Somerset LMC Weekly Update Friday 30th November 2018
Date sent: Friday 30 November 2018
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- Bricanyl Turbohalers
- GPC News 4 – England LMC conference news – 23 November 2018
- Influenza & Measles
- Falsifying Medicines Directive
- New GPC Policy on Seniority
- Indemnity Scheme in England FAQs
- Rapid Response Service
- News from the Performance Advisory Group
- Wheelchair Referrals
- Vaccine Update Issue - 288 - November 2018 ** Winter is coming & new training available
Bricanyl Turbohalers:The department of Health and Social Care has asked us to forward this update on Bricanyl Turbohaler (terbutaline 500microgram). Astra Zeneca has informed DHSC about a supply problem (and it’s nothing to do with Brexit, yet). Interim deliveries are expected in late November and in December but normal supply will not resume until end of January. UKMi has produced a memo which details clinical management strategies, this can be viewed on the following link . Salbutamol products are available from a range of suppliers if patients are required to be switched during this period of short supply but “will require retraining if they are required to be switched to a different device".
Influenza & Measles: A contact at Public Health England informs us that the H1N1 flu strain is circulating with proven outbreaks at schools, nurseries, a prison and five care homes all of which have been outside Somerset. So far the CMO has not officially declared the influenza season open. In other news we are pleased to say that the level of reports of measles infections in the region is back to the baseline expected.
Falsifying Medicines Directive: The FMD will become law across the EU in February 2019. It is intended to stop counterfeit medicines getting to patients using official 2D barcodes on every package with an anti- tamper device. Medicines will be “decommissioned” by a 2D barcode reader at the point of dispensing. Naturally this is relevant to community pharmacists and dispensing doctors but also to every GP practice in England. Medicines in GP practices that are affected by this are all personally administered medications (eg. Joint injections, contraceptive implants and coils, emergency medicines, GnRH analogues etc) and immunisations. One would of course expect that such a major change to practice processes would come with some clear guidance and a clear time line. After all a kitchen refit is planned with a gantt chart (and may even include penalty clauses). Sadly this is not the case here. Fortunately, only about 15% of medicines production will be involved and, not being retrospective, only medicines manufactured after 9th February will be included. Although it is broadly agreed that government will fund the barcode readers under GPSOCs, as there is no integrated software yet (although it is on the radar of IT futures), there is virtually no capacity to deliver FMD in three months. Nevertheless the government says it is obliged to making a start despite the system-wide shortcomings which it readily admits. GPC will continue to try to reduce the effects on practice workload as far as it can.
Link to ProScript Connect's integrated FMD solution can be found here.
Link to 2D FMD Complaint Barcode Scanners Required for this Branch (£150.00 per Scanner) can be found here.
New GPC Policy on Seniority: The following motion was proposed and passed by a large majority for part (i) and a smaller one after an electronic vote for (ii) at the Conference of English LMCs last Friday.
SOMERSET: That conference agrees with NHS England that it is important to keep experienced GPs working in primary care and:
(i) urges GPC to negotiate an incentive scheme with NHS England to acknowledge the expertise of senior doctors
(ii) that this should be through a new system of seniority payments based on years of service.
Indemnity Scheme in England FAQs: The Department of Health and Social Care has published FAQs on State Backed Indemnity for General Practice. Understandable concerns have been expressed about the answer in the FAQ relating to funding arrangements. This was reflected in comments at the English LMC conference last Friday and led to an emergency motion which was passed unanimously. This stated: That conference is outraged and deeply concerned at the statement of 22 November 2018 from the Department of Health and Social Care that the newly state backed indemnity scheme may be funded from “existing resources allocated for general practice” and instructs GPC England to work with the government in ensuring that:
- the scheme is supported by new funding
- no GP is financially disadvantaged by a change to a state backed scheme
- all GPs and practices are protected from any future increases in the cost of the state backed scheme.
Rapid Response Service:This new service is now up, running and looking for your referrals. Up until 26th November 41 patients had been referred with an average of 1.8 days of care saving 28 acute admissions. Two patients required admission for iv antibiotics after failing to respond to oral treatment and two others were considered “frequent fliers, determined to be admitted”! Please remember the RRS is designed for patients who do not need hospital assessment but who would otherwise be admitted for lack of some support at home and simple interventions which is needed soon. Referral is via SPL and response can be within two hours.
News from the Performance Advisory Group: If a patient has taken a potentially toxic substance advice on what to do can be found on Toxbase. Document what has been taken and when and the advice given. If you decide not to admit a frail elderly patient with or without a STEP it is important to document the decision particularly if the patient is expected to die. PAG considers that practice responses to complaints are best written by the practice manager with input from any clinicians involved. Workload has a considerable impact on performance concerns and members of PAG felt that no GP should be expected to work 10 sessions a week. GPs should be aware that GPs in training are not allowed to work more than six sessions a week as being safe and sustainable. GPs may wish to reflect on this if they are concerned about their own workload. If medical records are altered after a consultation it is important to clearly record when the alteration has been made and why - altering notes retrospectively without clarity can lead to a GMC referral. With an unwell child – especially if unwell for several days – always consider sepsis. The Sepsis Trust Red Flag Toolkit is useful. GMC – make sure they have your up-to-date address and permission to contact you. A GP found themselves removed from the Register when they moved house and their fees weren't paid. A Direct Debit would have helped too!
Wheelchair Referrals: We have received confirmation that the process for wheelchair referrals is as follows: when the wheelchair service accepts a self-referral from a new patient Millbrook makes contact with a community therapist from the appropriate federation hub on behalf of the patient. A therapist then contacts the patient, assesses needs and completes the necessary referral paperwork.
Kind Regards
Jill
Jill Hellens
Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY
Tel: (01823) 331 428
Fax: (01823) 338 561
www.somersetlmc.co.uk
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