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Member Practice Update

21 February 2020 

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.

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. COVID-19 (Coronavirus) Brief 
  2. Major Incident Flooding
  3. Herefordshire and Worcestershire CCGs - Policy Alignment 
  4. Breast Cancer - Specialist Nurses 
  5. Cytology Stock Update
  6. PCN Update
  7. GP Academy - Closing Date Extended
  8. General Practice Fellowship Opportunity for Newly Qualified GPs
  9. Smart Medical Devices Survey 
  10. To all Smartcard Users - Notification of Planned Essential Maintenance 
  11. IQSP Spring Programme 2020
  12. Prescribing Top Tip 
  13. Perinatal Mental Health 
  14. Behaviour Change - Achieving sustained self-management with patients 
  15. Thursday 19 March - MSK & Chronic Pain Update Course 
  16. Celebration of Nursing and Nurses
  17. GP Portfolio Role Opportunity 

Find out about local and national events and training here

Redditch and Bromsgrove

South Worcestershire

Wyre Forest 


  • No Redditch & Bromsgrove news 
  • No South Worcestershire News 

  • No Wyre Forest news
  • No Herefordshire news

COVID-19 (Coronavirus) Brief

Sent on behalf of Jo-Anne Alner, Accountable Emergency officer

The current position: 


Numbers are still rising, albeit at a slower pace. 17,000 cases and 1,000 fatalities. Two fatalities outside China

However, they have lifted restrictions on freedom of movement, children are returning to school and they are allowed to travel. 


5,500 tested and nine positive. NHS 111 is coping; COVID19 has accounted for 1% of calls; 50% are going through to PHE 24/7 Helpline. Linguistic services are available.

New and Updated Guidance

A number of key guidance documents have been published this week, some written specifically to support Primary Care. So please ensure you spend time reading the following:

The key principles are to:

  • Identify potential cases as soon as possible.
  • Prevent potential transmission of infection to other patients and staff.
  • Avoid direct physical contact, including physical examination, and exposures to respiratory secretions.
  • Isolate the patient, obtain specialist advice and determine if the patient is at risk of COVID-19 infection.

This guidance also includes information on patient transfers and cleaning your premises following a possible case.

  • The  Novel Coronavirus (COVID-19) Patient Pathway guidance was published on 20th February. The purpose of this document is to set out the minimum operating standards for each element of the patient pathway from identification of a possible COVID-19 case, through co-ordination of required steps and on to discharge. On page five, you will find the Pathway for presentations of self-isolated patient with intercurrent illness or exacerbation of known co-morbidity. This pathway highlights guidance which is coming soon for patients who require transport and face to face assessment during the isolation phase.
  • Additional resources have been made available for primary care providers. Please ensure that you share and display these as appropriate: Posters for primary care settings are available here and you can sign up to the campaign page and get advised of the most up to date information to share. 

Please also find posters, advice leaflets and relevant web pages. 

Coronavirus: Affected countries 

Coronavirus: Primary Care Briefing 

Coronavirus: Home Isolation Advice 

Coronavirus: Poster 

Royal College of General Practitioners: Covid-19 

Gov.UK: Covid 19: Guidance for health professionals 

Major Incident Flooding

Sent on behalf of Jo-Anne Alner, Accountable Emergency officer

This week we have been the focus of the nation as we experience severe flooding levels across both counties. We have been operating at Major Incident Level, with LA, Health and emergency service partners, with the main priority being protecting life. Sadly, we had one fatality directly due to the flooding and approx. 500 properties flooded. However, approximately 6,000 properties have been protected across West Mercia by flooding defences.

Both counties remain in Major Incident “Response” mode and it is hoped we will move to full “Recovery” mode from Monday next week. We and the general public will still be living with higher than normal water levels for a few more days and they will be soon dealing with the consequences of flooding on their homes, businesses, roads and property. Water quality will be tested as the flood levels start to subside, but we must be vigilant for any water borne illnesses.

Thank you for all that you have done to keep your surgeries going during these unprecedented last few days, some of you in very difficult circumstances.

If you have any questions about either of the above major incidents, please feel free to contact me.

Jo-anne Alner
Accountable Emergency Officer
NHS Herefordshire and Worcestershire CCGs

Herefordshire and Worcestershire CCGs – Policy Alignment

On 1 April 2020, the four clinical commissioning groups (CCGs) in Herefordshire and Worcestershire; NHS Herefordshire CCG, NHS Redditch and Bromsgrove CCG, NHS South Worcestershire CCG and NHS Wyre Forest CCG, will be merging to form one single organisation, NHS Herefordshire and Worcestershire CCG.

For Herefordshire and Worcestershire this will involve moving from four CCGs to a leaner, more strategic single CCG. In achieving this there will be a change to the role of the CCG itself, shifting from the traditional model of commissioning to one with a greater focus on strategic commissioning on a bigger geographical footprint and making shared decisions with providers on how to best use resources, design services and improve population health.

As part of this process we are working to align all our internal and external policies.

Why are we looking at the policies?

Because we are currently four separate organisations, there are different commissioning policy documents across the two counties. The CCGs have been working together to align our policies, to ensure that people of Herefordshire and Worcestershire are receiving the same care within the same timeframe, based on the same clinical reasons.

We have already aligned many of these into approved policy documents. In these instances, there has been no change to the patient’s treatment, eligibility or pathway. The only difference is that now the policy applies to both Herefordshire and Worcestershire residents within a single document.

The policies have been reviewed by CCG staff, hospital clinicians and GPs, as well as colleagues from our local partners to ensure they are in line with robust clinical evidence, national guidance and are the same for patients in Herefordshire and Worcestershire.  All of the policies will be published on the new website from the 1 April 2020.

In a small number of cases, the policies are not able to align without the need for change. These are the polices we will discuss below.

What does this mean for me?

In most cases, there will be no impact to patients at all. At present, there is one policy which has been highlighted as a potential change for patients. The details can be found here.

As we continue to work through our policies, we will keep you updated with any of those which may have an impact on patients.

What are we proposing to change?

The following policy has been highlighted for a proposed change:



Give your comments

Date open for comment

Closing date for comments

Varicose veins

Information and proposed changes (or see attached)



Call - 01905 681978

Tuesday 18 February 2020

Monday 23 March 2020


For more information click on the links in the table above.

How can I have my say?

The CCGs are keen to hear your feedback about the proposed changes relating to our policies.

Please give your views by Monday 23 March 2020.

If you have any queries or would like the survey in another format, please email the engagement team or call 01905 681978.

Breast Cancer - Specialist Nurses 

Sent on behalf of Jeannette Howes, Strategy and Transformation Manager 

As part of the Personalised Stratisfied Follow Up, if Breast care patients present at surgery, re-entry will be via Breast Support Worker at the Trust and not a new referral within 2 week wait.

Specialist nurses can be contacted on the dedicated telephone helpline number 01905 760113 which will include voicemail facility based at Worcestershire breast unit in the Breast Care Nurses office.

The helpline is monitored between 0900 and 1700 Monday to Friday and patients will be contacted via a Specialist nurse within 24 hours.

If appropriate patients can return to clinic to be seen, and offered a clinic appointment, or if necessary, an appropriate diagnostic test, where possible within 14 days of the telephone call.

Cytology Stock Update 

Sent on behalf of Karen Kendall, Acting Head of Department, Cytology Laboratory, Wolverhampton NHS Trust 

'We contacted you recently to advise you of an ongoing national issue regarding the availability of vials and cervex brushes from our supplier (Hologic)'

Read more 

PCN Update

General Practice Nursing Development Grant Scheme- Expressions of Interest Sought

National and local workforce strategies have highlighted career development within varying qualified nursing roles as a means of encouraging GPN retention. Further to the guidance, evidence and feedback informed by the General Practice Nurse 10 point Plan, The Long Term Plan and the Herefordshire and Worcestershire CCGs GPN engagement evening, held in December 2019, we are now able to offer a GPN development grant scheme to our practice nurses.

The scheme outlined below has been designed to retain existing GPN’s within the counties whilst enhancing an individual’s skills and knowledge in areas of interest to them and supporting areas of need for Primary Care Networks in Herefordshire and Worcestershire. The grants are offered with the intention that all study will benefit local Primary Care Network needs and the wider health care system within Herefordshire and Worcestershire.

PCN- GPN Development Grant Scheme

We are able to offer 25 individual educational grants of up to £500 to existing GPNs to support developing their knowledge base within their chosen area of expertise that creates an addition to their skill set and enhancement of patient care within Herefordshire and Worcestershire’s general practice’s and particularly within PCNs.

These grants may be used to support a key learning objective such as funding a diploma (which would in time support work within Herefordshire and Worcestershire PCNs), supporting time to develop in chronic disease management such as asthma, diabetes, COPD, wound care, anti-coagulation, sexual health, minor injuries etc This would not only enhance the nursing work force skill set but also increase a personal satisfaction within the individual to undertake a new qualification which would bring about a greater job satisfaction, aiding retention of the nurse. 

Grants will be awarded based on completion of the attached EOI form aiming for a geographical spread of funding across the counties and according to criteria devised in association with local GP Leaders, Integrated Care System partners and the CCGs.

Eligibility Criteria

To ensure we are awarding funding appropriately and add value to Herefordshire and Worcestershire general practice, we will apply eligibility criteria. All applicants must be:

  • A current GPN working within Herefordshire and Worcestershire GP practices (open to any GPN in current employment for 2 or more years within the GP setting)
  • Be planning to stay in Herefordshire and Worcestershire for at least 2 years
  • Be willing to share learning/brief case study across Herefordshire and Worcestershire
  • Have discussed the grant proposal within their local PCN to ensure it fits with PCN need/direction of travel


Disclaimer: If for any reason you withdraw from your role before the end of the 12-month fixed term, we will expect you to discuss your intentions with us and may request some of the funding be returned.

Closing date: 13th March 2020

Please send completed expression of interest along with confirmation of support from your Practice/PCN to the workforce team by 13th March 2020.

PCN Portfolio Role Development Scheme Flyer

GP Academy - Closing Date Extended 

GP Academy opportunity - closing date extended to 28th February 2020, we have 5 more funded places on the March date and 6 more funded places on the April date - OPEN TO ALL GPS regardless of qualification

Development of the Herefordshire and Worcestershire GP Medical Education Academy- Funded places open to ALL GPs

The scheme outlined below has been designed to retain existing GPs within the counties whilst enhancing an individual’s skills and knowledge in Medical Education and supporting education and learning needs within Primary Care Networks in Herefordshire and Worcestershire.

Objectives of the GP Medical Education Academy:

  • To develop educational skills of GPs in Herefordshire and Worcestershire to perform small group teaching
  • To develop the skills and abilities of GPs in supervision, to enable them to supervise in practice to build on the number and quality of local GP supervisors for students. These skills should be transferable to the allied multidisciplinary team e.g. nurses, paramedics and pharmacists.
  • To promote a portfolio career in medical education to help build resilience and promote local recruitment and retention, keeping GPs once qualified and keeping GPs in their jobs as a Portfolio GP.
  • To create a longitudinal informal career mentoring network including a database of GPs who can be called upon to support teaching, training, and supervision opportunities
  • To discover and develop new medical educators and educational leaders in the area, to identify talent and then to mentor and use that talent to further roll out the GP academy across the STP


To find out more, please see the below flyers which include training dates and application information.

Development of H&W GP Medical Education Academy 

GP Academy Expression of Interest Form

Teaching the Teachers - Skills for Healthcare Educators - 3 day workshop 

General Practice Fellowship Opportunity for Newly Qualified GPs

The Training Hub and GP workforce team are developing a fellowship programme targeted at newly qualified GPs (GPs qualified since November 2018). 

The aim of the programme is to help newly qualified GPs understand how practices operate, roles of other organisations and what opportunities are available locally for them to upskill. 

We believe the programme will be beneficial for both the practice and the newly qualified GPs. 

Examples of topics that will be discussed include; QOF, CQC, PCNs, LMC, NHS structure, partnerships, mentoring and much more.​

Practices will be paid back fill to allow the GPs to attend the programme. The programme will start in April 2020 with a mixture of online modules and 4 face to face meetings over 12 months. 

If you are a GP who has gained CCT since November 2018 or a practice with a newly qualified GP, please email the workforce team so that we can discuss the fellowship programme in more detail. 

Smart Medical Devices Survey

Hoople, at the request of Herefordshire and Worcestershire CCGs, are gathering information on the current status of smart medical devices in use by practices across Herefordshire and Worcestershire. 

Based on these findings the CCGs will then look to provide each PCN with one smart ECG, one Spirometry device and one BP machine.

Could we ask that your practice completes the Smart Medical Devices Survey by 23rd of March 2020 so that we can collate this information.

To all Smartcard Users – Notification of Planned Essential Maintenance

The Care Identity Service (CIS), the system for authenticating, registering and issuing NHS Smartcards, will be relocating services between data centres on Wednesday 4 March 2020 to undertake essential maintenance work.

Maintenance Window: 18:30 to 23:59 Wednesday 4 March 2020.

During this time users will be unable to create, renew or modify cards. Authentication, Directory and Portal services will still be available.

Users of the BT Identity Agent client may be required to restart their client to re-authenticate with their smartcard.

The BT IA client is no longer supported by NHS Digital and migration needs to be completed to a supported version to avoid maintenance impact and for improved functionality.

IQSP Spring Programme 2020 

Letter to Worcestershire practice colleagues from Dr George Henry, IQSP Clinical Lead and Lynda Dando, Director of Primary Care, Herefordshire and Worcestershire.

Read more

Prescribing Top Tip

This week's Prescribing Top Tip is regarding the Picato Licence Withdrawal

Perinatal Mental Health 

The perinatal mental health team from Worcestershire Health and Care NHS Trust wish to invite all health and social care colleagues, involved in caring for pregnant women and new families to attend one of four interactive masterclasses to raise awareness of perinatal mental health. 

Read more

Behaviour Change - Achieving sustained self-management with patients 

13th March | Birmingham

Delivered by The Behavioural Science Team    


This course is aimed at front line clinical practitioners whose job involves helping/advising people to self-care e.g. adhere to treatment.

This one-day introductory course is aimed at front line clinical practitioners (e.g Practice Nurses; Advanced Nurse Practitioners, Diabetes Nurses; Pharmacists and GPs) whose job involves helping / advising people to self-care. The course will cover aspects such as assessment, basic skills in Motivational Interviewing, increasing knowledge about the usefulness of interventions such as Acceptance and Commitment Therapy and basic CBT, and helping you to understand the utility of specific Behaviour Change Techniques within your interventions.

Book here

Thursday 19 March – MSK & Chronic Pain Update Course

This is an IQSP Education Event, in Conjunction with Red Whale. 


The Bank House Hotel

Registration 1:30 session will commence 2:00pm – 6:00pm

This is a free entry event for one GP from each Herefordshire and Worcestershire practice (standard fee for the day’s course is £225 per head)

Please note for Worcestershire GPs this is one of the IQSP/PCE Study Events so backfill funding has already been paid for one GP from each practice to attend. Once the free tickets have been allocated a number of spare tickets will be available at a subsidised fee of £80.

Please follow the link to book your tickets (allocated ticket and additional tickets) or use the link on the flyer.

Course Flyer

Celebration of Nursing and Nurses 

Education event – University of Worcester

24th June 2020 – 9am-2pm Riverside Building, University of Worcester

This event seeks to celebrate Nurses, the Nursing Profession and 25 years of nurse education at the University of Worcester. 

A variety of key-note speakers from national, regional and local levels will celebrate past achievements, highlight local innovative practice, discuss the future of nurse education and inspire us to promote nursing as a profession.

This free event is open to all Registered Nurses and Educators. 

Lunch and refreshments will be provided.

Please book online here

Course Flyer 

GP Portfolio Role Opportunity 

Rapid Diagnostic Centre Clinician

The CCG are currently scoping a GP portfolio role to support the H&W rapid diagnostic centre non-specific symptom pathway. This role would be an employed role for 1 session per week, with up to £3, 000 education and learning grant to support further education in this speciality.

Patients presenting with non-specific symptoms such as sudden/unexplained weight loss but with no clear indication of a specific suspected cancer, can be referred to the RDC non-specific symptom pathway.

They will initially be contacted by a CNS and triaged to determine whether the patient can go straight for test/investigation or require face to face assessment.

Following relevant tests/investigations/OPA, a virtual MDT will then determine the most appropriate pathway for the patient – this could be a cancer specific pathway or long-term condition pathway/elective care pathway. Unfortunately, despite best efforts some patients will not receive a diagnosis and continue to be unwell.

As we do not have a General Physician service for these patients to be investigated further, we will initially have to refer these patients back to primary care. The ambition is to have a GP portfolio role within secondary care, working alongside other key services and with access to additional diagnostic testing not currently available within primary care, to enable these patients to remain under the care of secondary care until a definitive diagnosis/plan has been made for the patients ongoing care.

The NSS pathway will initially only be rolled out to one or two PCNs but will eventually become available to all practices/PCNs within the STP. The initial pilot phase will be used to finesse the NSS pathway and also to obtain a better understanding of the services required for those patients who do not have a cancer diagnosis.

We are therefore looking for a GP with an interest in extending their general physician skills to specialise in the management of patients with non-specific symptoms. We will initially be looking at 1 clinical session per week. Following the initial pilot, further sessions may be required.

If you would like to know more about this opportunity, please contact Anita Roberts or Dr Carl Ellson for an informal discussion.

Please complete the Expression of Interest form by 6th March 2020 and return to the workforce team email address.

Read more