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Somerset LMC Weekly Update Friday 26th June 2020

Date sent: Friday 26 June 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 19th June - Friday 26th June.  You can follow this link ​for a more detailed assessment and an explanation of the General Practice Alert State system.
The survey for this week is now open until Monday 29th at 7pm.

Liability Contribution Agreement June 2020 for PCNs: The LMC commissioned Porter Dodson to create a template agreement for PCNs use and can be found in the password protected area of the LMC website you will need to be logged in to access this (listed under Porter Dodson section) if any individual PCN would like to make any changes please do contact Porter Dodson direct.

COVID-19 Staff Antibody Testing: NHSE has given the CCGs a tight schedule to offer all NHS and social care staff, including primary care, a test. We know that many GPs and staff are keen to have a test despite the ambiguity of the results for what is essentially a piece of public health research. The LMC wishes to be pragmatic but has to bring the following potential problems to your attention. 1. registration: to get access to Ordercomms staff will need to be registered as a temporary resident or for immediate and necessary treatment. Neither of these are true and we normally discourage registration at place of work for good reasons. Nevertheless it is the only way to get a test. This leads to 2. confidentiality: a named GP will see the results of work colleagues. No doubt professionalism will triumph here. Finally 3. indemnity: which has just been solved after CSNGP initially refused to cover the work there was a development this week when GPC confirmed with DHSC & NHSR that this will be covered by the COVID fund via CNSC (Clinical Negligence Scheme for Coronavirus).

Implications for life insurance following antigen and antibody tests: The British Medical Association (BMA) has published guidance for doctors on life insurance and income protection during the pandemic.This follows a number of doctors raising concerns about the impact of Covid-19 on their application and how insurers are taking into account the results of antibody and antigen tests for the virus, and after reports about doctors having their applications for insurance policies deferred as a result of Covid-19. Read the guidance  here.

COVID-19 Test Results: Last week we mentioned that YDH is now able to notify practices of patients with positive antigen tests by email. This is not intended to replace existing processes like discharge summaries. The Trust is already distributing alerts to a number of practices and if you would like them too please contact Neil.Hayes-Webster@ydh.nhs.uk
(YDH can also provide a list of positive results to date)
Some colleagues also complained that they have been receiving CV19 antibody test results for both acute Trusts’ staff registered with them via Pathlinks often in an unmatched state. As we said last week practices need TAKE NO ACTION on these results. SPS believe these come as a result of the request forms being wrongly filled in. The requestor should be the medical director of the Trust.

Self-isolating before elective surgery: Patients having planned operations are now being asked to self-isolate with their families for 14 days before to reduce the risk of CV19 being taken into hospitals. This has led to the question of who should supply the self-isolating Fit Note for the employers of those affected who cannot work. The Somerset Foundation Trust has assured the LMC that the "calling letter" will suffice as the pre-op Fit Note and that an accompanying leaflet explaining this is being prepared. 

Face Coverings in Primary Care: GPC Richard Vautrey writes. “The PHE guidance recommends that those working in reception and communal areas who are unable to social distance should wear a fluid repellent mask. We believe patients should be encouraged to wear face coverings whenever they attend the practice (with practices continuing to triage arrangements to keep face-to-face contact to a minimum) and that staff should continue to be enabled to work remotely, whenever possible, to create more space for social distancing. We believe that CCGs and NHSE/I should also fund perspex screens... to protect staff and reception areas, reducing the potential for spread of infection.” National guidance from NHSE is still awaited. 

Face Coverings on Public Transport: Following the release of government guidance regarding the wearing of face masks in various public settings practices are reporting increases in requests from patients for letters of exemption. The government guidance on exemptions suggests there is no requirement for evidence, therefore it should be sufficient for an individual to self-declare. Practices are not required to provide letters of support for those who fall under the list of exemptions. The responsibility for issuing exemptions is with the transport provider, not GPs – see for example, this information from First Bus and Arriva. Similarly, practices are under no obligation to provide letters of support for anyone who does not fall under the list of exemptions but considers themselves to have another reason to be exempted.

Insurance Policies for Increased Cyber-security: The LMC understands that as the way practices work insurance companies are seeking to create new markets e.g. for video consultations. As this is NHS work irrespective of how conducted indemnity is provided through the CNSGP. If a data breach happened as the result of a concerted cyber-attack then again NHSD would be responsible for providing protection. However if a breach was due to alleged carelessness at the practice then a complaint would be a matter for the Information Commissioner's Office. The ICO would look to see that the practice had taken all reasonable measures to protect personal data. If fault was found a fine would be issued but this cannot be insured against. In the same way you cannot take out motor insurance against a speeding ticket. The LMC cannot give advice on commercial products but would advise extreme caution before accepting that a genuine area of risk exposure was being covered.

Revalidation Date Changes: The General Medical Council (GMC) has confirmed that doctors' revalidation submission dates have been put back by up to 12 months due to the coronavirus pandemic. It means doctors with a revalidation date between 17th March 2020 - 16th March 2021 can have their revalidation delayed for up to a year.

GP Recruitment event 15th July - We are going online: Our popular GP recruitment events of the past four years gave GPs and GP Trainees the chance to meet up and talk to a wide variety of Somerset practices all in one session. We have re-designed the format so this year you are able to do this online. Registration and participation is free. There will be two sessions available to book on the day which hopefully will fit within any work commitments, they will run from 14.30-17.00 and 18.30-21.00 you can book either or both, the full detail on the event and how to book can be found here.
Practices that would like to take part in this event the full detail of how the evening will run, booking details and what we are asking you to prepare can be found here.

PSA - Beware misleading reference range in younger patients: The normal range for PSA quoted in the biochemistry reports from Somerset laboratories is 0-4 ng/ml but this does not reflect the age related normal ranges for younger individuals stated on the Urology 2 week wait referral forms:
40-49 yrs 0-2.5 ng/ml 50-59 yrs 0-3.5
So there is a risk that clinicians may falsely be reassured by a “normal “ result between 2.5 and 4.0. Somerset Pathology Services reports that, once there is agreement amongst urologists regionally, the reporting reference range will be changed (including for older patients) but it seems sensible that we should be aware of this risk whilst we wait.

 

Kind Regards

 

Jill

Jill Hellens

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

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

www.somersetlmc.co.uk
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