Somerset LMC Weekly Update Friday 6th December 2019
Date sent: Friday 6 December 2019
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- 'Grip and Control' the latest blog from LMC Chairman Dr Nick Bray
- Are you interested in making a real, positive difference to General Practice in Somerset?
- Admitting Patients with Flu-Like Illness
- Re-Imbursement for Extra Work Caused by Lab Error
- Flu Update
- Intercollegiate Safeguarding Guidance
- The latest issue of GP PAG Pieces (formerly PAG Bites)
- ALS Polypharmacy
Are you interested in making a real, positive difference to General Practice in Somerset?: Somerset LMC is looking for a Deputy Medical Director for one session a week. This is an interesting role for a GP working in Somerset in any capacity. Working alongside the Medical Director, you will in time, be able to advise and support GPs and practices in a range of circumstances: contractual, regulatory, personal and pastoral. Pay is competitive and there is a 14% additional contribution to a private pension fund. There is a job description and person specification on the website but please contact email@example.com for more information in the first instance.
Admitting Patients with Flu-Like Illness: A message from Val Yick, Infection Control Nurse at TST: Patients with suspected influenza, even those who are really sick, should be referred to the medical team for assessment. The ambulance crews will divert to the ED as necessary but paramedics’ interventions can lead to clinical improvement during transit allowing direct admission to the Acute Medical Unit (AMU) even if the patient were deemed too unwell initially. Val will be grateful for your bearing this in mind.
Re-Imbursement for Extra Work Caused by Lab Error: Colleagues will recall the very welcome news that the CCG agreed to pay £10.13 for every patient involved in the problems at the laboratory earlier this year when a field safety notice came to light. All patients who had undergone CA125 and PSA testing during the period that the suspect software was in use had to be reviewed and most (although not all – for example men with a known history of prostate cancer in remission who would have been retested anyway in due course) were retested. Because every case needed reviewing, but not all needed contacting, counselling, retesting and then new the result checked, we deliberately set the fee at a rate to take this into account. The CCG intended to use the word “retest” in the form sent to practices but agreed to change it to “review.” Unfortunately this change was made in the communication but not on the claim form. The principle still applies however and practices should submit the total number of patients involved in their return.
Flu Update: Practices will be aware that the MHRA have now issued advice on antivirals as the incidences of flu in the community are rising, you will find a summary and weekly report here and full MHRA details here .
Intercollegiate Safeguarding Guidance: Colleagues will recall that we published the new, improved safeguarding requirements suggesting that GPs, nurses and many practice staff should have level 3 safeguarding. It made recommendations about the number of hours required for training and stipulated that some of it needed to be face to face. These recommendations caused GPC concern about the impact on service delivery for general practice. CQC and the Responsible Officers Network (RON) for appraisal have used these guidelines as their benchmark for expectations of organisations and individuals thus “raising the bar” in a potentially problematic way. GPC tackled this in three ways:
1. Richard Vautrey wrote to NHSE for clarification on the GMS contract and was told that it does not directly stipulate the level of safeguarding training required.
2. Mark Sanford-Wood spoke to the RON and they have agreed that the intercollegiate document is guidance only and that level 3 safeguarding should be an aspiration. It should certainly not be regarded as a pass/fail. Somerset LMC does not believe that any local appraisers will take an unhelpful view but please tell us if any do. It is the appraisees’ role to judge whether the level of CPD activity undertaken in an area is sufficient to maintain proficiency in that area. The appraiser can challenge this but it is not their job to judge whether time spent in CPD meets the level described in this or any other guidance.
3. The Policy Lead for Contracts & Regulation pressed the same point with CQC and was given a clear assurance that inspectors will regard the guidelines as aspirational. They will not fail practices who have coherent and reasonable safeguarding processes rather than taking the guidelines out of context. Again please tell the LMC at once if you have a different experience.
ALS Polypharmacy: Developed primarily for GPs, these Action Learning Sets (ALS) are based on work undertaken in Yorkshire and Humber AHSN. They aim to help GPs understand the complex issues surrounding stopping inappropriate medicines safely and will also help PCNs deliver the Medicines Optimisation elements of the new GP QOF contract. HEE South are evaluating these ALS with a view to rolling out this methodology across England.
Please find details of this free HEE training to be held in Bristol and Exeter.
Crown Medical Centre, Venture Way, Taunton, TA2 8QY
Tel: (01823) 331 428
Fax: (01823) 338 561
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