Somerset LMC Weekly Update Friday 9th December 2022
Date sent: Friday 9 December 2022
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- MD Soundbites!
- GPC News (Mandatory Training on Learning Disability and Autism & Pooled Code Practices Warned to Check for Significant Reimbursement Shortfalls)
- Practice Posters
- Tier 2 Sponsorship Again!
- Update Regarding CQC Requirements for Paramedics Working in Primary Care
- Behaviour Therapy Insomnia (CBTi) via Sleepstation
- Somerset CQC Inspectors
- The Claire Wand Fund
- Job Vacancies
MD Soundbites!
Group A Strep: Those of you at the coal face this week will have seen a significant increase in the number of children presenting with infections. The BMJ this week reports – Strep A: GPs are put on alert as cases and deaths rise. This link provides a good review. There has been a steep increase in scarlet fever during 2022 to 2023 with the rate of iGAS following a similar pattern. Group A streptococcal infections report on seasonal activity in England 2022 to 2023. Prompt treatment of scarlet fever with antibiotics is recommended. With the number of patients we are seeing (or being asked to assess) it is easy for cognitive bias to lead to error. One simple technique is just to take a few seconds and ‘slow down’ and consider a check list.
To refresh the symptoms, signs and treatment of scarlet fever are: Scarlet fever: symptoms, diagnosis and treatment
- Fever over 38.3º C or higher is common
- White coating on the tongue which peels a few days later, leaving the tongue looking red and swollen (known as ‘strawberry tongue’)
- Swollen glands in the neck
- Feeling tired and unwell
- Flushed red face, but pale around the mouth. The flushed face may appear more ‘sunburnt’ on darker skin
- Peeling skin on the fingertips, toes and groin area, as the rash fades
This is a useful visual guide that you can have easy access to on your desktop.
So you have made the diagnosis and you issue a prescription in liquid form and you are told – ‘Sorry doctor there is a shortage of antibiotic liquid medications but we do have tablets’, your heart sinks as you are not certain the child will swallow tablets. I found this link useful, the leaflet can be downloaded and may be useful to carers. For the Somerset joint formulary guidance - here is the link and how to notify the Somerset Health Protection Team.
Another really helpful link for advising on how antibiotic tablets can be dissolved can be found here.
For a really informative audio update on the pragmatic management of GAS you can listen to the Wessex LMC Podcast.
GP Access to More Imaging: NHS England decided in November that is was expanding direct access to diagnostic scans across all GP practices, helping cut waiting times and speeding up a cancer diagnosis or all-clear for patients, see link. This will undoubtedly divide opinion as there will be GPs who welcome this and others who will say no more please. I am pleased to say that the ICB are looking at what this means for the wider system and are currently evaluating options, I will share further information as it develops.
Enjoy the weekend when it comes and for those that are delaying the Christmas tree remember that on Sunday we are only 2 weeks away!
Justin
Medical Director
justin.geddes2@nhs.net
GPC News:
Mandatory Training on Learning Disability and Autism: LMCs have raised that a recent NHS England Primary Care Bulletin references ‘ The Oliver McGowan Mandatory Training on Learning Disability and Autism’. This is one form of training available, but to clarify, undertaking this specific training is NOT mandatory. There is a requirement under the Health and Care Act 2022, that all practices ensure their staff have training on disability and autism appropriate to their role.
The Secretary of State for Health is required to set out a Code of Practice detailing the requirements. This has not yet been published and is expected in 2023, until then practices should not be pressured to undertake specific training, and should decide what training is appropriate for their staff.
Pooled Code Practices Warned to Check for Significant Reimbursement Shortfalls: Practices in England and Wales with a pooled list are being advised to check for significant shortfalls in reimbursement since the transition from Open Exeter to PCSE. An explanatory letter is available to download here.
Practice Posters: We have put together two posters (longer and shorter versions) that practices may wish to put up in waiting rooms or use text for patient screens
Tier 2 Sponsorship Again! The BMA partnered with legal firm Magrath Sheldrick, who oversee our immigration advice service, to develop a webinar on navigating the GP sponsorship process. The webinar is aimed at GP employers and offers practical tips on how to navigate the current sponsorship process to recruit non-UK nationals and addresses frequently asked questions on the process itself. The link to the webinar is here.
As mentioned in previous updates 75% of our GP trainees next year will require this sponsorship, so please let’s keep them in Somerset and apply to be a sponsor, the ICB will reimburse the costs if shown to help with resilience and once the licence is granted it remains for 4 years until you need to reapply. Further detail on the LMC website. When you do receive your licence please let the office know as we keep a list that is also shared on the Job section of the website.
Behaviour Therapy Insomnia (CBTi) via Sleepstation has now been available in Somerset nearly 6 months. Sleep problems affect nearly 1/3 of adults. Pleasingly the number of referrals has eclipsed expectations. Feedback from those referred has been excellent including comments such as “It has given me hope that things are and will get even better”, “I’m really impressed how successfully this works”. People can self-refer or be referred by professionals. Consider referring anyone who fits the referral criteria and has ongoing insomnia. Sleepstation also offers excellent free interactive teaching for practice teams. More details can be found at www.sleepstation.org.uk.
Somerset CQC Inspectors: Following the CQC training event a number of practices were unaware of the local teams name, currently these are Janet Pitt janet.pitt@cqc.org.uk and Chloe Frost chloe.frost@cqc.org.uk.
The Claire Wand Fund: This is a charitable fund that makes grants to GPs to provide scholarships and grants for research and education. Examples of awarded grants include research projects initiated by GPs, audits, course fees where the course will lead to the development of new clinical services within the applicant’s practice, and travel for the study of general practice in different cultures. The fund welcomes applications twice a year, at least three weeks prior to the April and October trustee meetings. Claire Wand Fund | Providing Education and Research Grants for GPs | Claire Wand Fund - Providing Education and Research Grants for GPs.
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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