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Somerset LMC Weekly Update Friday 21st May 2021

Date sent: Friday 21 May 2021

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

GPC England of No Confidence in NHSEI Leadership: Yesterday, following the poorly-received letter from Nikki Kanani & Ed Waller sent to practices last week about the need to return to face-to-face consultations, the BMA GP Committee supported (unanimously or overwhelmingly) motions which led to the release of this uncompromising press statement which can be found here.

COPI Notice reminder of extension to 30 September 2021: A reminder that the COPI Notice issued on behalf of the Secretary of State in March 2020 has been extended to 30 September 2021. The Notice was issued under the Health Service (Control of Patient Information) Regulations 2002 to support healthcare organisations including GP practices to share information to support efforts against coronavirus (COVID-19).
Full details of the notices are published at the following link: Coronavirus (COVID-19): notification to organisations to share information - GOV.UK (

Foreign Travel, Vaccination & The NHS App: As reported in two previous updates patients can obtain all the information needed via the NHS App and should not be asking practices for any documentation, we would suggest that the following is posted to practices websites, extract below

Covid Vaccine status: In preparation for the requests that may arrive in general practice, please see below all relevant links that you may wish to use to inform messages on your websites and signpost patients to, with some suggested draft text if at all helpful.
“Thank you for contacting the surgery enquiring about COVID vaccination certification.
We are unable to issue this certificate at the practice.
Please see
Proof of your vaccination status will be available on the NHSapp, (*** you may choose to delete this -which is also valuable for accessing your health records and ordering repeat prescriptions***)
The NHSapp can be downloaded from
here for iPhone or here for android.
Alternatively you can call the NHS helpline on 119 (from 17 May) and ask for a letter to be posted to you. This must be at least 5 days after you’ve completed your course of the vaccine, the letter may to take up to 5 days to reach you.“

CHIS: have become aware of a change in coding to the 6in1 Hexavalent vaccine, which has affected the data exported from practices using HI Hub for immunisation data returns.
We are working with practices to identify the cause and believe it is possibly due to the changeover to the new QOF payment system and the direct upload of data to CQRS via the GP extraction system.
Whilst we hope to rectify the issue as soon as possible, we may need to request immunisation data via clinical system report or CSV file, to ensure that our records are complete and accurate, and that all children are called for outstanding immunisations correctly. A further update will be provided as soon as possible

Spirometry Survey: Spirometry was suspended at the beginning of the pandemic as although it is not in itself an aerosol generation procedure the coughing it usually provokes is. This led to spirometry being reappraised and BMA advice remains to refer to hospital. Clearly secondary care has limited capacity too. Therefore the LMC was pleased to hear that the CCG Respiratory Lead Dr Steve Holmes is looking into moving the test to the proposed new PCN-based investigation/diagnostic hubs in the medium- to long term. These could also offer Forced Expiratory Nitrous Oxide testing for diagnosing asthma. The LMC supports this approach and GPN advisor Paula Messenger will be involved in the work. For these reasons we are happy to promote this brief survey which will be a vital part of a what could be a very useful development. This survey will close at 5pm on 11th of June. 

OASIS Contact Details: Bridget Carne writes: an education meeting with OASIS revealed colleagues often don't get information about their patients from the physios. Mostly this doesn’t matter but when there are problems or a patient comes back to the GP asking for referrals or medication the practitioner doesn’t have any idea what the physios have diagnosed, treated or planned. After this the physios who were presenting made enquiries and provided the following contacts. If emailing or ringing please give patient details and the Physiotherapist involved (if known) they will forward to the right person for a response.
Physiotherapy MSK and Podiatry Bridgwater Booking Office:
Bridgwater Booking Office: 01278 436733 (For Bridgwater, Burnham on Sea, Dulverton, Williton & Minehead areas)
Physiotherapy MSK and Podiatry Chard Booking office:
Chard Booking Office: 01460 247555 (For Bartec, Chard, Crewkerne, Dene Barton, Frome, Shepton Mallet, South Petherton, Wellington, West Mendip, Wincanton areas)
Physiotherapy YDH:
MSK Physiotherapy appointments at Yeovil District Hospital 01935 384510

The Somerset Emotional Wellbeing (SEW) Colleague Resilience Hub: It connects all health and care colleagues with wellbeing support when they need it. The SEW Hub includes the seven day support line, website and podcast, peer support and training opportunities.
The official launch date is 7thJune. To request printed promotional material to cascade within your organisation please complete the form here and email by Wed 26th May.
There are also digital resources like email signature blocks, video call backgrounds and desktop wallpapers that you can use to promote the SEW Hub. Thank you for helping to spread the word about the Resilience Hub; it is important that all colleagues know how to get help when they need it during difficult times.

Importance of full Documentation of Consultation: Another case report from the OOH service reminds us of the need to take and record a full set of observations especially in patients at high risk. A patient in his 70s with diabetes and on methotrexate developed urinary symptoms after a cough and cold which reminded him of a previous UTI. He was a bit “hot and bothered” and unsteady but in the treatment centre (TC) his temperature was 36.2C, pulse 88, pO2 99%, BP 140/78 and he had “some ketones” and no nitrites in his urine. He was given an antibiotic, a sample pot for future reference and verbal safety netting advice. Unfortunately the next day he collapsed, was admitted but died soon after. The cause of death was DKA secondary to sepsis of unknown origin. There will be an inquest and HMC has asked the TC clinician to attend. Internal learning points so far include the absence of a respiratory rate record (although this was probably normal), the consequent absence of a NEWS2 score, the rest of the urinalysis result, the absence of a blood sugar or ketones level and the fact that written follow up guidance was not provided. The patient was almost certainly not septic when seen but given his vulnerability to sepsis it would have been best practice. A sad case where what was almost certainly a mutually satisfactory consultation at the time was judged forensically after an unexpectedly adverse outcome.

The new Somerset Emotional Wellbeing programme: This has been set up to protect the Wellbeing of the whole health and care workforce including everyone in general practice. This has never been more important than now. The next LMC/TH Thursday lunchtime webinar on June 3rd is an essential introduction to the programme for every general practice manager, employer, team leader and supervisor please. Book here.


Kind Regards



Jill Hellens

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

Tel: (01823) 331 428            
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