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Somerset LMC Weekly Update Thursday 1st April 2021

Date sent: Thursday 1 April 2021

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

We wish all our readers a very happy Easter and hope you all manage to get some well-earned rest over the bank holiday weekend.

COVID-19 vaccines and pregnancy: There has been some confusion around the eligibility of pregnant women for the COVID-19 vaccine. While it is not currently available to all pregnant women, those who are at high risk of exposure to the virus, including health and care workers, or with high risk medical conditions are eligible. This includes women diagnosed with gestational diabetes in pregnancy or those with a BMI of more than 40 at their antenatal booking appointment.
The benefits and risks of COVID-19 vaccination in pregnancy should be discussed on an individual basis. The discussion should include acknowledgement that, while there is no known risk associated with giving other non-live vaccines to pregnant women, there are no specific data as yet about the safety of COVID-19 vaccination in pregnancy. More information including FAQs and a decision aid are available from the RCOG website.
In addition, the National Clinical Director for Maternity and Women’s Health, and the Chief Midwifery Officer, have published a letter setting out actions for maternity services to identify and invite pregnant women for vaccination, and enabling them to make an informed choice about receiving it.

GMS/PMS regulations - pandemic amendments: NHSEI has confirmed that the temporary changes to the GP contract under the pandemic regulations which were due to lapse at the end of March have now been extended until 30 June 2021.
As with previously, this means:

Network Contract Directed Enhanced Service (DES) and improving general practice appointment data (GPAD): NHSE/I has published  a suite of documents to support the updated Network Contract DES from April 2021. These documents implement the changes set out in the  21 January 2021 letter and include a cover note outlining the key changes, the updated Network Contract DES Specification and Guidance, and a number of supporting guidance documents, including a set of FAQs.
They have also published guidance for practices on standard national general practice appointment categories to support the mapping of local appointment slots to these new categories. This follows joint NHSE/I and GPC guidance published in August 2020, which introduced an agreed definition of a general practice appointment.
Practices are required to record all appointments in their clinical systems in line with this definition. Practices should refer to new system specific guidance, published by NHS Digital, which provides tips on how to improve data quality recording.
The final piece of guidance is for Primary care networks implementing the Investment and Impact Fund  for their practices as per the requirements set out in the Network Contract DES.

Only one penny on the LMC Levy: With the contract uplift of 2% planned for 2021/22 the LMC has decided to limit the change in the levy that funds its work to the same level. This means that your LMC will now cost you a very reasonable (and rounded down) 58p per patient.

Learning Disability Health Checks: Learning Disability Health Checks: We have received a number of  questions asking about coding and CQRS extractions.  The CQRS automated extraction will search on the SNOMED codes, Learning Disabilities Heath Assessment – 413126003 or Learning Disabilities Annual Health Assessment  - 199751000000100. Please remember you are required to add manually the number of  eligible patients this is NOT your QOF register which contains patients of all ages; the ES is for patients aged 14+.  It is worth checking your register and how many checks done since April 2020 not least as each is worth £140. 
It is a requirement is to use the National Health Check Template, the Ardens LD template supports the National DES and QI modules. The Coding “Health Check done” page includes the correct codes to record a LD check has been completed or declined. EMIS also have the national template under EMIS Library-> Primary Care Templates->National Template for LD annual health check.  Please check you have the correct codes in the template you are using. The national target for LD health checks is 67%. Please send questions to Luke Best at

Talk about Advanced Care Planning (ACP) Project: To ensure there is an ACP on what is important to your patient REGARDLESS OF DIAGNOSIS Marie Curie is accepting referrals for anyone who might benefit from talking with a trained and supported volunteer worker. The CCG is funding a three year project to promote personalised care led by lay people. Only specific clinical tasks will be sent back to practices or neighbourhood MDTs like for new or reviewed STEPs.
After referral by telephone or simple digital form by any member of the MDT Marie Curie will contact the patient to explain the service and get consent to meet. When the ACP is made a copy will be sent to EMIS together with the SNOMED code Has Advanced Care Plan. It will then be visible to community and secondary care via SIDeR. However when the project launched on 1st April the SIDeR ACP digital form was not ready owing to assurance processes.  The LMC has been asked that for the first few weeks Marie Curie instead emails an ACP to the practice’s generic account to be uploaded into EMIS making it visible via EMISV to SIDeR. For this interim adding SNOMED code 714748000 (Has ACP) would be appreciated.  Once SIDeR is ready later in April any ACPs created like this to will be uploaded into SIDeR, copied to EMIS and the previous uploads can be archived. Year 1 of the ‘Talk about’ project will be focussing on PCNs that face Taunton namely:Bridgwater; CLICK; N Sedgemoor; Taunton Central; Taunton W; Tone Valley & W Somerset. 
For more information or to make a referral contact Marie Curie on 0800 3047 412 or

Look Alike, Sound Alike (LASA) Errors: Nothing to do with Tibet, this is where medications with similar names are confused with one another and the incorrect drug is accidentally supplied (writes Devon Docs’ Mark Eggleton). Memorably a prescription for Lustral (sertraline) was once dispensed as Levitra (vardenafil). When the patient noticed the error and returned to the pharmacy he was told (allegedly) the two drugs did pretty much the same thing. 
The current ‘top five’ of medications confused with one another are (in some cases surprisingly):

Do beware of LASA errors when taking medication histories from patients and use SCR to confirm.

Webinar - Template Update for 2021/22 with Miles Carter – Ardens for EMIS WEB: 20th April 13.00-14.00 and 29th April 19.00-20.00. Please book via the LMC events page.
This training has been designed for GPs, Practice Nurses and Practice Managers and will be delivered by Dr Miles Carter a GP Partner in Oxfordshire and Chief Executive, Ardens EMIS.  The content will include:

Optimising Document Workflow: Many practices have implemented Document flow successfully resulting in often a 70% reduction of paperwork reaching their GPs thereby saving a large amount of GP time.
We have organised four half day online training sessions with EPI for those practices who either did not attend the training in 2017-2019 or who wish to attend as a refresher to enable them to implement a safe and effective system of correspondence management. We must stress that for this to be a success in practice it is critical for a GP to attend with their practice manager (or appropriately senior managerial person) and a suitable administrator or key document handler. Dates available 22nd April (9.00-12.00), 6th May (13.00-16.00) and 27th May (9.00-12.00 & 13.00-16.00).  Please book online here.  

Community Sub-Dean for Taunton / Somerset 4 hours per week: There is a planned expansion of student numbers at the Peninsula Medical School. From September 2021, students will be placed in Taunton; both in Musgrove Park Hospital and practices in the surrounding area for their community placements.  This will initially start with year 3 students, expanding to 3, 4 and 5 over subsequent years.
They  are seeking to appoint an experienced GP champion  who is passionate about medical education and keen to help train tomorrow’s doctors, has a sound knowledge of General Practice in the Taunton area and has established positive relationships with these practices. Please find a full  description here, If you would like to discuss this exciting role further, please do not hesitate to contact Charlotte Perry, Undergraduate Lead for Peninsula Medical School at  Application via a letter with an accompanying
Please note applications for this role will close on Monday 19th April at midday, with a view to hold interviews during the following 2 weeks.


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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