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Somerset LMC Weekly Update Friday 22nd May 2020

Date sent: Friday 22 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 15th May - Friday 22nd 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 25th at 7pm.

The Somerset Primary Care Board: Held its first meeting yesterday. The Primary Care Board took over from the Somerset GP Board (a regeneration if you like) which had laid the ground work for its development. The aim is to represent primary care providers in Somerset, and all general practitioners in the county, in discussions about system wide service development with the Somerset Health and Care system (SHCS) generally, and the sustainability and transformation partnership and Integrated care system (STP/ICS) in particular.
It comprises what we feel is a powerful group of Primary Care colleagues including the LMC, Somerset Training Hub, SPH, Clinical Directors, Trust Primary Care Medical Directors and CCG Primary Care leads to ensure we have a strong voice in system development. Dr Berge Balian was elected as Chairman, Dr Barry Moyse as Secretary and myself as Vice Chairman. We will keep you regularly updated through the LMC updates.

PPE For Patients GPC Chair R Vautrey writes: “ We secured the change to the PHE guidance to enable practices to ask all patients to do this as we are still at a stage where everyone could be suspected as having COVID-19. If they arrive without a mask or face covering they could be offered one as they arrive. We give them gloves to wear as well.”

Electronic Repeat Dispensing & Prescription Duration: Please recall that if patients are stable on drug regimens ERD can be helpful BUT changing the prescription duration at the same time (eg from 28 to 56 days) can put undue pressure on the supply chain.  Please don't do it.

Urgent Admissions or Assessments: Taunton & Somerset hospital has asked us to remind you that for the safer management of patients most referrals from primary care should go straight to a speciality and not the ED. Specialists will accept a referral arising from a remote consultation. To make sure your patient is seen in the correct place please ​use SPL which is open 7 days a week from 0800 to 2100 and outside of these hours call the Musgrove Park Hospital switchboard on 01823 344464 to contact the relevant specialist.

Lockdown Restrictions 'Eased' by HMG: The immediate impact on practices may be concerns from some patients about the risks of going back to work or for children returning to school where social distancing proves difficult. Practices are already reporting patients requesting Fit Notes or letters for their employers. Patients making these requests should be directed back to their employers. Employers should be making reasonable adjustments and performing risk assessments for their staff with occupational health support when necessary. A Fit Note should not be needed.

Shielded patient List for Community Pharmacies: Our pharmacy colleagues are concerned that not all shielding patients have adequate arrangements in place for delivery of their medications, in order to help, practices may wish to carry out the request and search that was distributed in the CCG bulletin dated 19.05 . We have been advised that the entire process should only take 15-20mins and would not wish for practices to spend longer than this given current constraints.

Mandatory training during the coronavirus pandemic: The CQC has updated its myth-buster about mandatory training considerations in general practice to include information about the coronavirus emergency. Read more here. ​​​​​​

Risk assessment guidance: The Office of National Statistics published data on Covid-19 related deaths by ethnic group last week, which showed that those with Black, Asian and minority ethnic (BAME) background are more likely to die from the virus. The BMA is deeply worried and has been lobbying government to take urgent steps to address this as this data highlights the need to protect BAME communities from COVID-19 and that they are effectively risk assessed. Read the BMA statement here ​​​​​​. Various national organisations have developed resources that are included below for your information. SAAD score

Shingles Vaccinations: Sent on behalf of NHS England and NHS Improvement – South West Public Health team - We do expect the delivery of this vaccination to continue wherever possible and encourage general practices to look for all reasonable opportunities to deliver shingles vaccinations along with all other immunisations delivered by practices. Should you have any queries please do not hesitate to contact us at ​​​​​​, we thank you for your continued support with these important Public Health vaccination programmes

NHS Digital national GP data extraction to support COVID-19 planning & research: NHSD issued a Data Processing Notice outlining a tactical GPES extraction for planning and research related to CV-19. This was requested by BMA & RCGP to relieve the burden on GPs at this time to provide data for research. Under this interim arrangement NHSD will become the data controller for a predetermined data set extracted from GP records with all requests to practices redirected to them. BMA and RCGP will have sight of the process for requesting data and with NHSD will review would be applicants. NHSD has requested all practices to register by 27 May.

CQC Phone Calls Starting GP's: around the country were surprised to learn last Thursday (14 May) via a blog from Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services at the Care Quality Commission’s (CQC), that the regulator would be soon be ringing surgeries to discuss the challenges they are facing and how they can be supported. The LMC has good relationships with our local CQC team but also recognises that so many of the ground breaking innovations being made to improve patient care and keep patients and teams safe from CV19 have been made in the welcome absence of regulatory distractions like CQC, appraisal and revalidation. Practices now planning to “reset” to “live with” CV19 and at the same time deal with backlog of general cases caused by lock down will welcome CQC’s assertion that the calls should be supportive. The LMC would like to hear if that is not your practice’s perception.

Medicine Administration Records (MAR): Andrea Trill at Somerset NHS Trust writes, "I am delighted that GPs completing standard MAR chart should be a thing of the past by July. This is never was contractual so thank you for your understanding in doing them up to now. Community nursing teams are working hard to complete the training to transcribe onto MAR charts (including insulin) and we are hopeful that most will have done so by 1st July. They will be using EMIS Viewer to make checks. Between now and July you should see a reduction in requests for MAR charts. You will understand CN teams are stretched with more patients remaining at home and the practical difficulties of visiting patients needing shielding or social distancing. So if occasionally you are still asked to complete a chart, or supervise a district nurse, that would be helpful but please do let me know (via the LMC) if this persists after 1st July.
For the time being (and after discussion with the LMC) we have elected not to extend this to the palliative care MARs because it is harder to transcribe variable doses and we felt it might risk delay in patient care if a new prescription was required. We expect to look at this in phase 2. Thank you for your support in helping the community nursing teams and for being so patient for so long."

Mental Health and Wellbeing Pastoral Support Matrix: As I am sure you have been aware it has been Mental Health Awareness Week this last week and the mental wellbeing of you and your staff is more important than ever at this time. The LMC is a member of the Somerset Pastoral Care for Frontline Staff Cell (a cross-provider group set up to provide pastoral care all frontline staff during the Covid 19 pandemic). They have developed a comprehensive Matrix listing the current forms of self directed/self help support services available to staff across all organisations. This is a reference resource for the whole system and in addition to the  LMC pastoral support and the Somerset Safehouse. ​​​​​​
The Matrix is intended as a resource for managers, clinicians and staff at all levels. We would ask that practices make the link available to all staff including locums, those working from home, on sick leave, maternity leave or shielding.
The master version hosted on Google Drive at the following link, will be reviewed regularly and can be used online on Google Docs but it is preferable to be downloaded by users and opened with Microsoft Excel
We welcome any feedback on the Matrix by email to 

Listening and Chaplancy Line for Somerset Avon and South Gloucestershire: One of our Somerset GPs has helped set this line up to provide listening not counselling via a one-stop phone number. The intents and aims if of the service can be found here, contact numbers here.

Nursing Associates in Primary Care - Developing the Nursing Workforce: Have you considered developing your nursing workforce and employing a Qualified Nursing Associate? In June 2020 there will be 28 Nursing Associates (NAs) qualifying in Somerset and a further 20 qualifying in October. Indeed, across the South West there are expected to be 351 qualified NAs in total joining the workforce. While most will be looking to work in their NHS Trusts, some are training in Primary Care settings, including General Practice. While many will not have primary care experience they will be NMC Registered, have attained a Level 5 foundation degree and have a wealth of knowledge and experience in caring for people of all ages across many settings.
If your HCA is leaving or your Practice Nurse is retiring you may see an opportunity to introduce and develop this role either within your practice or across the PCN. We have been contacted by a couple of NAs due to qualify in June, who are actively looking for jobs in a General Practice in Somerset. Therefore to assist practices we have added a new category of Nursing Associate to the jobs section of the LMC website and if you would like further information on the role and benefits of employing a Nursing Associate please contact the Somerset Training Hub email:
And if you are interested in developing a nursing career pathway by taking on an Apprentice or supporting the career progression of your existing HCAs to NA and then to Registered Nurse, an apprenticeship route is an excellent way to do this. For more details email: ​​​​​​​or ​​​​​​​

LMC Office Phone lines: due to the increase in calls recently and the fact that the team are still remote working we thought we would offer other numbers for you to contact us all:

And Finally...

GP In Somerset: We want to know what you have been up to, both at work and at home during lockdown. This is for the GP in Somerset campaign, which has been designed to show other clinicians from across the UK, what it's really like to live and work in this beautiful county.
So... please send us your photos, videos, accounts and anything else you think your fellow primary care colleagues might like to see.
We'd also like to ask you a couple of questions:

Please send everything to ​​​​​​​and we will collate everything to use across Facebook, Twitter and Instagram.
Looking forward to hearing from you,
Jess and Ollie.


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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