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Somerset LMC Weekly Update Friday 24th August 2018

Date sent: Friday 24 August 2018

All Somerset GPs and Practice Managers  This and Previous updates can be found here 

New palliative care Medicines Administration Record (MAR) charts: some colleagues will have already seen these new MAR charts introduced by SomPar specifically for palliative care drugs. The main difference, apart from their being designed especially for just-in-case and syringe driver medications, is the front page giving useful examples of doses and drug regimens for commonly prescribed drugs. These were deliberately introduced without fanfare by the Trust but this seems to have, perhaps inevitably, led to some confusion amongst community teams. The old MAR charts can still be used. The LMC (and the new management at SomPar, now it is in alliance with T&S) was interested in pursuing pre-printed labels for commonly used drugs at commonly prescribed doses (most recently suggested by Dr James Hickman) but we are informed that a method to link MAR charts into the EMIS record to allow printing of the whole chart in the consulting room is being developed. The LMC has not forgotten that MAR charts are records of administration in the community and are NOT prescriptions for the supply of medication as they are in hospitals. We will be pursuing this too now that SomPar is under new management.

Somerset cancer care rating: In a letter from CCG Chief Officer to T&S and YDH the Trusts were told that Somerset has moved from a Good to an Outstanding rating for cancer care. This was a rating made across the board including early diagnosis and so reflects well not only on the excellent hospital teams but also, to a certain extent, on primary care.

Child Safeguarding “Early Help Assessment” Form: The LMC remains grateful to the CCG Safeguarding team for their efforts to improve this unwieldy and often useless form especially where more serious concerns need to be raised urgently. The team has managed to persuade the Somerset Safeguarding Children Board to discuss a proposal for a separate child protection referral form in its meeting in October. The draft attached is based on Essex’s referral form. Essex is the “improvement partner” for Somerset. It is a short, clear form that can be used on electronic record keeping systems or as a portal. It is four pages long only because of the demographic information required. If it is approved it will embedded into EMIS with a view to as auto populating much information as possible. The section regarding consent is good practice, but not essential for child protection. The last three sections of the form are related to the child protection concerns staff have. An email and the associated documents to the GP safeguarding leads will or recently has been sent with a request that they disseminate it within their practices with a request that comments be sent to the CCG’s generic email account: . The LMC encourages primary care colleagues to contribute to this important and welcome proposal.

NHSE Premises consultation: You will be aware – some more than others! – of the problems that premises and ownership can present to practices in terms of space and attracting new partners. It is perhaps not surprising that NHSE, the GPC and Dr Nigel Watson’s (Wessex LMC) Partnership Review for the DH are all considering premises. NHSE is calling for ideas in a consultation exercise to be administered by the GPC as an outcome of the 2018-19 GMS contract negotiations. Some of you may have received an email from NHS England about this. NHS England is holding a four-week open call for solutions via which it is inviting submissions from interested stakeholders. GPC would like to encourage LMCs, practices and individual GPs to submit (potential) solutions that address both individual issues and systematic issues. We welcome a range of proposals, from those designed to address specific issues to those which would require a more significant system reconfiguration. The open call will run from until 5 September 2018. The call for solutions pack sets out further information about what the review is considering and how you can submit a response. We encourage you to read the call for solutions pack before submitting your response. Call for solutions pack.  You can respond by online survey: by pressing and clicking this link. The format required is, however, quite specific with timescales, accounting for future IT developments, benefits, additional funding, positives and negatives, value for taxpayers’ money, risks and scoping unintended consequences but don’t let that put you off! GPC will be sending out a separate survey to practices shortly to feed into the premises review.

Heath Education England GP Specialist Recruitment is calling for new case studies about what’s great about being a GP ahead of the next round of recruitment for GP training applications opening 7 – 29th November 2018. National campaign activity is largely targeted at Foundation year doctors, to help raise awareness of the benefits of a career in primary care as they are thinking about or ready to choose their specialty options. Targeted social media has proved to be an effective channel to communicate information using our community Facebook page for example . This year, they would like to feature some accounts from GPs and GP trainees who are willing to help describe how you feel about treating your patients and what you have achieved. As young doctors spend most of their training and working life in hospitals, the aim is to better show what can be achieved by working in primary care: such as the skill of the primary care clinician in triaging; determining a diagnosis or treatment with multiple undifferentiated presentations; the challenge and stimulation of using the range of your medical training: dealing with conditions not limited to one body part or system; the ability to influence, educate and help prevent illness and the satisfaction of a good outcome for the patient. The case studies on the GP National Recruitment Office (GP NRO) website are regularly viewed, providing an easy to digest, peer to peer account that describes the ability to incorporate special interests into general practice and the flexibility to tailor a portfolio career. With this in mind, are you able to provide a reflective 500 word account of a particular patient or group of patients within your clinical practice, special interest or portfolio experience? If the experience sticks in your mind it’s likely to be out of the ordinary or include some unusual aspects that the audience would be interested to read and learn that really happened. It could mean that something you discovered (that eureka moment) or an intervention that you instigated or researched that made a difference. If you interested please email GP Recruitment where the team will be on hand to guide you through.

News from the Performance Advisory Group: Prescribing antibiotics for a chest infection via a telephone consultation can be a minefield: think carefully - it is generally much safer to see and assess these patients.  Medication reviews should include both compliance and the quantities prescribed. A patient was being sent two months’ supplies every month inadvertently. When they died a relative sent a 25kg bag of unused medicines up to the chief pharmacist in London. PAG was asked to review the GP’s role.

Top Tips : Fluad is still not available on EMIS on the drug formulary, we have been informed that the drug formulary with fluad in it is in testing and will be released as soon as it is passed. There is no date given yet. Practices will need to add this to protocols at a later stage.

NICE Guidance on honey drinks for coughs and colds: Colleagues will have seen the latest shattering news from NICE proving your granny was right all along. With many GPs having pre-empted this by keeping bees themselves the LMC Medical Director (a recent convert) is proposing the foundation of a Medical Beekeepers’ Association. This will allow the exchange of views on the latest in Varroa mite control, the spread of the Asian Hornet (from France, obviously) and desensitisation from bee stings. It will also mean that we can put MBA after our names without all that painful and prolonged studying of business management.

Kind Regards


Somerset LMC
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Attached file: Item 10.4 Draft Level 4 Acute Child Protection Referral July 2018.docx

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