Somerset LMC Weekly Update Friday 10th February 2023
Date sent: Friday 10 February 2023
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- MD Soundbites!
- Somerset Urgent Community Response Service (UCR)
- Update on the Digital Firearms Flag
- Unexpected Clotting Blood Rests - Haematology Specialist Tips
- EMIS WEB – QRISK Reminder
- Job Vacancies
Stand your ground …. there has been some debate this week about whether GPs should take up the prescribing for certain complex issues. One of the areas of debate has been the prescribing for patients with transgender issues. It was a rather hot topic when we spoke about this in the LMC this week. Our advice would be that no clinician should prescribe anything in an area of medicine that they do not have the appropriate expertise or are comfortable accepting the consequences of the medication prescribed. More information is on the LMC website, including a GP letter template for NHS or private. As generalists we know a huge amount but if there are areas of clinical practice that you do not feel confident in prescribing our advice is don’t and seek advice. For more detailed guidance you can check out the GMC guidance.
Being a busy bee is admirable but even bees need to rest! Yes, GPs and our staff and colleagues are busy but we need to find time to think. Previously I have highlighted the importance of safe working in general practice but as a practice and clinical team do you need to do more? Just because your work patterns have always been set in a particular way does not mean it has to stay that way. There is clear guidance from the BMA - perhaps dedicate some time to consider the implications for your practice. Everything flows from creating a change to the historic cultural shift of the self-destructive urge within some practices to continue to work harder and longer to meet patients’ needs. Set some limits to be safe!
This cultural shift was a focus at an LMC away day this week. More on that in the coming weeks but our vision is
‘To encourage and support General Practice to be safe and sustainable in order to thrive’.
Yes, safe and sustainable! Many of you will be aware that the Springmead practice will close later this month, we do not want any more. Just like many of you the LMC team are feeling the pressure and we have to change how we work. We could not be more committed to supporting you but we do recognise that we have to focus on what will have the biggest impact on making your working lives as good as possible. This is why we have been committed in obtaining Winter Resilience Funding and creating meaningful actions with the ICB. We have seen the final proposed position from the ICB which includes £1 per weighted patient but we are disappointed with the time that it has taken for the ICB to reach their conclusions. We do not believe that they are doing everything they can to support us. Fundamentally, we are still not in a position to clarify how EA slots can be moved to core hours or how available locum capacity will be shared. The ICB would like to release payments to practices as soon as possible, which we welcome - they will be writing directly to you all shortly about this.
If you are off next week due to half term have fun and for those that are not catch up next week.
Somerset Urgent Community Response Service (UCR): Providing a 2-hour response for urgent care at home. UCR is part of the long-term plan and though nationally been in place for 3 years, it started in Somerset since April 22. A video describing the service is available here.
When does it run? 08.00 to 20.00, seven days a week.
Eligibility? It is available for anyone over 18, not just housebound pts who are at risk of admission into the hospital without an urgent response. Overall It is there for those who are deemed at high risk of admission within 24 hrs.
- Falls: Level 1 (no injury falls), level 2 falls (fall with minor injury). All locality teams and Rapid Response teams have Mangar lifting equipment at base to respond rapidly to avoid ambulance callouts.
- Decompensation of frailty
- Sudden change in function/mobility requiring an urgent therapy review
- Palliative/end of life crisis support
- Urgent provision of equipment to support a person experiencing a crisis or is at risk of admission. In cases of unpaid carer breakdown – short term support may be available where informal care has broken down. It does not cover macro-provider or formal care breakdown.
- Increased or new confusion/delirium or worsening of dementia
- Urgent catheter care
- Urgent support for diabetes
Who are the team? SFT. Rapid response service, district nurses, pharmacy techs and advanced care practitioners.
How are patients referred into this service? For clinicians refer through SPL (Somerset Primary Link. Referrals also can be made from 999, care homes, GPs and through the pendant alarm providers. GPs hospital admission requests are able to be diverted by staff working within SPL to UCR.
What happens is additional clinical input is required? The RR team would initially liaise with the ANPs available and they can do direct admissions, they intend to refer to Hospital at Home. They are not linked into the complex GP team.
Please contact LMC Medical Director firstname.lastname@example.org if there are any issues with referrals to this service.
Update on the Digital Firearms Flag: The digital firearms flag will be relaunched on SystmOne (TPP) and EMIS Web (EMIS) systems on Monday 6 February, GPs should add the appropriate SNOMED code to a patient's record when they receive notification of a firearms certificate application or when a certificate is granted, and this will automatically add a marker to the patient’s record.
EMIS WEB – QRISK Reminder: From April 2023 the integrated QSCore calculations will no longer be available in EMIS WEB. Please click the link for more further information from EMIS.
Crown Medical Centre, Venture Way, Taunton, TA2 8QY
Tel: (01823) 331 428
Fax: (01823) 338 561
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