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Member Practice Update

  1 August 2018

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:

Find out about local and national events and training here.

CQRS – technical issues affecting quality services

This message is an update regarding technical issues affecting data extraction for CQRS services.

There has been a technical issue affecting the transfer of data from GPES to CQRS, preventing achievement data for several services being available for practices to view and declare.

This has now been resolved and the June 2018 achievement data for the following services is now available to view and declare in CQRS:

  • Shingles Routine 2018/19
  • Shingles Catch Up 2018/19
  • Pertussis 2018/19
  • Men ACWY 2018/19
  • Learning Disabilities Health Check 2018/19
  • GMS PMS Core Contract 2018/19

Manual Entry:

If practices have manually declared any June 2018 achievements and they have not been financially approved, their achievement data may have been over-written by the automated extraction for the above services.

If practices have no achievement data present in CQRS they should enter this manually as per standard procedure.

Flu Immunisation Clinics

The CCGs have been approached by Hereford and Worcester Fire and Rescue Service, asking whether there is anything they can do to support people getting vaccinated against flu for 2018/19.
A suggestion has been made that they could provide transport for patients that find it difficult to get to their surgery to attend one of the flu clinics.
They are interested to know how many practices would have patients that would benefit from this support and would therefore be interested in taking the Fire and Rescue Service up on this offer?
Could you please email Emma Roberts directly on eroberts@hwfire.org.uk if your practice would be interested in this service.
Could you please respond to Emma by 15 August 2018.

This offer was made last year and a number of practices did make contact however, due to timing it was deemed too late to implement anything for 2017/18. Emma will be making contact with those practices that responded last year to so to see if you are still interested and you need not reply again to this email.

Safeguard Adult Review - Learning Briefing

Please see below a link to the latest Safeguarding Adults Review Learning Briefing published on behalf of the Worcestershire Safeguarding Adults Board.

Access the briefing here.

Information Sharing Advice

Please see below advice for practitioners providing safeguarding services to children, young people, parents and carers.

Access it here.

NHS England consults public about Evidence-Based Interventions

People are being asked for their views about plans to stop offering treatments that are clinically ineffective.
NHS England is proposing that the following interventions should no longer be routinely commissioned by CCGs because they are ineffective or have been superseded by a safer alternative:

  • Snoring Surgery (in the absence of Obstructive Sleep Apnoea)
  • Dilatation and curettage for heavy menstrual bleeding in women 
  • Knee arthroscopy for patients with osteoarthritis
  • Injections for nonspecific low back pain without sciatica

They are also recommending that thirteen other interventions should only be performed in specific circumstances where they have been proved to be clinically effective.

For more information and to respond, please visit: www.engage.england.nhs.uk/consultation/evidence-based-interventions/
The deadline for responding is Friday 28 September 2018.


Prescribing Top Tip

Eye Drops - Prescribing Quantities

Prescribing inappropriate quantities of eye drops can result in patients stockpiling bottles, or potentially running out of their medication before their usual ordering cycle. The table below shows the volume of product required for one month. On average, one drop is = 0.05ml (i.e. 20 drops per ml).


mls required per month (one eye only)

mls required per month (both eyes)

1 drop once daily



1 drop twice daily



1 drop three times daily



1 drop four times daily



1 drop five times daily



The majority of, but not all, multi-dose eye drops must be discarded 28 days after opening.

Examples of quantities sufficient to last a month of commonly prescribed products for glaucoma are detailed below:

Latanoprost or latanoprost/timolol 1 drop daily, into one eye – 1 x 2.5ml bottle
Latanoprost or latanoprost/timolol 1 drop daily into both eyes - 2 x 2.5ml bottles
Bimatoprost or bimatoprost/timolol 1 drop daily into one eye – 1 x 3ml bottle
Bimatoprost or bimatoprost/timolol 1 drop daily into both eyes - 2 x 3ml bottles
Brinzolamide 1 drop twice daily into one eye - 1 x 5ml bottle
Brinzolamide 1 drop twice daily into both eyes - 2 x 5ml bottle

A useful rule of thumb for glaucoma drops is one bottle per eye, per month.

For single (unit dose) eye drops the same unit dose can be used for both eyes but it is good practice to use separate units if one eye is infected and the other is not.

Increasingly, some ophthalmic products have expiries greater than 28 days. Two formulary examples for the treatment of dry eye are:

VitA-POS® eye ointment - 6 month expiry. A 5g tube contains 300 applications and should last 150 days when used at the common dose of one application at night in both eyes.

Optive 0.5% eye drops – 6 month expiry. A 10ml bottle contains 300 doses and should last 50 days when used at the common dose of one drop three times daily in both eyes.

Reviewing repeat medications of ophthalmic products is a good opportunity to check that appropriate prescription quantities are prescribed and that patients are following appropriate ordering patterns. Over-ordering by patients may be habitual, resulting in stockpiling; but may also be due to poor application technique or unawareness of the product expiry.

If you have any suggestions for inclusion in the 'Top Tips' then please send them to akingham@nhs.net

Veteran Friendly GP Practices

Veteran friendly GP practices launched by RCGP is being supported by NHS England. 

Please see below leaflets for more information:

NHSE Military Veteran Aware Accreditation poster

NHSE Veterans' Mental Health leaflet

NHSE Military Veteran Aware Accreditation GP Top Tips

Redditch and Bromsgrove Practice News

Alliance Board Highlight Report

The July highlight report is now available to read.

Access it here.

South Worcestershire Practice News

Alliance Board Highlight Report

The July highlight report is now available to read.

Access it here.

More routine appointments with Improved Access

How often does a patient call to make a routine appointment and then become frustrated because the next available appointment isn’t for days?

Improved Access appointments can help with this. So, don’t forget, next time a patient calls to make a routine appointment, you can offer them an appointment during your usual opening hours or you can offer them an appointment in the evening, or on Saturday and Sunday, at their nearest hub.

The hubs are based at Malvern Health Centre, Droitwich Medical Centre, Riverside Surgery and Farrier Surgery. Patients can also receive telephone consultations via the ‘virtual’ hub on Saturdays and Sundays. Just open up the Improved Access appointment book in EMIS, look and see what appointments are available, get consent, offer the appointment and make the booking. It’s as simple as that.

There are often a few unused appointments each week which could be filled plus it might make life easier for a receptionist when they are trying to find a suitable slot.

Wyre Forest Practice News:

Alliance Board Highlight Report

The July highlight report is now available to read.

Access it here.