Somerset LMC Weekly Update Friday 18th October 2024
Date sent: Friday 18 October 2024
Sent to all Somerset GPs and Practice Managers This and previous updates are available here
- MD Soundbites! New this week... Our ambition to rebuild general practice
- GPAS (General Practice Alert State)
- Collective Action
- Clinical News/Updates
- Medical Examiner Update
- Radiology Requests
- Suggested Inclisiran Rejection Letter
- Update on Prescribing from Hospital Outpatients
- Connecting the Dots Meeting - Information for GP Partners/Salaried/Locums/Practice Managers
- Sexual Harassment Policy Advice
- South West Advanced Practice Governance Matrix, Utilisation in Practice – Webinar Series - Safe Working in General Practice (BMA) This guidance is regularly updated with new items and suggestions
- Job Vacancies
- The Health & Self Care Podcast - this week... Your Pelvic Health
Collective Action
Somerset LMC would like to support you in being able to undertake those elements of collective action that you would like to implement. As you know GP partners/contractors in England voted overwhelmingly for collective action. The BMA collective action identifies 10 actions that you can take. To help us support you we have today emailed Practice Managers at every GP practice in Somerset, asking that collective action is discussed within your practice and your thoughts shared in our survey. We specifically want to know which of the collective actions you are undertaking or which you would like to undertake? We understand that some of this is rather confusing. We would like you to start thinking about what services you would like to stop providing? Yes, you have read this correctly, what services would you like to STOP providing. Some LMCs have been successful in identifying services that practices can serve notice on. These are services that GP practices are not contracted to provide and are in effect providing these services for free. Within the email that we have sent to the Practice Managers there is a list covering these services entitled ‘Service Gaps in Somerset’. Are there services within this list that you would continue to provide if funded? Or are there services that you would never want to provide even with appropriate funding?
So please look out for the email and return the survey. Also save the date for the first Somerset ‘Ask the LMC webinar’ which is scheduled for 5th November between 13.30 and 14.30. This will be an opportunity to ask the Executive Team questions about collective action and help us support you best. Book your webinar place here.
Clinical News/Updates
Medical Examiner Update: Feedback from the service is that it is going really well. It would help the Medical Examiner Service if the certifying GP completes EMIS referral with proposed Cause of Death (COD) and Next of Kin (NOK) details and sends this as early as possible in the working day, to allow a same day reply if possible.
Radiology Requests: Radiology have requested more detail for ultrasounds in general and in these specific areas highlighted below to avoid rejections. Patients are able to see the reason for requests via their NHS app.
- Unscheduled bleeding on bleeding on HRT: Radiology are requesting more information for this. Lots of requests stating bleeding on HRT only- but they are asking for more details in keeping with BMS guidance, eg positive for 3 major risk factors/if coil in situ, continuous/sequential HRT).
- Soft tissue lumps: These are only accepted if a lump meets any of these criteria: diameter >5cm, changing over time, symptomatic. If a benign lesion cannot be excluded on USS, then radiology will arrange an MRI.
- Renal USS: If the request states to exclude renal colic and patient is 45 or over, radiology will upgrade to a renal CT scan. However if the request only says flank pain then an USS renal will be arranged.
- Prostate requests: Of late there has been a number of requests for USS to exclude prostate cancer or assess prostate size. These will be rejected as the only USS scan that would be accepted in relation to a prostate would be for assessment of residual volume.
- PCOS: We await new guidance on this from gynaecology in due course.
Suggested Inclisiran Rejection Letter: We would like to highlight our steer that Primary Care should avoid prescribing Inclirisan until we have successfully negotiated a guaranteed long-term funding stream for this work with our ICB. If you choose to decline this work, you may wish to use this new rejection letter that we have created. In the interim, you can choose to take on this additional work, but you should not feel under pressure to do so.
Update on Prescribing from Hospital Outpatients: SFT have informed the LMC that they have issued guidance to their staff about issuing prescriptions from outpatients – we hope that this will reduce requests for practices to prescribe.
Prescribing following an out-patient appointment:
- If the medication is needed within two weeks, please prescribe and issue the full course
- If a routine medication can wait for 2 weeks, please ask the patient to go to their practice for the prescription AFTER 2 weeks.
It is the responsibility of the clinician who wishes to prescribe the medication to undertake the appropriate pre-treatment assessment and counselling. Please document this has been done in any out-patient letters to the GP team.
Connecting the Dots Meeting: This is a chance to share projects, ideas and discuss areas that impact on both Primary Care and SFT. It is informal and you can come and listen in, bring an item you would like to raise, or just join in with the discussion if you feel it is relevant to you. The next meeting is on Wednesday, 30 October 2024 at 13.00-14.00. This session is on Healthcare Scientists. Click here to join the meeting.
Information for GP Partners/Salaried/Locums/Practice Managers
Sexual Harassment Policy Advice: Adrian Poole of APERS Limited has provided a new, legally compliant sexual harassment policy and guidance note for practice use, these can be found in the Practice Support Unit (PSU) area of our website (you will need to be logged into the LMC website to access these documents, please contact somersetlmc.office@nhs.net if you do not have a log in). This advice will be included in an updated copy of the staff handbook which is due to be released soon, and comes with Adrian's normal disclaimer over its use, without taking advice specific to your circumstances. Please note that this is released in anticipation of the change in the law coming into effect on 26th October 2024, so your urgent consideration is recommended.
South West Advanced Practice Governance Matrix, Utilisation in Practice – Webinar Series, commences 11th November 13:00-14:00
The South West Faculty of Advanced Practice will be facilitating a series of webinars to explore how the advanced practice governance maturity matrix is being utilised in practice. Guest speakers from a range of South West organisations, such as GP practices and NHS Trusts, will share how they have approached Advanced Practice Governance Matrix and incorporated it into their work. You can sign-up for the webinar series here.
Kind regards
Somerset LMC Team
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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