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Member Practice Update

10 May 2019








Welcome to the Member Practice Update


This weekly Member Practice Update is produced by NHS Redditch and Bromsgrove, NHS South Worcestershire and NHS Wyre Forest Clinical Commissioning Groups for circulation in your practice, to provide you with essential guidance, information and useful support.

Please Note: Following feedback from GP’s this update will now come out on Fridays rather than Wednesdays.

Your views and feedback are very much appreciated. If you have any comments, suggestions or contributions for inclusion in the Member Practice Bulletin, please e-mail the communications team.

In this issue:

  1. CCG Merger Proposal 
  2. Mental Health Services Initiative
  3. GP Workforce: First Five GP Network Launch and NHS England Survey
  4. GP Workforce: National Workforce Reporting System (NWRS) Registration Reminder
  5. NHS App Reminder
  6. Primary Care Estates Strategy
  7. Prescribing Top Tip
  8. Proposal to discontinue routine telephoning of Campylobacter stool isolates to general practice
  9. Last Call for Bookings - Dementia Education Event 


Find out about local and national events and training here.

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  • No Redditch & Bromsgrove news 
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  • No specific South Worcestershire news
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  • No specific Wyre Forest news 




CCG Merger Proposal

The NHS Long Term Plan makes clear that every STP footprint in the future will have more streamlined commissioning arrangements by 1 April 2021 to enable a single set of commissioning decisions at system level. For Herefordshire and Worcestershire this will involve moving from four CCGs across to a leaner, more strategic single CCG for Herefordshire and Worcestershire.

In doing so and achieving economies of scale, the CCG will be able to realign much of its current workforce to provide greater resource and support for the emerging Primary Care Networks. The CCGs believe that the sooner they are able to do this, the sooner they will be able to release this support for Primary Care.

Other anticipated benefits of forming one CCG to replace the four current CCGs include:

  • Greater financial resilience, meaning at-scale finances which will reduce risk and fragility and provide greater economies of scale 
  • More leverage, clout and influence with current providers
  • Consistent, fair and equitable service contracts across Herefordshire and Worcestershire
  • Single commissioning policies across Herefordshire and Worcestershire, putting an end to ‘postcode lotteries’ for services and treatments across the two counties
  • Opportunity for the CCG to evolve into the system manager role being vacated by NHS England

Next month the CCGs intend to consult on the proposal to form one CCG for Herefordshire and Worcestershire by 1 April 2020.

Before seeking the views of the public and wider partners, the CCGs would like to hear from member practices on their immediate thoughts and any concerns they might have about the proposal.

A meeting with all Worcestershire practices is being planned for 25 June at 2.30-5pm ( the Strategic Commissioning Meeting now funded via PCE). We’ll discuss this in greater detail as well as the final 2019\20 PCE contract and development of PCNs. Please hold this date, venue to follow. 
   




Mental Health Services Initiatives

At its March Meeting, the CCG Governing Bodies approved their Financial Plan for 2019-20. Within the overall plan the CCGs have committed to increasing investments on Mental Health services as part of the Mental Health Investment Standard (MHIS), requiring all CCGs to increase mental health investment by overall CCG growth plus 0.7%.


The following investment plans have been informed by feedback from practices as part of the Autumn/Winter IQSP Programme and the ambitions laid out in the Mental Health 5-year Forward View (MH5YFV).

Scheme

Implementation Date

Narrative

Eating Disorders

Oct 19

To develop existing service model, moving closer to best practice guidance as per CCG service review. Key priority is to undertake physical health monitoring within secondary care, in line with LMC feedback.

Personality Disorders

Oct 19

New service development to fill current gap in provision within county and reduce pressure on other services working with this patient cohort, by providing both care coordination and advice/support to other services.

Perinatal Mental Health

Apr 19

Service expansion in line with national best practice guidance and to meet 4.5% of population birth rate access target.

Crisis telephone triage

Sep 19

New development based on national best practice/Long term Plan to improve patient journey, increase efficiency of current services, and ensure CRHT meets CCQI / UCL Core Study requirements for self-referral.

Crisis Café

Dec 19

New development to complement Crisis telephone triage, providing VCS-led therapeutic, non-clinical alternative to A&E for patients experiencing crisis. To be based in the north of the County, with Crisis Assessment Suite in Worcester the A&E alternative in South Worcestershire.

CARS

Oct 19

Increasing capacity of service to improve core offer and reduce waiting times, including for psychology.

 

Older Adult CMHTs

Oct 19

Additional capacity to facilitate rapid response to prevent carer breakdown and reduce admissions to acute and mental health beds.

SMI Physical Health Monitoring

Apr 19

LIS agreed to provide all 12 health checks within primary care, supporting parity of esteem with physical health, closing the mortality gap. Five Year Forward View for Mental Health requirement.

Adult ADHD

Aug 19

New local diagnostic and review service, to fill current in-county service gap. Interim arrangement with Dudley and Walsall Partnership Trust expanded to include diagnostic assessment pending implementation of Worcestershire service.

Dementia Diagnosis

Aug 19

Additional capacity following demand and capacity review to clear current backlog of referrals and provide 12-week referral to diagnosis pathway.

Crisis Assessment Suite

Aug 19

Additional staffing for Crisis Assessment Suite and Health Based Place of Safety to support alternative to A&E on WRH site, 24 hours a day.

IAPT

Jul 19

Additional capacity to increase access with focus on expanding support for people with long term conditions and increasing therapists in primary care.

Children’s SPA

TBC

Creation of a Single Point of Access (SPA) to receive all referrals for mental health and behavioural issues, streamlining referrals process for GP practices and schools.

CAMHS and R4W

TBC

Additional capacity to meet increased access target for children and young peoples’ mental health services of 34%.

Umbrella Pathway

TBC

Additional capacity to clear current backlog of referrals and provide a waiting time of 15 weeks.




GP Workforce: First Five GP Network Launch and NHS England Survey

NHS England have provided the CCGs with funding to create a First Five Network, appoint a First Five GP Clinical Lead and offer mentoring opportunities for First 5s. The CCGs are pleased to announce that Dr Mobeen Ahmed has been appointed as the First Five GP Clinical Lead for Herefordshire and Worcestershire. Mobeen will be working closely with the regional NHS England team and other First Five Clinical Leads across the Midlands and East region. In addition, we will be launching mentoring opportunities for first 5s in the coming months.

What is a First 5?
It is essentially a GP within the first five years of qualification. This cohort of GPs in general can be vulnerable as they go out into the world of general practice in primary care and value some support to help them establish themselves as fully qualified GPs.
 
How can the First 5 Network support you?
We are planning to launch a number of initiatives through each area (this may vary according to geographical demographics) e.g. mentoring schemes, CPD events, GP Health Service, support with annual appraisal preparation; and we are also seeking to gather your views on what is most important and relevant to you.
 
The establishment of a First 5 network enables workforce leaders in the STPs (Sustainable Transformation Partnerships) and NHS England /NHS Improvement to support our First 5 GPs in a number of ways and through various initiatives which are designed to support you and your early career development in primary care.
 
In order that the First 5 network offers the things that are most helpful to you, we would be grateful if you could complete the survey at www.engage.england.nhs.uk/survey/3d60ed60/. The survey comprises a few short questions, it closes on 15/05/2019 so please do take 5 minutes out to complete it.
 
Once we have the outcomes of the survey we will let you know what the key themes are, what support schemes will be introduced and when they will be launched. In the meantime if you want to have a discussion with your clinical lead, feel free to email the Workforce team on sowoccg.workforce@nhs.net



GP Workforce: National Workforce Reporting System (NWRS) Registration Reminder 

On the 1 April 2019, the National Workforce Reporting System (NWRS) moved and is no longer part of the Primary Care Web Tool (PCWT).

To support this move, an email was sent to all GP practices asking them to create a new user account and password.

This is therefore a gentle reminder to re-register and to thank the users who have already reregistered. If that includes you, then please ignore this message.

If not, please follow this link or contact us by email, referencing 'NWRS Access Request' in the subject field and clearly stating the practice(s) that you work for.

Further information and guidance is also available on the NWRS web page, or you call on 0300 303 5678.




NHS App Reminder

A reminder that Herefordshire and Worcestershire Practices are to be set-up with the NHS App ready for Monday 13th May, all details and support within this link: www.digitalhealthforum.co.uk/nhs-app/



Primary Care Estates Strategy

Worcestershire CCGs currently have an estates adviser working with us who is carrying out an analysis of our premises capacity and use, which will be included in our STP Estates Strategy due to be submitted later this summer. To meet CCG governance requirements, it will need to go to our Primary Care Commissioning Committee in June.

In order to get a more detailed picture of each locality, we need to meet GP representatives to explain what we’re doing and discuss thoughts around future working in each area.  Gathering this information will also help us apply for funding towards improvements, extensions, possibly new builds, should any become available in the future.

We intend to visit each area by the end of the month and most of the meetings around the county have been arranged. Either Lynda Dando or Hollie Hastings will be attending, together with Jo Hall and Adrian Hayward, our adviser.



Prescribing Top Tip

TARGET Toolkit Website Resources

The Target Toolkit is a well-known, central resource that facilitates the optimisation of antibiotic prescribing in primary care. It aims to influence the personal attitudes of both prescribers and patients, challenge social norms, and address perceived barriers to responsible antibiotic prescribing. It is therefore a key tool to help tackle the overarching, and ongoing, global issue of antimicrobial resistance.

The toolkit contains many useful resources, including a range of patient information and pictorial leaflets for common self-limiting infections where antibiotic treatment should not be required. The respiratory tract and urinary tract “Treating Your Infection” patient leaflets can be accessed directly via the EMIS library which will enable them to be easily printed and shared with patients during consultations.

There are four such leaflets and they can be found on local EMIS systems at:
 
Document templates> EMIS Library> Public Health England


EMIS have now also produced a protocol which can be used to launch both leaflets. This can be found at:

Templates & Protocols> EMIS Library> EMIS Protocols> Public Health England.

Instructions on how to activate the protocol are available on the toolkit website. Note that these instructions cite the respiratory infection leaflet but should also be pertinent to the urinary tract infection leaflets.

If you have any suggestions for inclusion in the 'Top Tips' then please send them to akingham@nhs.net




Proposal to discontinue routine telephoning of Campylobacter stool isolates to general practice


Background:
At present, the microbiology laboratory telephones all Campylobacter isolates from stool samples to the referring general practice Monday – Friday. Following a review of workload, it has been suggested that this service does not add significant value to patient care and takes up a significant proportion of both laboratory and general practice clerical staff time.

Proposal:

From Monday 3rd June 2019, Campylobacter isolates will no longer be telephoned to general practice routinely. The result will be available electronically as normal. The laboratory will telephone results at the discretion of the medical microbiologist on duty, where clinical details indicate. Such examples include in children <3 months, if the request details indicate the patient is significantly immunocompromised or if the isolate is part of a suspected outbreak. Results will be electronically notified to Public Health England automatically, as normal.

If there any concerns about this proposal, please e-mail hugh.morton@nhs.net before 3rd June.



Last Call for Bookings - Dementia Education Event

Dear Colleagues, this is a last call for bookings for our Dementia Education Event, taking place on 14 May. The event is open to all professionals caring for and supporting people with a diagnosis of dementia, their carers and families. The full details and booking link are here. Bookings are closing at lunch time on Monday.