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Somerset LMC Weekly Update Friday 22nd September 2023

Date sent: Friday 22 September 2023

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

Post-Menopausal Bleeding (PMB) - Self Referral: The ICB will shortly be sharing details of a PMB Self-Referral Clinic – the service went live on the 13th September. This will allow women who have PMB to refer themselves to a one stop clinic if they fulfil the criteria. There are 7 locations throughout the county. At the appointment an USS / examination / pipelle biopsy will be undertaken if indicated. The details of how women can refer themselves, and what the referral criteria are is detailed on the attached link. Patients can book an appointment by going online, phone, text or e-mail. If the woman is not eligible for the service they will be directed to their GP. It is hoped that the service will reduce the pressure on general practice, reduce the time taken to make a diagnosis and improve outcomes. Please share the information in your practices to bring this service to the attention of your patients.

B12 – Couple of Tips: The LMC are sighted that some doctors have been concerned about the number of low B12 results they are receiving. We have linked with Dr Sadie Thomas, Consultant Clinical Biochemist and Clinical Director of Southwest Pathology Services. We can assure GPs that there is no problem with the assay but there are better tools such as MMA or holotranscobalamin, but both of these are too expensive currently for general use. New NICE guidance on B12 is due next year so watch this space…

However, big practical point - B12 in blood is not stable so the longer after collection the lower it is likely to be. This is a particular problem with add-ons.

Her advice to us would be, only measure B12 if it is absolutely indicated, e.g. neurological symptoms or haematological changes associated with B12 deficiency, patient on metformin or history of autoimmune disease, as there is a good chance the result will come back low.

Practice Centrifuges: Somerset Pathology (Taunton) and the Trust are changing their Lab computer system and electronic ordering systems to WinPath and ICE next Summer. As part of this process they are looking to streamline the sample collection process to try and reduce the number of blood tubes taken as part of a patient’s phlebotomy pathway and one area where Somerset is out of consensus with most other areas in the country is our use of 75mm SST tubes (3.5ml draw volume) instead of the slightly larger 100mm SST tubes (5.0ml draw volume). The larger SST tubes would allow the lab to perform more tests on a single tube, reduce the need for a second tube for endocrine testing and reduce instances of insufficient samples.

They are aware that surgeries do centrifuge some of their samples and hence if they make this change they need to make sure that this would not impact on this process and practices. We have developed a very short survey to establish which practices have centrifuges and whether these centrifuges would be compatible with the slightly taller tubes and would also not impact on any of their other processes.

Cross-PCN Energy Buying Group Offer: Taunton PCN are delighted to report that they have created a cross-PCNs energy buying group. We are told that across the independent GP surgeries the average energy saving is over 20% so far. All but one of Taunton GP surgeries are members now. Symphony Healthcare Services Ltd joined recently.

The energy buying group is neither restricted to Taunton nor to GP surgeries: they have a PCN in Cambridgeshire on board, as well as an accountancy firm and a charity. There are no limits on who can join the group, only that they aspire to save a significant amount of funds on their electricity and/or gas bills.

The win for each member: lower energy costs.
The win for the group: the more businesses/ members join the lower the unit energy costs for the whole group.
(It is therefore important to keep us all together under one umbrella).

If you are interested in quickly and easily achieving significant savings on your electricity and/or gas bills, please let them know and they will link you with our energy syndicate consultant for a no obligations discussion/quote.
Contact: Dr Christian Hornung (Taunton Vale Healthcare),

GP Career Plus: A further 10-session funded programme, held over 6 months, starts in November 2023, this is aimed at GPs in various stages of their career including those out of the workforce due to ill health, parental leave, and those considering retiring/leaving (not those in the new-to-practice fellowship or in first 5 years post-qualification). This programme has been developed with a supportive, coaching focus and is designed to help GPs discover a more fulfilling work life balance and therefore support practices in the retention of those experienced staff who are vital to Primary Care.

We are now filling places for the 11th programme which starts in November 2023, so please do contact to secure your place. For more information and learn how you or your practice can benefit from this new and exciting programme take a look at TeamNet Career Plus.

Paediatric Coeliac Patients: Somerset Foundation Trust (SFT) confirm that all children are followed up for Coeliac disease in paediatrics until they are 18 by the paediatricians and dieticians checking growth and blood tests.

Paediatric Podcast: Dr Ruth Bowen is a GP who interviews local specialists from around Bristol, North Somerset, and South Gloucestershire on a range of topics related to primary care paediatrics - the non-blanching rash, enuresis, the limping child, infant feeding issues, and more!
This podcast is aimed at primary professionals only and does not substitute professional medical advice or consultations. Topics will be discussed with BNSSG primary care in mind, and with references to local referral pathways, but the majority of content covered will be based on national guidelines and applicable nationally. BNSSG Paeds Pod (podcast) - BNSSG Training Hub | Listen Notes.

And finally...

Instagram: LMC/SGPET/STH are now on Instagram so do give us a follow, next step tiktok!

Kind regards


Jill Hellens

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

Tel: (01823) 331 428            
Fax: (01823) 338 561
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