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Somerset LMC Weekly Update Friday 24th September 2021

Date sent: Friday 24 September 2021

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

Protecting GPs from Abuse & Assault, Richard Vautrey Writes: GPs and their practice teams have come under sustained attack from the media, from Sajid Javid who is severely out of touch with the reality we face and, worst, from individuals culminating in a horrific attack in Manchester last Friday that has left many in the profession feeling besieged and demoralised. The BMA is taking immediate action to ensure the Government understands the seriousness of the abuse. BMA letter to the Secretary of State for Health.

Read my message to the profession, including resources for practices how to remove violent patients from your practice list, and how to protect yourself from online abuse: Protecting GPs from abuse and assault (

LMC Response to Attack on GP Staff in Manchester: After the attack on colleagues at Florence House Medical Centre last week, Somerset LMC stands in unity with the Association of Greater Manchester LMCs. We condemn all bullying, harassment, violence and abhor the attack that left a GP with a skull fracture and several staff members seriously injured. We join with them in wishing those injured a full and speedy recovery and in thanking the Police. The assault has been linked by some with the recent press campaigns to “bring back” face-to-face consultations and ignorant demands in the House of Commons (not made by Somerset MPs) that GPs should “get back to work.” In fact, at the present we have no idea what motivated this attack. We also recognise the real difficulties patients are having accessing NHS services. But no one is helped by propagating one side of the story, further stoking demand and expectations. We deplore the lack of support our hardworking teams have had so far from ministers, MPs and the national NHSEI.


End of the Shielding Programme and Closure of the Shielded Patient List (SPL): The government has announced the end of the shielding programme so patients will no longer be advised to shield. The Shielded Patient List will also be closed and NHS Digital will retain the capability to identify high-risk patients in the future. Patients will be written to about this change and what support is still available. Practices do not need to inform patients themselves but any future changes to the COVID-19 risk status for patients will no longer be captured on the national list.

Consultant-to-Consultant Referrals: We continue to receive regular questions when a consultant asks a GP to make an onward referral to another speciality for the same problem or symptoms that the patient was referred to them. The following form of words has been agreed between the CCG, the acute trusts and the LMC to be used in such cases.

Dear Team/named clinician
You recently wrote to us asking for the GP practice to refer your patient on to another secondary care service (insert department).

Historically this was how the NHS hospital contract worked but this changed some years ago. The new way of working together in Somerset is for the clinician who decides an onward referral is necessary to make it directly. This speeds up the process for the patient and has no financial consequences for the Trust.

Accordingly we are returning this request to you so that you can make your referral. Do please copy us in so we can confirm it has happened.
Yours etc.

Non Site Specific Rapid Diagnostic Service (NSS-RDS): The pilot for referrals to this service (previously reported) will be rolled out to all practices from Monday 27th September. The aim is to diagnose cancers in over 18s with atypical presentations that don’t fit any 2ww pathway but whom you suspect may of have something seriously wrong. To help rule out other diagnoses filter tests” (listed on the eRS form and in an Ordercomms RDS test group) are to be done and reviewed first. Consultations will be remote where possible to reduce travelling: the aim is for all tests to be done in one hospital visit. After assessment the patient will be referred on to the right specialist, cancer or otherwise, WITHOUT referring back to the GP. If nothing serious is found we send back a summary and management advice. We hope this will be useful and improve cancer care in Somerset. For questions 01823 343105.

C the Signs rollout for Somerset on 29 September 2021 has been approved by Somerset, has been adapted to local cancer referral pathways and will contain all 2WW referral forms for all Trusts/Hospital Providers that Somerset refer to. Thank you all for returning the signed Data Processing Agreement. The deployment will be as follows:

  1. Remote installation to all practice terminals across all sites will be completed by SCW downloading and installing the tool remotely
  2. The local configuration will take a maximum of 10 minutes per practice (further information to follow)
  3. C the Signs will provide practice managers with a username and password to access it from their terminal at 9am on 29th September
  4. The tool will be ‘live’ from 29th September

The C the Signs team will be happy to arrange additional training sessions throughout September and October. Please contact to request a bespoke demo at your local Practice or PCN meeting. You can also still register the live webinars here. Alternatively, you can access an EMIS video demo here at a time that suits you. This training is vital to ensure practices get the most out of the tool.
C the Signs provides full technical support to practices. Please escalate any technical queries or requests for support to: or via the support line 0207 157 9656 (9am-5pm Monday to Friday).
For any project related queries please contact

BMA Annual Representative Meeting ARM was held last week. Council chair Chaand Nagpaul’s highlighted the pressures GPs are under, that GPs and that primary care teams have worked in vaccination centres while practices continued to provide essential services to their patients. He pointed out that it is soul destroying for GPs to be publicly vilified for not being able to operate normally and that it was a failure of leadership by the NHS not to defend GPs. He said “what we needed was for ministers and NHS leaders to visibly congratulate and thank GPs and primary care teams for their heroic efforts in saving tens of thousands of lives.”

Patients with Post-COVID-19 syndrome often present with diffuse hair loss. This is usually non-scarring. Full advice around investigation and management of alopecia can be found at the primary care dermatology society website . Baseline bloods include FBC, TFT & ferritin. Guidelines say iron supplementation should be considered when ferritin < 40. Most cases in COVID, where no other cause is found, are probably linked to chronic telegenic effluvium (CTE). This is associated with severe trauma or illness, will usually recover over time but it may continue for several years. People often require emotional support. A patient information leaflet is available for CTE at .
John Dolman, HEE GP Fellow at Somerset Training Hub.

LMC and Training Hub Paramedic Fellow: Paramedics working in Primary Care in Somerset have a new ambassador employed by the Somerset LMC and Somerset Training Hub to support and represent them at local and regional level.  Paramedic Catherine Hayden has worked in general practice and urgent care since 2016 when she left frontline emergency work behind to pursue new opportunities in the newly emerging primary care practitioner roles in West Somerset.  Having worked in general practice in Minehead and currently Taunton, as well as for Devon Doctors Group as part of the out of hours team, she now takes on the role of Primary Care Paramedic Ambassador for one day a week in addition to her clinical work. Catherine can be contacted via email on , she works mainly on a Tuesday for the LMC/Training Hub but can be available at other times when required. Please read Catherine's Biog here.

Somerset Training Hub Knowledge and Library Services:  The Training Hub, SFT and YDH head librarians won national funding to have a primary care dedicated Knowledge and Library Specialist for a year as one of 14 pilots across the country.  This is a wonderful resource for Primary Care.  Any searches can be done.  This service is lead by Paula Younger and she would be delighted to hear from you all. .

Paula has kindly done a search for us on teenager resources.  Some links for teenagers (and their parents/caregivers/family):

Depression, anxiety, self-harm, eating disorders, addiction - Stem 4 - supporting teenage mental health    CAMHS Resources Websites 
Quizzes, factsheets, features - Health for Teens   Association for Young People's Health 
Mind - supporting your teen's wellbeing during coronavirus (aimed at caregivers)
Teen Tips resources for schools and parents
Paula has also highlighted ten book titles all recommended by NHS staff as uplifting ‘ feel good titles ’.

Medical Student Teaching Opportunities in Taunton and Yeovil Academy: We are looking for enthusiastic GPs for 5th Year Cluster Based Teaching in both the Taunton and Yeovil Academy. These are small group teaching sessions, lasting 2.5hrs on Wednesdays, in blocks of 9 sessions. The day is fixed but the timing of the session may be flexible. The first block starts in November. Teaching experience is desirable but not essential. If you would like to apply or have any questions, please contact year5-cbt-quick-ref-guide-2021-22.pdf ( Hannah Jenkins (Academy GP Lead for Taunton) and Laurence Huntley (Academy GP Lead for Yeovil).

The New Somerset Emotional Wellbeing Programme Webinar 7th October on Zoom: An essential introduction for all managers, team-leaders, employers and supervisors that will explain more about the key parts of this important initiative including,

Booking details here.

Cleaning Standards Training for Practice Managers: The National standards of healthcare cleanliness 2021 apply to all healthcare environments and replace the National specifications for cleanliness in the NHS 2007 (and amendments). This training is aimed at practice managers to give them a simple overview of the standards, and a timeline of implementation.  Delivered by Julia Bloomfield, Infection Prevention and Control Nurse Specialist on Friday 15th October 2-4pm via Zoom.  Book your place 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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