Somerset LMC Weekly Update Friday 19th July 2024
Date sent: Friday 19 July 2024
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- MD Soundbites!
- GPAS (General Practice Alert State)
- And so it begins contd....
- Clinical News/Updates
- Amendment to seasonal flu 2024/25
- New regulations restrict the prescribing and supply of puberty-suppressing hormones to children and young people under 18
- Rheumatology at Musgrove
- Changes to the referral process for YDH and Community MSK Physio Services
- Cardiology reporting ECGs through Musgrove Hospital - Information for GP Partners/Salaried/Locums/Practice Managers
- Pathology Lab (update re systems down)
- LMC GP Connect Survey
- Intramuscular Pabrinex requests from SDAS - News from the GPC
- *Save the Date* - Practice Finance Health joint webinar 7 August 12:30-14:00
- Template letter requesting access to a patient’s record
- GP Connect update - Training/Events
- Connecting the Dots
- Post Graduate Certificate in Primary Care
- How to design a career you'll love with Dr Rachel Morris - Safe Working in General Practice (BMA) This guidance is regularly updated with new items and suggestions
- Job Vacancies
- Somerset Emotional Wellbeing Podcasts
And so it begins cont..
The first of the BMA’s suggested actions is Limit daily patient contacts per clinician to the UEMO recommended safe maximum of 25. Divert patients to local urgent care settings once daily maximum capacity has been reached. This is a key element to the BMA safe working guidance. 7.5.2(c) of the GMS contract states that one of the “appropriate responses” by a practice to a patient is to “invite the patient to make use of, or direct the patient towards, appropriate services which are available to the patient, including services which the patient may access themselves”. This can include NHS 111, MIUs, Extended Access etc. Therefore, this action is acceptable under the current contract. There are several factors that practices need to consider with this action. ‘Safe working’ is not something that will be penalised by the ICB or CQC. However we do understand that both of these organisations will want to understand the systems the practice has in place when allocating their capacity. The LMC would advise that these policies exist in written form. It is important that practices are not utilising a ‘first come first served’ service and that there is a process in place to ensure that all patients receive an element of triage to ensure each has an appropriate disposition.
Practices cannot turn off their phone lines when capacity is reached and need to ensure that they have a system in place to respond to any requests that come through in this time. As above, practices can, contractually, signpost patients to other healthcare providers for urgent needs. Remember that General practice is not commissioned to deliver urgent or emergency care. We would encourage practices to have individual discussions around ‘exceptions’ to the rule when it comes to capacity. We are aware many practices will continue to field requests for certain patient groups such as palliative patients, those with learning difficulties or young children even when capacity is reached. Importantly we would also ask that all practices continue to field calls from other health care professionals such as paramedics or hospital colleagues even when they have reached capacity. GPs have a valuable role to play in providing further information to help other professionals manage our patients and the LMC would encourage all practices to have a process in place to ensure that these discussions are able to occur during core hours.
Further to our article last week on referrals the BMA have issued a Focus on Proformas and Referral Forms in General Practice, to support practices in taking back control of workload and reducing bureaucracy.
Clinical News/Updates
Amendment to seasonal flu 2024/25 – An amendment has been made to the National Flu programme for 2024/5 on 2 July. The recombinant quadrivalent vaccine (QIVr) is not available for this years adult flu vaccination. There is an update General Practice specification, please follow this link to the details on our website.
New regulations restrict the prescribing and supply of puberty-suppressing hormones to children and young people under 18: Please see this emergency ban, New restrictions on puberty blockers - GOV.UK (www.gov.uk ). Additional information is available on Gender Identity - NHS Somerset ICB
Rheumatology at Musgrove: The LMC has been in discussions with rheumatology about the difficulties for both patients and clinicians in contacting this team. The department is urgently addressing this severe capacity issue and plans are in place which are in keeping with GIRFT planning guidance and the emerging CQC requirements for rheumatology services (NEIA Audit | British Society for Rheumatology) . This includes staff recruitment and merging rheumatology support for both YDH and Musgrove which will resource the helpline. Until this service is fully in place, please see link here to the interim urgent contact details for the department.
Changes to the referral process for YDH and Community MSK Physio Services: As a first step in bringing Yeovil, Deane Barton and Community Physio services together, referral processes are being streamlined. For YDH and Community Physio, the primary referral route will be the new online patient triage form instead of the patient telephoning in. For now, the referral route into Deane Barton Physio Team remains unchanged. For more information and examples of the templates please see the ICB bulletin next week. During this transitionary period, the booking office telephone lines will continue to be answered. FCPs working within Practices / PCNs have created AccuRX templates to support this change, and an example template will be included in the ICB bulletin. Whilst the referring email address remains the Bridgwater booking office, PhysiotherapyMSKBridgwater@somersetft.nhs.uk it is overseeing bookings at YDH and the community sites.
Cardiology reporting ECGs through Musgrove Hospital: The current Advice and Guidance Service enables routine reporting of ECGs. On occasion, there may be an urgent ECG requiring reporting, and options could be to contact cardiac nurses (limited capacity), SDEC or to email an ECG to cardiology. However urgent ECG reporting is not a commissioned service within SFT and if you have a concern that can not be answered through these routes, an admission would be required.
Information for GP Partners/Salaried/Locums/Practice Managers
Pathology Lab have been in contact to say they are aware that practice systems are down and they also have no access to EMIS viewer, they have asked practices to fill in a paper request form please.
LMC GP Connect Survey, please spare 2 minutes to complete this short survey which will close on Friday 9th August.
Intramuscular Pabrinex requests from SDAS: The LMC have had recent enquiries about administering this drug following requests from SDAS. It is an amber drug (listed as parenteral thiamine) on the Somerset Formulary, https://nhssomerset.nhs.uk/wp-content/uploads/sites/2/Somerset-Traffic-Light-Status-60th-Edition-July-2024.pdf. It does not require a formal shared care protocol and so it can be prescribed by GPs on specialist advice. It is important that GPs work within their competency and so if GPs do not feel able to prescribe then this should be discussed with SDAS. However where GP’s have the competence to deliver this treatment, it is able to be prescribed and given in primary care.
Training/Events
Connecting the Dots The next Connecting the Dots meeting is on 24 July at 1 pm to 2 pm. The speaker at this meeting is Dr Adrian Hayes who is a Consultant Medical Psychotherapist and will be discussing people with Personality Disorder/Complex Emotional Needs and how to stay compassionate while reducing burnout. Click here to join the meeting If you would like the link for future meetings please contact Beverley.Peacey@somersetft.nhs.uk
How to design a career you'll love with Dr Rachel Morris: 17th Oct, 9.30-1 Taunton Racecourse. Rachel Morris, who runs Not a Frog Podcast, will be running this session for GPs. This was created for our New to Practice GP Fellows, but we have space. For more details and to book see 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
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