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Somerset LMC Weekly Update Friday 31st January 2020

Date sent: Friday 31 January 2020

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

Practice Training survey for UWE modules: Keep an eye out for the CCG bulletin on Monday, the CCG will be asking practices for the training needs for both maintaining existing service delivery and for your future. Included in this is the provision of funded places on advanced level courses delivered by UWE which are negotiated in the Spring. To ensure they are meeting the needs of primary care they need to identify training requirements which will help inform the planning and allocation of places.

QOF Personalised Care Adjustments: Following the concerns raised by practices about the loss of opportunistic prompts following the roll out of the QOF changes in 2019, TPP have confirmed to NHS Digital that they will add a status flag to the patient record which will alert practices to the fact these patients may be missing QOF care as part of their roll out of v44 of the QOF business rules. This will be implemented in the next two weeks. NHS Digital will explore whether additional functionality can be added to v45 of the QOF business rules to ensure that the two invitation PCA will only come into force at the end of the reporting period i.e. 31st March.

Online consultations: Practices will be aware that online consultations are included in the 5 year framework for contract reform and while from April 2020 they will be working towards this the intended go live date is April 2021 providing the functionality is in place. The GPC have assured us that our understanding is correct, please see the wording from the contract below.
5.10 NHS England and GPC England have agreed eight specific improvements, backed by agreed contract changes, in areas where it is realistic to make early progress, given available functionality: (i) all patients will have the right to online and video consultation by April 2021.

Physician-assisted dying briefing: In February, for the first time, the BMA will be surveying members to inform a debate at the annual representative meeting (ARM) on physician-assisted dying. To make sure you don’t miss out, please check that your contact details are up to date (including your preferred e-mail address) and that you have ‘opted-in’ to receive membership updates from the BMA. To find out more and to download the briefing pack before you take part, visit BMA website here.  

DWP end of life survey: The Department of Work & Pensions is evaluating how the benefits system supports those nearing the end of their lives. As part of this they have published a survey for clinicians involved in caring for the terminally ill. The results will help support DWP in making decisions how best to support EOL claimants and how clinicians feel about the current system and where they think it can be improved. Take the survey here. ​​​​​​

Bariatric Referrals - from Rhodri King at TST: The weight management service at Musgrove Park Hospital have recently audited the results of pre-clinic screening for Cushing’s disease (soon to be published in Clinical Obesity) and have concluded that these tests (overnight dexamethasone suppression test or urinary free cortisol) are not helpful and are no longer required. They may still be requested following clinic review if there is adequate clinical suspicion. Certain biochemical and nutritional testing prior to clinic continue to be helpful however, and if the following could be performed on referral or within 6 months of their appointment, we would be very grateful: FBC, HbA1c, LFT, Calcium and albumin, B12, Folate, Ferritin, Urea, electrolytes and creatinine, Vitamin D, TSH.These can also be found on tQuest/ordercomms under: Test groups>Bariatric Surgery>Pre-bariatric Surgery referral. Thank you very much for arranging these tests over the years and for your ongoing support

Your latest drug shortages: Azathioprine 25mg tablets were out of stock (OOS) until this week. With ranitidine gone, astonishingly Famotidine 20mg and Nizatidine 150 & 300mg are OOS. Accord is expected to be OOSof phenytoin 100mg capsules until early May 2020 due to a regulatory change at their factory but Flynn Pharma can support the market until then. As phenytoin is classed as a MHRA Category 1 anti-epileptic drug, switching to an alternative formulation requires monitoring and may also require specialist support, advice or referral. For older readers, Pfizer, the sole supplier of Prazosin (Hypovase) 500mcg tablets is out of stock until Valentine’s Day. Pfizer has limited supplies owing to manufacturing delays Valproic acid (Convulex) 150mg/300mg/500mg capsules will be OOS until April. Pfizer (again!) is OOS of Efexor 75mg XL capsules until 6 March 2020 and Efexor 150mg XL capsules will also be out of stock until 14 February. Alternative branded generics remain available. And finally, Sofradex ear/eye drops are OOS but alternative preparations for use in the ear/eye remain available.

New FP10 and prescriber endorsement: NHSE&I has published a new FP10 NHS prescription form with the new prescriber endorsement ‘FS’ for free supply of sexual health treatment. Existing stocks of the old form already in the system should be used up first. Both forms will be accepted for processing during the transition. The new prescriber endorsement will become live from 1 February 2020. Until the necessary changes have been made to prescribing systems, prescribers should revert to issuing paper prescriptions with 'FS' manually endorsed next to each item intended for the treatment of an STI. Where ‘FS’ has been added as a handwritten endorsement on a computer-generated form, this should be counter-signed in the usual way. Dispensing doctors will continue to use paper prescriptions with a handwritten endorsement. More information is available here.  

Top Tip...

MJOG: If anyone who is using MJOG, and they have gone to snomed they must let MJOG know as there is some reconfiguration that is required for the coding to work correctly.


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
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