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Somerset LMC Weekly Update Friday 21st February 2020

Date sent: Friday 21 February 2020

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

General Practices' Alert State: Somerset LMC’s assessment of General Practices’ Alert State for the period 14th February - Friday 21st February.
You can follow this link for a more detailed assessment and an explanation of the General Practice Alert State system.
This information is for awareness and consideration when making decisions which may have an impact upon General Practice across Somerset.
This is the first week of sending the survey to Practices and we would expect and hope for a higher return rate in forthcoming weeks.
The survey for this week is now open until Tuesday 25th at 7pm. 

Covid-19: Updated guidelines for Primary Care from NHSE were issued on the 18th February. On the system conference call on Wednesday, we discussed what practices should do if, despite warning notices, possible cases present at the reception desk. The pragmatic approach is to first establish how they travelled to the practice. Those who've walked or arrived by public transport, or who have been on the premises for a while should be isolated in a room as in the guidance. If the patient has arrived by car they should return to it and phone 111 themselves from there. The area needs to be cleaned afterwards using a chlorine-releasing agent, but there is no need for the practice to close and a full 'deep clean' is not needed.

General Practitioners Committee Roadshow: Somerset LMC have secured Dr Mark Sanford Wood Deputy Chair of GPC England, to deliver a local Roadshow outlining the reformed GP contract. The event will take place at Woodlands Castle Taunton 7-9 light supper from 6.30 There will be opportunities to ask questions. The agenda will be circulated shortly. GPs, Practice Managers and Nurses are welcome to book online here. ​​​More information about the GP Contract Agreement is available here.

Arden’s templates: It was agreed by the Somerset GP board on Wednesday that Arden’s would be funded for a further year from Transformation monies held by SPH

24hr Urine Tests & Clinical Details: After a significant incident where a 24hr urine container was sent to the lab unlabelled, leading to a delayed diagnosis, we contacted Dr David James at Somerset Pathology Services. "We would advise ensuring that the order comms label is affixed to the container BEFORE it is given to the patient. Once labelled in this way there should be no problem….unless the clin info is “.” or “GP request”,  which unfortunately means that processing is stalled for tests sent to referral labs until we receive relevant clinical information. (Did you know that about 6% of ALL requests have nonsense clinical info such as “.” Or “\”?)"

Cervical screening results: We have been asked by the South West screening team to remind practices again that the Cervical Screening Laboratory at North Bristol Trust cannot give results to patients who call them asking if their sample has been processed. Please do not give the laboratory telephone number to patients if they call after getting a “non-receipt of screening results” letter. If a patient calls to enquire it is the responsibility of the GP practice to contact the laboratory if there is a concern about non-receipt of results. All sample-takers should be recording (and auditing their cervical samples taken for quality and recording the number of inadequate samples) so they can follow up on any results not been returned to the practice.

From the MHRA - Ingenol (Picato): The licence of ingenol mebutate gel has been suspended as a precautionary measure while the EMA continues to investigate increased incidence of benign and malignant skin tumours in several clinical studies. Stop prescribing ingenol gel and consider other treatment for actinic keratosis. Existing stock is being recalled from pharmacies and wholesalers. Advise patients who have been treated with ingenol mebutate gel to continue to be vigilant for new skin lesions within the treatment area and to seek medical advice should any occur. Report any suspected adverse drug reactions.

Hepatitis B Vaccination for Renal Patients: Last year NHSE Specialist Commissioning wrote to all Trusts saying that from July 2019 it was the responsibility of the provider Trust to vaccinate renal dialysis patents and not to refer to their GP. This enacted a decision in the 2018 NHSE GMS Contract commissioning intentions to make clear the responsibility to deliver Hep B vaccinations to renal patients rests with the renal service and not with general practice unless there are locally agreed arrangements.

Fit For My Future Engagement Events: lead Dr Alex Murray has emailed all PMs to encourage attendance at Primary Care Workshops to develop the future for community based services. We have a bed-based focus of services in disparity with the services available in communities to support people live well generally and with long term conditions, to maintain independence and, ultimately, to ‘die well’. For too long the community based services have been under resourced, struggling to meet rising demand. A new model of care is needed that shifts focus to prevention, early intervention and community support across routine and same day urgent care. FFMF wants to talk to GPs and the wider primary care team about the model to understand in each locality what new configuration would have the biggest impact on primary care capacity and resilience.
There will be four evening workshops, with [free] food from 6.30pm-7pm, closing at 9pm. Alex is keen to ensure that primary care has a real voice in designing the model for the future before implementing the new model in 2021.

YONM 2020 - Awards Show how much you value your Nurses/Nursing Teams: The Chief Nursing Officer awards have been developed to reward the significant and outstanding contribution made by nurses in England and their exceptional contribution to nursing.
These awards recognise the enormous range of skills, expertise and compassion that modern nursing represent. They celebrate nurses who go above and beyond their everyday roles to provide excellent care, leadership and inspiration to their colleagues and patients. Further detail here includes application template, previous examples of awards here.
Please complete the template and submit by Monday 13 May 2020.

And finally...

Pandemic Panic from Private Eye: “An average of 600 die [in the UK] from complications of flu. In a bad year more than 10,000 deaths occur. In 2013 there were more than 13,000… Most deaths occur in the elderly and other high risk groups…yet many high risk individuals and NHS workers don’t bother getting vaccinated and no one wears a face mask. In contrast, at the time of writing, there have been nine confirmed cases of Covid-19 in the UK and no deaths…Yes it’s exciting that a virus may have come via snakes, bats and pangolins to infect us. Yet it may be less deadly than boring old Influenza A in a bad year. So get a grip and wash your hands…” Dr Phil Hammond “MD”


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
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