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Weekly Update Friday 6th February 2015

Date sent: Friday 6 February 2015

Domiciliary Phlebotomy Service. Please find below an email response from the CCG about the query the LMC raised regarding 'failed' attempts under this service. It seems that advising the GP about the situation is to alert us to the situation and not to 'close the case'. The LMC are seeking further clarification from SPFT about the action that they will take at this stage.  It also seems that these events are part of the Performance Management of this contract and that Federation links have been asked to feedback this information back to the CCG. The LMC felt that GPs should be aware of this process.

Further to your email question below about the new Domiciliary Phlebotomy Service provider and failed attempts at venepuncture, I can respond as follows:-

Where the phlebotomist has been unable to take the blood sample, a second clinician will be asked to undertake the visit.  If it is still not possible to obtain the blood sample we would expect the service provider to notify the referring clinician and agree on the next steps.  The purpose of this notification is to alert the referring clinician rather than to close the case.

As part of the procurement, the service provider had to demonstrate that their staff would have appropriate training, skills and equipment to manage patients from whom blood samples are difficult to obtain, and this is included within the service specification.   During the procurement process, bidders were asked to confirm how such patients would be managed and the evaluation panel were reassured by the responses.  We therefore anticipate that incidents of failed venepuncture will be infrequent and that the service provider will work with the referring clinician to make arrangements for any occasions when this does occur. Failed attempts at Venepuncture is one of the measures within the performance monitoring framework for the contract and as such we will be reviewing this with the provider. 

Where an appointment is made but the patient is not home on two occasions the Phlebotomy Service will work with the patient and the GP to withdraw the offered home visits, supporting the patient to access clinic based services (unless the patient was absent due to hospital admissions).

We are aware that SPFT are linking with you directly as part of mobilising the service and we have also written out separately to the Federations to nominate points of contact so that we can ensure that communication flow about the new service is timely.

To Health. We met with To Health yesterday regarding NHS Health Checks and clarified some of the queries that Practices have sent to the LMC. We have also now seen the GP contract for the service and raised some concerns and suggested some amendments which have been accepted by To Health, however a legal opinion may need to be sought. It would be useful to know how many practices have expressed an interest in providing this service, we would be grateful if you could e mail lmcoffice@somersetlmc.nhs.uk to confirm either way.  We will produce a report on this meeting which will be circulated to Practices next week.

Somerset Transfer of work survey. Please could you send your completed forms to the LMC office by the end of February so that we can collate the results. We are aware that some Practices have decided to do the survey in February so we hope to have the results out to you in March. Thank you for your help with this.

Lymphoedema. We understand that Practices have been informed that the follow up of these patients after discharge from the service should include an annual Doppler done by Practices. We would like to confirm that this is NOT agreed with the LMC. We have always strongly maintained that Doppler’s are not core work and this is understood by the CCG. We are unsure from where this information has come from and have sought clarification from the CCG but it is our understanding that these patients should be seen by the ambulatory service.

Workforce Minimum Dataset update from GPC GPC issued a position statement on the Workforce Minimum Data Set (WMDS) in January .The statement included advice for practices on the data submission and asked for further feedback on its implementation, so that concerns could be taken up with the Department of Health (DH). Following this feedback, GPC advised practices to await further guidance before proceeding with the preparation of the data.

GPC has now held an urgent meeting with the DH, where we highlighted the areas of concern. The meeting was positive, with a willingness on both sides to work together to resolve the issues. We are meeting with them again very soon. GPC will also soon be in a position to share the advice received from the ICO and we are drafting a GPC response to the Privacy Impact Assessment consultation.

Our advice remains that practices should await further guidance before proceeding with the preparation of the data. As a reminder, the first data submission will be due at the end of May, so we will issue further guidance as soon as possible.