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Somerset LMC Weekly Update Friday 8th May 2020

Date sent: Friday 8 May 2020

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

SGPET Covid weekly update with all online education can be found here

General Practices' Alert State:  Somerset LMC’s assessment of General Practices’ Alert State for the period 1st May - Friday 8th May.   
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 11th at 7pm.

Performers List update (England): We have been informed by PCSE that the Performers List public facing website went live on Monday 4 May. The new website will be more interactive than the current site, and an individual can do a search and download the search into an excel file. At the moment there is the capability to do a search by local office however, in two weeks there will also be the search field of CCG and an individual practice, therefore a practice or LMC could do a search and have a list of all the performers within their practice or CCGs that they cover. As this is the public site it will not provide any contact details or their GP type. We encourage any GP who has not already done so, to log onto PCSE online and check their details.

Primary Care Covid-19 guide version 3: This document from the CCG is available on the LMC website here at the top of the page, you will need to be logged into the site to access it, your log in will be the same for the LMC site as it is for the SGPET one. If you don’t have a log in this can be requested on both site on the home pages. The CCG have now hyperlinked the index so will be a lot easier to navigate.

Foundation Trust Radiology Department update: As a response to the regional COVID-19 status, the radiology department is broadening the scope of its service. A service for urgent patients has been maintained throughout the COVID-19 outbreak and this service will now be expanded to less urgent patients. To ensure safety for both patients and colleagues we have introduced additional steps to the patient pathway. Please see below for further details.

Ultrasound service

Plain film x-ray service

Care Homes and CV19: Richard Vautrey of the GPC said that NHSE had backed away from contractual change and agreed with the BMA that most practices are working hard to do the right thing, and that's outlined in the NHSE guidance, not contractual change. There is no longer suggestions of bringing forward the DES requirements and instead there is a focus on working together, including with LMCs, on doing what we reasonably can to support both our patients and our colleagues in care homes at this critical time.
PRESS STATEMENT: "It’s encouraging to see NHSEI appear to be listening to our concerns and changing their approach to one that is much more in line with what practices are already doing to support their patients in care homes, and the staff who work in them.
“CCGs and local authorities must now work to support this, by enabling care homes to use virtual consultations to a greater extent. This should facilitate multidisciplinary working, not just with practices, but also community nursing teams and secondary care specialists."
“It goes without saying that where practices have additional costs as a result of their Covid-19 response efforts, this will need funding. We also need those CCGs that don't have local schemes in place to resource additional support for care homes to rapidly commission those.”​

Somerset Path Services CV19 Testing: We thought you'd be interested to read that SPS now can do 350 CV19 tests daily with an average turnaround time of 20 hours with extra fast track capacity to provide an answer within 50 minutes. As far as primary care is concerned the extra work on CV19 means that other microbiological samples are at "level 4" (down from the normal service "5") meaning that you may find that routine MSUs are coming back more slowly than usual.

Priority Medicines for Palliative & End of life care during a pandemic: Colleagues will find this authoritative and SHORT document interesting not least for the extended indications for levomepromazine and (for those of a certain age) the reminder of glycopyrronium.

QOF achievement: We understand from the CCG that QOF achievement for 19/20 is close to national average levels. The CCG isn’t allowed to comment on QOF data until it is published nationally as it still has to be validated and adjusted but wanted practices to know how grateful they were for all your hard work in returning us to this level. It is a fantastic achievement as we had thought this would be a transitional year with achievement still well below national average. It is all the more impressive considering that the end of the year was taken over by coronavirus which will have curtailed final QOF catch-ups. Being seen as high achievers on QOF will have benefits for both practices and the system. Well done all!

Verification of death in times of emergency: It is fair to say that verification of death (VOD) has been a point of contention nationally but happily, as far as we know, not in primary care in Somerset so far. It has always been one of the duties of a doctor, and a privilege too if one has cared for the deceased, to pay one’s last respects in a ritual that can help to bring closure to families. The cause of dispute is that the BMA maintains that in English Law any competent adult can verify life extinct but other bodies, including those representing clinical groups, believe that training is required. There is also the need to bear in mind the dignity and respect due to the bereaved. This has come into sharper focus recently where there is a need to reduce physical contact to protect families and clinicians from harm: even if CV19 is not implicated in the death you might be bringing it into the house unwittingly. Therefore HMG published the following on Tuesday which we commend to you. 

Marie Curie Helpline 0800 3047 412 Monday – Saturday 09.00-17.00 is there to help anyone who has suffered a bereavement during the lock down, whatever the cause. The service also has qualified bereavement support workers available for more in-depth support if needed. Professional referrals can be taken with the patient permission.

BMA GP and practice toolkit: Updates to the toolkit this week include a new section on I&R and IGPR scheme doctors returning to work and contractual responsibilities of providing care during COVID-19 pandemic (in the service provision section)

CQC and RCGP guidelines: Practices may wish to refer to this BMA and RCGP guidance on work prioritisation in which we gather CQC are taking an interest to use as a benchmark for practices during this period, it is guidance and practices should only follow where clinically appropriate to do so.

Online Consultation - A Summary From GPC's Lead Dr Paul Cundy: From February, the strict technical definition of “on-line” is that it is something connected to or controlled by a computer. So exchanging e-mails with a patient is on-line consultation. This is confirmed by NHSE/X “Online and video consultations enable people to make contact with their GP practice without having to wait on the phone or take time out to attend surgery...” “You may be able to use online services to: book, check or cancel appointments with a GP or nurse/ order repeat prescriptions; see parts of your health record, including information about medicines, vaccinations and test results; see communications between your GP surgery and other services, such as hospitals”. Full summary and guidance on Contractual/imposition/practice choice can be found here

Recovery Post Covid: may we recommend another excellent paper written by Dr Steve Holmes and Dr Rob Stone of TST.

And Finally...

Professor Neil Ferguson: Epidemiologist and modeller of Imperial College has had to resign from the Scientific Advisory Group for Emergencies (SAGE) after being caught at it, breaking lockdown social distancing rules. He has also had to stand down from the lesser known Scientific Hypocrisy Advisory Group.


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
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