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Member Practice Update

 15 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.

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


Dementia Diagnosis Rate  

An email letter was sent to Practice Managers on 14 August 2018 regarding Dementia Diagnosis Rates. It included attached dementia searches and dementia prevalence targets to support the countywide action from the latest round of IQSP visits.

Any practice who has not received this information should contact primary care at sowoccg.worcestershireprimarycare@nhs.net and it will be resent to you.

Any queries, comments or concerns related to the searches or prevalence targets can be directed to Dr Nikki Burger

GP Election Process for Redditch and Bromsgrove and South Worcestershire CCGs 

Member practices within Redditch and Bromsgrove and South Worcestershire are advised that an opening has arisen for a GP Governing Body Member.

Both roles will be for a minimum of 1 session per week, with a term of office concluding on 31 March 2020. Please note that availability on Wednesday mornings for monthly Governing Body commitments is an essential requirement of the role.

The election process for these roles will be held concurrently. The call for nominations will be disseminated via next week’s bulletin (22 August) and will provide full detail of the intended process, timescales and relevant documentation.

DOCMAN 7 unprocessed documents 

We have been made aware of the issues relating to DOCMAN 7 unprocessed documents. 

We have also now received a copy of the letter sent to you by Dr David Geddes from NHS England that sets out a timetable of actions to be followed.  You will also see from this communication that NHS England are in discussion with the BMA General Practitioners Committee (GPC) as well as working with DOCMAN, NHS Digital and other stakeholders to look at the issues that have arisen including workload implication.
As and when we know any more information we will let you know, but for now it is clear that these processes are being directed nationally by NHS England.


New Primary Care Commissioning Manager (GPFV) 


Steve Connelly joined us this week as our new PC Commissioning Manager and will primarily focus on the GP Forward View. Steve has been in the NHS since 1999 working for various PCT's/CCG's, although primarily in Birmingham and Solihull. Steve brings with him experience in Third Sector and Secondary Care contract management as well as lots of Primary Care expertise. Steve is looking forward to working with you and would welcome the opportunity to come along to the practice manager meetings to introduce himself. If you have any comments/questions reference GPFV please contact Steve via his NHS email.

For those of you into football, he’s a Birmingham City fan!

Herefordshire and Worcestershire Programme Management Office (PMO) Core Team 

As the Herefordshire and Worcestershire STP is now into its 3rd year and working towards an Integrated Care System (ICS), an opportunity arose to review the PMO functions currently delivered by the STP, Herefordshire CCG and the Worcestershire CCGs. Following system agreement in July 2018 to integrate the Herefordshire CCG, Worcestershire CCG and STP PMOs, the Herefordshire & Worcestershire (H&W) PMO has been formed and formally goes live on 3 September 2018 (but the central e-mail address was launched on 13 August). 

We are very pleased to be introducing the new H&W Core PMO team who will be providing the PMO function across the H&W system. There are a number of other people affiliated to the H&W PMO, but for simplicity only those people directly line-managed by the Head of the H&W PMO are shown on the organogram below.


The 4 main functions of the PMO are*:

  1. First point of contact for all STP-related NHS England/Improvement returns and information – this will include collation and co-ordination of returns for:

    a.         Portfolio and programme assurance reporting
    b.         Operational planning
    c.         RightCare

  2. Provide a standard framework, approach and reporting function to enable operational teams to deliver the portfolio and programmes of work to include the on-going development of Verto PMO software.
  3. Supporting core STP governance forums / meetings, and county-based Financial Recovery and cost improvement programmes
  4. Continued partnership working with PMO teams based in providers and County Councils

As part of this integration, a new PMO email address has been set up: rbccg.hwpmo@nhs.net to ensure that communications relating H&W STP are consistent and received into and sent out from the central inbox. This e-mail address went live on Monday 13 August 2018.

The PMO functions will be continually reviewed and developed as we move towards the ICS, this will include how the PMO function provides system assurance around performance.

*The PMO does not have project or programme management resource

Prescribing Top Tip 

Prescribing Trusses

A common query received by the Medicines Commissioning Team concern the prescribing of trusses.

Trusses can control but not cure hernias and are sometimes used as a conservative treatment option, together with lifestyle advice.
Only those trusses that are listed in the Drug Tariff part IXA (Appliances) can be prescribed. When issuing a prescription for a truss, the following information must be included:

  • The type of truss - (Elastic band or Spring)
  • The position of truss needed based on the presenting hernia: inguinal/scrotal/umbilical (inguinal is the most common)
  • Whether it is single or double (depending on whether the hernia is unilateral or bilateral)
  • If the truss is single, the side (left or right) must be specified.

These can be selected generically on EMIS, for example: "Elastic band truss inguinal single left". Only one truss at a time should be prescribed.
Truss measuring and fitting is carried out by the dispensing community pharmacy or appliance contractor who will claim additional professional fees for this service. For the fitting, the patient has to be lying flat and the hernia has to be fed back into the body prior to the fitting. The pharmacist or appliance contractor has to be satisfied that the hernia is a good fit.

Unfortunately truss measuring and fitting is not a core pharmacy service and the number of pharmacies that are able to provide this service is diminishing. If practices are unable to locate a local provider then they could contact the Medicines Commissioning Team.

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

CCG Key Messages August 2018 

The CCG Key Messages of the month are now available to download.

Read More

Clinical Pharmacists in General Practice: Pilot Scheme Evaluation 

Clinical pharmacists in General Practice was launched as a pilot in 16-17, with practices in South Worcestershire and Wyre Forest included in the first wave.

Nottingham University has evaluated the pilot, with key findings from surveys and reporting data showing that the clinical pharmacist role:

  • Increases capacity of General Practice to see patients and that this capacity benefits the GP
  • Improved patient safety in relation to medicines
  • Was accepted by patients who unanimously agreed appointments were of high quality and they were more likely to understand their medicines.

Further information and the full analysis is available here.

Learning from an ‘End of Life’ Round Table Review 

Earlier in the year a Worcestershire GP contacted the CCG to raise concerns regarding how a patient’s ‘preferred place of death’ wishes had not been met following her transfer to acute care from a nursing home. She was admitted after paramedics attended the nursing home as a response to staff contacting NHS111 to request an Out of Hours GP visit. She sadly died in hospital 14 hours after her admission.

The CCG Quality Team invited all of the providers involved to a ‘Round Table’ meeting, the aim of which was to jointly review the whole episode of this person’s care, understand what went well; what didn’t go well; and whether there are any improvements that could be made in relation to supporting people at the end of their life. Representatives attended from West Midlands Ambulance Service; The GP practice; the Integrated Urgent Care service (GP OOHrs and NHS111); the Nursing Home; Worcestershire Acute Hospitals along with the CCG Adult Safeguarding Lead and Quality Managers.

Read More

Learning from Serious Incident Investigations Potentially Avoidable Harm  

Since January 2018, Worcestershire has seen two Serious Incidents involving patients who sustained burns at home, were initially treated within the community, but were subsequently referred onto the Queen Elizabeth Hospital, Birmingham for skin grafts due to the nature of the injuries.
In one of the cases, the QE contacted the CCG to raise concerns regarding the patient’s journey through primary and secondary care before being referred onto their services for specialist intervention.
Investigations into both cases identified failure to follow Midlands Burn Network Referral Guidance resulting in a delay in the patient accessing specialist review and treatment.
The providers involved have worked together to ensure recommendations from the investigations have been taken forward. This includes ensuring that all staff are aware of and consider the Referral Guidance when treating patients with burn injuries.

Details of the Network and links to Referral Guidance / Treatment Guidelines are provided below. This includes:

  • Patient Referral Guidance/Flowchart
  • Care of Children with Small Burn Injury Information
  • Care of Children Burn Injury Carer Leaflet
  • Minor Burn Dressing Flowchart

Read More

GP online services webinars for Patient Participation Group members 

NHS England’s primary care digital transformation team is holding a series of free webinars aimed at Patient Participation Group (PPG) members to help them understand all about GP online services and how they can support their local GP practice to encourage more patients to register for the service.

The webinars will last between 60-90 minutes and the dates are:

  • Wednesday 29 August, 10am – 11am
  • Monday 17 September, 1pm – 2pm
  • Wednesday 24 October, 10am – 11am
  • Monday 29 November, 1pm – 2pm
  • Wednesday 19 December, 10am – 11am

To sign up please go to: www.events.england.nhs.uk/gp-online-services-webinar-for-patient-participation-group-ppg-members

St Johns Vacancies 

Vacancy for GP

St Johns House Medical Centre, Worcester, is looking for a committed GP to join our dynamic forward thinking, friendly practice team. We work from exceptional, well-equipped premises in Worcester serving a patient population of 12,500.

  • High QOF points achieved
  • CQC rating of good
  • Excellent nursing, ANP and HCA teams
  • Supportive admin team
  • Two clinical pharmacists
  • Daily team coffee meetings
  • Twice weekly case review/referrals review meetings
  • Weekly MDT meetings
  • Good working relationships with neighbouring practices
  • Opportunities for development and special interests welcomed, e.g. trainer

We are ideally looking for a partner, but for the right candidate, we would consider a salaried position, with a view to progressing to partnership (ideally 6 sessions p.w.) Start date negotiable.

Please contact Sarah Baker, practice manager or Sue Lloyd, assistant practice manager to arrange an informal visit (01905 421688).

Vacancy for Advanced Nurse Practitioner

We have an exciting opportunity for an Advanced Nurse Practitioner to join our friendly team in well equipped newly built general practice premises at St. Johns House Medical Centre, Worcester.

We are looking for an enthusiastic, caring and motivated ANP to join our team. We are CQC rated good and have excellent QOF achievement with a practice list of 12,500 patients.

We will expect you to:

  • Provide safe and effective health assessments and treatment of patients attending the surgery or visited at home
  • Deliver face to face and telephone services which will enable patients to obtain health advice from the appropriate health care professional
  • Be accountable for your own practice, including the assessment, diagnosis, treatment or referral of patients
  • Contribute to our team-working culture
  • In return we offer:
  • Friendly/supportive team
  • Daily coffee time
  • Twice weekly case review/referrals review meetings
  • Weekly MDTs with wider health care team
  • Opportunities for development and interests
  • Competitive salary, according to experience and prescribing status

For an informal visit and discussion please contact Sarah Baker on 01905 421688