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Member Practice Update

  02 November 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:

Winter Indemnity Scheme 2016 announced (Publications Gateway Reference No: 05983)

As part of broader work to address the issue of rising indemnity costs as outlined in the General Practice Forward View, NHS England will re-run a winter indemnity scheme to support GPs to work in out of hours setting. The scheme is now running until 31st March 2017.

You can find our more information including how GPs can make applications through their Medical Defence Organisations (MDOs) at the following link:

Contact for further information: england.primarycareops@nhs.net

Ambulatory Emergency Care (AEC) service information for GP’s and Primary care

AEC services are now operational across both the Worcester and Alex acute hospital sites. Primary care direct referrals can be made by following the guidelines set out on the attached flyers which have been developed with acute trust clinicians delivering the service across Worcestershire acute sites. Please note there are two different central contact numbers for Worcester and the Alex site for GPs to ring when they require same day ambulatory emergency care for eligible patients.

If you require further information or have any queries please contact:

Making Time Audit Tool

This audit was developed by the Primary Care Foundation as part of a research project commissioned by NHS England with the initial results being published in ‘Making Time in General Practice’:

It helped create the evidence base for the recent ‘Forward View for General Practice’. Initial results suggested that, on average, 27% of appointments in general practice were potentially avoidable if other services and support were put in place. The CCGs would like to utilise this tool by asking practices to complete a one week audit prior to 31 December 2016, as part of the Promoting Clinical Excellence contract. The data will inform practices and the CCGs where support for resilience and sustainability is needed with feedback being provided to individual clinicians as well as at practice, locality and CCG level.

A letter will be sent to practices this week providing more information.  

Child Flu Immunisation programme

Following a query from a GP practice in regards to the 2016/17 National Flu immunisation programme for children we can clarify the programme was extended this year to all children of appropriate age for school years 1, 2 and 3 (5-6, 6-7 and 7-8 year olds). This is being commissioned by NHS England local teams and is to be delivered in the primary school /private school setting by the School Age Immunisation Service (SAIS). The SAIS should inform the GP Practice of any flu immunisation in this cohort within 2 days for at risk children and 5 days for healthy children. No children are being offered influenza vaccination through community pharmacy this year.
GP’s are the only provider commissioned to offer flu vaccination to all 2, 3, 4 year olds (but not 5 years or older) on 31st August 2016 and to any child over 6 months in an “at risk group”. There will be a potential overlap in those children in a clinical at risk group who are being immunised at school. GP’s will need to be aware that this group could present to GP practices, if the Practice has sent generic mailshots from the practice for those chronic conditions covered by the immunisation programme and there will be a need to check that the child has not had it at school before the practice carries out immunisation. Please ensure healthcare professionals who will administer the flu vaccination to children are aware of this.

Further information is available via:

The local SAIS for Worcestershire can be contacted via:

Tel: 07990 667070

Countywide IQSP Update

Redditch & Bromsgrove
The first Autumn visit schedule is now complete. Thank you to all who attended. The discussions have stimulated areas of focus for practices and the CCG, including the challenges faced by both. They have also revealed an in-valuable range of ideas, processes and best practice and we thank you for sharing these with us. Can we ask if you haven’t already completed the IQSP Evaluation  (Survey Monkey) you do this as soon as possible. The link to the survey is here. Arrangements are currently being made for the 2nd R&B IQSP Steering Group meeting, to review the evaluation and agree any follow up visits to practices before the end of the year.

Wyre Forest
Planning is almost complete and the visits commence later in November. The documents to support the meeting will be sent to each practice, in advance of the visit. Can we ask that once you receive these you review them in advance of the visit and if you have any queries regarding the source or data used in the Primary and Secondary care data pack you make contact with Ben Furlow and Sam Hill, before the meeting.  Thank you.

South Worcestershire
IQSP 8. Visits commence next week. All practices will receive their electronic packs over the next 2 weeks – hard copies will follow.  Until the new intranet is up and running all generic documents, top tips and guidance, supporting the clinical focus and other topics included on the agenda, can be found on the SW website. The link to this is here.

Prescribing Top Tips

Denosumab – Prescription Administration in Primary Care

  • Denosumab (Prolia®) is indicated for the treatment of osteoporosis in men and postmenopausal women at increased risk of fractures, administered as a 6-monthly subcutaneous injection.

  • Detailed guidance on eligibility criteria, information to be conveyed to the patient, pre-administration monitoring, vitamin D loading and on-going monitoring can be found on the APC website at: Denosumab - local guidance

  • To prevent erroneous ordering by patients and/or care homes denosumab SHOULD NOT be added to the prescription screen as a repeat item.

  • It should be added as an acute item and a 6 monthly recall system set up to ensure that subsequent doses are given in a timely fashion.

  • The manufacturers of Prolia® have produced a guide to adding the drug onto the EMIS system. This describes the process to be followed when initiation takes place in the secondary care setting, however it can be easily adapted if initiation occurs in primary care. This guide can be found on the “Prescribing Resources for Clinicians” section of the APC website, at: Denosumab training guide

Practices are advised to review their patients on current repeats for denosumab, change them to acute and check that recall mechanisms are in place. A search on EMIS can be found in:

Worcestershire PCT Search & Reports - Medicines Management Countywide – Top Tip searches – denosumab on repeat.

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

Stakeholder Feedback for Periodic Review 2016

A Periodic Review of a portfolio of awards delivered by the University of Worcester is being undertaken, including:
  • BSc Health Sciences Top Up
  • MSc Advancing Practice and pathways
  • BSc Nursing Studies
  • MSc Nursing Studies
  • BSc Fundamentals in General Practice Nursing
  • UAD Return to Nursing Practice
  • PG Award Practice Certificate in Independent Prescribing

Fundamental to this Review is an evaluation of the provision from the perspective of our practice partners, including commissioners, employers and practice mentors. There is no obligation for you to participate, however, your contribution would be  of great value. The online feedback form can be accessed via the link below:


You will find a series of 10 questions, which all ask for ‘tick box’ responses.  We have also provided space for you to insert additional information to explain your response if you wish.  As the over-riding aim of this Periodic Review is to ensure that the courses we provide are not only good quality, but fit for purpose, we would very much appreciate any explanatory details that you are able to provide. The online feedback link will be open until 5pm on 7th November; we will be reviewing all documentation on 8th November in preparation for the Periodic Review in December.

Your responses will be in confidence and used only for the purpose of completing this Periodic Review, and informing future course development strategies.  If you have any queries or concerns that require a direct response, please do not hesitate to contact us directly:

Kerry Gaskin Principal Lecturer in Advanced Clinical Practice and Academic Lead for CPD

Dr. Helen Taylor Principal Lecturer and Department Lead: Quality Assurance and Student Enhancement

With sincere thanks in anticipation of your assistance with this Review, and for your on-going support of the University of Worcester and our

Autism Strategy Launch

Following the Wider Launch of the Autism Strategy held on Thursday 20th October please find attached:

- Corporate Video
- Joanne's Story
- Anne's Story
- Claire's Story

@NHS Twitter Account Launched

A pioneering new initiative to lift the lid on the NHS through the voices of the people on its frontline went live last Monday (17.10.16) with the launch of the @NHS Twitter account. A UK first, @NHS will see a different NHS patient or member of its 1.3 million staff become curator each week over a three month pilot and report first hand their experiences of the health service.

Integrated Urgent Care Update

The latest issue of NHS 111 West Midlands 'Integrated Urgent Care Update' Is available, read it here.

Leadership In Action Update

The latest issue of West Midlands Leadership Academy's e-newsletter Is now available, read it here.

Neurology Study Day

Worcestershire Royal Hospital is hosting a GP Study day around Neurology, MS & Parkinsons on Friday 25th November 2016.

Topics Include:

  • MS Nurse Disease Modifying Therapies
  • Management of Headache
  • Parkinson’s Disease
  • Senior Complex Neuro’ OT
  • Motor Neurone Disease
  • Epilepsy Management

Speakers Include:

  • Dr Tom Heafield, Consultant Neurologist
  • Dr Chris Pycock, Consultant Neurologist
  • Stephanie Nicholls
  • Deborah Clarke
  • Jayne Roberts
  • & More

For more information and to sign up to attend, download the flyer here.

16 Days of Action against Gender-Based Violence

The launch event will highlight the headlines from research undertaken by the NCSPVA on behalf of the Cavell Nurses’ Trust and will focus on some key issues in relation to the culture of organisations which are conducive to disclosure of domestic violence by employees. The event will also showcase examples of good practice from local employers, including the University of Worcester.

Delegates are invited to bring a Christmas present suitable for a child of any age. Christmas presents collected will be donated to children in local refuges in Worcestershire. All donations should be unwrapped and new or in very good condition.

This event is free of charge and open to all, but booking is essential.
Please book early to avoid disappointment.

To book a place, please go to:


Economic Summit

West Midlands Academic Health Science Network is hosting their annual Economic Summit, on Thursday 8th December.

For more information on how to register to attend click here.


Redditch Locality News:

Promoting Clinical Excellence Contract for R&B

Following the period of Consultation, and issue of individual practice’s Promoting Clinical Excellence Contracts we have been asked to clarify some points. For example:

The appointments can be completed during any week prior to 31 December, and the findings will be used to influence decisions for GP Forward View monies.

The aim of the Making Quality Referrals funding available under this broad heading of “Making Quality Referrals” is to be invested in whichever way is an appropriate fit  under this framework to ensure appropriate referrals with minimal variation. Training you might want to send any of your team on to support “making quality referrals” is a practice decision.   

The Primary Care Commissioning team will be available at the next Practice Managers meeting to clarify any questions, or if you would like a separate visit to your practice we can accommodate this. In the meantime if you have any further questions please contact

South Worcestershire Locality News:

Promoting Clinical Excellence – Distribution of Funds Initially Held as a Reserve

The Primary Care Clinical Advisory Group has now confirmed how the unallocated PCE reserve should be spent, and this is in line with the proposal outlined at the Practice Manager’s meeting.

Practices will receive additional funding in November to cover:

  • Funding to assist with aspects of PCE, such as Care Navigation, equipment, training or clinical time for Making Quality Referrals, as determined by the practice. The funding is based on payment of £1000 for an average sized practice.
  • Appointments audit – using the Making Time Audit Tool - paid at £100 per practice

A contract variation is being prepared for these two items, and, in addition to completing the audit, practices will be required to outline how they plan to use the additional £1000 per average practices.

A small amount of money has also been set aside to help towards practice pressures in minor surgery and Practice Managers have notified the CCG of estimated additional activity in this area.

Diabetes Local Improvement Scheme

The revised Diabetes LIS, as presented at a recent Practice Manager’s meeting, is being finalised to ensure that the educational  competencies  reflect feedback from the Diabetes network. Because of this it is proposed that the new service specification will be adopted from 1 January to align any changes  with the final quarter’s claims.