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Member Practice Update

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

IAPT for Long Term Conditions: Two new Step 2 CBT courses
Living Well with Diabetes
and Living Well with Respiratory Problems

The Improving Access to Psychological Therapies (IAPT) service is expanding to provide tailored psychological treatments for people with long-term respiratory conditions or diabetes.

Two thirds of people with a long term health condition (LTC) will also have a comorbid mental health problem, mostly anxiety and depression. Comorbid mental health problems have a number of serious implications for people with long-term conditions, including poorer clinical outcomes, lower quality of life and reduced ability to manage physical symptoms effectively. NICE guidance recommends Cognitive Behavioural Therapy for people with a LTC struggling with the impact of their condition, with a growing evidence base suggesting that more integrated ways of working, with collaboration between mental health and other professionals, offers the best chance of improving outcomes for both mental health and physical conditions.

The Healthy Minds IAPT service will be working closely with community Diabetes and Respiratory teams to deliver Step 2 psychological therapies for people with common mental health difficulties living with Diabetes and Respiratory problems (including asthma and COPD). The service is open to any patient 16 or over with a long term respiratory condition or diabetes, who also meets the criteria for treatment in IAPT.

The service will be going live on 21 May 2018 so referrals are now being accepted. Referral for GPs will remain via the Single Point of Access (SPA) so please continue to refer there for IAPT for Long Term Conditions (IAPT LTC). Community Diabetes and Respiratory teams can also refer, as well as patients who can self-refer to the Wellbeing Hub as normal.

If you have any queries or would like any more information about the service, please email jack.wainwright@nhs.net who will respond.

Clinical Information provided with Samples Submitted to Microbiology

Microbiology would like to highlight the importance of the clinical information provided with specimens submitted to the microbiology laboratory.  Complete information will aid the interpretation of significance of isolates obtained from cultures and will help to identify patients needing a follow-up, ensuring timely and optimal management by the Microbiology and Infection Control teams.

Recently, an investigation was undertaken into two possibly linked cases of Group A Streptococcal infection in post-partum patients. There was a delay in identification of one of the patients as her sample, sent from her GP practice, was labelled ‘lower vaginal swab’ with no further clinical information given when in fact it had been taken from an inflamed episiotomy wound. Although this did not impact how the sample was processed, it had implications on the subsequent interpretation of the result and the clinical advice. It also resulted in a delay in this patient being identified as part of the cluster of potentially linked cases.  

The Microbiology Laboratory appreciates time available when seeing patients is often short, but would like to highlight that the more information provided on the specimens sent to the laboratory for culture, the more accurate and timely the results will be coming back.

CCG Key Messages - May 2018

Please see below the CCG Key Messages for May 2018.

This document includes an update from the Accountable Officer, information on financial recovery, a quality update, primary care and GP forward view information and details from the alliance boards.

Access the document here.

Estates & Technology Transformation Fund (ETTF)

A reminder that you only have until 8 May to submit bids against the ETTF as outlined in the email to practice managers sent on Friday 27 April and attached here.

Contact Jo Hall (jo.hall@nhs.net) if you have any queries.

Message from St Richards Hospice regarding fax referrals

From 1 June 2018, St Richard’s Hospice will no longer accept referrals or patient identifiable data by fax and all referrals for hospice services will need to be sent via email using the following address: srhgateway.referrals@nhs.net
We are very aware of the pressure under which health services are currently working, therefore we have not taken this decision lightly. However, to meet the requirements of GDPR (General Data Protection Regulation) we feel that we need to reduce the risks surrounding patient identifiable data currently communicated by fax.

As a result from 1 June 2018:

  • The current fax number for St Richard’s Hospice will be removed from the referral form and will no longer be operational
  • The referral form located at www.strichards.org.uk/our-care/referral-form-for-health-professionals/ already has a referral email address clearly identified
  • A template of this referral form has been developed for integration into EMIS. Please ensure the updated SRH Referral Form is uploaded on to your system as soon as possible and all other versions are deleted/removed
  • Please remove from systems or destroy hard copies of previous St Richard’s Hospice referral forms

If you have any further queries, please contact Vanessa Gibson vgibson@strichards.org.uk at St Richards Hospice.

The Living Well Service

The Living Well Service can support and encourage your patients to take positive steps to improve their physical and emotional wellbeing. The team of trained advisors can support and encourage patients to:

  • Eat healthily (promote five a day message on fruit and vegetable intake)
  • Become more physically active
  • Work with patients BMI 30+
  • Engage patients into community activities to improve their emotional wellbeing and connect with their communities
  • Promote benefits of stop smoking, drink sensibly.

The Living Well Service offers a countywide service and works with patients from locations of highest need. For more information about this client-led holistic service, or to make a referral please contact Living Well Service on: 01905 675850 or email

A Guide to Eating Disorders booklet

This booklet was written by a Specialist Eating Disorder Consultant working at The Aspen Centre, Warwickshire.

It aims to give clinicians an introduction to eating disorders, the features and complications with guidance on medical and psychiatric assessment.

Access the booklet in Word or as a PDF.

Pathology user survey - Reminder

A reminder that the pathology user survey is now open and can be accessed here.

Please take a few minutes to complete the survey and provide your feedback on the service.

Also, please note that the next Pathology GP user meeting will take place on Tuesday 19 June, Pathology Seminar Room, Worcestershire Royal Hospital at 9.30am.

If you're interested in attending or want to find out more about the meeting, email wah-tr.dutyBMS@nhs.net.

Prescribing Top Tip

Prescribing of Tadalafil

The use of tadalafil once daily 2.5mg and 5mg tablets is not supported for NHS prescribing in Worcestershire.

Worcestershire APC has approved a Tadalafil Once Daily Position Statement which summarises the evidence underpinning this local commissioning position.

Tadalafil once daily is also included in the NHS England Items Not To Be Routinely Prescribed In Primary Care  guidance document on the basis that more cost effective products are available. A tadalafil once daily patient information leaflet which explains the position to patients is included as one of PrescQIPP’s National Patient Information Leaflets.

The use of tadalafil once weekly, PRN formulations (10mg and 20mg) is supported for NHS prescribing in Worcestershire in line with SLS restrictions.

Tadalafil is now off-patent and prices have accordingly dropped, as detailed in the table below:


Old Price (DT Feb 2018)

New Price (DT May 2018)

Tadalafil 10mg (4 tabs)



Tadalafil 20mg (4 tabs)



All prescriptions for Cialis® should now therefore be written as generic tadalafil. Based on 12 month’s prescribing data to the end of Feb 18 it is estimated that if all Cialis® weekly tablets were written generically this would save £57,818 throughout the county.

Note that, despite this price reduction and generic availability, at this time SLS restrictions still apply, as the drug remains listed as “tadalafil” in Drug Tariff section XVIIIB: Drugs, medicines and other substances that may be ordered only in certain circumstances

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

Worcestershire Safeguarding Adults Board publications

Please find below two publications from the Worcestershire Safeguarding Adults Board (WSAB)

The briefing sets out the lessons that were learnt which have implications for current practice within Worcestershire. 

This poem aims to promote and raise awareness of 'Making Every Contact Count'

Wye Valley NHS Trust ceases providing services at Hillside Annexe 

From last Monday (April 23), the last patient left the Hillside annexe in Hereford.

The building is now no longer in operational use by Wye Valley NHS Trust and will, in the near future, be handed back to Herefordshire Council, the owners of the building.

Please read this statement for more information.

Home Office Criminal Exploitation of Children and Vulnerable Adults Guidance

View the guidance here.

NHS70 - Individuals who have made a difference

As part of the forthcoming NHS70 celebrations this year, CQC are creating a publication that focuses on individuals who have gone the extra mile to improve services, whether it be a practice nurse, midwife or a healthcare assistant etc. It needs to be someone who has initiated or been involved with something that has helped raise the profile or improved the way patients are cared for. 

Each example needs to be 200-300 words and any photos that you might have.

If you feel that you have someone within your practice that could be included in this publication, please email worcs.comms@nhs.net

Please send any examples before the end of May.