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Somerset LMC Weekly Update Friday 3rd July 2020

Date sent: Friday 3 July 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

Track & Trace Implications for Practices: Anyone who tests positive for CV19 will be contacted by NHST&T and asked to share information about their recent contacts within 2m (still) for more than 15 minutes. The contacts will be directed to isolate for 14 days. GPCE raised the implications for HCPs identified as contacts with knock on effects on business continuity. NHSEI said that if someone who has visited a practice (or works in one) tests positive the case will be sent to local Public Health who will make an assessment with the practice. Anyone wearing PPE at the time will not count as a contact.

Andrology (Semen Analysis): SPS tells us that it is reopening andrology clinics, starting with the backlog of cases caused by the CV19 closure. It is running extra clinics with more staff. However new patients should still be warned to expect delays in getting an appointment.

GP Payment Timetable and Resilience Guide: We have now updated the GP payment timetable with the current guidance, timelines and specifications and have added a resilience guide for practices which has been developed from the visits that the team have conducted over the past few years, we do hope you will find this a useful support and resource. Some specifications are still awaited so please do check back as we will update as these become available. If any practice would like support from the resilience team please do get in touch.

New to partnership payment scheme: Further detail has now been published on this scheme which was a commitment in the 20/21 contract to encourage new partners into General practice, The scheme gives eligible participants a sum of up to £20,000 plus a contribution towards on-costs of up to £4,000 (for a full time participant) available to support establishment as a partner, as well as up to £3,000 in a training fund to develop non-clinical partnership skills the full detail on the scheme here and to apply practices will need to e-mail:

Pension Update: The BMA has updated its guidance for GPs about the annual allowance, following extensive lobbying, resulting in two important changes that affect the 19/20 and subsequent tax years. As an emergency measure for 2019/20 NHSEI made a commitment to pay the annual allowance tax charges in full for eligible clinicians in the NHS pension scheme. Doctors who were subject to an annual allowance tax charge should use the option of the ‘scheme pays’ regulations to pay the tax due for 2019/20. From 2020/21 onwards the reduced Tapered Annual Allowance will only affect those with adjusted income of £240,000 and over. Read the full guidance here.
The BMA has also won a court appeal against the Government’s controversial changes to pensions rules introduced in April 2019, granting the Secretary of State for Health and Social Care the power to suspend pension payments to a doctors or NHS professionals charged with certain criminal offences, but not yet convicted. Read the BMA statement here.

Cortisol Blood Test Results - Previous Reference Range Could have Mislead: Please be aware that the guidance on reference ranges that is being added by Somerset Pathology Services has been changed, after discussion between SPS and the endocrinologists at TST.
Previously the lab reference range was
0700hr - 1000hr 185 -624 nmol/l
1600hr - 2000hr <276 nmol/l
but now the guidance states: “A 9am cortisol of < 150 is very suspicious for adrenal insufficiency. A value > 400 means there is very low probability of adrenal insufficiency. Values between 150 - 400 are indeterminate and, if there are clinical features to suggest adrenal insufficiency then a Synacthen test should be discussed with the endocrinologists.”
For a good summary see here.
Please note this is NOT a change in assay, but a clarification of how we should have been guided to interpret the results in the past. It may be worth re-considering this change in guidance, particularly if you have patients who are still symptomatic etc, for whom you thought adrenal insufficiency/ Addison’s had been ruled out in the past.The LMC is grateful to Dr Nick Gompertz for this item.

New Trust Email Address from the DPO: Following the merger of Somerset Partnership and Taunton & Somerset Trusts the new Somerset NHS Foundation Trust (SFT) moved to a new single email address for all staff on 1 July – NHSD has a national secure email standard which accredits non NHS Mail email for sending confidential data to from NHS Mail addresses ( Both Somerset Trusts (SFT& YDH) are working toward NHSD accreditation with CCG support. This has been delayed due to Covid-19, but will proceed again soon. However the new SFT system maintains the same security standards as the old addresses and both Trust email addresses have long been regarded as being secure to send to from addresses. On the basis of assurances from SFT and YDH, and with CCG SIRO (Senior Information Risk Owner) the CCG regards the new SFT and existing YDH addresses as secure to send to from accounts without the need for encryption.

General Practice Fellowships for Newly Qualified GPs and Nurses: Final updated guidance and funding from NHSE has been delayed by Covid but in Somerset we are offering to all newly qualified GPs and nurses who have qualified from July 1st 2019 onwards and in a substantive practice post:

Further details of this scheme will be released as soon as national guidance and funding are confirmed but in the meantime please send any queries to

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

Top Tips...

New QOF Indicators – Asthma:WEB are still working with NHS Digital on the SNOMED coding for the new QOF indicators, currently EMIS is working on version 44. However for those using the Ardens Templates , these are being updated with the new business rule set codes. Asthma register is now from age 6 NOT 8 years old.
Practices will be expected to use a minimum of two diagnostic tests to confirm an asthma diagnosis. These tests should be performed up to 3 months before any date of diagnosis and up to 6 months after this date. The business ruleset 45 which is available on NHS digital and is still subject to testing states the diagnostic tests are spirometry testing for asthma, FeNO test performed or Peak expiratory flow rate.
Asthma Review has been amended to incorporate aspects of care positively associated with better patient outcomes and self-management. They will be looking for the latest Asthma Control Questionnaires, number of exacerbations in the last 12 months and Asthma management plans in the last 12 months.
Practice will be required to record smoking exposure in children and young people under the age of 19 years old. Most recent record of exposure to second hand smoke up to 31 March it is expected you could use “Passive smoker”.
Practices could be working on these indicators now by making contact with the patients via telephone or video consultations, questionnaires can be sent prior to the consultation.

MMR – All Ages now need to be claimed through CQRS: Following the publication of the Interim report of the Vaccination and Immunisation Review in October 2019 NHSE/I has agreed changes to the payment of MMR vaccines from 1 April 2020. In summary in 2020 they require an automated payment service for the following patient groups receiving MMR vaccination: Children 0-5 years Children 6-15 years Adults 16 years and over. A management count is also required to monitor adherence with a targeted catch-up campaign in those aged 10/11 years.
Participation in an MMR catch-up programme for patients aged 10 and 11 years will form part of the core requirements of vaccination and immunisation services from 1 April 2020. Practices will be required to audit the records of this cohort and when a patient is identified as unvaccinated or partially vaccinated, they are required to contact the patient on three separate occasions to try to get the patient to be vaccinated


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
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