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Somerset LMC Weekly Update Friday 22nd January 2021

Date sent: Friday 22 January 2021

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

Support for 2021/22: On Thursday GPC agreed with NHSEI it would continue with increased funding planned for 2021/22 with minimal contractual changes from April with previous agreements delayed. The aim is to give practices stability through the pandemic and whilst involved in the CVP. Some of the planned changes will be implemented subject to agreement later but with adequate notice.
The full details will be available on the BMA website but in summary:

COVID-19: infection prevention and control (IPC) - GOV.UK ( made:
Addition of mental health appendix and title change for IPC guidance to ‘Guidance for maintaining services within health and care settings.’ Guidance amended to strengthen existing messaging and provide further clarity where needed, such as care pathways to recognise testing and exposure.

COVID-19: the green book, chapter 14a - GOV.UK ( Change made:
Updated to include changes to the advice on timing of vaccine in those being given immunosuppressive treatments and further detail on history of previous allergies.

Covid Vaccine for Locums: We have been contacted by GP locums unsure of how they will be vaccinated a procedure has now been set up to ensure all frontline staff receive vaccinations, and so please do e mail who should be able to assist you further.

From the CCG Wednesday Update: In the letter from James Rimmer, CCG Chief Executive, on 12 January 2021 there was an explicit acknowledgement of [ the hard work done by ] PCN CDs and managers...towards the pandemic response. We want to take this opportunity to recognise the hard work and commitment of all staff in general practice that are supporting both the pandemic response and “business as usual”. This includes practice managers who are often juggling more than one role to support the primary care response, along with the administration staff making numerous calls to book patients into appointments and offer reassurance that their time for a vaccine will come. What has been achieved is a result of the collective hard work from across the Somerset health and care system. Thank you.

COVID@Home: Colleagues are reminded that the “step up” arm of this scheme for patients testing CV19 positive but not yet requiring admission to monitor their O2 at home was one of the seven national priorities for primary care set during this stage of the pandemic. The devices are provided by NHSEI. We are planning to set out definitive LMC advice in due course but, for now, we have been asked to remind you again of the risk that silent hypoxia can represent in this illness, sometimes leading to delayed admission and worse outcomes for patients.

Workload prioritisation - RCGP/BMA guidance level 4 and 5: The GPC have updated their joint guidance with RCGP on workload prioritisation for primary care , which sets out what practices should consider doing are in a national lockdown, to help practices during the immense workload pressures are currently under. This is in addition to the set of further measures that we agreed with NHSE/I to help and support practices.

Ballot on PCN DES: In November the LMC England conference passed the following resolution for GPCE to ballot the profession regarding the mandate to continue to negotiate the PCN DES: Conference notes that the BMA GPC (GP committee) England has never secured a robust democratic mandate for the PCN DES and so again asks the GPC England to secure a firm mandate from the entire profession by means of ballot before negotiating any extension or changes to the PCN DES for the year 2021 / 2022.
As we reported recently the online ballot was held this month with the question: Prior to any further negotiations, extension or changes for 2021/22, do you give GPC England a mandate for the PCN directed enhanced service?
Voting has closed and the results have been validated and verified. Total votes: 4,534 Outcome: Yes: 80% (3,619) No: 20% (915). This provides a mandate for GPC England to continue to negotiate on the PCN DES, seeking improvements and further developing it as part of the whole GP contract for the benefit of practices and our patients

Recovery Convalescent Plasma Trial: Colleagues will have seen this month that the REMAP-CAP trial into treatment of ICU cases with plasma was stopped after no benefit was seen. The RECOVERY trial which includes patients at earlier stages of COVID-19 infection was suspended but is now continuing to recruit donors. NHS Blood & Transplant engagement manager for the SW, Emily Jones, would be grateful if practices would consider using the resources that are available to make this more widely known

Fit Notes (med 3) & Isolation Notes: Colleagues are reminded we are still required to issue Fit Notes (FNs) as normal but not for CV-19 (see below). NHS 111 does not any issue FNs so please don’t direct patients to it. During the pandemic DWP is encouraging employers to use discretion on medical evidence required to justify sickness absence. Some might even do it.
The advice to issue FNs remotely as much as possible continues. A properly (sadly regulations still demand “wet”) signed FN, scanned and emailed to the patient will be accepted by DWP for benefits. Unsigned FNS CAN be rejected by employers and DWP. The hard copy need not be kept with an electronic record. If the patient is unable to get emails they can collect or have it posted to them at practice discretion.
Isolation note service:
This is an automated service that can be used to get evidence (but not a FN) of the need to isolate if a patient or someone they live with or is in a support bubble with has symptoms of CV19 or has been told to self-isolate by Test & Trace. It can be used to cover continuing periods if symptoms persist or develop following the initial period.

CCG seeks Practices interested in new GP Community Pharmacist Consultation Service (CPCS): Somerset practices now can refer patients with minor conditions for a same day consultation with a community pharmacist via the CPCS. This will help patients receive the right care, in the right place, with the right person and at the right time following successful pilots around the country. At this very busy time NHSEI is confident that this pathway will help to relieve pressures. Somerset CCG will be providing full support to help with the implementation of the programme. To find out more see animation here and/or express your interest in taking part, please contact the CCG’s Ed Garvey

CRP Checks: The CCG have asked us to remind practices that as we are approaching the financial year-end it is vital that practices check that the Contractor Registered Population (CRP) are currently correct on CQRS, this will ensure that any discrepancies can be rectified before year-end as these figures will be used in the final QOF 2020/21 payment calculation and Aspiration payments for QOF 2021/22.
After checking your clinical systems for the list size as of 1 January 2021 and the current list size held for your practice on CQRS. If there is a difference of 30 patients or more please do contact the Somerset CCG via before 8 February 2021.

MDU Charging extra for CVP sessions: It is very disappointing that the MDU has chosen to charge extra premiums for professional cover, its argument being that more activity generates more risk of being referred to the GMC. (Indemnity for damages is covered by CNSGP.) GPC has pointed out that the risk of professional referral for a vaccination session is vanishingly small compared to a session in general practice. The MDU (which is strapped for cash after its business decision to reduce premiums ahead of the state-backed system expecting retrospective cover to pay for it - BCM) has replied that it disagrees. As it is a private business nothing can be done other than colleagues considering to seek cover elsewhere.

The GP Career Plus: scheme is a series of twelve facilitated and financially supported peer support meetings over 6 months - please download the flyer for more info. The intention is to run one set of GP Plus sessions starting early March 2021 and another later in the year. These sessions will take place on a Tuesday morning, but if there is enough interest either a Wednesday or Thursday may be possible as well.
If you are interested in taking part, please contact Thelma Gotsell on .
GP-Link Groups provide an opportunity to meet up informally on Zoom with colleagues outside work. Keeping in touch and being able to debrief and share is particularly important now. Why not join one of the new online evening groups being set up in by facilitators from GP Career Plus with the support of the LMC, SGPET and SPH - full detail here.
Summary of support for GPs in Somerset

And Finally...

We need our strength to persevere through this dark winter. We’re entering what may be the darkest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation, one nation. And I promise this, as the Bible says, “Weeping may endure for a night, joy cometh in the morning”. We will get through this together. Together.’
– President Joe Biden’s inaugural address.


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
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