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Member Practice Update

 12 September 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.

  • No specific Redditch and
    Bromsgrove news
  • No specific South
    Worcestershire news
  • No specific Wyre
    Forest news

GPFV Transformation Funding 2018-2019 – Funding still available for 2018/19 

NHSE mandated that the 18\19 Transformation Funds could only be used to improve access. We have made a local decision to allow applications from practices, working together ideally, for use against any of the 10 High Impact Changes as well as Improving Access and hope that we see more bids come through following this local flexibility. What’s still really important is that practices are able to demonstrate the difference that the funding has made using the Making Time Audits or any other benchmark pre and post funding.  The CCGs will consider making available some form of  Transformation Funding in 19\20 but only if we can evidence the benefit ie release of capacity, workforce development, streamlined ways of working, working at scale, etc.

Here’s some of the successful bids we’ve received to-date:

Development of a Practice website which encourages patients to self-care, find the support they need and release capacity in the practice. A practice in R&B is piloting this on behalf of the CCG. If successful, then this might be an IT investment which the CCG can make on behalf of all practices.

Licence fees for your EMIS Anywhere Laptops procured in 2016 will finish on 8th September. If you recall, the capital and recurring costs were covered by the Primary Care Infrastructure Fund for year 1 and year 2 but the CCG made no guarantees there would be any funding to cover the recurring costs from year 3 onwards which currently is £433 (ex VAT) per tablet per year.

Recently the CCG obtained utilisation of the N3 usage of these laptops (the real purpose of the procurement of the laptops) and, whilst some are heavily utilised, the CCG felt a high proportion were being underutilised for which they were intended – remote access to N3 to access EMIS Web.   Therefore, the CCG have decided that funding will cease for these laptops but practices will have the option to use Transformation or Improving Access funds to continue paying for the license fees. All R&B practices have agreed to use their funds for this purpose as well as taking some innovative approaches to Improving Access delivery. James Harley will contact practices in the South and Wyre Forest separately.

Active signposting
- National Mind, local Minds and local GP surgeries co-designed an early intervention programme (Active Monitoring) suitable for individuals presenting at their GPs with low to moderate mental health problems. Active Monitoring is a self-directed, psycho-educational programme of 5 face to face sessions and is based in 7 GP surgeries in South Worcestershire across 8 weeks. The practices are hoping to see this impact upon appointments and workload.

The funding available for this year is £1.40 per patient (based on actual list size at 1st April 2017) , paid upon approval of a plan, and the remaining 10p paid on submission and approval of an End of Year assessment report.

The Transformation Fund proposal template for 2018-19 funds has been attached again (Appendix 2 is attached in word format) and groups of practices are expected to use this template for proposals this year. Completed templates should be sent to the Primary Care Team via sowoccg.worcestershireprimarycare@nhs.net prior to the Transformation Fund Panel dates which will be regularly communicated via the weekly GP bulletin. 

If you would like to discuss any ideas or plans you may have please contact Steven.connelly1@nhs.net (Primary Care Commissioning Manager – GPFV) or call Steve on 07540  127100

Influenza 2018/19 Update 

The Local Improvement Scheme for the use of antiviral prophylaxis is currently being updated for 2018/19. The scheme supports payment to practices for carrying out an assessment, obtaining consent and writing a prescription for antiviral prophylaxis in the care home setting.

Please find below paperwork in relation to the Seasonal Influenza Vaccination Programme for Health and Social Care Workers 2018/19 for your reference:

The scheme is available to all practices and if you wish to participate, please could you complete the enclosed sign up form and return to the GP Primary Care Advice Support Transformation Team (PCASTT) email at: england.gp-contracting@nhs.net by no later than 30th September 2018.

Health and Social Care staff will be eligible for a free flu immunisation this season. Further details are awaited from NHSE however it is anticipated that the delivery will be the same as last year either from their own GP or via a participating pharmacy. A revised Influenza Toolkit and supporting documentation will be issued again to all Worcestershire Care Homes and Domiciliary Care Services.

Echocardiography Changes 

Please note the following letter we’ve received from Dr David Wilson – please can make sure you circulate this within your practice:

I would like to politely remind all doctors referring patients for open access echocardiography to ensure that they follow up the result of these investigations. Historically we have endeavoured to do this in secondary care though recently the echocardiography systems have changed and coupled with the pressures we are experiencing in secondary care this has made this difficult. However we are looking at our processes to ensure that we can set this up once again. We are also making plans into how we can streamline referral pathways in the future and you should hear from us in due course with regards to this.

If significant LV systolic dysfunction is identified then please continue to refer patients to both community heart failure nurses and to cardiology secondary care for further cardiology work up.

Development Day Survey 

The CCG are working to finalise the agenda for the Development Day on the 29th of November and are looking for input into what you would like to discuss on the day. Have your say on the content of the day by completing this survey by 21 September.

CCG Key Messages 

This month's CCG Key Messages are now available, access them here.

Interpreting & Translation Services  

NHS England (West Midlands) manages contracts and service level agreements for the provision of interpreting and translation services for patients attending primary care appointments in Coventry, Warwickshire, Herefordshire and Worcestershire. There are currently agreements with 5 suppliers in place for the following services which expire on 30th September 2018:

  • spoken face-to-face interpreting for patients whose first language is not English
  • non-spoken face-to-face interpreting for deaf & hard of hearing patients
  • telephone interpreting
  • written translation of clinical documents.

NHS England’s procurement strategy for these services is to move away from having separate contracts and agreements for the different types of interpreting and translation services and to implement a single managed service contract.  A competitive tender process has therefore been undertaken using the Crown Commercial Service Framework for Language Services: Interpretation and Translation Services (RM1092).  As a result, a contract has been awarded to DA Languages Ltd. for the provision of these services, commencing on 1st October 2018.

DA Languages has been providing spoken face-to-face interpreting services for patients attending GP Practice appointments in Worcestershire since October 2017. From 1st October 2018, Worcestershire GP Practices will also be able to use DA Languages for non-spoken face-to-face interpreting for deaf & hard of hearing patients, telephone interpreting and written translation of clinical documents. DA Languages will be communicating with you shortly to provide further information and guidance on how to book these services. It is planned that Worcestershire GP Practices will be able to make bookings for telephone interpreting and written translation of clinical documents with DA Languages from 1st October 2018. Up to 30th September 2018 Worcestershire GP Practices should continue to use thebigword for these services but this option will not be available after then.

NHS England has asked DA Languages to work with primary care contractors on a collaborative basis to facilitate and promote the use of telephone interpreting as an alternative to face-to-face delivery when appropriate to do so. This will include integrating a section on the form for the person booking the service to provide reasons for requesting a face-to-face booking for spoken interpretation rather than a telephone appointment.

DA Languages will also be providing non-spoken face-to-face interpreting for deaf & hard of hearing patients and it is planned that Worcestershire GP Practices will be able to book this service from 17th September 2018 for appointments taking place on or after 1st October 2018. For appointments taking place up to and including 30th September 2018, Worcestershire GP Practices should continue to use Deaf Direct Worcestershire for this service. DA Languages will be working in partnership with Deaf Direct to ensure a smooth transition of service for patients and you will be able to request named BSL interpreters through the DA Languages online portal when making a booking.

If you have any questions or concerns about the provision of interpreting and translation services for patients attending primary care appointments in Worcestershire please contact us at england.gp-contracting@nhs.net


Adrenaline Self-Injection Pens Supply Update  

There are on-going supply issues with all three currently marketed adrenaline self-injection pens Epipen®, Jext® and Emerade®.

It is our understanding that supplies from wholesalers to pharmacies of Epipen® 0.3mg and Epipen® Twin Pack 2x 0.3mg are only made following proof of a current prescription and are restricted to two pens per validated prescription. There is no current date for an end to these arrangements.

The supply restrictions on Epipen® are resulting in an associated pressure on the supplies of the alternative brands, Jext® and Emerade®. In order to help to mitigate these supply pressures, practices are advised to:

  • Ensure that patients are advised to order their pens in good time where this is possible.
  • Ensure that a close dialogue is maintained with local pharmacies on this issue. The situation is fluid and pharmacies will be able to advise practices on the brand of adrenaline pen that is the most readily available at any given time.
  • Where it is feasible, attempt to expedite any urgent requests from patients for prescription changes.

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