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Somerset LMC Weekly Update Friday 17th July 2020

Date sent: Friday 17 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

Letters requesting exemption from wearing a face mask - you don't have to provide them: After the government finally decided to make wearing a face covering in a shop compulsory from 25th July it did not take long for a practice to get a request for a letter of exemption. The LMC consulted the GPC and received the following reply. "We specifically raised this with NHSE and there is full agreement that GPs should not be approached to write these. We would encourage practices to decline... It is actually rather difficult to envisage any circumstance in which the wearing of a face mask would be genuinely medically contra-indicated." Practices may wish to share this letter with patients that are requesting exemption notes from the GP and also post to your websites.

Flu Clinics - one thing we do know: The 2020 flu vaccination campaign is going to be the “biggest ever” according to Mr Hancock but much remains to be decided. Clearly distancing and PPE requirements - current guidance is to change apron and gloves and wash hands after every patient - will make this year’s clinics different. Without a considerable increase in the fee it might even make it non cost effective to do. We await details on possible new eligible groups, targets and supplies with interest. However one thing is clear: if you propose to do a clinic outside the practice you WILL be indemnified under the CNSGP as NHS work is covered irrespective of where it is done.

Flu Calculator: Wessex LMC have developed a flu calculator to help their practices plan for the upcoming flu season and they have very kindly shared this with us for our practices to use.

RCGP report - General Practice in a Post-COVID World: The Royal College of GPs has published its report General Practice in a Post-COVID World which outlines how GPs will be on the front line dealing with the physical and psychological consequences of the CV19 pandemic and the need for urgent government planning and funding to prepare general practice services for the extra work.

Tquest/Ordercomms Requests for Community Nurses to take samples - specify a date: District nurses cannot see the clinical problem you enter on Ordercomms when requesting a test for them to take the blood. The date the test is required is often left unfilled so if it needs to be done urgently or at some set time in the future (e.g. for a routine repeat check) you need to specify a date. Otherwise the standard is that the test will be done within 3 working days but staff availability can prolong this.

Contract Update from NHSEI Highlights of 9th July Letter: Continued suspension of appraisal and revalidation. GPC is working with NHSEI and GMC on more proportionate and supportive appraisal process.Watch this space.
QOF restarted on 1 July (focussing on flu, prescribing, screening and maintaining registers, as well as modified QI indicators to focus on returning services to patients with cancer or learning disabilities) with income protection for those indicators that have not been prioritised for return and an expectation on practices to discuss their prioritising of clinical care with the CCG. QOF guidance to support this approach will come soon but in summary the points relating to influenza and cervical smear targets will be doubled to 58. Those for quality improvement (74), prescribing indicators (44) and disease registers (81) will remain the same and the other indicators (310) will have income protection paid on historic achievement (tbc). BMA encourages practices to use professional judgement in their management of patients with LTCs, to do what they can within their capacity over the coming months and by doing so show the delivery of good quality care is not dependent on contractual requirements.
Practices should return to providing new patient reviews, routine medication reviews, over-75 health checks, clinical reviews of frailty, shingles vaccinations, and PPG arrangements.
The worklist process from CCAS will be maintained at 1 per 500 in order to ensure any local outbreaks or second wave can be managed without further changes.
Friends and Family tests and the requirement for consent for ERD remain suspended The Investment and Impact Fund will begin in October, but details of exactly what is to be delivered are still being discussed. You’ve had 27p per patient in advance.
DSQS will return from August for dispensing practices Encouragement for PCNs to continue with their recruitment (and provides further assurances around liabilities).
Commissioners are encouraged to reinstate LES/LIS in an appropriate and controlled way. 
Wessex LMC have kindly shared a spreadsheet listing all the changes.
Further guidance will be provided following further discussions with NHSEI.

Contract Presentations: Yvonne Vigar who many of you will know works with the LMC on resilience and education has developed a number of short presentations on the GP contract and practice finance these are all available to view on  Youtube at the links below and on the LMC website here.

  1. Contracting Routes 
  2. Key Elements of the Contract 
  3. New elements to the contract 
  4. Practice Finance 
  5. QOF - maximising income 

Information sharing during CV-19 - From the DPO - It's good to share: To better support patients in Somerset many areas have established Multi-Disciplinary Teams (MDTs). This has drawn in some newer partners such as social prescriber/voluntary sector organisations and care homes. This can result in questions about ‘whether we’re OK to share?’ Data protection legislation provides clear legal gateways supporting direct care for patients through both GDPR and the Data Protection Act. The Control of Patient Information (COPI) Notice issued on behalf of the Secretary of State in March 2020 provided an additional legal basis for sharing of patient data in response to the pandemic. These measures support MDTs working with an expanded neighbourhood model and enable them to operate and provide a forum for input to support the best possible multi-agency approach to patient care. In Somerset we can also recall the Somerset Overarching Information Sharing Protocol (ISP) which provides a high level framework of principles and assurance around data protection and information sharing. Sign up from system partners demonstrates commitment to those principles and that organisations declare a shared level of assurance on good information governance systems and practice.

Information Sharing agreements: CCG IT have asked us to remind you that the LMC supports and encourages EMIS phase 3 (access for Community Pharmacies) and Phase 4 (CCG clinical roles - Safeguarding, Continuing Healthcare and SEND). If your practice has not yet signed the Level 2 Information Sharing Agreements for these two instances via the email sent from Docusign (an e-signature tool used by the CCG),we would encourage you to do so any queries you may have please e-mail

Extra work coming out of Secondary Care: Colleagues will have noticed a surge in requests for practices to do even more work after secondary care consultations. This is a national problem caused by the lock down and the novelty for many specialists of working remotely. It is being addressed by GPC. However the LMC is in talks with the local acute trusts and Drs Andrea Trill & Katheryn Patrick being both GPs and medical directors are ideally placed to help hospital colleagues understand that primary care is not made of unbreakable elastic.

Student Nurses Need You!: ​Plymouth University is asking practices to consider taking a student nurse on placement. They know this is a difficult time and you may not be able to do it now but if you might in the future Plymouth are holding Q and A sessions. Placements are a vital part of the future workforce learning experience. By promoting excellent nursing practice, you can greatly contribute to the development of student nurse competence, so that they will be able to make an evolving contribution to the services your organisation provides. The University POPPI website has helpful information about the benefits of hosting students, the setting up process, support provided, payment received for hosting, testimonials and other resources. These are all available here.
The University will be hosting Q and A sessions via Microsoft Teams as follows: 28 July (1-2pm): Join Microsoft Teams Meeting 27 Aug (1-2pm): Join Microsoft Teams Meeting If you are intending to join the above sessions, can you please email so that they have an idea of numbers.


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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