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Member Practice Update

19 October 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:


European Antibiotic Awareness Day - 18 November

European Antibiotic Awareness Day November 18th is fast approaching and is part of World Antibiotic Awareness Week.

The three Clinical Commissioning Groups in Worcestershire are again working with health and social care partners across the county to remind patients of the importance of only taking antibiotics when necessary in support of European Antibiotics Awareness Day.

One way to promote better antibiotic use is by making an Antibiotic Guardian pledge. Antibiotic Guardian is a UK-wide campaign which aims to improve behaviours around antibiotic prescribing and use.

This campaign supports the UK 5 Year Antimicrobial Resistance Strategy 2013 to 2018, which sets out actions to slow the development and spread of antimicrobial resistance.

Please make your pledge to become an antibiotic guardian and pledge to “champion Antibiotic Guardian within your organisation by encouraging at least 10 others to pledge".

More information about the campaign and how to pledge is available at http://www.antibioticguardian.com

Further information and resources will be sent out nearer the time.

Changes to clinical waste services

On 16 September 2016, NHS England launched a new national framework agreement setting out consistent standards for collection and disposal of clinical waste from GP surgeries and unwanted medicines from pharmacies.

The new supplier will be PHS Group and the new contract will begin on 14 November 2016. PHS may already provide clinical waste services to you at the current time and if so your collections and service will not change.

Find out more, including what will happen next is this NHS England letter.

Roll out of Black Pear (EPaCCs System) – User Guide & FAQs

Further to recent communications re go-live of the Black Pear EPaCCs (Electronic Palliative Care Co-ordination System), please download the User Guide which should help when navigating the system. 

Please also view a list of frequently asked questions which will hopefully assist with any queries you have about the system.

Please also note the following:

  • Patient death – All GP Practices will have their own system of recording information once a patient has died.  Please continue to follow this process for patients who have not been added to the EPaCCs system.

The following process will need to be adopted for patients who have been added to the EPaCCs system:

GP Practice to open the patient’s EPaCCS form and mark the record as 'closed'. The reason for closing the record entered as 'Patient Died' followed by the Date of Death.  On saving the EPaCCS form a notification is sent to WMAS and the EPaCCS form is closed.

If the patient is not on the EPaCCs system, please do not add them to the system to then remove them.

  • Patient consent – Patient consent is required in order to create a shared record.  Please do not proceed with the EPACCs process where consent has not been obtained.  It is important to obtain the patient’s consent in order to comply with Information Governance rules.

The record is not initiated until consent has been given. A data field records the type of consent for sharing the record. This includes whether explicit consent has been given, whether it was a best interest’s decision or whether the decision was made by a Lasting Power of Attorney. The record also records if consent for the record has been withdrawn.

If you have any queries re the User guide, please contact Tomasina Collier, IM&T ETD Specialist (Worcestershire), Midlands and Lancashire CSU, Mobile: 07899 692927, Email: tcollier@nhs.net

Child and Adolescent Mental Health Referrals 

Over recent weeks CCGs and the LMC have been working with the CAMHS team to streamline and simplify the referral process for patients who require the services of CAMHS. 

After considering the current referral form, it has been agreed that a new and simpler form was required and in particular asked the patient’s GP to only provide information that is likely to be held in general practice. Please note that a key part of the agreement with CAMHS is that a “brief summary printout” from the practice EMIS system would accompany the letter if at all possible.  It would also be helpful if the section on whether social services were involved with a child could be completed, although it is accepted that on some occasions the general practitioner may have no knowledge regarding this.

If  a GP is uncertain that the referral will meet the Threshold for CAMHS and/or the GP feels that Targeted Early Help Support is more appropriate to meet the child’s needs  please ask the Parent to call the Family Front Door (01905 822666) to speak to a Social Worker/ Initial Screening Contact Officer-This is a Self-Referral by the parent and a form will not need to be completed.

GP’s can call Community Social Workers who are available for advice - Use the Family Front door (FFD) Portal for all up to date Social worker telephone numbers.

Please be aware that there will be a new emotional wellbeing service for children and young people in Worcestershire which will include online counselling as well as a face to face service. This is due to be fully operational from February 2017. GPs will be made fully aware of this service and the referral criteria prior to the launch.

Download the new referral form

Download a self- populating EMIS template for surgeries in Worcestershire

For queries with the template, please contact Clare Gibbs, Primary Care Data Quality Facilitator – clare.gibbs@nhs.net

Releasing Capacity and Fulfilling the Potential of Primary Care Event – 9 November 2016 - LMC & CCGs Countywide Development Day 

Thank you to all the practices that have already responded regarding clinical coverage and attendance.  

On 17 October the booking form was sent to practice managers, this included an area for sign up for the afternoon breakout sessions and can be found at this link. Each delegate will need to select the first and second session they would like to attend. There is space to select an alternate in case there is over booking in a session. We need final numbers via the booking forms by the end of business on 25 October.

As part of the PCE contract there is funding for one GP to attend the event. If practices would like to close for the day we are happy to provide clinical coverage for your practice through Care UK, to allow the majority of your practice can attend. Practices opting not to close are welcome to send as many delegates as they wish but need to be aware only one place can be funded through the PCE contract. If your practice would like to close for the day please contact Denise Horton denise.horton@worcestershire.nhs.uk by the end of business on 19 October so arrangements can be made for coverage.

Please be sure to include a contact email for each delegate on the booking form as there may be materials sent out to the participants prior to the 9 November. Also, please note any dietary requirements that need to be catered for. 

Any questions regarding the event can be directed to Denise Horton denise.horton@worcestershire.nhs.uk

Prescribing Top Tips

Buprenorphine patches are approved for use in Worcestershire ONLY for:

  • Patients with dementia who require opioid analgesia and who cannot tolerate or swallow oral preparations.

  • Palliative care patients who are unable to swallow.

All other patients should be prescribed an oral preparation as this is more cost effective.

Where buprenorphine patches are indicated BUTEC is the most cost effective option:


Drug tariff price / 4 patches

(based on BuTrans)

Butec price/ 4 patches










Based on prescribing data for the 12 months September 15 - August 16 an 80% switch of generic buprenorphine and BuTrans brand to Butec will give annual savings of:







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

Management of common infection committee

NICE are looking for members to join the “management of common infection committee” and are looking for  the following health care professionals to contribute to this guideline development.

They are looking for a

  • GP
  • Community Nurse
  • Infection Control Specialist

For more information visit https://www.nice.org.uk/get-involved/join-a-committee/member-management-of-common-infections-committee 

Closing date 25 October 2016.

My Medicines Passport

Communication of medication changes across interfaces is a well-recognised issue within the NHS. Whenever a patient transfers care settings there is a risk that information about their medicines is not transferred, or inaccurately transferred.

My Medication Passport is a written record of a patient's medicines. It is designed to improve communication between patients, carers and healthcare professionals and maintain a record of changes made to the patient's medication. Features of the My Medication Passport include:

  • relevant information about the patient

  • relevant information about the patient's GP/ other healthcare professional

  • list of medicines the patient cannot take and the reasons why

  • compliance aids in use

  • list of the patient's current medicines

  • changes made to current medicines and why

  • blank pages for the patient to record additional medical information such as vaccinations, screenings etc.

What are the aims?
The passport aims are to help patients/carers have a complete record of their medicines as well as an understanding of the reasons for any changes being made to their medicines. It's designed to empower patients/carers to take control of their medication and help seamless transfer of medication information across healthcare interfaces.

How has it been developed?
My Medication Passport is part of the wider Imperial College Healthcare NHS Trust Improving Prescribing for the Elderly (ImPE) project, funded by CLAHRC NWL. The main aim of the project was to develop a medication review system based on the evidence based tool called "STOPP" (Screening Tool of Older Persons potentially inappropriate Prescriptions)  to identify and stop medications which are causing harm in the elderly. As part of the Patient Public Involvement (PPI) work stream of the project, the idea of a "Medication" Passport was generated by patients in September 2010.

What is the vision for the My Medication Passport?
My Medication Passport was first tested with patients from Imperial College Healthcare NHS Trust (St Mary's, Hammersmith and Charing Cross  Hospitals) where 7,000 booklets were distributed to both inpatients and outpatients in 2012. A slightly modified version was launched to the North West London community in April 2013. The popularity of this patient tool is such that orders continue to be received from all parts of the UK, from Scotland to Cornwall. Several research projects are currently underway to explore how the passports are being used and the resulting impact they have both on patients/ carers, healthcare professionals and the wider community.

How to order?
The item is free to order and can be done

Online: https://imperial.eu.qualtrics.com/jfe/form/SV_aibYPt3V0NHSS8t
Telephone: 020 331 58144
Email: clahrc.nwl@imperial.ac.uk

Sepsis - General Practice Sepsis Decision Support Tool

Every year in the UK there are 150,000 cases of sepsis, resulting in a staggering 44,000 deaths - more than that of bowel, breast and prostate cancer combined.
The Sepsis Trust have produced a clinical tool kit for use in General Practice settings which we would like to draw to your attention. The Royal College of General Practitioners are also promoting this tool kit and recognise the importance of better detection and prompt action in reducing the burden of sepsis.

The full resources can be accessed via http://sepsistrust.org/professional/professional-resources/

As part of this toolkit is linked to the identification of sepsis for use within community settings, there are a number of flow charts available and these relate to identification of signs and symptoms linked to different age groups and women in pregnancy with separate guidance available for neutropenic sepsis. The decision support tools categorise symptoms into red flag sepsis, which requires immediate actions and amber flag, which require further review. A letter and a laminated version of the General Practice Sepsis Decision Support Tool has been issued to each Worcestershire GP Practice, which if viewed on line can also be used as an interactive assessment process. This is just one of the tools available and only covers non pregnant adults and young people over the age of 12 with tools for other groups being available from http://sepsistrust.org/

The tool kits set out to promote prompt diagnosis of possible sepsis and ensure that the interventions termed as the Sepsis 6 can be delivered at the earliest opportunity. It is these interventions which if undertaken in the first hour, that greatly increase recovery. 

Sepsis Six include:

1. Administer high flow oxygen
2. Take blood cultures
3. Give broad spectrum antibiotics
4. Give intravenous fluid challenges
5. Measure serum lactate and haemoglobin
6. Measure accurate hourly urine output

Further information is available via the Infection Prevention Team.

Healthwatch open meeting

Healthwatch Worcestershire is holding an open meeting on Friday 11 November 2016, 9.30-11am at Wyre Forest House, Kidderminster.

If you're interested in attending, view this leaflet for more information.

Learning from Excellence seminar

The West Midlands Patient Safety Collaborative are bringing their “Learning from Excellence” seminar to Worcester on Monday 28 November 2016.  

This is a free afternoon event open to all NHS professionals.

Find out more and book your place via www.eventbrite.co.uk/e/where-did-it-all-go-right-learning-from-excellence-for-quality-improvement-tickets-28146871049 

Learning and Improvement briefing

The briefing is based on a report from the University of Warwick and the University of East Anglia, analysing 293 Serious Case Reviews (SCRs) from 2011 – 2014. 

The learning from national SCRs is extremely important. Although Worcestershire has not initiated a SCR in the last two years, the Board assesses that national learning is relevant to local practice and should be given careful consideration in reviewing how services are delivered locally to our most vulnerable children and their families.

Download the Learning and Improvement Briefing


South Worcestershire Locality News:

Medicines Optimisation Service

A reminder that for the Medicines Optimisation Service 2016-17 quarterly claims should be based on practice list size at 1 April 2016. 

Any queries contact Anne Kingham or Sue Chauhan

Hospice’s nursing excellence recognised

The excellent training St Richard’s Hospice provides for healthcare students been recognised at the NHS and University of Worcester Mentor Awards 2016. 

The hospice’s In-patient Unit team received the award for the excellent support and mentoring they provide to University of Worcester’s student nurses and other health professionals training as part of their learning placement. 

Representatives of the team were delighted to accept the Outstanding Practice Placement Learning Environment award at a special ceremony at the University Arena.

The Mentor Awards is an opportunity to recognise and celebrate the outstanding contributions of healthcare providers in the training and mentoring  the next generation of health professionals. 

Nurse award

Wyre Forest Locality News:

Cyber awareness/digital inclusion

With access to health services more readily available online, there are a couple of opportunities in Wyre Forest for people who are less technology minded to get online.

Digital inclusion, offers a service to people who want to learn the basics and gain confidence to go online. More information is available on this poster.

The internet cafe at Cookley Village Hall is available on Tuesdays, 2pm onwards for people to pop in and find out anything about computing. More information is available on this poster.

Please help promote these where you can.


Primary Care Committee update

At Primary Care Committee on the 12 October the committee supported the reinvestment of the PMS premium for Wyre Forest and Redditch and Bromsgrove with a focus on the key priority areas:

  • Proactive care for older people living with frailty-diagnosis, frailty register, clinical lead, education, care planning
  • Excellence in management of long-term conditions – atrial fibrillation, detection and management
  • Effective use of resources – making quality referrals
  • Right access – releasing capacity in general practice – run audit tool
  • Prevention – pre-diabetic screening pump priming

The committee also supported ‘The Sustainability in primary care Fund: Wyre Forest CCG’ which is a Memorandum of Understanding (MOU) between the Wyre Forest Federation and the CCG which seeks to:

  • Achieve a balance between supporting Federation to have local freedom to choose the improvement projects that they will focus on
  • Enable the CCG to consult with the federation about local and county-wide commissioning matters
  • Build in opportunities for the CCG to ask Federation to support issues affecting the wider NHS across Wyre Forest

The Committee supported the introduction of an Alliance Agreement with WF practices, the WF Federation and the CCG.

The focus of the Agreement for Wyre Forest is medicines. The services to be included in the Alliance Agreement for 2016/17 are;

  • Primary Care Prescribing (GMS/PMS contract)
  • Medicines Optimisation Service (LIS)
  • INR testing (LIS)
  • Near Patient testing (LIS)

For further information contact the Wyre Forest locality Team.