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Somerset LMC Weekly Update Friday 23rd December 2022

Date sent: Friday 23 December 2022

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

It has been yet another challenging year for General Practice and we want to assure you that your Local Medical Committee is always here for you. We wish you all the very best this Christmas and for 2023. Stay well and hopefully you all get some well-earned rest with family and friends.

Urgent on call numbers over the Christmas period:


MD Soundbites!

Well the Christmas week is here and perhaps like me you are clinging on for a few days off over Christmas. I know that some of you will also be working for out of hours over the weekend and if you are thank you. As the year comes to an end most of us reflect on the year passed and the pressures that we are likely to face during the coming year. I was reminded this week of the amazing work we do when I spoke with a fellow GP. They recalled how a simple act of breaking down cultural boundaries, in a consultation with parents of a concerned child, where their first language was not English, enabled them to address concerns and provide excellent care. We need to continue to talk and support each other. Carrie MacEwen, GMC Chair message for winter is worth a read.

However, as we face overwhelming pressures that are resulting in some practices providing mainly urgent on the day care this week it is important to share practice measures of help. At the General Practice Provider Board (GPPB) this week we demonstrated how senior primary care and system leaders working together can generate solutions. Our proposals are with the ICB as they consider the GPPB proposed urgent actions. Some of the areas of focus included suspending Enhanced Access, bolstering clinical workforce and allowing practices the flexibility to know what works best for them. Unfortunately, there is no national agreement as to the steps that are needed but we hope that the excellent work that the LMC/GPPB are undertaking with our ICB colleagues will lead to meaningful support which we so desperately need.

Heads up! On the 1st Jan there is a new Lower GI Cancer referral form that includes a section on ‘Anaemia and absolute Iron Deficiency Probable’ that is positive and is in keeping with national guidance.

On behalf of the Executive team at the LMC and the committee we wish you all a very Merry Christmas and wish to thank you all for the amazing work that you do.

Justin
Medical Director


Anaemia in Pregnancy: SFT (Somerset Foundation Trust) has made some changes to their guidance, that of the CKS guidance to be more proactive. Anaemia and iron deficiency both have significant implications: maternal fatigue, increased risk of antepartum and postpartum haemorrhage, delayed healing of caesarean and perineal wounds, negative effects on the quantity and quality of breast milk and increased length of stay and transfusion requirements. The fetal implications include poor fetal growth and increased and preterm delivery.

To simplify levels SFT recommends a ferritin level with the FBC at both booking and at 28 weeks and to start treatment with a ferritin of <30 OR an Hb <110g/l.

First line treatment is ferrous sulphate 200mg or ferrous gluconate (if previous bariatric surgery) on alternate days to aid absorption. The advice also includes taking it on an empty stomach with a source of vitamin C such as orange juice, not within an hour of tea or coffee or other medications. For further information, UK guidelines on the management of iron deficiency in pregnancy (wiley.com)

ARRS Roles (Digital Transformation Lead and GP Assistant) - new pay codes: NHS England has updated the Network Contract DES to include the pay codes for the two new ARRS roles, digital and transformation lead and GP assistant, that were brought into the Network Contract DES in October (in blue, at the bottom of page 45).

General Practice Workforce Engagement: NHS England are keen to hear views and understand the impact new roles and retention schemes have had on general practice, to inform future plans. If you would like to provide your view on this please join the conversation here. Closing date 11th January.

Somerset New to Practice General Practice Fellowship Programme for Newly Qualified GPs: Are you or do you know a GP that has qualified since April 2022 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 have had up to 47 fellows, so you may already have one of our fellows 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. This programme continues to evolve according to the needs and aspirations of our fellows. Our next cohort will start in April 23 and the closing date is 28th February 2023. 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

Health Education England Apprenticeship Events: HEE are planning 2 identical events (8th February in Bristol and 15th February in Plymouth) on apprenticeships. This is suitable for anyone involved in workforce development in primary care, particularly relevant to practice managers and others involved in HR. To book your place email: nhsapprenticeships@hee.nhs.uk.

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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