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Somerset LMC Weekly Update Friday 19th January 2024

Date sent: Friday 19 January 2024

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

Clinical News/Updates

ADHD Referral Difficulties: LMC are aware of the recent difficulties of referring into their service and are in discussions with the team. Our agreement from March 2023 remains that referrals can be made via a referral letter, and as much information as possible is encouraged. Details around the impact, duration, context, pervasiveness and whether the behaviours have been present since childhood should be included to enable triage. The team will then send a patient questionnaire to the patient which will be required to be returned by the patient in a timely manner directly to the ADHD team for them to accept and process the referral. Failure of the patient to complete the form will result in the referral being closed.

Private Bariatric Postoperative Monitoring: In December 2023 we released an update about the management of these patients, which is now being retracted and we await the outcome from the ICB discussion. This means that patients who would have met the new criteria for a NHS referral after having bariatric surgery abroad, will need to be placed on hold. We will update you as soon as we can.

Changes to Ordercomms: Somerset Foundation Trust will be replacing Ordercomms with Clinisys ICE from July 2024. The switch to ICE is a complex one, with over 30 million pieces of data to move, and multiple other dependent systems to upgrade and integrate, their team have been working on the switch over for the past year and as the system develops, are planning roadshows, demo sessions as well as the actual training on the system. They would like help from clinical colleagues across the county to help ensure that ICE is set up to get the most from it, and to ensure that it has been thoroughly tested. If you would like to help, please contact Tanya Fitzer who is managing the project tanya.fitzer@somersetft.nhs.uk.

Home Oxygen Service Assessment & Review (Update): The ICB as you are aware have had an issue with the new Baywater Pulmonary Rehabilitation and HOSAR (Home Oxygen Service Assessment & Review) contract. The issue is with the connectivity with the MESH system (which enables them to access the SPINE and send electronic outcome letters). Digital, CSU and their IT are working on a solution which should be in place by the end of January. Currently there is no robust way to send outcome letters to GP practices which is causing a clinical risk with them not being able to view antibiotic prescribing and prescribed oxygen from the service. The ICB have agreed as an interim measure to send the outcomes via NHS.net email communication. Email addresses have been checked by the provider with each practice.

Mirena 52mg LNG IUD - Extended License for Contraception for 8 Yrs: On 11/1/24 FSRH released this FSRH CEU Statement confirming that the Mirena 52mg LNG-IUD can now be extended to eight years for contraception use. This applies to individuals who already have a device in-situ. There are no changes to the recommended duration of use when a Mirena 52mg LNG-IUD is being used for endometrial protection as part of HRT or for heavy menstrual bleeding. The Faculty of Sexual and Reproductive Healthcare (FSRH) will consider whether this extended use advice can/should be applied to other 52mg LNG-IUD devices, other than Mirena. Currently there is no change to the recommendations for the other LNG-IUDs.

Supporting HC2 Application for Asylum Seekers: An HC2 certificate entitles individuals to free NHS prescriptions and other healthcare. NHSE guidance improves the process for issuing HC2 certificates to people seeking asylum. It sets out the background and eligibility to the certificate, provides advice on seeking treatment before a certificate has been issued and how to renew a certificate.

Updated Guidance on Pressure Ulcers 'How to Safeguard Adults' is Now Live: DHSC has completely revised and published on 16.1.24 the Safeguarding Adults protocol: pressure ulcers and raising a safeguarding concern. These documents help practitioners and managers across health and care organisations to provide caring and quick responses to people at risk of developing pressure ulcers. The guidance and appendices also offer a process for the clinical management of harm removal and reduction where ulcers occur, considering if an adult safeguarding response is necessary.

News from the GPC

Death Certification Reforms: The government has confirmed that the death certification reforms will be enacted from April 2024, including the role of the medical examiner (ME) becoming statutory. Once the new death certification process comes into force, all deaths in England and Wales will be independently reviewed by a medical examiner or a coroner. The main changes:

Other changes including a new Medical Certificate of Cause of Death, which can be completed by a doctor who attended the deceased at any time (at present MCCDs can only be completed if the doctor saw the patient within 28 days before death or after death). Read more here.

MAPs to be Regulated by the GMC - Write to your MP: The Government has announced that physician associates and anaesthesia associates are to be regulated by the GMC. The BMA thinks that this will add further, dangerous confusion and we need every MP to be aware of this issue, oppose the legislation and force the Government to abandon its plans. Please help by using this tool to email your MP.

Online Access to Records - Data Breaches from Misfiling of Records: There is ongoing work continuing behind the scenes focusing on making the online access to records project safer. Our outstanding concerns regarding how this was imposed on the profession can be found here. If you have any examples of potential or actual harm that has arisen, for example: the accidental misfiling of data/letters in the wrong patient's record, or when information should have been withheld from online view in order to prevent harm, but wasn't, and which has only come to light now more patients have access to their records, please pass on details to info.gpc@bma.org.uk.

Information for GP Partners/Salaried/Locums/Practice Managers

GP and GPN Fellowship Update: This week we have been informed by NHSE that ‘there will be funding for all fellows that are on-boarded (registering) by 31.03.24’ for the full two year programmes, including mentor support. We would like to encourage anyone interested to register interest THIS MONTH as NHSE will be able to honour the 2-year fellowship if you have a new job starting or completing training by May 2024. If anyone is thinking of joining the fellowship after March 24, please get in touch as soon as possible too. We await further information about the future of recruitment and retention schemes and we have started conversations with our ICB on this vital matter. For interest in GP Fellowships please contact catherine.ievers1@nhs.net and for Nurse Fellowships paula.messenger1@nhs.net.

2024 National Foundation Trainee Pharmacist Recruitment Scheme to Recruit into Foundation Training Programme (2025-26): General Practice could be involved in this training for which there is funding of £26,500 per foundation trainee pharmacist. For more information please see here and note the closing date for applications for 2025/26 is 1st March 2024. The application form is here, and details about imminent webinars before the deadline can be found here.

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
General Practice in Somerset Great Place Great Potential

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