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Somerset LMC Weekly Update Friday 12th March 2021

Date sent: Friday 12 March 2021

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

Using EMIS Enterprise Search & Reports (S&R) to report on COVID@HOME Pulse Oximetry: It is now mandatory to collect and to report the “on-boarding and off-boarding” of patients aged 65+ with a positive test result on Pulse Oximetry@home link. The CCG is working with NHSEI to ensure collect the minimum data collection to cause the minimal additional burden upon practices. To this end the CCG has activated S&R to allow extraction of the information direct from EMIS with the CCG Digital Team acting as Data Processor. The Control of Patient Information Regulations 2002 (COPI) notice 20 March 2020 overrides the Common Law duty of confidentiality for sharing patient data for CV-19 related care. The CCG will be sending that out together with a Data Protection Impact Assessment (DPIA) with details of data flows, the legal basis and risk assessment. Using COPI it is important Data Controllers maintain a record of data shared, so it is recommended that this activity is recorded by practices.
Formal Information Sharing Agreement and Data Processing Agreement will be developed and circulated in due course as the CCG will be inviting practices to use S&R more widely for national data collections (e.g. SMI) and local data analysis for practices and PCNs.  Using S&R for CV-19 now means an opportunity to gain experience but if you agree to enable it no other data reporting will take place until the ISA/DPA is in place. For the CCG to access the CV-19 O2 data via S&R each practice needs to activate the DSA within EMIS. Please tell when you have switched this on. (If you choose not to use S&R other data collection methods can be used but will have to be run by the practice. CCG Digital can advise on this too.)

Long COVID Service: In December we reported on the Post COVID service which is run by a team of GPs* supported by an MDT (GPs, mental health, OT, fatigue service, BOC, social prescribing). Since then 68 patients have been referred. A new form which includes referral criteria is on E-templates and both will be in the CCG GP Bulletin this week. All referrals go to Appointments for patients are virtual and can last up to an hour. After assessment the patient can be supported with a range of options from a rehab programme to fatigue or OT referral. There is talk of a singing group being set up later this year [IPC permitting]! Most of these services are run from a post ICU perspective but the focus in Somerset has been in primary care. Waiting times will reduce from April as the third GP comes on board but referrals are bound to increase. Questions to
*Dr Steve Holmes, Dr Rebecca Hall, and Dr Jon Dolman.

Ardens & Team Net: The LMC was pleased to learn that the PCN CDs voted in favour of purchasing Ardens (starter) and TeamNet for all practices out of the retained portion of Winter Covid funding for countywide projects after the project had been endorsed by the Primary Care Board.  The CCG has also agreed that these purchases will support the NHS seven national priorities so Somerset Primary Health will now organise the purchase of these products.

Flu Claims 20/21: NHSBSA  has also published information for practices administering flu vaccines, about claiming for reimbursement, completing end of season 2020/21 flu vaccine declaration, and guidance around NHSBSA’s post payment verification process.

Amended QOF SFE 2020/21 (England): The Department of Health and Social Care has now published the amended QOF SFE for 2020/21. The QOF guidance will be published next week.

The New Roles in Primary Care National Toolkit: This has been developed to enable Primary and Community Care Training Hubs to work collaboratively with Primary Care Networks (PCNs) towards the development of the Primary Care workforce, as outlined in the GP Contract. This site contains a lot of useful information for PCNs and Training hubs alike and can be found here.

Clinical Case from Devon Doctors: This was referred from 111 to ED but contains useful learning for all making remote assessments. The patient, in his 80s, called 111 because he had chest pain having fallen over his dog the previous day. He was assessed with (the famously risk averse) NHS Pathways, then by a experienced clinician and was given advice and safety netted. Two days later a relative called because he was in more pain, was breathless and had developed swelling on the affected side extending up to his neck and face. In the ED he was found to have multiple rib fractures, a large pneumothorax and gross surgical emphysema. After a chest drain he made a full recovery. The case was reviewed at a joint 111 / OOH / ED meeting. All agreed that 111 management was correct at both contacts and probably the patient or family should have called again sooner. However the ED team recalled that the elderly may play down their symptoms or genuinely present as less unwell than they really are. Most older patients with chest trauma have minor injuries but falls where objects such as furniture are struck can cause severe injuries including flail segment and even this may initially present with relatively minor symptoms. Significant deterioration is typically observed over 24-48 hours. So if you find yourself remotely assessing an elderly patient who has sustained a chest injury recently with worsening pain or added symptoms then consider early assessment in ED.

New CHIS Manager: InHealth Intelligence are pleased to announce that Tracy Cook has been seconded to the post of GP Engagement Manager for South West CHIS. Some of you may have met Erik Renz, who previously held the post before moving on earlier this year. Tracy's main aims will be to encourage the take-up of HI Hub across the region and enabling practices to get the best out of it, to work with practices to improve data quality and to involve them in future developments within CHIS. 
If you have any queries relating to CHIS processes, please contact Tracy at or telephone 01278 589225 ext 8352 / 07912 93191.

Aminophylline Discontinued: Napp is discontinuing Phyllocontin Continus 225mg and Phyllocontin Forte Continus 350mg MR tablets. Supplies of 225mg are expected to be gone by 30 March and of 350mg expected to be exhausted by 5 April. Prescribers will need to review affected patients and optimise inhaled therapies (probably best ask your nurse?). Patients who still require a methylxanthine will need to be switched to theophylline tablets (Uniphyllin Continus). And so another faithful friend of our older readers shuffles off...

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

New funding initiative to enable more GPs to train trainee Doctors: Funding is available from the CCG to reimburse 50% of backfill costs for 20 GPs who sign up with the Somerset GP training scheme and complete the Educational supervisors course.
As part of the endeavour to increase the workforce in primary care and in particular increasing the number of GPs, the intake of trainee GPs is expanding.  Consequently more trained GP supervisors are needed and more trainee places in primary care to accommodate these extra trainee GPs to help keep them in Somerset.
The courses are delivered online (though may return to face to face later in the year) the time commitment is 6 half days over a period of about 6 weeks. The funding is open to those GPs joining the next two cohorts, the first cohort starts towards the end of April (specific dates to be confirmed) with second one taking place in July.
Please email expressions of interest in becoming a GP trainer to: Stephen Holmes or Bridges Penny (Yeovil District Hospital NHS Foundation Trust)

Expressions of Interest  for the GP Assistant (GPA) Programme - Phase Two: There is another opportunity for practices in Somerset to be a part of the GP Assistant Programme (GPA) Phase 2 roll out. This is a 9 month (approx.) programme designed to upskill HCAs and Reception/Administration staff to work in a specific support role to help relieve pressure on GPs. Somerset practices were part of Phase One in 2019.
Devon Training Hub are leading the roll out across the South West Region, supported by Somerset Training Hub. Please find below 3 documents that explain what the programme entails, an FAQ sheet and an application form for potential candidates to express an interest.
GP Assistant Programme 
GP Assistant FAQs
GP Assistant Application Form
Please can you bring this to the attention of your GPs and any staff that may be interested in the role and encourage them to apply if appropriate. All enquiries to
Closing date for initial applications is 31st March 2021.
If you need to contact the Somerset Training Hub please email


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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