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Member Practice Update

 19 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.




Thank You! Dementia Diagnosis Rate 

Many thanks to practices for the work they have done so far on undertaking the dementia searches and increasing the numbers on the dementia registers. Overall across the 3 CCGs we have seen an increase in 200 patients on dementia registers between April and September. Please keep it up! For those who haven't started the searches yet, please be encouraged that there is a tangible difference that this work is making and we need your contribution as well.

It is also worth reminding practices and clinicians that, where patients are demonstrating signs of some impairment but that you do not consider them to have dementia currently, we should be using the MCI code. This is part of the PCE contract, but will also allow you to run searches in future to identify patient who may benefit from a future review/recall.

There are also a group of patients who clearly have advanced dementia, and there is a tendency to either not notice they aren't on the register as it would appear so obvious, or fear of adding them to the register as this will generate the "QOF response" of needing bloods, scans etc. The type of patient this relates to is often in a care or nursing home. In cases like this, it is entirely appropriate to add them to the dementia register and exception report them from the new diagnosis bloods etc. There is no need to refer them to the memory clinic. 

Download the latest prevalence figures from 1st September.



 

New Referral Template COPD Team/Pulmonary Rehab  

Please ensure the new referral template, for the Acute Trust’s COPD Team, is loaded to EMIS. The template is available here. All future referrals will need to be made using this electronic template. Referrals can be made for the following services:

  • Pulmonary Rehabilitation – for all COPD patients with MRC > 3 or with MRC 2 with a recent hospital admission
  • top up Pulmonary Rehabilitation
  • COPD symptom management
  • acute COPD assessment and management
  • admission avoidance hot clinics (currently in Redditch and Bromsgrove only)
  • Fit to Breathe maintenance classes


If you would like to know more about the COPD Team, the services they provide or would like to discuss patients you may want to refer please contact the team directly on 01905 760023 or via Email at wah-tr.COPDTeam@nhs.net.




Legionella Risk Letter 

GP's and OoH teams should have received a letter on 14/09/18 regarding the possible Legionella risks at WRH.

Following positive Legionella results from water samples taken on Worcester MAU on 30.08.2018 we wish to make you aware of the possibility of healthcare acquired Legionella infection in patients who attended the following areas of the hospital: WRH MAU, WRH AEC, WRH A&E Majors.

Download a copy of the full letter here.



Temporary Suspension of All Dermatology Referrals to Gloucestershire Hospitals  

Worcestershire CCGs have received notification from Gloucestershire Hospitals NHS Foundation Trust, that they have suspended acceptance of referrals into their Dermatology Service from 14th September 2018. The Trust has agreed this approach with NHS Gloucestershire CCGs. The Trust confirm that the suspension will cover all referrals into the service, including 2 week wait cancer referrals. The Trust have confirmed their intention to reinstate the service from the 31st October 2018.
 
Worcestershire CCGs have requested confirmation of the Trust intention to patients recently referred or already on the waiting list pending consultation/treatment. We have also requested sight of any action plan developed to monitor progress back to full service delivery.
 
We will share any further information with you when received but ask that you please do not refer any patients with dermatology conditions to this Trust until further notice.
 
Please note, we have sent this information to all practices in Worcestershire to make sure you are all aware of the situation and that no patient’s care is compromised as a result of this suspension.



EMIS Anywhere Laptops  

You may be aware that the recurring licenses (N3 and Roaming Data) for your EMIS Anywhere Laptops procured in 2016 are about to, or have already, expired.
 
If you recall, the capital and recurring costs were covered by the Primary Care Infrastructure Fund for year 1 and year 2 and 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 laptop per year.   The £433 per year provides;

  • N3 Connectivity (through SafeNet token)
  • 4G Roaming data (1GB monthly allowance per device)
  • Egton Support


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 under-utilised for which they were intended – remote access to N3 to access EMIS Web. Therefore, the CCG have decided that if practices wish to continue to use the laptops for remote access to clinical systems (Emis Web, Docman 10, Emis Mobile for Windows (coming soon)), funding for the licenses must come from the GPFV Transformation Funds or Improving Access monies. The CCG can assist with this process rather than practices acting individually – if you would like to take up this offer please contact James Harley as soon as possible.



GP Governing Body Election Processes – Result and Update  

The GP Governing Body Election Processes for the vacant positions in Redditch and Bromsgrove CCG and South Worcestershire CCG have now concluded.

We are pleased to announce that Dr Moheb Shalaby has been successful in his application for the Redditch and Bromsgrove Governing Body role, subject to ratification by member practices. Dr Shalaby will subsequently be formally inducted within the CCG in the coming weeks.

Unfortunately, no nominations were received for the South Worcestershire Governing Body GP role. In recognition of the importance of securing clinical representation, the election process will be relaunched. The nomination period will open on Wednesday 26th September, with all associated information disseminated via the Member Practice Update. This will also be promoted at the quarterly South Worcestershire Engagement Day on 3rd October.



Flu Season 

Making the most of online appointments:

Includes information on how flu clinics can be used to register patients for online, as well as providing information and links to further resources on the wider benefits of GP Online Services and Flu promotion for both patients and practices. Download here.

EMIS:

Many practices will be experienced with EMIS preparations for Flu, however if you would like any assistance with creating an EMIS Flu Protocol or to see if the system can be automated elsewhere to help ease the burden of the Flu season, please contact the Primary Care Team to see if they can help.




Seretide Price Reduction  

NHS list prices of the three most commonly prescribed presentations of Seretide® have been reduced as of 1st September 2018. The price reductions and comparison with the current preferred formulary inhaler equivalent for asthma (based on inhaled corticosteroid classification) are given in the table below:

Seretide Presentation

Prev Seretide® Price

New Seretide®
Price

Fostair® presentation

Fostair® price

Flutiform® presentation

Flutiform® price

Seretide Evohaler 125

£35.00

£23.45

Fostair® MDI 100/6

£29.32

Flutiform® MDI 5/125

£28.00

Seretide Evohaler 250

£59.48

£44.61

Fostair® MDI 200/6

£29.32

Flutiform® MDI 10/250

£45.56

Seretide Accuhaler 500

£40.92

£32.74

Fostair® Nexthaler  200/6

£29.32

NA

NA


As highlighted, the new list price of Seretide® Evohaler 125 is now lower than either of the preferred formulary options. Practices planning on switching patients with asthma from Seretide®  Evohaler 125 to a preferred Worcestershire device for purely financial reasons are therefore advised that this would not represent a good use of practice time, or resources. Switches and changes from Seretide® Evohaler 125 to a preferred formulary inhaler for clinical reasons could still of course be considered.

Practices should continue to step down patients, where this is clinically appropriate, in line with the current Worcestershire Asthma Guidance.

Formulary preferences for asthma devices are unchanged at this time and all prescribing of Seretide® remains restricted to existing patients only.

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



Early Inflammatory Arthritis 

Download the updated EIA form. This form replaces any previous versions and should be imported to your EMIS system and be used where appropriate from this point forward.

Please note the guidance within stating that the form is only to be used for ‘patients who require rapid assessment for new onset persistent symptoms/signs of an inflammatory arthritis’



SRH Nurse Essentials Course  

Thursday 11th December 09:00 - 17:00
Badger Medical Ltd, B9 5EY

What is SRH Essentials?

The Faculty of Sexual and Reproductive Healthcare (FSRH) recognises that nurses are the first point of call for many patients with sexual and reproductive health needs. Raising the subject and helping women to become aware of their fertility and the risk of unwanted pregnancies or STIs are important aspects of day-to-day primary care.

Find out more about this one day course.



 

South Worcestershire:

General Practice appointments booking  

General Practice is changing the way in which receptionists book patients appointments.

From November reception staff will be trained as Healthcare Navigators and will (at the request of the Doctors) be asking patients certain questions to signpost patients to the most appropriate clinician / service straight away. This will enable the patient to receive the most appropriate care from the most appropriate person at the most appropriate time.

Download a promotional flier here.




Wyre Forest:

General Practice appointments booking  

General Practice is changing the way in which receptionists book patients appointments.

From November reception staff will be trained as Healthcare Navigators and will (at the request of the Doctors) be asking patients certain questions to signpost patients to the most appropriate clinician / service straight away. This will enable the patient to receive the most appropriate care from the most appropriate person at the most appropriate time.

Download a promotional flier here.