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Somerset LMC Weekly Update Friday 22nd September 2017

Date sent: Friday 22 September 2017

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

Frailty Coding and CQRS We are aware that there is quite a bit of confusion on this matter ,and that various guidance documents from NHSE, GPC and NHSE Employers are not entirely compatible. This has been an evolving area and it is important to make sure you are using the most recent information.

It appears that the EFI – which is NOW a risk stratifying tool and not a diagnostic aid – has been over sensitive , so batch-coding may lead to over diagnosis of frailty. The best solution if you have batch-coded is to review the coding and if necessary remove the code or add the correct readcode depending on the scale of frailty. This can be done when these patients have the required falls risk assessment (or formal medication review for the severely frail) .

The recently issued single sheet guidance from NHS England GMS 2017/18 Frailty Contract Guidance on Batch-coding, which we recently circulated, links to another NHSE paper Supporting routine frailty identification and frailty care through the GP Contract 2017/18 which includes in its glossary some useful pragmatic descriptions of frailty, but we understand that the contract technical guidance Requirements for 2017/18 GMS Contract Changes (latest version May 2017, version two) takes precedence for CQRS reporting purposes and it lists the data that is required. Essentially this covers all patients with severe frailty and those with moderate frailty who, in the GP’s opinion, should also be included.

We have also asked for confirmation from the CCG why they have requested a completion of a TEP and the clinical commissioning document for SPQS as this appears to duplicate the work involved.

Somerset GP Board The Board has been asked to feedback on ideas that could make the system work better with a view to winter pressures (that we all know are all year now) so we would welcome any suggestions that practices have in this respect. Please email the LMC office with these ideas before Friday 6th October so that we can feedback to the CCG soon.

National Diabetes Audit Data submission to the National Diabetes Audit is included in the GMS contract this year and we have just heard that 97% of Somerset practices made a full submission. All practices participated. Although we scored highly this year around 70% of practices did not submit all seven files on first submission. The CCG received data sheets from the national team weekly and chased all these practices up - sometimes more than once. Practice staff generally seemed unaware that a full submission had not been made and that the practice would therefore not be paid!

The LMC will ask GPC to request that the National Team does in future let practices know when data submissions are incomplete, but part of the problem is that practices often only have one person familiar with the submission procedure, and if she or he is absent for any reason it may not be apparent that data is missing .

Please note that there will be two NDA data collections next year. The CCG has built up a small network of practice staff who are very familiar with NDA and offer help to practices who were struggling with the audit, so if you need help with this please contact

Violent Patients The LMC are aware that practices are having some difficulty in getting violent patients removed from their list and seen in the violent patient schemes that are available in the county, in order to make a stronger case to NHSE and remind them of their contractual obligation we would be grateful if you have not already informed us of any problems to please do so

General Practice is changing The LMC are working with the County practice managers group on a countywide campaign to educate patients on the changes happening in General Practice, to enable practices to share some information during the Flu season we have put together the attached  information sheet that practices can print off and give to patients at the flu clinics or leave in the reception areas.

Dispensing and Non Dispensing patients We have been advised by a dispensing practice that any minor changes made to a patient record such as address change, the record also changes from dispensing to non-dispensing. Please also be aware that this can also happen with GP2GP transfers. It also appears that PCSE are data cleansing the addresses when a house or street name doesn't’t match exactly with the address shown by Royal Mail, this is a particular problem with rural practices, and again affects the dispensing status. We strongly advise that you do monthly searches on who your non-dispensing patients are and make sure that they should be non-dispensing. The LMC shall be raising this with EMIS.

Somerset School Immunisations pathways 17-18 This is a useful reference document covering all the immunisations now given to School aged children in the county. It is also available on the LMC website

Scam requesting payment of invoice Practices should be aware that these scam e mails are circulating again, the e mail appears to come from a legitimate practice supplier e mail address  and asks for payment of an outstanding invoice.

Kind Regards


Jill Hellens

Executive Director

Somerset LMC

TEL: 01823 331428

Fax:01823 338561

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Attached file: General practice is changing Final.pdf

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