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Somerset LMC Weekly Update Friday 19th January 2018

Date sent: Friday 19 January 2018

All Somerset GPs and Practice Managers This and Previous updates can be found here  and on the LMC App

Choice of Flu Vaccine for the 2018 Immunisation season  Unfortunately the decision as to which Flu vaccine to order for next year has actually become harder rather than easier over the last week.

Everyone agrees that adjuvanted flu vaccine should be offered to the over-75s, and it looks as though CCGs will be funded for this. For those between 65 and 74 the position is not so clear. The JCVI says that although over 75s are the priority, it is cost effective to use adjuvanted vaccine for both groups. It is obviously easier if practices can keep purchasing and delivery simple as possible, though whatever you do you will now need at least two injectable vaccines, but it looks as though CCGs will not be funded for the difference in price between adjuvanted and standard vaccine for 65-74 year olds. For about 73,000 patient at £4.50 extra a time that adds up to £328,500, which the CCG just does not have. And although the vaccine may be cost effective in abstract, we just don’t know how that compares with the potential benefit of all the other things that money could be spent on.

We also need to remember that vaccine manufacture is complicated and somewhat unpredictable. From time to time a manufacturer’s batch will fail quality control and never come to market. If everyone has ordered (assuming the manufacturers have the capacity) just the one single adjuvanted vaccine currently available for all their over 65s we could be in trouble though as the immune response to conventional vaccine in the over 75s is very poor it is arguable that that cohort will not be much worse off.

The arguments about the quadrivalent vaccine are very similar. Although it offers protection against B/Yamagata, which is currently circulating and which is not covered by the trivalent vaccines, B infections tend to be less serious and so incur less direct NHS cost than do A strains, against which both types of vaccine are equally effective. Unsurprisingly, in the last couple of days there has been critical media coverage asking why the NHS is recommending a less effective vaccine on price grounds, but the same questions about security of vaccine supply and relative cost benefit need to be considered . If all under-65 at risk patients were to be given quadrivalent vaccine this autumn it would cost the CCG another £1m.

Perhaps more important for flu transmission is that the Fluenz Tetra nasal vaccine used in the children’s programme is quadrivalent, and that is likely to have more impact on reducing spread than the choice of vaccine for individual “at risk” patients.

Escalation Calls with NHSE Somerset CCG, Acute Trusts, community Trust, and OOH We would like to thank all the practices that responded so quickly to our call for urgent information regarding the recent pressures in primary care, We only had 40 minutes notice for the first call and the response was truly amazing, we have turned the information received into a narrative paper that has been shared widely with system directors, Nick speaks more about this in his blog.

DBS Checks for Locums A quick reminder to all Somerset locums that you are able to apply for a DBS check via the update service from the Avon LMC office here

Updated prevalence  guide, calculation and Searches for SPQS The suite of documents have all been updated and can be found on the PSU area of the website (you will need to be logged in to view and they are right at the bottom of the web page) we are unable to post the searches onto the website so please download them from the winzip file attached

LMC Practice Training

Optimising Document Workflow – Tuesday 30th January 9.00-12.00, Bridgwater This is a repeat session if the practice GP Champion, Practice Manager and Lead Document Handler missed the previous sessions. https://www.somersetlmc.co.uk/events/4861. Please book before 23rd January.

SNOMED CT Awareness – Thursday 1st February 13.15-16.30, Ilminster Details on the change from read codes to SNOMED taking place in April. https://www.somersetlmc.co.uk/events/4965 . Please book before 25th January. 3 places left but we can run a morning session if there is a lot of interest

NHS Pension Update 2018 – Tuesday 6th February 13.15-16.30, Bridgwater Details on the NHS Pensions Scheme legislation for practices. https://www.somersetlmc.co.uk/events/3321 . Please book before 30th January.

 

 

 

Kind Regards

Jill

Jill Hellens

Executive Director

Somerset LMC

TEL: 01823 331428

Fax:01823 338561

www.somersetlmc.co.uk

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Attached file: Prevalance Searches.zip

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