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Member Practice Update

  14 December 2016

Welcome to the Member Practice Update

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

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 ccgcomms@worcestershire.nhs.uk

In this issue:

  • No South Worcestershire News
  • No Wyre Forest News

Quadrivalent flu vaccines

The quadrivalent flu vaccine is not currently supported for prescribing in Worcestershire. The evidence and affordability of the quadrivalent vaccine will be considered by Worcestershire Area Prescribing Committee at the beginning of January and practices will subsequently be informed to enable them to order their vaccines.

Serious Adult Review

Worcestershire Safeguarding Adult Board (WSAB) have recently undertaken a Serious Adult Review into the death of an Adult with Care and Support needs. The criteria for a Serious Adult Review was met as defined in Chapter 14 of the Care Act (2014) which states “Safeguarding Adult Boards must arrange a Serious Adult Review when an adult in its area dies as a result of abuse or neglect, whether known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult”.

The purpose of having a Serious Adult Review is not to reinvestigate nor to apportion blame, It is:

  1. to establish whether there are lessons to be learnt from the circumstances of the case about the way in which local professionals and agencies work together to safeguard vulnerable adults
  2. to review the effectiveness of procedures (Both multi-agency and those of individual organisations)
  3. to inform and improve local inter-agency practice
  4. to improve practice by acting on learning (developing best practice)
  5. to prepare or commission an overview report which brings together and analyses the available findings of the various reports from agencies in order to make recommendations for future action.

One of the findings from this recent Serious Adult Review was that whilst all GPs considered mental capacity, this was not consistently recorded in the records. Recommendation 14, as part of the Multi Agency Action Plan is “Disseminate information to GPs about training opportunities available. Resend MCA/DoLS Competency Framework and to ask GPs to incorporate into the appraisal process".

For those GPs who have not yet undertaken Mental Capacity Act training and Deprivation of Liberty Safeguards training to do so. This is currently incorporated into the Safeguarding Adults Face to Face Training organised by the CCG for which there is a statutory requirement to undertake every three years. The following dates for the Adult Safeguarding Training are available:-

Tuesday 22nd Nov – Barnsley Hall
Wednesday 14th Dec – Barnsley Hall
Thursday 23rd Feb – Grey Gable Surgery, Worcester
Thursday 6th Apr – Upton Surgery, Worcester

All sessions are from 1.30pm-4.30pm and can be booked through Charlotte Keogh (Team Secretary) on 01527-482919 or email at charlotte.keogh@worcestershire.nhs.uk

As stated in the recommendation, it is suggested, as best practice that the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) Competency framework (as developed by partner agencies for WSAB) is resent to GPs (see embedded document below). This framework was developed to support partner organisations in the development of a workforce that is competent and effectively trained in MCA and DoLS practices and which is continuously improving. It outlines the sets of competencies required for particular categories of job roles.

Previously MCA & DoLS training has been based upon attendance at training at a range of levels. However completion of training does not evidence a worker’s competence in any particular area or task, only that they have attended a training course.

This framework sets out a competency based approach to enable all staff working with adults to develop their skills. It is designed to raise standards and promote a consistent and appropriate response to adults whose mental capacity may be in question. It has been devised to provide a baseline for demonstrations of competence by staff that support adults.
As best practice it is recommended that GPs incorporate the MCA/DoLS Competency Framework into the appraisal process. The Competency Framework is available here.

Additional findings from the Serious Adult Review, were that there was a lack of continuity for the patient and whilst this did not contribute to the patient`s death, over the period, for the terms of reference for the Serious Adult Review, the patient saw approximately ten GPs and never saw a GP more than once. Some GP practices have made the choice to develop a Named GP Visiting service (within their own practice) for all patients in the community who are unable to get to General Practice, which provides continuity of care for patients. GPs may wish to consider implementing this.

Kooth Service

Kooth.com is a free, safe, confidential and non-stigmatised way for young people to receive counselling, advice and support online. A newly commissioned service by Worcestershire Health and Care NHS Trust Kooth delivers 1000’s of counselling sessions each year in Local Authorities across the UK. Available until 10pm each night, 365 days per year, it provides a much needed out of hours service for advice and help. As 50% of referrals to CAMHS are deemed inappropriate to their criteria, Kooth gives GPs an alternative way of ensuring patients can access free support when they need it, in a medium young people know and use.

Our therapy team are qualified counsellors and psychotherapists, clinically supervised in house and independently to deliver evidence-based interventions. They deliver CBT, solution focused and humanistic approaches such as narrative and other relational therapies. The team are all employed by Xenzone, headed by their line manager and receive on-going professional development and training. They work closely together to ensure the best outcome is achieved for the young person. The counsellors have clear pathways into others services too, ensuring the young person gains information needed and are signposted to the most appropriate provisions.

As you and your staff have day to day contact with young people, it is important that they and the young people know about Kooth.com and understand what it can offer. Therefore I would like to offer free training sessions for your staff. This could be part of your staff meetings as it only takes 30 minutes to give a presentation with a Q&A period. If you would like more information or to book free training, please contact Angela Jones (integration and Participation Worker) by phone on 07944 725 941 or email her at angela.jones@xenzone.com.

Friends and Family Test Monthly Data

Follow this link to access the Friends and Family Test report for October 2016.  

The first worksheet displays submission patterns for last year and this year, for all practices. Using the drop down arrow in row 6 on the second worksheet ‘practice specific’ allows you to drill down to your own practice details.

Just a reminder to all Worcestershire practices that the FFT is a contractual requirement (Clause 16.7a of the GMS contract) and becomes a contractual issue if it isn’t submitted for a period of 3 months or more. Practices need to be aware that a non-submission is also picked up on NHS England’s performance framework dashboard. Practices are strongly encouraged to ask their patients to take part in the survey and to submit data every month. The original brief from the BMA is that “Submission closure is the twelfth working day after month end, so please ensure you have your data submitted before then".

Capita Contact Information

There have been requests from practices regarding who to contact at Capita when they have an issue that needs to be escalated. Jonathan Gore is the Regional Liaison Manager (West Midlands) and is part of the National Engagement Team and can be contacted at jonathan.gore@capita.co.uk.

Prescribing Top Tips

Labelling Of Topical Medicines

When prescribing topical medications it is important that the prescription administration information is as explicit as possible. This is of particular importance when third party carers, who may be unfamiliar with individual patients, are responsible for the administration.

Prescriptions should specify:

  • The quantity of ointment or cream to be applied:  (liberally/sparingly/ fingertip units*)
  • How many drops to instil, where applicable.
  • The precise area of the body involved including left/right descriptor if applicable.
  • The frequency of application. 
  • Extra information to clarify clinical indications for application e.g. “when skin is dry” or “on inflamed areas only” .

The directions “Apply as directed” should be avoided wherever possible.

* Topical corticosteroids can be prescribed by fingertip unit (ftu) – a fingertip unit is the amount required to cover the terminal phalanx of the index finger and is approximately 0.5g of cream or ointment. Suggested numbers of ftus for application to specific body areas are given in the table below:

















More information can be found in our current dermatology guidance which can be found here.

If you have any suggestions for inclusion in the 'Top Tips' then please send them to Anne.kingham@worcestershire.nhs.uk

MeetingDem UK National Conference

UK National Conference
21 March 2017: 10:00 to 15:30 (tbc)
University of Worcester Arena Hylton Rd, Worcester WR2 5JN

The MEETINGDEM Research programme aims to implement and evaluate the Meeting Centres Support Programme (MCSP) in the UK, Italy and Poland. This community driven, locally based means of delivering effective post-diagnostic support for people living with dementia and their families has been operational in the Netherlands for many years. MEETINGDEM has taken the learning from the Dutch model and adapted it for delivery in the three new countries.

We have established two Meeting Centres in the UK, one in Worcestershire and one in Herefordshire, in partnership with the Alzheimer’s Society, and are currently in the middle of the evaluation phase to assess the benefits and cost effectiveness of the intervention and are planning to hold a day conference to share the results of the evaluation.

If you are interested in attending it would be good to have an indication of this by registering here.

We will circulate a more information and a detailed programme closer to the event. For more information now please email: dementia@worc.ac.uk

Introduction to Health Assessment of the Child and Young Person - 5 Day Skills Workshop

As Healthcare provision changes to meet the needs of the population, practitioners are crossing professional boundaries to meet these demands. Health Assessment whether comprehensive or focussed, forms the basis of clinical decision-making, and every patient/practitioner contact is an opportunity for assessment.

This 5 day workshop enables practitioners to explore and enhance their knowledge and skills in the performance of health assessment of children and young people within the context of professional practice.

This workshop is running from the 13 - 17 February 2017.

Find out more, and how to attend.

Redditch & Bromsgrove Locality News:

Chart of the Week

We are often asked for more comparative information to enable practices to know where they stand on a variety of indicators in comparison with other practices. Therefore we publish a chart in the Member Practice update on a variety of topics. Please let us know if this is helpful and also for any topics that you would find it useful for us to cover.

This week’s Chart of the Week is ‘Emergency Admissions from Care Homes’ and the data is April - August.

Chart of the Week

Patient Network

The CCG is hosting another series of Patient Network events following the successful launch in 2016. These events are aimed at patients who are members of their practice patient groups. The next series of events will take place in early 2017, and are aimed at providing residents of Redditch and Bromsgrove with the opportunity to have their say and get involved in commissioning decisions.

The dates of the next Patient Network events are;

  • Redditch Patient Network event - Thursday 26th January 2017 2pm-4pm
  • Bromsgrove Patient Network event- Tuesday 21st February 2017 4pm-6pm

Individuals are able to book a place on one of the above events by contacting: Vickie Deacon, Business Support Officer on Vickie.deacon@worcestershire.nhs.uk or 01527 482955 by 20th January 2017.