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Somerset LMC Weekly Update Friday 14th July 2017

Date sent: Friday 14 July 2017

All Somerset GPs and Practice Managers                      This and previous updates can be found here

Document Workflow: Supporting Documents We have now delivered 24 sessions of this training throughout the county for which feedback has been excellent,  we are hoping to secure further GPFV funding to support this training and sign posting for 17/18.  Further mop up training sessions are planned for September, details will be shared soon. We have now received electronic documents of both the work book and the top 200 read codes, which practices are free to use and adapt accordingly. Work Book Top 200 Codes

Transgender cervical cytology take 2  The LMC received a question from a practice after a notification from Essex Contractor Services that now deals nationally with patients who change title and gender. A patient had been reassigned from the female to the male gender. The notice pointed out, citing regulations, that it was now the practice’s responsibility to call and recall the patient for cervical smears should the patient wish to continue to take part in screening. As GPs are not normally involved in screening call, and recall and probably have no mechanism to do it reliably, this naturally caused concern. We can now report that indeed practices bear the responsibility. The BMA policy is that screening must be organ- and not gender- specific so that, unless a patient has undergone total hysterectomy, cervical cytology screening should be offered which is self-evidently right. The question is, by whom should it be offered? The NHS Choices website does mention that routine letters of invitation will not be sent by Primary Care Support England to patients with a male title and that patients “may have to remind” their GP about screening which seems sensible: a good relationship and partnership between patients and their GP is of course the bedrock of good practice in every area. Sadly such goodwill cannot be relied upon legally. The BMA Equality, Inclusion and Culture Department (quoting the GMC), the PCSE and the Screening Helpdesk at NHSE(S) have all confirmed that, ultimately, it is currently the duty of GPs to remind patients about the screening. In answer to an additional question NHSE(S) has reassured us that samples sent with a male identifier will not be rejected by the processing laboratory. In May the Somerset Cytology Screening Board considered the matter and the minutes state that local policy will be updated to include these patients to make sure that their screening needs are properly met.

Colleagues may be interested in this link which goes into breast and other screening programmes as well.

General Practitioners Committee (GPC) Ballot on Closing Practice Lists . Practices should by now have received information about the GPC ballot - if not please let us know.This is a more complex matter than it may at first seem, and we urge you to read the excellent FAQ booklet carefully before reaching a decision.

It is essential that just one person responds on behalf of the practice, and whatever decision you make now it is very important that it is one you are prepared to abide by in the future. GPC really needs to be sure as to how practices will act in all likely circumstances.here and FAQ

Emergency Oxygen Supply in Practices Although practices are not contractually required to have oxygen available for emergency use, the CQC expects it, and most GPs find it reassuring to know that there is something useful they can do for critically ill patients in the surgery.

However, many practices only have small cylinder giving about 20 minutes supply and with the huge and growing pressure on the ambulance service they cannot guarantee that a vehicle with oxygen will always arrive in time.

Where oxygen is appropriate, it does not always need to be delivered at maximum flow, and this should be adjusted to maintain a saturation of 95% which may help the supply last longer. If despite this the supply does run out and the patient’s saturation begins to fall you should notify Ambulance Control that the situation is now critical and that will usually mean they attend immediately.

However, it is probably sensible in this day and age for practices to have two small cylinders, partly for reassurance and in case of malfunction, and partly because of the apparent tendency of emergencies to appear in pairs…

Referral process for community dietetics The service has  changed their referral process for GP surgeries from 1/2/17. All surgeries should now e mail referrals to DieteticsReferals@sompar.nhs.uk and not send them by post.

PCSE reporting templates Can we remind practices to please complete these and return by 24th July they were shared in the  30th June update, we have only received 4 to date.

Kind Regards

Jill

Jill Hellens

Executive Director

Somerset LMC

TEL: 01823 331428

Fax:01823 338561

www.somersetlmc.co.uk

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