Somerset LMC Weekly Update Friday 4th February 2022
Date sent: Friday 4 February 2022
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- Covid Vaccination Programme
- Vaccination as a Condition of Deployment (VCOD)
- Mandatory Vaccine Update Guidance Our legal advisor sounds a note of caution
- Take Care During Physical Examination
- GP Appointment Figures
- Prostate Specific Antigen (PSA) From Somerset Pathology Services
- From Somerset Pathology Services #2 Haemochromatosis (HFE) Genetics
- ORCHA - Organisation for the Review of Care and Health Applications
- VAT Update for PCNs
- Somerset New to Practice General Practice Fellowship Programme for Newly Qualified GPs (20th February Closing Date for April Cohort)
- TNA Apprenticeship Programme Apr 2022 - Closing date for Applications 14th Feb 2022
- Free Remote Legal Surgery Sessions for Somerset Practices with Veale Wasbrough Vizards 10th February – book your 1-2-1 session here
- Job Vacancies
Covid Vaccination Programme: NHSEI has agreed to extend the period during which the £10 supplement is attracted for vaccinations given to immunosuppressed people – this was due to end on 31st January but is now extended to 31 March. The ES specification has been updated on the NHSEI website.
Vaccination as a Condition of Deployment (VCOD): On Monday evening Mr Javid said to the House of Commons, “Given these dramatic changes [Omicron being > 90% less virulent etc.] , it is not only right but responsible to revisit the balance of risks and opportunities that guided our original decision last year. While vaccination remains our very best line of defence against Covid-19, I believe that it is no longer proportionate to require vaccination as a condition of deployment through statute.” The same day the NHS Chief Executive and others wrote to (just about everybody including) GP providers, “We are aware that, based on the guidance already issued to the service, you will have begun to prepare for formal meetings with staff on their deployment if they remain unvaccinated. This change in Government policy means we request that employers do not serve notice of termination to employees affected by the VCOD regulations.”
Take Care During Physical Examination: Next week is “Sexual Violence Awareness Week” and the Survivors Trust have put together some posters for patients and professionals. The “three actions for healthcare professionals” is a sensible reminder of good medical practice. We cannot always know about a patient’s past and not following chaperone policy can obviously increase the risk of distress for patients and complaints sometimes even involving the police. Remember that just about anything can feel “intimate” to some. Standing very close to someone in a darkened room while looking at their retinae is intimate for example. To reduce risk to both patients and staff the CCG safeguarding team recommends practices review their chaperone policy with the “three actions” in mind. The safeguarding team and LMC are planning to produce a model chaperone policy using the trauma informed approach in the near future.
CHECK Ask the individual if they are comfortable before & during each step of the appointment.
EXPLAIN Help the patient feel at ease by explaining each step of the examination before you do it and encourage them to ask questions.
REASSURE Remind the individual that they can stop the procedure at any time - they are in control.
GP Appointment Figures: For December were a staggering 20% (4.9 million) higher than two years ago, pre COVID. As well as vaccination rollout, we continued to care for patients with COVID and deliver the day-to-day care our communities need. In fact, 2021 saw GP practices in England book more appointments than ever before, with an unprecedented 367m appointments.
Prostate Specific Antigen (PSA) From Somerset Pathology Services: Following recent updates to NICE NG12 Suspected cancer: recognition and referral, we have updated our PSA cut-offs based on this guidance. The following cut-offs are now in use:
| Age (year) | PSA cut-off (ug/L) |
|---|---|
| <40 | 2.5 |
| 40-49 | 2.5 |
| 50-59 | 3.5 |
| 60-69 | 4.5 |
| 70-79 | 6.5 |
| >79 | 6.5 |
These cut-offs have been checked against local population data and are a better fit than our previous reference range (from the manufacturer) of <4.0 ug/L for all age groups. Please remember that PSA is neither sensitive nor specific and increases with normal ageing, therefore it is difficult to identify ideal cut-offs. The test must be used in conjunction with digital rectal examination and clinical judgement. Please contact Duty.Biochemist@SomersetFT.nhs.uk if you wish to discuss.
From Somerset Pathology Services #2 Haemochromatosis (HFE) Genetics: Changes have been made to the requesting HFE genetics on tQuest. Samples will only be sent for testing if they meet the following national testing criteria:
- Tranferrin saturation is high and/or
- The patient has a sibling or parent who are p.C282Y homozygote
Therefore it is vital that this information is provided in the clinical details of each request. If there are no recent Ferritin or Transferrin Saturation results available, please send an additional gold top (SST) sample and request Ferritin and Transferrin Saturation when sending a purple top (EDTA) sample for HFE genetics. Testing is not indicated in: Asymptomatic parents of p.C282Y homoygotes, relatives of p.C282Y heterozygotes, children aged <16 years. Please see https://www.exeterlaboratory.com/genetics/haemochromatosis/ for further information or contact Duty.Biochemist@SomersetFT.nhs.uk if you wish to discuss.
ORCHA - Organisation for the Review of Care and Health Applications: Practices will be aware from a recent CCG Update that they have teamed up with ORCHA to create a website that contains 6000 health and related apps, we have also posted the detail on the LMC website.
VAT Update for PCNs: Lentells accountants have now updated their VAT advice to PCNs which can be found here, we have also posted to the PCN Legal and accountancy area of the website.
Somerset New to Practice General Practice Fellowship Programme for Newly Qualified GPs: Are you or do you know a GP that has qualified since May 2021 and is/will be working in Somerset? If so this funded fellowship programme may be of interest. It is a 2 year programme designed to provide personalised support to newly qualified GPs to help gain confidence and to develop enjoyable, fulfilling and sustainable careers in general practice. NHSEI is aiming for a 100% uptake and nearly all of our Somerset GPs have joined. We started in April 21 and currently have 24 fellows, so you may already have one of our them working in your practice! We have had great feedback, and one of the highlights is the benefit of the mentoring, appreciation of paid time ( £10,000 pro rata per annum) to undertake chosen CPD or interests and the online monthly Thursday lunchtime 30 minutes session with various speakers. Example topics include: knowing about appraisals; PCN overview; lifestyle medicine; managing difficult blood results on a Friday afternoon and time management. It is also wonderful to see the development of peer groups forming throughout Somerset and I really hope this continues beyond fellowship. This programme continues to evolve according to the needs and aspirations of our fellows. Our next cohort will start in April (closing date 20th February) and then again in October. See programme, application form and needs analysis for more information. If you would like to find out more or apply, please contact Dr Catherine Ievers catherine.ievers1@nhs.net.
Kind regards
Jill
Jill Hellens
Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY
Tel: (01823) 331 428
Fax: (01823) 338 561
www.somersetlmc.co.uk
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