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Somerset LMC Weekly Update Friday 8th February 2019

Date sent: Friday 8 February 2019

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

GP reports for Her Majesty's Court & Tribunals Service (HMCTS): From their local news update “What’s New in January.” “After 31.3.2019, HMCTS will no longer pay for GP records as there is no obligation to do so. If tribunals want GP records they should incorporate the directions in a formal direction/order. The BMA has advised GPs that they must abide by such a direction and provide the records without charge.” We believe this amounts to medical records being subpoenaed or summoned by the Court. More good news but hopefully a rare occurrence?

Direct To Test (DTT) Gastroscopy for GPS at Taunton & Somerset: The gastroenterology department at T&S is keen to extend this service which has been enjoyed for some years in other parts of the county. The LMC was involved at the very beginning to the process. This may not suit all colleagues but many will be pleased to have the option which is likely to start from March. Existing referral pathways will not be closed. Urgent referrals of course must go through the 2ww route and the DTT form has reminders about this. We hope that it will auto populate in time. If any significant pathology is seen or subsequently identified on histology the patient will be taken under hospital care at once and without any need for re-referral. You will be amused but probably not surprised to hear that the current process has some 24 steps from GP referral to final report! Common benign histological reports are attached for interest.

Gynaecological 2WW Referrals: The Gynae oncologists at the two main acute Trusts understand the time constraints GPs have but do appreciate it when 2ww referral forms are fully completed. Furthermore some practices automatically append pages of records, like lists old drugs and vaccinations, which really don’t matter in these cases. Knowing about whether a translator is required, if there is a history of depression or anxiety and WHO status is far more important. We have also been asked to point out that the team is always happy to speak to GPs if there is a borderline case or there are questions about patient capacity or frailty making some tests or treatments unsuitable. Furthermore if a blood test is required for a 2ww referral it makes sense to get the sample taken promptly in keeping with the urgency of the situation rather than at a routine phlebotomy appointment.

Urgent Treatment Centre Test & Learn: The CCG was given a very tight schedule by NHSE to set up this centrally dictated “must do” so sensibly decided to choose the MIU at Bridgwater Community Hospital for the pilot site in conjunction with OOH provider Devon Doctors who already run a treatment centre there. The first phase is to open on 4th March using existing opening hours (08:00-21:00) leading to opening until 22:30 by mid-May. Recruitment for radiographers and Band Five nurses is proceeding and so now GPs interested in working sessions at the UTC are being sought. The Bridgwater Bay Federation has been involved through Harry Smallwood and Tim Horlock but this invitation is county wide. To begin with this will be on an informal basis (well, it is “test and learn”) and the employer will be the Taunton & Somerset Trust which plans to deploy some of the GPs in the ED there.

Ear Wax Irrigation: What we used to call syringing is costing the CCG around £500k in referrals to ENT. Can you imagine what half a million quid’s worth of earwax looks like? The CCG are now contemplating paying practices to do this work and so are planning to survey practices on the number of patients being treated already. The LMC greatly welcomes the prospect of practices having the chance to be paid to do something so important to many patients. As Dr Phil Hammond says, “People are always going to come in with ear wax”!

Drug Supply Update: The latest bumper edition is well worth a read with news about Carbagen (a brand of Carbamazepine), Clexane 40mg (there are alternatives), Madopar, Pethidine 50mg injections (remember that?) and even Metronidazole 400mg tablets being amongst many drugs hard to come by. There is better news on Naproxen supply but Adalat capsules and Retard preparations have or are being phased out by Bayer after long service. Imigran injection refill packs will be out of stock until July but Sun Pharmas generic Sumatriptan is in good supply. Another old friend that has been moved to the bed nearest the door is Aciclovir eye ointment which GSK is stopping making in June because of quality control problems. Virgan (Ganciclovir) will be available instead. Branded Cilest is also leaving the UK in July but probably not because of Brexit. The CCG has advised pharmacies to follow their due processes before returning scripts to GPs.

Flu: May we remind practices to check that they have uploaded their Flu data, we have also had some enquiries about Staff Flu Vaccinations, Practices cannot claim for administering the flu vac for our own staff (unless they are patients) but can claim on FP34d and you must not register them as a TR, further detail was shared in an update on the 26th October which included the Top tips kindly shared by Wessex LMCs   

OTC Meds: Please see clarification from NHS England about stopping the prescribing of medicines available OTC

Clinical Admin GP: We have details of a local GP who is currently taking a break from Clinical work and is instead helping practices with note reviews and clinical admin where required, they are on the medical performers list and if you would be interested in knowing more please e mail the office and we will put you in touch somersetlmc.office@nhs.net

Students in General Practice and Work Experience: Having been to several career fairs across the county and beyond we are often asked if practices would be willing to take work experience students, given the difficulties in recruiting and retention we feel that anything we can do to encourage the students into GP training or other roles in GP should be encouraged, practices would need to ensure that the correct confidentiality protocols are in place and an agreement signed before commencement of a placement. There is more comprehensive information on the website here
If you would be willing to take a student for short term work experience please let the office know somersetlmc.office@nhs.net

 

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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