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Somerset LMC Weekly Update Friday 7th December 2018

Date sent: Friday 7 December 2018

Sent to all Somerset GPs and Practice Managers          This and previous updates are available here

Transformation Study Day follow up slides: please find attached a few slides for you to share in your practice for those colleagues who were unable to attend the day in November and to initiate discussion, this also may help in completing the survey in last week’s update if this raises any queries please do email

New procedure for CHC fast tracking: Some practices were concerned when this came in at short notice the end of November. The manager at SomPar apologised that GPs were not invited to meetings during the development as she had judged we were unlikely to find time in our busy schedules. In fact only the single page Section 1 of the documents relates to GPs and this will replace the traditional “letter of support.“ Our unfortunate DNs will have to fill in the 17 page Section 2. As one GP has remarked, “…heaven knows how long the slow track form is!” SomPar anticipates further refinement of the paperwork as it gets feedback which you are invited to provide through the LMC.

Adult Safeguarding capacity under MCA 2005: A lesson from reviews (including serious case reviews) is that GPs are often not recording that an assessment of mental capacity has been made or simply writing “has capacity.” It is better to consider the four main questions separately: is the patient able to understand, retain and consider information and then able to communicate a decision? Some practices have an EMIS template to help remember this. Also recall that every decision is different and that capacity to make a decision can change over time.

Suture Tariff minor surgery: We have been asked to raise this by the Association of Surgeons in Primary Care. Ethicon sutures used in minor surgery should be reimbursed under the Personal Administration payments but not every available suture is reimbursable: only those on the list and for which an FP10 with the correct product code is generated and submitted are recognised by the NHS Prescription Services. Unfortunately, the company, part of the Johnson and Johnson group, has decided to standardise their produce codes globally in Project Vantage, which means that the ASPC has had reports of GPs not being able to buy the sutures they are used to using as suppliers have run out of old stock bearing the old product codes. Please see this newsletter which should explain the changes in code. Note these changes in preparation if you want to continue to claim for sutures used.

Sleep Studies Referral (YDH only):The sleep studies nurses have come up with a good referral form which concentrates on the Epworth areas that matter and stresses the importance of driving to the patient including if necessary for work. The LMC has reservations about dedicated referral forms but this one will actually save GP time plus they have agreed that referrals not using it will not be rejected which is really sensible.

CQC needs help: CQC is transforming its approach to registration with the aim of streamlining and improving processes to make it quicker and easier for providers and is seeking your input into the development of its approach. CQC is looking to talk to aspiring or newly registered managers to make sure these changes meet your needs. This is an opportunity for you to: influence the future of managing registration and creating a smoother experience and share feedback on your existing experience directly with CQC colleagues who are developing the approach. Please email if you are interested in getting involved.

MHRA dispensation on movement of QIV: We have received information from NHSE national team regarding movement of QIV stocks. The same rules as currently apply to aTIV are being extended to QIV for where there are shortages. Further details can be found here. 

ImmForm - Submitting GP practice staff Flu vaccination uptake data on ImmForm for Frontline Healthcare Workers:The next survey for submitting the Flu vaccination uptake data for your GP practice Frontline Healthcare Workers opened on Monday 3rd December. You will have until Tuesday 11th December to submit your staff uptake data. Further information can be found here. 

FLUAD update from Shaun Green: Somerset GP Practices ordered and have had delivered 101,740 Fluad vaccines this season which equates to >80% coverage for the >65 population.Considering the issues in other parts of the country this reflects really well on your efforts to obtain the correct vaccine. (You read the guidance letters and emails!) I have managed to support about a dozen GP practices obtaining stock from practices with excess Fluad.
At this point in time however, I am now unable to facilitate any more transfers unless practices contact me to say they still have excess stock they are now willing to transfer. I have no information on stocks ordered by community pharmacies but given practices have ordered 80% of at risk population and our normal years vaccination rates have historically not reached 80% I would suspect some community pharmacies still have stock available. If they do then practices should direct patients to those pharmacies. Options for practices without Fluad would be as per the guidance.
Many thanks for those practices who have helped each other and shown real system collaboration for the benefit of their patients.

LMC: Going to meetings so you don't have to: As an insight to what your LMC does for you here is an excerpt from the notes of a meeting attended by your esteemed Chairman. “X asked if given the deficit discussions, looking at the service based on a bottom up and top down review, along with affordability should drive the decision and ensure any future model is right for patient flow, does not drive up cost and travel times.” As they say more succinctly in W1A, “this is about establishing what we do most of best and finding fewer ways of doing more of it, less.”

Kind Regards


Jill Hellens

Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY

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