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Somerset LMC Weekly Update Friday 10 June 2016

Date sent: Friday 10 June 2016

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

New Insulin  Prescription Charts for Community Use
You will be pleased to hear that the small group that has been working on this has finished its work and  a new chart will start to become available this month. The old version has been extensively modified, and although the new one looks complicated we think that  it is significantly easier to use and much safer.   The main improvement is that each chart is now valid for up to six months.  The chart is overprinted in various fields to minimise the chance of error and there is a printed example section to show  prescribers how to  request variable dose insulin depending on the patient’s blood sugar. Staff are requested to assess periodically whether the patient is fit to administer his or her own insulin (there is a simple decision tree to help with this) and there is also an excellent  flow chart for the treatment of hypoglycaemia. The back of the booklet contains a blood glucose monitoring chart and  at-a-glance guidance for prescribers on the management of insulin doses during an acute illness. Please take a minute to look through the chart when you first come across one, and although it has been piloted, we’d be glad to hear any comments or suggestions for future editions.

Ambulance Response Programme Clinical Coding Trial at SWAST
Since April SWAST has been trialling a new clinical coding system for 999 calls that divides them into new categories:

Category Red: Immediately life threatening. The patient is in cardiorespiratory arrest, or in a peri-arrest state, and needs immediate treatment at the scene to preserve life where life can be saved.

Category Amber: Emergency. The patient needs an emergency response – using blue lights and sirens. This group is divided into:

Amber R (Response): Patient requires a face to face clinical assessment at scene, possible clinical treatment at scene, and, in most cases, onward conveyance to hospital for definitive treatment For example – a patient with suspected myocardial infarction

Amber T (Transport): Patient in whom rapid transportation to hospital is the key priority because they require the services of a hospital, often a specialist facility , and are less likely to need ambulance treatment on scene. For example – a patient with a suspected CVE

Amber F (Face to Face): Patient who requires assessment and treatment (at scene) is a priority the patient may or may not need subsequent transportation to hospital, depending on the circumstances.

Category Green: Urgent. The patient needs an urgent response – not using blue lights and sirens. This group is divided into:

Green F (Face to Face): Patient requires assessment and management at scene by an ambulance clinician, which may include transport to hospital or another location.

Green T (Transport): Transport only.

Green H (Hear and Treat): Patients suitable for “hear and treat” (advice over the telephone, including referral to other services).

Health care professional calls to the Ambulance service will in future be assessed against the new categories. Requests for admission or hospital transfers will receive a Red response where the criteria of cardiorespiratory arrest or peri-arrest are met. Most HCP calls will require an Amber response i.e. emergency “blue lights and sirens? response, where the next available appropriate resource will be sent to the call. Clinicians are available in the ambulance Hub should you wish to discuss a particular case

More details are available on the LMC Website

Requests for Access to the Records of Deceased Patients
Once a patient has died, the GP practice is no longer required to respond   to requests  from the family,  or another representative, for  access to his or her medical record.  This  is now the responsibility of the National PCSE service run by Capita.

However, practices have been contacted by Capita with  a request that they review the  record of a deceased patients to make sure that any information that the patient may have, directly or indirectly,  wanted to remain confidential,  and any third party references,  are removed.

We have had the following  email  from the GPC about this:

“We are currently negotiating with Capita on this process at national level, for redacting records that have been requested as a ‘subject access request’. We are not keen on putting the burden on practices to redact, even if they receive funding for it, as that creates more workload which a lot cannot take. One of the suggestions was that a central pool of doctors who redact all medical records across the country. Capita have estimate that each redaction takes 1 hour and they get an estimated 10,000 per year.

While negotiations are ongoing, we would recommend that the practice continue with how they previously undertook this work. If they have not done this before, then I suggest they decide whether they are willing to do it and decide how much they think it is worth – using Capita’s estimate: an hour of clinical time to redact, plus administration costs, plus any amount for taking responsibility for authorising the release.”

 

Best wishes


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

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