and it's members to address, (along with the ICB, NHS England, The Secretary of State) as there is a clear departure of integrity, openness (given the evidence already provided) along with suspected non disclosure to other LMC members about the complaints prior to higher election on the Committee of this contentious Doctor.  

Another LMC in the UK, a GP representative (with a very poor surgery historic overall patient satisfaction online public rating), is as at August 26, trying to draw collective action at LMC conferences, using the BMA as a platform, trying to cite that 'emailing your GP with complaints' is harassment - clearly they also want to shirk accountability and not deal with the internal issues at the surgery (how patients are being treated; repeated unaddressed issues), which is giving rise to the complaints.  This echoes similarities to the aforementioned LMC/surgery.  This LMC is even trying to state that asking for a SAR; Subject Access Request (which legally we are all entitled to); being persistent in complaints, threatening regulatory action; sending correspondence is harassment - it isn't.  They fail (and choose not) to see the person/patient is quite clearly upset by something that has gone wrong within their medical care - a normal emotional/psychological reaction.  It's a scare tactic deployed by the LMC to cite harassment to try to dissuade you from achieving a rightful remedy.  Naturally, at times, a patient will be very upset and send a lot of data - as it's evidence to illustrate their point; sometimes more comes to light later on.  None of this constitutes harassment.  There is a duty by a surgery to investigate your concerns/complaints, no matter the cost, time or resources yet even then, they try and say you are a 'burden on resources'; creating more upset, frustration and distress.  This is concerning; will induce friction and is a DARVO reversal technique, designed to thwart any rightful resolve, accountability or legal recourse.  I would strongly urge anyone in such circumstances to undertake legal counsel.

At times, the complaint handler at a GP surgery doesn't 'get' what you are saying, maybe its' serious complaints; sometimes the responsible party/parties won't apologise or there may be conflicts of interests during complaints - all inducing increasing frustration/upset to the complainant. 

Often complainants do not get a LRM (Local Resolution Meeting) for dubious reasons; denied 1; thus fuelling even more frustration/upset for the complainant, hence citing even more contact. 

It isn't harassment; it's HURT. 

A LMC should encourage local resolve/resolutions between a surgery/patient.   

This petition calls for SCRUTINY on LMCs; their members; independent oversight on nominee elections, annual review of all members inconjunction with the ICB , NHS England, and The Secretary of State (to consider all complaints against members) prior to any nomination/election.  

It isn't difficult to see that 'sorry'; demonstrating empathy and accountability; can do a lot to fix matters and put things right.

It is essential that medical governance bodies, like the LMC, maintain the highest standards of accountability and transparency to ensure and promote patient well-being - this should always be their foremost priority.

Imagine being under the care of a medical professional you should trust, only to find that they have exploited their role within the LMC to sidestep rightful scrutiny/accountability under complaints.  It's a betrayal not only to their patients; their psychological well-being; the reputation of their surgery, but to the integrity of the entire health system/NHS itself.

This isn't just about the oversight of a Doctor; it's about ensuring LMCs across the country are fulfilling their mandate to regulate and guide with impartiality and focus on the welfare of the patients and ensuring Doctors in general, uphold high standards within their role in general practice and within the PCN.

Advice for patients with ongoing complaints (already complained to either the GP surgery/ICB) which are not being resolved:

1 - Firstly you should look online for the local LMC to see if a Doctor at your surgery, whom a complaint is made about, resides on the committee.

2 - Raise your concerns with the LMC directly.  Be aware, there could be collusion - they won't be on your side.  You must inform them however in writing of your complaints/concerns.

3 - Obtain your own legal counsel - this is very important.

If the LMC is notified of a patient complaint about 1 of their members;

• all complaints should be logged and retained by the Administrator on secure systems and divulged appropriately to members of the LMC;
• all LMC members should be served with a copy of all patient complaints about the Doctor.  In terms of patient 'confidentiality' breaches, there could be summaries given, of said complaints, provided to members - this is crucial for elective purposes, going forward.

In addition, an independent oversight body/the ICB, NHS England, The Secretary of State should set in motion over the LMC to ensure:

• adequate scrutiny of nominees on nomination;
• mandate it necessary to ask for any patient complaints about the Doctor prior to appointment on the LMC (particularly for executive roles) to be presented to the Committee;
• that no 'conflicts of interest' occur during ongoing complaints by patients which affect or could influence the outcomes of any ongoing investigation, due process, or disciplinary actions against said Doctor(s) at a practice.

The LMC MUST, turn their focus away from Doctors' rights to a level of trying to silence complainants via threats and instead implement transparent processes for reviewing complaints internally (away from the Doctor(s) under complaints), providing patients with a clear, supportive pathway via local resolution via their GP for airing grievances or reporting misconduct by medical professionals.  They should work alongside a surgery/patient not against patients, intimidating them, to serve their members or own political 'agendas'.

It isn't just vulnerable patients LMCs work against by sending unwelcomed letters; its' Secondary care they can also target.  There have been other instances of LMCs:

• Repeatedly encouraging GP practices to opt out of Shared Care Agreements (SCA), detriment to patients - this is detailed online in form of repeated bulletins;
• Sending out contentious, controversial letters - this is again is weaponization rather than representation:

Issued in Oct 25, by the BMA and regional LMC leaders, the leaked draft; faced backlash over a contentious letter distributed to regional GP practices that they were to avoid signposting patients to community pharmacies, controversially claiming that the Pharmacy First scheme relied on "less-skilled people" and aimed to downgrade patient expectations.  This contentious letter faced major backlash by pharmaceutical bodies, the Health Secretary and was condemned as 'adversarial, irresponsible, unprofessional and harmful to patient care'.  Some ICBs even issued immediate breach notices to practices refusing to enable the pathway.  This related to the GP contract 25/26 changes whereby practices were required to allow community Pharmacies to automatically feed consultation summaries straight in to the GP workflow via GP Connect Update Record by 1.10.25.  Pharmacy First is an NHS England service launched in January 2024 that allows people to get care for certain common conditions from qualified pharmacists, meaning they can walk into a high street pharmacy at a time that fits with their everyday schedule rather than having to book an appointment with a GP in order to get treatment. 

Sadly, as at September 26, LMC members are now again attacking Pharmacy First as there are current plans to expand the Pharmacy First scheme so that patients can be treated for conditions including acne, migraines and ear infections without visiting their GP - this isn't undermining the role of GP (as stated by the LMC), but is prioritizing patient service access/speed in line with the government's 10 year plans - it is needed for quick turnaround.  Also, some Doctors do not wish to treat acne scarring (dismissing it as minor/insignificant), even going as far as to not issuing referrals to secondary care, ignoring the psychological/emotional impact it can have on patients on a daily basis or worsening of said symptoms (empathy deficit) so this is good news for sufferers - fragmentation or 'choice' is very much welcomed.  Pharmacists are valuable, highly skilled and trained people - you are in safe hands.

It is further argued that LMCs act as 'defensive trade-union-style' echo chambers during broader primary care crises rather than addressing local patient accessibility and service delivery.  LMC member GPs are frequently to be found in debate on social media platforms arguing/ranting in favour of GP 'first and foremost', whilst threatening strikes - of course it is important to have GP but times move on and patients need access to quicker healthcare and service delivery - this is where pharmacies and hubs come in.  We all need continuity of care and GP important but fragmentation/choice is also needed.  

The Pharmacy First service lets patients get fast care and prescription medicines for common minor illnesses directly from community pharmacists without a GP appointment so they play a vital role within healthcare.

Key Benefits for Patients -

1. No appointments needed: You can walk into a participating high street pharmacy and request an on-the-spot consultation.
2. Quicker access: “Quicker access to healthcare for common conditions.”
3. Extended availability: Pharmacies offer the service during normal operating hours, including late nights and weekends.
4. Direct prescription treatment: Pharmacists can supply prescription-only medications—including antibiotics and antivirals—for common conditions (such as sore throats and sinus infections) when clinically appropriate.  5 more ailments have recently been added as at 10.9.26 to Pharmacy First: treatment for acne, migraines, scabies, ear infections and rhinitis.
5. Flu jabs can be given.
6. Weight loss advice can be given. (without harmful GP prescribed drugs)
7. You can get a free blood pressure check

Another LMC, as at August 26, is calling for collaboration with the GP Federation to 'shape neighbourhoods' - despite ongoing, persistent online complaints about the GP surgeries in the local LMC area of representation - rudeness and a considerable lack of care towards patients being common recurring themes.  

I put the view that LMC involvement within healthcare is DISRUPTIVE, rather than 'representative'.  LMCs do not act in patients' interests.  1 LMC member even expressed a view that patients do not have a 'right' to see their GP yet constantly campaigns for GP retention - that speaks for itself.  Sorry, but we do have a right; we shouldn't be intimidated by you and you shouldn't disrupt our care by constantly striking, getting people's backs up!  

It is questionable whether LMCs should be considered for collaboration in neighbourhood shaping, going forward, as part of the government 10 years plans - their values must be in alignment with the needs of the community, first and foremost.

Statistics from reputable sources show that transparent and accountable medical regulatory bodies directly contribute to higher patient satisfaction and trust. Yet, when accountability falters, so does patient confidence, negatively impacting the entire healthcare structure.

The time to take action is now.  Join me in calling for scrutiny; an immediate review and reform of the LMC's processes to ensure every decision made reflects the priority of patient interests above all.  Your signature can drive the change needed to protect patients and restore trust in our medical governance.

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