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Member Practice Update






17 January 2018


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 worcs.comms@nhs.net

In this issue:


Find out about local and national events and training here.

RB-3collumnheader
  • No Redditch and Bromsgrove specific news

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  • No South Worcestershire specific news
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  • No Wyre Forest specific news


Keep up the good work!  


Prescribing Policy Update:

Since we introduced the new prescribing policies back in September, prescriptions for gluten free items has reduced by over 90% across Worcestershire.

Thank you to all staff for adopting these new policies so well.

Frailty Unit Update:

Since opening:

  • 364 patients have been seen by FAU and 41% (n= 150) have been discharged on the same day. 
  • 72.55% FAU attendances are from Redditch/Evesham postcodes.

Whilst WMAS have done considerable work to promote FAU the current frailty criteria excludes a high volume of patients on their initial presentation. It is often only after initial assessment and medical queries being ruled out, that the patient is deemed appropriate for frailty

Comparing Nov 2016 and Nov 2017 the following has been found:

  • There has been an increase in the number of  patients discharged the day of attending the FAU
  • 27.35% patients discharged the same day in Nov 17 compared to 20.26% in Nov 16 – likely an effect of the FAU
  • Reduction of 521 bed days - 4,038 in Nov 2017 compared to 4,559 in Nov 2016 - this would be the equivalent of around 57 admissions (based on AVG LOS of 9 days) 
  • Average LOS reduction of 1.78 days (1.40 days excluding 0 LOS)






Transformation Fund reminder – Remaining panel dates  


If you have yet to submit a proposal for the GP Forward View Transformation Fund, please note there are two further approval panels between now and March 2018.

  • Panel date: Tuesday 30 January 2018 – deadline for proposals to be submitted will be Friday 26 January 2018
  • Panel date: Monday 19 March 2018 – deadline for proposals to be submitted will be Thursday 15 March 2018

Please submit your proposals on the completed proforma to worcestershire.primarycareccg@nhs.net

Helen Southwell and Hollie Hastings will be able to assist with your proposals, please contact them directly.





Clinical Pathway Lead for Dementia Vacancy 


As part of the action plan issued by NHSE following the Intensive Support Team Visit for Dementia Diagnosis Rates the CCG has agreed to appoint a clinical pathway lead for Dementia.

Further details are available through the following links:


If you have any questions please contact Carol Rowley.





SNOMED CT Update 

As you are aware SNOMED CT is the clinical vocabulary replacing v2 Read Codes within the NHS and must be adopted by all general practice service providers from 1 April 2018 onwards. We have been assured that EMIS will be mapping current V2 read codes to SNOMED, including updating any national templates/searches/reports and protocols (including QOF). However, the advice from NHS digital to date is that any locally developed templates/searches/reports and protocols will need to be reviewed and mapped at practice level. The full rationale for this can be found in this document. Any templates/searches and protocols developed by the CCG will be amended and distributed to practices in due course.

There is still some uncertainty regarding the level of support practices will receive from EMIS. However, the CCGs are committed to support practices to manage this change and will be providing regular updates as and when they are released by NHS Digital. In the meantime, we strongly recommend practices start to consider the following:

  • Housekeeping - Archive/delete any local templates or reports you no longer use (if they haven’t been used in the last 12 months, do you really need them?)
  • Identify high priority searches and templates for reviewing soon after moving to SNOMED CT
  • Consider some of the text changes – for example terms ending in NOS, NEC will no longer exist
  • Gain confidence in SNOMED by accessing Webinars and online training materials available via EMIS and NHS Digital resource centre
  • Nominate a practice SNOMED practice champion/ super user

There is a wealth of training materials available on the NHS Digital resource centre, including YouTube animations, live webinars, pre-recorded webinars and presentations. To access these materials users will need to click on the link above, select ‘EMIS Web Snomed CT Implementation in Primary Care’, then ‘Education and Training’. In addition, we have handpicked three fact sheets that we would encourage users to start to read and digest in preparation for the transition to SNOMED CT in the spring. These can be found via the following links:


We will be keeping you informed as new information is released.

If you have any further questions regarding SNOMED coding, please do not hesitate to contact Clare Gibbs or Ray Giles.





Influenza management update  

PHE Antiviral Guidelines can be found via this link.

The treatment algorithm is on page 8 of the guidelines for suspected or confirmed influenza.

Definition of Influenza

Oral or tympanic temperature ≥37.8C and one of the following:

Acute onset of at least one of the following respiratory symptoms: cough (with or without sputum), hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing or an acute deterioration in physical or mental ability without other known cause.

Symptomatic Contacts of an Influenza Case

  • If in at risk groups and contact within 48 hrs, antiviral treatment may be prescribed

Asymptomatic Contacts of an Influenza Case

Should someone visit or contact the surgery and say they have been a contact (same household) of someone with confirmed influenza:

  • If in at risk groups and contact within 48 hrs, antiviral prophylaxis may be prescribed
  • In not in at risk group advice regarding signs and symptoms should be given and what to do should they become symptomatic
  • There is still benefit in advising immunisation to unimmunised individuals in at risk groups.

Swabbing

  • Swabbing is not undertaken in General Practice
  • Swabbing of residents will only be undertaken as part of a care home outbreak.





Community Transport Schemes Reminder  

Two community transport schemes launched across Worcestershire in September 2017, offering improved access to health services in the county.

Community Transport Connections is available for patients and visitors travelling between the Alexandra Hospital, Redditch and the Worcestershire Royal Hospital, Worcester.

The service is delivered, in partnership by the county’s existing Community Transport operators.

A further community transport scheme also launched, which offers patients a way of attending GP and hospital appointments. Journeys to Health is available for patients registered with any Wyre Forest GP Surgery, as well as Tenbury Wells Surgery and Great Witley Surgery. The service is provided in partnership with Wyre Forest Dial a Ride, Tenbury Transport Trust and Community Transport North Worcestershire.

Both schemes are available for anyone unable to travel by any other means. All transport will need to be pre-booked and will be provided at a small cost, using volunteer driven cars and multi-purpose vehicles.

Initially these are pilot projects, running until March 2018. They have been funded by the Department for Transport’s Total Transport initiative and supported by Worcestershire County Council and healthcare organisations.

Please note that these schemes do not cover every area of the county.

Please contact the CCGs Communications Department for promotional materials.





Supporting GP Contributions to Child Protection Conferences and other Safeguarding Meetings  

Re: Requests to attend Initial Child Protection Conferences/Review Child Protection Conferences or other Safeguarding meetings

It is appreciated that GPs cannot cancel surgery to attend at short notice and that attending for this length of meeting within what are often short  timescales was just not doable. We want to make sure that your views/thoughts can inform discussion and that you are aware how important this is.

Measures are in place to support GPs Contributions to these processes:

  • The ability for professionals to be able to teleconference in to these meetings. To enable this, the conference call details for dialling in should be included in the invite to the Child Protection Conference by Worcestershire County Council Children’s Services. In addition the contact details for the Conference Chair will be included in the invite to conference so that professionals can have a conversation prior to the conference if they (or a well briefed representative) are unable to attend or if unable to dial in and share information

  • GPs could send another qualified member of staff to represent them at conferences (such as the Practice nurse). This would enable a clinician to input in to the conference and report directly back to the practice

  • The ‘Conference Reporting Template’ should be completed as a minimum by the GP (or appropriate representative completing on the GP’s behalf) as this will help inform the overall discussion regarding the child and/ or parents/carers. (The report should always be completed and returned even if it is to state that there has not been any contact with the child/and/or parents/carers who are the subject of the conference).

In addition Worcestershire’s Multi-Agency Safeguarding Hub requests information that is required for meetings held within the hub. These requests may require quite a fast response from the GP Practice. These are sent from secure email to secure email at the GP Practice. The hub includes both children and adults teams from WCC, Police, health and others who contribute on a virtual basis, such as probation as necessary.

Contact Ellen Footman to find out more.





Prescribing Top Tip  

Download the January 2018 summary of Worcestershire preferred brands.





Adjuvanted Trivalent Flu Vaccine (Fluad®; Sequirus) 

NHS England has sent correspondence to GP Practices informing them of  Joint Committee on Vaccination and Immunisation (JCVI) advice that the use of the adjuvanted trivalent flu vaccine (Fluad®; Sequirus) should be a priority for those aged 75 years and over. The Worcestershire APC  Influenza Vaccines 2018/19 position statement has therefore been revised to this effect and can be found here.





PHE Stroke Resources FAST 

Be aware that Public Health England is sending a resource pack around the 'Act FAST' stroke campaign. The pack includes A4/A3 posters as well as leaflets. Please make these resources visible to patients visiting your surgery.

Download digital copies here.





Reach4Wellbeing Service 

The Reach4Wellbeing Team is part of Starting Well Service in Worcestershire, they promote and support emotional wellbeing for Children and Young People age 5-19 years. They are a team of seven staff, with one case worker for each of the following areas: Wyre Forest, Redditch & Bromsgrove, Worcester & Malvern and Wychavon.

Their aims are to Promote Positive Wellbeing, Reach Children and Young People in their Communities and Reduce the Stigma of Mental Health. 

Find out more about Reach4Wellbeing
.





DVLA changes to driving regulations from 1 January 2018  

Changes to the law concerning medical fitness to drive for diabetes mellitus are to take effect from 1 January 2018. The amendments on diabetes reflect developments in the diagnosing and treatment of diabetes since the 2006 Directive came into force.

The change to regulations applies to group 1 drivers only. The EU directive specifies blood testing for group 2 drivers (but not for group 1) and consequently the DVLA has not considered making a change for group 2 drivers in these regulations.

Find out more.





OxyShop Reminder  

OxyShop – The new online system that makes ordering oxygen as easy as ever! With OxyShop you can create, amend and directly send HOOFs to the West Midlands regional supplier Baywater in a few clicks. It is the fastest, most secure way of ordering oxygen, so sign up now!

Find out more.