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Somerset LMC Weekly Update Friday 28th July 2023

Date sent: Friday 28 July 2023

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

News from the GPC:
Implementing a Triage System in General Practice: 
As there is currently no standardised care navigation or triage system for GP practices, the BMA have developed a resource that is designed to support general practices to implement a triage system if they wish to do so. Ensuring that patients are seen by the appropriate clinician in the right place and at the right time supports good patient care and experience, reduces pressure on GP practices and allows GPs to spend their time where it is needed the most. For practices interested in introducing care navigation and/or triage, we have provided a number of case studies along with two triage flowchart examples that can be tailored to suit your own practice

General Practice Responsibility in Responding to Private Healthcare: GPC England has published guidance on general practice responsibility in responding to private healthcare, to help practices reduce this extra workload. Due to nearly 7.5 million people on NHS waiting lists in May 2023, patients are increasingly resorting to seeking private healthcare to deal with their health problems, which is adding extra workload for general practices. Our guidance covers what the responsibilities are for general practices in response to private providers making requests, such as making private referrals, providing medical information about patients, organise further tests, issuing prescriptions, and onward NHS referrals.

GP Trainee Visa Sponsorship: The BMA is continuing to address the long-standing barriers to staying and working in the UK currently faced by trainee GPs as they approach completion of their training. As a temporary solution, the BMA has been working to secure agreement from the Home Office to allow an additional four months on Skilled Worker visas for GPs at the end of their training. This is intended to allow extra time to secure work with an employer and arrange sponsorship with them. The additional time will be available for all IMG trainee GPs who have successfully completed their training, and the Home Office has now confirmed this scheme will apply to GPs completing their training with Skilled Worker visas expiring from June 2023 onwards.

UK Visas and Immigration has been working with NHSE to ensure those GPs who complete their training this summer are identified when they submit their application. Those eligible should already have been contacted by NHSE with details of the application process. Note that you cannot apply more than one month before the current visa is due to expire (the end date on the BRP card or visa).

We will continue to work with government to find a permanent and lasting solution to this issue. If you believe that you may be eligible for this extension but have not been contacted with details, please get in touch with the international team via

If you are on a visa, please see the supporting information which confirms the procedure for extending your visa for 4 months beyond your CCT date.

Skilled Worker Visa (Formerly Tier 2 Visa): 31 Somerset practices now have been granted a licence, which is brilliant, 85% of our GP trainees are international medical graduates and will need sponsorship to stay working in the UK, many we have spoken to want to stay in Somerset, with some already asking about partnership. It would be great if all our practices obtain this licence in order to give these trainees a good choice of posts across the patch and help regain a strong workforce for general practice in the county. The ICB are still funding practice applications. For more information on the process please see here and email to gain ICB funded support. Don’t forget to inform the office once your licence is granted as we keep a full list of practices on the jobs section of the LMC website.

2WW Gynaecology Update: The 2WW pathway for gynaecology has been amended in accordance with NICE guidance and SWAG Cancer Alliance (Somerset Wessex Avon Cancer Guidance). These are pathways that are being implemented throughout the country. As indicated in the NICE guidance for Suspected Cancer (NG12) and British Gynaecological Cancer Society (BGCS) Uterine Cancer Guidelines: Recommendations for Practice a transvaginal USS and pelvic examination are important first steps in determining the level of risk of endometrial cancer. The essential features of the changes are that patients being referred under a 2WW pathway for gynaecology need to be examined, bloods requested, and an urgent USS will need to be requested and reviewed. Currently our patients that are at high risk of gynaecological cancer are not being seen with the appropriate time frame. A detailed letter summarising the changes and the new 2WW gynaecology pathway will be ready to be shared by the ICB shortly. The changes to the 2WW pathway will be implemented in August.

EMIS Issues: The LMC have been receiving communications regarding issues with EMIS. If you are experiencing any issues that you need support with in regards to EMIS WEB, please send them to and please include any case numbers in relation to the issue.

Historical Radiology Results from SFT: The LMC has received a number queries in regards to the information that SFT asked us to send out last week. There isn’t a way of recalling the reports unfortunately. A colleague from one of the practices did a test on their records and this is the process, you will need to reject/file them if you wish to get them out of your workflow, it takes about 5 seconds to file, each one. You can copy and paste some text such as “Received as part of an accidental transmit by MPH. MPH confirmed report has already been seen/actioned. Recommended to reject” and just CTRL+V that in the reason box on each one when it asks. This practice received 300 reports and it took about 25 minutes.
This issue has been reported on DATIX and an investigation into how this happened and how it can be avoided again is being dealt with. This is a suggestion on how to help as the LMC are aware these results are mixed in with new results. We would like to thank the practice that did this test.

NHS England National General Practice Improvement Programme: This is a fully funded programme for general practice. The intensive model is 26 weeks and the intermediate 12 weeks, it is designed to find the areas that are in need of improvement, working with the support team to enable better processes to be put in place. They look at care navigation, document workflow, appointment management, managing demand, capacity and access etc.
There is one more phase of the intensive model which starts on 4th October. The programme talks about being suitable for practices or PCNs, it does state that practices have to be nominated by ICBs however this is done through the application process. There is also the potential to apply for around £13,500 of funding to support the transformation. This could include locum GPs to help clear any back logs. Full information can be found here.
A local practice manager has kindly shared the slides from a recent webinar on the programme which you can view here.

Oral Anxiolytics in MRI Scanning: Following the article in the update 16th June and how the GP community is divided in their views on prescribing in this setting, we have developed a template letter for both the trust and patient for those who do not wish to prescribe in these circumstances.

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 56 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 minute 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 October 23 and the closing date is 7th September 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

Kind regards


Jill Hellens

Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY

Tel: (01823) 331 428            
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