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Somerset LMC Weekly Update Friday 13th March 2020

Date sent: Friday 13 March 2020

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

Covid-19 and foreign travel: The LMC is aware that some patients are approaching practices for letters supporting a decision not to travel abroad owing to the Covid-19 outbreak citing for travel insurance reasons. This is often because patients are worried about having an pre-existing condition and so being more at risk from the virus. Colleagues may feel sympathy in such cases but there is no point in issuing such letters. If the Foreign & Commonwealth Office (FCO) has issued a travel restriction on a country or territory then insurers are normally obliged to pay out under the terms of the policy. If the local government has issued a travel ban on foreign tourists including those from the UK then the same applies. If someone chooses not to travel solely because they are concerned about a potential risk the insurer will not compensate the traveller with or without a GP letter. It is of course possible that helplines are asking patients to speak to their GP just in case but this is still true. Practices may choose to direct travellers to this website for up-to-date FCO advice.

Covid-19: As announced yesterday the UK is now in “delay phase” of the Coronavirus epidemic.
Practices should have reviewed and shared business continuity plans with staff and received supplies of Personal Protection Equipment (PPE).
National recommendations now are persons with persistent mild respiratory symptoms including temperature above 37.8 are to self-isolate for 7 days. This will have an impact on workforce as well as work load and as part of planning practices will have looked at ensuring GPs where possible have remote access. AccuRx have added this week video consultation to their services offered to increase what is possible to do both remotely and in practice for housebound patients who have mobile phones.
We recommend for practices who have not already done so to consider combining available resources should staff illness impact on day to day functioning. Practices are reminded that although they should consider future working arrangements, they should follow national guidance and not stand down routine work or review of patients with long-term conditions until advised to do so.
The LMC will continue to work with all involved to ensure your concerns are addressed but is mindful this a marathon not a sprint and over the next few weeks and months as cases increase working together with our colleagues from neighbouring practices, pharmacies, district nursing teams and our hospitals is essential.
As a reminder CQC have an expectation that they are notified if an event occurs that prevents a practice opening or running safely. There is a form on the provider portal details here.

Network News…

PCN scenarios (England) Over the next few days the GPC will be releasing some real-life PCN scenarios, covering income, workforce, services and workload impact showing how PCNs are/can operate with the contract changes. The first of these can be found on the GP Contract page (PCN section) and the first scenario published here.

Now That’s a Good Idea! 
Although the Somerset PCN Clinical Directors meet regularly and discuss what is going on in all the PCNs in the county, until now there has been no accessible site where all the schemes and developments can be seen in one place by everyone.
The LMC has now set up a PCN area in the “Bright Ideas” section of the website (that already hosts suggestions and case studies from individual practices , Federations and Trusts), and we hope you will find the additional material interesting and useful.
Please contact the LMC office is there is anything you would like to post

General Practices' Alert State: Somerset LMC’s assessment of General Practices’ Alert State for the period 6th March - Friday 13th March.
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.
The survey for this week is now open until Monday 16th at 7pm.

Special LMCs conference March 11th: The LMC Special Conference, called after the draft PCN DES specifications were rejected by the GPC in January, went ahead in London on Wednesday. The GPC had since accepted a new set of specifications, and in view of the rapidly evolving situation with Covid-19, there had been considerable discussion on the BMA listserver as to whether the event should take place. In the event, the agenda committee had decided that the GPC needed to hear opinions from grass-root LMCs. Several LMCs, including our neighbours in Wessex, had decided not to attend. An account of the proceedings can be found here but the most contentious motion was the last of the day, when conference voted by 83 to 53 that ‘the profession should reject the PCN DES as currently written’. What this means in practice is not clear, but the PCN DES has been agreed by the GPC, who are the only body mandated to negotiate on our behalf, for 2020/21 and will be offered to practices to sign-up for this April. There has been no official word from the GPC yet following the vote, but we hope to learn more from our GPC representative, Mark Sanford-Wood at the GPC Roadshow at Woodlands Castle on Tuesday evening, 17th March. There are now limited spaces which can be booked here.

Pensions annual allowance: Tax charge please find the GP letter on the 2019/20 pension annual allowance tax solution, the FAQs on the NHS England website have already been updated. 
This is in addition to the announcement in the budget about the raising of the annual allowance threshold.

NHSmail now live for locum GPs: NHSmail for locum GPs went live this week – giving them access to local, regional and national information. You can register here. ​​​​​​​

MMR catch-up for 10-11 year olds (This is Contractual): From April 2019 NHS England and GPC England agreed that a catch-up campaign for would be part of the GP contract. The programme is for 10 and 11 year olds in light of the measles outbreaks. As part of that catch-up process practices were asked to notify the school nursing service to follow up/offer the vaccination at school if there had been no response from their attempts at the practice. The Somerset school-aged immunisation nursing team, also known as Somerset SAINT are the team to contact if you have any children who have not responded, they can be contacted at or 0300 323 0032. Anna Masserick Public Health Programme Manager for NHS England and NHS Improvement - South West has made contact with the team to collect the information.

Immunisations for CLA and HE: The school aged immunisation nursing team wanted to clarify that they are only commissioned currently to deliver HPV in year 8 and 9, DTP and MenACWY in year 9 and are now able to offer these to CLA children if they miss their school vaccinations (so 14-18 year olds). They are not currently able to vaccinate anyone below the age of 12 for any outstanding immunisations as a catch up, this is the GP based programme. They also don’t currently hold any MMR vaccine so are not able to offer this to anyone (although this is likely to change within the next 6 months or so).


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
Fax: (01823) 338 561
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