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Somerset LMC Weekly Update Friday 19th February 2021

Date sent: Friday 19 February 2021

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

COVID-19 Population Risk Assessment: DHSC have issued a letter this relating to a new COVID-19 Population Risk Assessment tool that will be used to identify those at highest risk from COVID-19 and if they are not already on the Shielding List they will be automatically added, and therefore eligible for vaccination.  Patients will be notified directly and practices do not need to do this. Those individuals aged 19-69 added to the SPL should be recognised as having an equivalent risk to those previously identified as CEV. In practical terms, this means that those under 65 should be prioritised ahead of others in cohort 6 once the new high risk flags are visible on practice systems.

Green book: An update to the green book chapter on COVID -19 has just been published, so please use this version if referring to it.  Full web version here.

Deployment of port security software: Somerset CCG are taking steps to improve security of removable media devices (USB sticks, memory cards and other intelligent devices), to mitigate the risk of cyber-attack, data loss or the transfer of viruses / trojans.
A pilot has been running this week with three practices and on Friday 26 February the SCW will deploy port control software to your PC or laptop.  In this first phase of the roll-out, (which will last approx. 6 weeks), the software will be set to ‘listening’ mode.  This software will not be able to see any data on your device, it only registers the type of removable device.  You should not notice anything different at this stage. Further detail on the LMC website

CHIS: Now receive all their demographic updates via NEMS (National Events Management System)  Every new registration, deduction and demographic change practices make on their systems is sent to CHIS immediately.
CHIS have reported that some  incorrect changes including incorrect registrations and address updates have been received . AS they  share these with Health Visitors Health they are trying  to make contact with parents of children who aren’t living in our area.
Clearly it’s in everyone’s interests to make sure the most up-to-date data is entered as the wrong information could mean babies not being called at the right time or HVs having to make unnecessary calls to families. For more information on NEMS email

Government White Paper on NHS reform and Integrated Care Systems (ICS): HMG has now published its White Paper  ‘Integration and Innovation: working together to improve health and social care for all' on plans to reform the NHS, including proposals to make ICSs statutory and make major changes to way services are procured, by doing away with the need for competitive tendering for instance. The BMA has released a  statement on the white paper stressing the need for clinicians to be at the heart of any changes and will be producing a summary shortly. In January BMA submitted a response to NHSE’s legislative proposals, on which the Government’s plans have been based, highlighting the importance of ensuring proper clinical, GP, and LMC representation. The proposals set out that GPs [in fact “representatives of general practice” a phrase which will have been carefully chosen and therefore will need careful watching – BCM] will be one of the few statutorily required categories of ICS leadership. There will also be flexibility in how “place level” (AKA CCG) working is organised which the LMC will have a key role in shaping.

Assessments carried out for detention under the Mental Health Act to take place in person: Following a ruling in case bought by Devon Partnership NHS Trust against the Secretary of State, NHSEI has issued directions to all mental health providers not to carry out any assessments for the purposes of determining whether or not an individual should be detained under the Act remotely  by any medium. This applies to all members of a medical team involved in the decision and should be considered as the overriding guidance until further notice.

YDH Stroke Clinics: For reasons beyond anyone’s control YDH stroke services have been severely short of workforce for the last three weeks. Dr Rashed regrets this means that it may not be possible for all patients to be dealt with in a timely manner as per the guidelines. Some may have to wait for longer than one week. It is important that those referring are aware of this and not to tell patients to expect to be seen within one day or even within one week. Secondary care is affected too. Those attending ED/AEC medical take will have appropriate assessments and investigations and be started on the treatment as per protocol and will not be deferred to the TIA clinic. Patients with ongoing neurological deficit should be admitted to hospital and not sent home with TIA clinic referrals. We will report again when the crisis is over.

Amendments to European Health Insurance Cards (EHICs) and S1 forms (UK) Regulations: Travel abroad may still seem an unlikely prospect now the PM’s innate enthusiasm has been curbed but in anticipation of the happy day there have been some minor amendments to the GMS and PMS regulations relating to EHICs and S1 forms to allow for reciprocal healthcare arrangements with EU member states. The amendments are in GMS regulation 74F and PMS regulation 67F  that govern information relating to overseas visitors– where, if patients choose to provide EHIC, S1 or PRC details on registration, then GPs must send them to NHSD or NHSBSA.  The new wording allows for the possibility that, on registration, patients may in future submit other (unnamed) documents which are equivalent to EHICs or S1s, which could be required as part of a “listed healthcare arrangement” between the UK and an EU/EEA country. At present the UK government has not agreed any listed healthcare arrangements so there is no possibility of patients submitting them just yet. 

Award winners from South West Celebration Practice Nursing Event: Many congratulations to all our award winners. #teamsomerset

GPC UK Regional Election Result: The Somerset and N&E Devon region was uncontested and Dr Mark Sanford-Wood, deputy chair of GPCE, was returned unopposed. The LMC has sent its congratulations to Mark and looks forward to continuing to work with him. 

Find out how to join new representative body for PMs: The Institute of General Practice Management (IGPM) – the new and only representative organisation for Practice Managers – will be holding a webcast soon to run through how you can become a member and progress since its recent formation. Somerset LMC is keen to support this excellent initiative.

Contract agreement 2021/22 webinar (England): Following the recent contract agreement for 2021/22, GPC will be holding two contract virtual roadshows/webinars on the following dates:

Coaching and mediation/ Action learning sets: Somerset LMC are pleased to have engaged Yvonne Vigar from Astara coaching to offer these sessions which are fully funded and open to all Practice managers, deputies, operational managers and leads. For reasons of confidentiality we ask that members of the practice make contact with Yvonne direct to express an interest , full details can be found on the corresponding posters.
Coaching and Mentoring
Action Learning sets

Somerset New To Practice General Practice Fellowship Programme for Newly Qualified GPs: Are you or do you know a GP that has qualified since Nov 2018? If so, this funded fellowship programme may be of interest. It is a 2 year programme designed to provide personalised support to newly qualified GPs to help gain confidence and to develop enjoyable, fulfilling and sustainable careers in general practice. Our first cohort will start in March 2021. See programme here. Any questions, please contact Dr Catherine Ievers

New to Practice The GPN fellowship programme: Are you or do you know a newly qualified nurse or new to nursing in primary care? This is a 2 year fellowship linked to the above GP programme to support nurses and also provide a comprehensive education programme to address skills and knowledge required specifically when working in this field. Any questions please contact Alison Williams,

Somerset Emergency Department / 999 validation – getting better with age: The Integrated Urgent Care Meddoc director Dr Mark Eggleton writes, “Our Somerset validation figures, which were already pretty outstanding, are in fact even better than we previously thought. When we were recording ‘downgraded’ cases we were not counting those sent for F2F assessment within our own service. This means our 999 downgrade rate is 95% [previously 80-85%] and our ED downgrade rate is touching 80% [previously 60-65%]. And further we close about 40% of cases at the initial telephone stage. The remainder is referred to MIUs, some to in- or  out-of-hours primary care and or sent directly to hospital specialties. With the caveat that we haven’t seen Cornwall’s latest data, the Somerset validation service is ‘the best in the West’ as defined by SWASfT’s footprint. As ever, huge thanks and congratulations to our validators and to the clinicians who also step up to help when cases hit the Somerset queue en masse.”
Colleagues interested in getting involved in this interesting, satisfying and valuable work should contact

John Seddon: is an Occupational Psychologist, broadcaster and author specialising in change in service industries. He formed Vanguard, a consultancy company, in 1985 which operates in eleven countries. He is a visiting professor at Buckingham University. The LMC is intrigued because he has attacked current management thinking including the belief in economies of scale (he prefers “economies of flow”), and much of public sector reform including the use of targets, inspection and centralised control of local services. He is critical of target-based management. His latest book, Beyond Command and Control, was published on 30 September 2019. John’s final book tour is on 9th March via zoom.

GP Update Form: Please would practices complete the GP Update Form Template and return it by email to  to advise Somerset LMC of GP changes in your practice.

And Finally...

On Monday NHS England CEO Sir Simon Stevens channeling Sir Winston Churchill told the press conference that his message to the politicians was ‘give us the tools, the vaccines and we’ll finish the job’. 


Kind Regards



Jill Hellens

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

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