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Somerset LMC Weekly Update Thursday 23rd December 2021

Date sent: Thursday 23 December 2021

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

Merry Christmas & a Happy New Year: Goodness yet another year is almost over, even if most of it has felt like Groundhog Day (only without the happy ending so far). The LMC wishes all of you a Merry Christmas and a Happy New Year. We hope you all make time to rest and recharge with family and friends, and manage to keep well. The LMC office will be closing from 4.30 PM on Thursday 23rd December and will reopen at 8.30 on Tuesday 4th January. If you do have an urgent matter there are mobile contacts on the LMC office answerphone but these are listed below as well.
Dr Barry Moyse, Medical Director 07771 627149
Jill Hellens, Executive Director 07887 566510
Mandy Mason, Deputy Executive Director 07710 156495

Level 4 Major Incident: The Somerset hospital system is preparing for the worst after modelling on the Omicron variant and the early experience in London. A “short, sharp” peak of infections is expected in Somerset just before or early in the new year. Plans are taking into account primary care’s pressures, dedication to the booster programme and a likely temporary reduction in all NHS workforce owing to sickness and isolation. There is focus on getting across the right public message and trying to get patients home who do not now need hospital care nor any package of care. On Tuesday there were 140 of these, occupying a very substantial proportion of the hospital beds in the county. People are well aware that general practice will do its best but that most practices have no more to give. Charities will be more involved in giving people reassurance to stay at home and Trust staff who have volunteered for the booster programme will likely be redeployed to help too as more have come forward than needed for the jabs. The community team monitoring home oximetry will be expanded. Regular meetings through the holidays are being attended by your LMC and the CCG. We will keep you informed.

Local COVID-19 Medicine Delivery Units (CMDUs): Novel treatment for Covid-19 infection in clinically vulnerable individuals.  From Monday 20 December there has been a new national roll-out of Covid Medicines Delivery Units (CMDUs) across England. In Somerset this is being run through SFT with close collaboration with YDH to provide an all Somerset service. NHS digital have developed a web portal that identifies eligible individuals (10 discrete diagnostic cohorts criteria) within 24 hours of a positive Covid PCR swab result. These individuals are contacted by text and email and will be contacted by the CMDU within 48 hours (ideally 24) of the result. This should happen without the need for GP referral but if there are patients who practices feel need priority or referral this can be done by referring to Somerset Primary Link in the standard way. The Oximetry at Home service run alongside SPL will manage any primary care referrals and refer on to the CMDU. The two available treatments are (first line) sotrovimab, a 30-minute intravenous infusion requiring attendance at either MPH or YDH, or (second line) molnupiravir, a 5-day course of oral antivirals. The clinical assessment and triage of potentially eligible patients will be undertaken by the CMDU team.  For other potentially vulnerable patients there is a research trial using molnupiravir run through Oxford University (online recruitment via ). This is a new service and is being improved and adapted over the next couple of weeks so we are grateful for your patience with any initial glitches.

Paperwork Reduction: SELF-CERTIFICATION NOW FOR 28 DAYS GPC Chair Farah Jameel writes, “After work across government departments a number of temporary changes have been made in to support general practice teams through some of the paper work that we have to complete. These changes are unprecedented and are being taken in recognition of the extraordinary challenge general practice is facing to deliver the accelerated Covid-19 booster campaign.

· Fit notes increased to 28 day self-certification
· DVLA checks suspended for all but essential workers – HGV and bus drivers
· Firearms licence applicants asked to wait until after January unless urgent – ie needed for work with imminent expiry
· Prescription charge medical exemptions renewal suspended with those due to expire extended for 6 months
· COVID vaccine exemption processing timeframe dropped.

I know that together we will pull through this and continue to do our very best to look after our communities, patients and each other. The GPC and the BMA will continue to support you through the coming months."

BMA RCGP Guidance on Work Priority During Booster Campaign was finally published on Tuesday. Anyone expecting a definitive guide was disappointed: GPs need to decide for themselves what workload to “pause to make time for Covid booster jabs.” It also stressed that whatever steps taken to manage workload, the public must be reassured that general practice remains open and will be seen face to face when it is clinically appropriate. ‘Ultimately it is for practices to determine how they best meet the needs of their patients’. Practices should be reminded that there can be no indemnity guarantee. Link

GP Staff Can Now Use SFT Covid Testing Facilities: SFT is happy to offer Covid-19 Testing Service to Primary Care colleagues. Call the booking team on 01278 437147 or email 95% of results are generated and sent out by 8am the following morning. Swabbing is continuing throughout the Christmas period, but with a much reduced Christmas Day service which is therefore best avoided. Locations and times:
Priorswood Industrial Estate – 7 days a week Monday – Sunday 09:00 – 17:00
Bridgwater Community Hospital– 5 days a week Sunday – Wednesday 09:00 – 17:00
Minehead Community Hospital – 5 days a week Sunday – Wednesday  09:30 – 13:30

Referrals Through GP CPCS: NHSEI wants to remind you that all minor illness referrals to community pharmacies should be made through the Community Pharmacy Consultation Service rather than informally please. This is a very busy time for both community pharmacy and general practice and they recognise that everyone is trying to do their very best for patients. However, informal referrals into community pharmacy may result in some patients not accessing the care they need and prevents pharmacy teams from identifying patients that need to directly speak to the pharmacist.

Inhaled Budesonide in Covid: Revised guidance from NICE means the previous interim position statement citing inhaled budesonide as a treatment option for individuals with COVID infection has been withdrawn. Inhaled budesonide should only be considered as a treatment for COVID-19 in a clinical trial. People already prescribed budesonide should continue treatment if they test positive for COVID.

C The Signs Patient Consent to Data Upload: The LMC has heard concerns about patient consent to upload data to the C the Signs platform. CCG DPO Mr Kevin Caldwell has reassured us that a DPIA was completed in which consent was not judged the appropriate legal basis for the processing of patient data for this direct care purpose. Under GDPR Article 6(1)(e) – public task & Article 9(2)(h) – management of health and social care apply. Under Common Law, reasonable expectations/implied consent were considered appropriate. This was supported by the amended template privacy notice circulated to practices earlier this year which includes reference to the use of third party digital tools and software by practices to support specialist areas of care. Practices remain the data controllers for C the Signs as data processor in a similar way that practices use EMIS (a third party) to create a record when a patient registers. You wouldn’t seek formal consent from a patient to create the record as it would be within the reasonable expectations of a new patient and implied as part of the registration process. “As long as practices are letting patients know via their privacy notice that they use digital tools to support direct care with assurance that appropriate due diligence has been completed and documented, then my view is it is legitimate to rely on reasonable expectations/implied consent as a basis to process.”

NHS Safeguarding Learning Together Week – 17th -21st January 2022 12pm-1pm: NHSE is hosting a five-day programme with eight micro learning sessions with an overarching theme of distress, compassionate leadership and trauma informed approaches. Registration is open to all professionals with safeguarding responsibilities, so please use the links in this document to register your attendance. These sessions can be recorded as evidence of additional learning for those staff mapped to level 3 safeguarding adults / children training (use your reflective learning document to evidence your learning). Any questions please contact the CCG safeguarding team on

Information for Somerset Practices Referring Patients to NBT on a Breast 2WW Pathway: The NBT (North Bristol Trust) breast team are under extreme pressure currently and waiting times to be seen have increased. Please can you inform patients that they will be offered an appointment within four weeks and should expect to hear from NBT with an appointment within two weeks. Can you please ask that they do not contact the 2WW office unless they have not been given an appointment by 2 weeks after referral.

And Finally…

Nurses and Doctors Remain Most Trusted: The Ipsos Mori Veracity Index has been asked every year since 1983. In 2020 nurses topped the poll with 93% and 91% said they trusted doctors to tell the truth. The figures for journalists and politicians were (a surprising?) 25% and 15% respectively.

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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We have updated our privacy policies on both the Somerset LMC and Somerset GP Education trust websites.

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