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Somerset LMC Weekly Update Friday 27th July 2018

Date sent: Friday 27 July 2018

All Somerset GPs and Practice Managers  this and previous updates can be found here  (Tea and a biscuit needed this week!)

Revival of the Pink Book Some colleagues will recall the much loved ‘GP Pink Book’ which was a folder crammed with information about the various hospital departments at Musgrove with contact details and other useful information. At a meeting this week to discuss communications between Primary Care and TST/SomPar, it was agreed that it would helpful to have information about the various hospital departments, and essential contact information for practices available in a single on-line site. We know that communication difficulties are a major cause of frustration on both sides- Primary Care can struggle to get information from, or feedback to, the Trusts about patients, and hospital staff would like to have a direct line into practices, avoiding the typical greeting message that many now have in place. Practices will receive a request for updated contact details soon, along with any other information practices might wish to share on-line (maybe you offer vasectomies or other specialised services?), and we hope practices agree this will be a useful service. Obviously, colleagues will only find this useful if it’s kept up to date, yet there seems to be agreement from both Primary and Secondary care that such a site could be very useful.

Other ideas discussed at the meeting included a single box on letters from the hospital with actions for Primary Care (we made the point that letters now are usually dealt with by admin staff and this information needs to be easily visible in a consistent manner), and the equivalent box on a referral letter giving the principal reason for the referral (such as consideration for surgery, advice re medication, reassurance etc.) as this is not always evident from many referral letters, apparently.

GPs might be surprised to hear that hospital colleagues (TST at least) do not have access to the full hospital record when they see patients in an outpatient clinic (due to new paperlight working arrangments!) and so information in the referral letter is crucial.

We also discussed how hospital teams could be better informed of how Primary Care has changed, with many more roles now being taken on by other members of the expanded Primary Care team- patients should be advised to contact their practice team, rather than the standard “see your GP” if further action was required.

Flu Vaccinations for Staff 18/19  NHSE has received verbal notification from the National Flu team advising that funding will be offered via GP and pharmacy as it was last year. In addition, this year frontline health and care staff in the voluntary managed hospice sector will also be included.Formal notification is expected imminently. They will circulate the formal letters as soon as these are received, but in the meantime hope they hope it helps with local planning.

Flu Vaccine payments Practices should check their payments carefully. If a claim has been made using the manufacturer’s name only then it has happened in other areas that only the trivalent vaccine is being reimbursed even though the practice ordered and used quadrivalent (which are over £1 per dose dearer).

Phoning Microbiology Laboratory Reports Dr Mike Smith from T&S tells us that the lab has always phoned positive Salmonella and Group A Streptococcal cultures to practices because it used to take days for paper reports to arrive. With electronic reporting it is no longer necessary to phone them unless there is a good clinical indication. With Salmonella an electronic report is almost certainly just as good as a telephone call but Group A strep may be more complicated. At present the lab tries to ring the practice on identification and the electronic report goes out next day with antibiotic sensitivities. It is now proposed that, instead of phoning, a preliminary electronic report with the organism will be sent and then follow-up, final report with antibiotic sensitivities. The department may still phone, for example, where there are clinical details of a wound infection with no antibiotics, or “inappropriate” antibiotics named. The LMC has reflected back views from members, most of which were in support of this proposal (indeed those using the RUH tell us it has not phoned results through for some years), but there was a concern about absent GPs not always seeing their results promptly. This could, of course, apply to any pathology report and most will have policies for test results to be reviewed. However we have also asked that the flagging up of positive cultures be standardised and made consistent if possible to reduce this risk further

GMS and PMS regulations amendments Following agreement in the last round of negotiations, the amendments to the GMS and PMS regulations in England have and laid before Parliament. These have been released on but will not come into force until 1 October 2018. One of the main changes is to the section around removing a patient who is violent; these changes have been made following BMA concerns that some practices were left vulnerable when patients with a recent history of violence registered with a new practice without the practice being aware of the situation. Such patients should instead be provided general 3 medical services by a specially commissioned service. Some key changes to resolve this situation were reached. Where a patient has a violent patient flag on their record, it is reasonable grounds for a practice to refuse to register that patient (using paragraph 21 of part 2 of the Regulations ‘refusal of applications for inclusion in the list’). This is an agreement around interpretation of the regulations and so can be implemented immediately. The new addition to the Regulations, that if a practice does register someone with a violent patient flag on their record, they may remove them immediately by giving notice to the Board will come into effect in October. The GPC hopes that NHSE and CCGs will recognise the change coming in October and so may provide some scope for this too to be implemented right away. 

Occupational Health Services- New Service from Avon LMC  Avon Local Medical Committee have been providing Occupational Health Services to its GP Practices for the last few years, in association with the Avon Partnership Occupational Health Service.They are now in a position to offer this to Somerset practices further details and contacts can be found here

Parliamentary question on SAR requests The issue of inappropriate subject access requests being made by insurance companies was subject to a question in parliament this week.

Asked by Julian Sturdy: To ask the Secretary of State for Health and Social Care, what estimate he has made of the costs incurred to the NHS from third-parties making subject access requests under General Data Protection Regulation (GDPR) instead of using the Access to Medical Reports Act (AMRA) 1988.

Answered by Jackie Doyle-Price: No such assessment has been made. The GDPR is not the correct route for such requests. The right of access under GDPR confers more personal information than is needed or is justified for insurance underwriting. Accordingly, insurance companies should instead use the established mechanism of the AMRA 1988 to obtain summary medical reports from GPS. The AMRA allows the GP to charge a reasonable fee to cover the cost of copying the report. Read the full transcript here.

Sessional Page We have pulled together a lot of useful information for Locum and Sessional GPs in one area of the LMC website our thanks to Wessex LMCS for allowing us to build on their good work on this

DDRB Award Following strong representation by the GPC to the DDRB they responded with a report advising that GPs should receive a 4% uplift on pay and expenses.It is extremely disappointing that on this background the government has announced that it does not intend to honour the DDRB award. GPC Chairman Dr Richard Vautrey spoke with Matt Hancock, the new Secretary of State for Health and Social Care, and stressed his  deep concern that the government has chosen not to honour the findings of its own independent pay review body across the entire NHS, but specifically for GPs,  he maintained that GPs would be getting 2% this year backdated to April with a further 1% to be added from next April. This will effectively be then consolidated to be the equivalent of a 3% award.what does this mean for General Practice,  find out in the BMA briefing here 

Top Tips;Frailty The automated extraction has occurred for the Frailty for this quarter (GMS PMS CCDC 2018-19). The extraction has only looked for Diagnosis codes for Moderate frail and Severe Frail from 1/4/18. Any that were coded last year won't be included so practices will need to reassess those previously coded and code them again for this year.

Kind Regards


Jill Hellens

Executive Director

Somerset LMC

TEL: 01823 331428

Fax:01823 338561

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