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Member Practice Update

  7 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:

West Midlands Integrated Urgent Care Service 

Following the launch of the new West Midlands Integrated Urgent Care Service last month resources have now been made available:

Download resources

The integrated urgent care service creates a new ‘front door’ to the NHS. It will aim to enhance patient journeys by removing steps that the patient sees in their healthcare journey, improving healthcare for the public and patients of the West Midlands, through closer working relationships between providers. These working relationships include the GP out of hours services, social care, the ambulance service and the NHS 111 service, ultimately aiming to provide a service that benefits patients round the clock.

This is an exciting transformational development to urgent care services. In some areas the provider of GP out of hours services remains the same, but all are committed to working to the Alliance Agreement, which encourages them to work together towards the common goal of integrated, quality care for patients 24 hours a day.

All providers and commissioners are working collaboratively to deliver an integrated service that is built around a clinical hub model. The new clinical hub at the centre of the integrated urgent care service will see a new way of working between NHS 111 and GP out of hours services.
Our local provider is Care UK who have been delivering out of hours services across Worcestershire for a number of years.

Prescribing Top Tips 

Dexamethasone Oral Preparations

Dexamethasone is now available as a sugar free soluble tablet which is a more cost effective option than ordinary tablets or the oral solution. The soluble tablets are available as 2mg, 4mg and 8mg and may also be easier to use than the solution.


Plain tablets –

Per tablet

Soluble tablets- per tablet

Oral solution

2mg dose



£1.41 (5ml of 2mg/5ml)

4mg dose

Not available


£2.82 (10ml of 2mg/5ml)

8mg dose

Not available


£5.64 (20ml of 2mg/5ml) or

£2.51 (4ml of 10mg/5ml)

As this is a new product and pharmacies may not have it in stock until they receive their first prescription the Medicines Commissioning team suggest that the practice advises their local pharmacy or pharmacies they are going to prescribe.

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

Top Ten Guidelines for Paediatrics Survey

It has now been 6 months since we released the Top 10 Guidelines for Paediatrics. We hope that you have found them useful and easy to use. We would be really interested to hear your views on your experience with them and would be grateful for you spending 1-2 minutes completing a survey monkey questionnaire to provide us with feedback. 


Paediatric admissions remain a target for the CCG and with this in mind we look for your support in using the guidelines to promote best practice care and to help reduce hospital admissions where it is clinically appropriate.

Updated Conflicts of Interest Policy

Please note that a countywide CCG Management of Conflicts of Interest policy has been updated to reflect NHS England Guidance published earlier this year. All individuals involved in or contributing towards commissioning decisions on behalf of the CCG are required to comply with the policy at all times.

In particular, the following applies to all GPs, practice managers and other practice staff actively involved in CCG decision making:

  • Filling in a declaration of interest form on a six monthly basis even if there is nothing to declare. 
  • Declaring conflicts of interest at meetings in relation to agenda items even if declaration has been previously made.
  • Declaring conflicts of interest on changing role, responsibility or circumstance
  • Declare all offers of gifts and hospitality over the value of £10 for gifts and £25 for hospitality
  • Filling in a sponsorship declaration form and ensuring it is authorised in line with the policy prior to accepting any offers of commercial sponsorship
  • Obtaining prior permission from the Conflicts of Interest Guardian in order to engage in any secondary employment 
  • Speak up about genuine concerns in relation to the administration of the CCGs’ Conflicts of Interest Policy.

Please take some time to read the Conflicts of Interest Policy, case studies and summary guide. If you would like any further information or advice, please contact Hana Taylor, the Head of Corporate Governance in the first instance.

Gloucestershire Hospitals NHS Foundation Trust - new electronic health record

Gloucestershire Hospitals NHS Foundation Trust (Gloucestershire Royal and Cheltenham General Hospitals) went live with their new Electronic Health Record software over this weekend. The change of software has implications on the Electronic Referral System (E-RS) and, as a result, a number of services are not available for direct booking at this time. GPs are advised to “Defer to Provider” and Gloucestershire will contact the patient directly to agree a convenient date and time to be seen. Gloucestershire are working hard to rectify the problem safely and expect normal E-RS service to be delivered within the next week.

More information will follow once provided.

Safeguarding update 

1. Levels of Need guidance (previously Threshold document) survey

It is a statutory responsibility of WSCB to provide a document which sets out the action to be taken where there are concerns about a child's safety or welfare, including Thresholds for intervention. By completing this survey you are enabling the Board to assess the usefulness of the document and how it might be improved to aid understanding. Listening to practitioner feedback is important and will inform the next update of the document to be undertaken by January 2017.

Please access the survey at:

2.  Escalation Guidance Survey

Following the refreshed Escalation guidance, Worcestershire Safeguarding Children Board (WSCB) is undertaking a large scale survey asking practitioners, managers and safeguarding leads if this process has been implemented in practice. The WSCB escalation process sets out the steps to be taken to address professional differences of opinion when a child requires a safeguarding response. This survey was previously sent out to the workforce in October 2016 but received a low response.

Thank you to those who have already completed it and there is no need to respond again, your answers will be included in the final report.

We are aware from Learning reviews and case auditing that escalating a disagreement can be difficult for professionals and if you have not used/ do not use / are not aware of the guidance completion of the survey is just as important as your response will help WSCB to ascertain whether the communication strategy needs to be reviewed. 

Please access the survey at:

The information you provide for both surveys will be confidential and all reports will be anonymised. For further information about these surveys please contact Angela Eason at aeason@worcestershire.gov.uk

Children's Centres, Parenting and Family Support 

Local authority commissioned early help services in Worcestershire are currently in a period of change. As of 1 December, this will include changes to the occupiers of some of our children's centres and a further period of transition as the use of those buildings evolves.

Further information is available in each of the children's centres and from people working across a range of services supporting children, young people and families. The information on the webpage www.worcestershire.gov.uk/childrenscentres will also be updated as timetables of activities are confirmed for 2017.

As well as the sessions run through children's centres, Parenting and Family Support providers (previously known as Early Help providers) will be delivering evidence-based parenting support in a variety of ways including parenting programmes, 1:1 support, group discussion and telephone support by qualified parenting practitioners. As well as parenting support, providers will also deliver targeted family support and support to those young people who are most at risk of leaving education and becoming unemployed. These services will be complemented by other prevention and early help services including school funded family support services (EIFS), Stronger Families and Positive Activities as well as those services provided by the voluntary and community sector.

In relation to health visitor and midwives appointments and checks - both midwifery and health visitors see all women/babies as part of the national Healthy Child Programme. The reviews can be undertaken at home, in clinic or a community setting and these reviews will continue to be delivered in a variety of settings including some children's centres. More information can be found on the Health and Care Trust website. 

Universal activity sessions such as 'Stay and Play' and support sessions such as breastfeeding groups are currently delivered in a variety of settings (not only the buildings known as children's centres) and by a variety of providers. Work is underway to support these sessions (where previously delivered or funded by Early Help providers and/or delivered in Children's Centre buildings) to continue to operate – again this information will be updated as details for 2017 are made available.

All centres will be making available information and advice on a range of issues including organisations that can support children and families who are in need of support with domestic abuse, housing, debt and parenting.

If you have a query about a specific provision or want to check out information posted elsewhere on social media or websites please email earlyhelp@worcestershire.gov.uk and we will get an answer back to you as soon as possible.

For information about support and activities at specific Children's Centres see www.worcestershire.gov.uk/childrenscentres 

Vacancy: Northumberland House Practice Manager 

Location: Kidderminster, Worcestershire
Salary: £35,000 - £45,000, dependent on experience
Closing date: Friday, 13th January 2017
Post commencing: May/June 2017

Northumberland House Surgery are looking to recruit an enthusiastic, highly motivated person to lead our team of loyal and dedicated staff. The surgery is a  friendly, high achieving 7 partner (10 doctor) GMS practice in superb new purpose-built premises. The surgery provides a wide range of services and serve a population of 13,200 patients. You will work closely with the partners in the management of the business, with a very supportive clinical and administrative team.

Northumberland House Surgery share the building with another large practice and employ an Administrator responsible for all matters relating to the building i.e. maintenance, contracts, room hire, etc.

Full details are available via the Wyre Forest CCG website.

NHS England Practice newsletter

This edition of the newsletter includes: 

  • Post Payment Verification
  • Enhanced Services Data Collection Timetable
  • eDeclaration 2016/17
  • Christmas Opening
  • Partnership Changes
  • Contacting The Team
  • Practice Contact Details
  • Contact Details for Patients

Download newsletter

HEE Primary Care newsletter 

Download newsletter 

Patient Online

Patient Online is organising a series of webinars to support GP practices to implement and get the most from providing online services to patients. The next topics include how online services can help patients with access needs. The webinars are open to all practice staff, and will last around 60 minutes. These sessions are an opportunity to ask questions, learn from other practices and find out how to access support locally.


West Midlands Leadership Academy Recognition Awards 2016/17

The 2016/17 NHS Leadership Regional Recognition Awards are open for nominations via the following link: http://www.hee.nhs.uk/wm/leadership/awards

The recognition awards for leadership last year were a great success and had almost double the number of nominations on the previous year.

Please nominate members of your team or associates who are celebrated leaders at all levels and across all professions who have ultimately improved people’s health, the public’s experience of the NHS and those leaders who we are truly proud to work alongside.

Please feel free to share this email with any of your colleagues who would be interested in making a nomination and help to promote and raise awareness of our regional Recognition Awards.

Nominations close on 6 January 2017, so please ensure your nominations are submitted in good time!

Download information pack for further details.

Trauma Informed Care Workshop

Monday 16 January 2017, Monday 23 January 2017 and Monday 6 March 2017 (half day) Room EE2011, St John’s Campus, University of Worcester.

This two-and-a-half-day workshop aims to increase delegates understanding of the impact of psychological trauma on individuals. It intends to enable workers to become more aware of their communication and build appropriate skills for working with people who have suffered psychological trauma. The workshop is appropriate for people working with adults or children in many settings including; health and social care, education and housing. Please see the attached flyer for further information.


This event is £300. We are limited in places and they will be offered on a first-come-first-served basis.

All staff employed by a Worcestershire NHS Trust or Wye Valley NHS Trust have to complete a study leave form (or equivalent) if they want (a) to study in works time, or (b) want the Trust to fund or part fund the course, or both. Upon receipt of your approved study leave form you will receive notification that your place is booked. 

In any given year the availability of conferences, events and study days will depend on delegate numbers. In the event of a conference, event or study day not being run due to a low number of delegates registering, delegates will in these circumstances be offered a full refund.

Download flyer 

Please contact Esther Dobson with any queries. 


Redditch & Bromsgrove Locality News:

Promoting Clinical Excellence Contract

Thank you to practices for promptly returning signed contracts. There are a few practices that still need to send in their action plans and these have been contacted directly.

We have received a few questions recently and so for clarification:

  • The AF indicator is not about new case finding, it is patients on your register for which you achieve over and above the QOF targets for anticoagulation.  
  • The frailty training date is yet to be confirmed, but we will be in touch as soon as this is arranged. The wording in contract section 1, A Frailty, is what we consulted on and are contracting for. We will be monitoring and therefore rewarding for new care plans and care plans reviewed. How the practice choose to organise the MDTs, including frequency is at practice discretion, three monthly was suggested good practice. However the AUA DES suggests care review should be at least yearly, or otherwise as need dictates e.g. after Admission or deterioration – so this could be variable depending on the patient. The composition of MDT will depend on practice and location.
  • The £100 pre-diabetes funding will automatically be moved to the referral indicator; a revised contract will not be issued for this.



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 ‘Advice and Guidance requests’ and the data is April 2016 - October 2016. 

The reasons why a clinician may wish to seek Advice and Guidance include: 

  • Asking another clinician/specialist for their advice on a treatment plan and/or the on-going management of a patient 
  • Asking for clarification (or advice) regarding a patient’s test results 
  • Seeking advice on the appropriateness of a referral for their patient (e.g. whether to refer, or what the most appropriate alternative care pathway might be) 
  • Identifying the most clinically appropriate service to refer a patient into (and how to find that service – e.g. what clinical term to search on)

Benefits of using Advice and Guidance- Patient 

  • The patient only starts the formal referral process once appropriate advice has been received (indicating the best clinical pathway or management route) 
  • Patients do not book an appointment that may subsequently be cancelled and redirected to another service, or rejected 

Benefits of using Advice and Guidance- Requesting clinician

  • Gives the opportunity for GPs to seek advice electronically from consultants, often helping to ensure that patients receive timely advice and if they need a referral are booked into the correct clinic
  • Used as an education resource, for the clinician – this may help with future management of patients 
  • Reduces the risk of a redirection or rejection of the referral and will better ensure that the correct services are offered to the patient 
  • May enable the patient to be managed in a community setting, with no need to refer to a secondary organisation.

Benefits of using Advice and Guidance- Commissioners 

  • Provides for greater confidence that the referrals reaching secondary care are appropriate for that setting 
  • It helps to support GPs to be aware of alternative services available within the community setting
  • If a patient can be treated in another environment this may result in some savings for the commissioning organisation.


Wyre Forest Locality News: 

PEARS referral form 

Download the latest leaflet and referral form for the PEARS service.