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Member Practice Update

21 February 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

Mandatory Frailty Assessment Unit Survey  

The Frailty Assessment Unit at the Alexandra Hospital opened on 16 October 2017. At the time of opening it was said there would be an interim evaluation undertaken. We are in the process of conducting the evaluation and would welcome your views which we will collect via this survey.

Completion of the survey is classified as one of the audits under PCE1, section 4, for which practices have already been paid.

Please complete the survey by Friday 2 March.

Practice Nurse Clinical Lead for Worcestershire 

Are you interested in an exciting challenge, a development opportunity and help shape the practice nursing workforce in Worcestershire?

Worcestershire CCGs are looking to recruit a Practice Nurse Lead (Band 8a) to support general practice nursing over the next 12 months. This is an exciting post which will be on a fixed term basis working with the CEPNs, LMC and CCGs 1 day per week.

  • Read more about it here.
  • Download the Job Description here.
  • Download the Expression of Interest Form here.

We are looking for the post to commence from April 2018. Please email the Expression of Interest form to: worcestershire.primarycareccg@nhs.net by 9 March 2018 using subject header: PNL EOI.



Process to follow When AF is discovered in a Pacemaker Check 

From March 2017, in the event that AF has been documented by a device, the Pacing and Device Team are sending  a standardised letter to practices. In these circumstances the GP will receive the standard pacing check letter, documenting the AF in the comments at the bottom, additionally, a separate letter will go out to highlight the finding. The Pacing Check Letter will also contain technical information, this is helpful as a technical resource in regard to possible emergency admissions to another hospital.

In the event of other abnormalities being detected, the technician will seek advice from a consultant cardiologist to determine the appropriate action, if any from Primary Care. A letter will be dictated to primary care with a plan if necessary. Generally the device report will detail any abnormal findings and what has been done - e.g. that the cardiologist has been notified.
The cardiology advice email service wah-tr.WorcesterCardiologyAdvice@nhs.net is recommended if practices receive a report noting something abnormal and the GP is uncertain what action should be taken. As a general rule, if the device check documents something requiring action there is no expectation for the GP to act, based on interpreting the pacing report. There will either be explicit information outlining what needs to be done on the pacing report, a separate letter will be sent detailing the action required or the Pacing and Device Team will take the required action.

Termination / Social Gynae Referrals Clarification 

Following last week's story around Termination / Social Gynae referrals, we have been made aware that this has led to some confusion amongst GPs and Practice Staff. To clarify, this only affects patients who would be treated in Herefordshire at Wye Valley, not patients who would normally be treated at Moor Street.

Apologies for any confusion.

CAS alert: Esmya® (ulipristal acetate) for Uterine Fibroids 

It is our understanding that the following MHRA report Esmya (ulipristal acetate) for uterine fibroids has been sent to all practices; further information can also be found in this EMA report.

Local Trust gynaecologist have requested that, in line with this alert, current patients are identified and monitored accordingly. If there are any concerns about continuing to prescribe or any advice required on alternative treatment following cessation the prescriber should go back to the initiating clinician. No new patients or treatment courses should be initiated.

Please could all practices confirm that they have identified any related patients and actioned the MHRA guidance accordingly by emailing directly to the Medicines Commissioning team’s generic email.

Prescribing Top Tip 

New Emollient Cream Now Available - ExCetra® Cream
A new emollient cream product - ExCetra® cream - has recently been added to both the Worcestershire Emollients Guidance and the Worcestershire Formulary.

ExCetra® cream contains white soft paraffin 13.2% w/w and light liquid paraffin 10.5% w/w and is equivalent to Cetraben® cream. The product is available in 100g & 500g pack sizes but the most cost-effective pack size is 500g. 

Notable excipients are cetostearyl alcohol & phenoxyethanol. The full SPC for the product can be viewed here.

Comparable prices to Cetraben® cream are shown in the table below:


                  Pack Size




Cetraben ®Cream




Excetra® Cream




Based on prescribing for the 12 months to the end of Dec 17, the potential cost savings from a 100% & 80% switch from Cetraben® cream 500g to ExCetra ® cream 500g are given in the table below, for the three Worcestershire CCGs:


Total Actual Cost  of Cetraben®

Equivalent Cost of ExCetra®

Potential  saving of 100% switch to ExCetra®

Potential saving of 80% switch to ExCetra®





































The Cetraben® – ExCetra® switch message will shortly be added to the Optimise® prescribing support software.

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

Health Walks 

In England, half of all adults are not active enough to benefit their health. This means that they are at risk of developing serious illnesses such as diabetes, heart disease and cancer.

But it doesn’t have to be this way.

Walking for Health is England’s largest network of health walks with over 400 active schemes, helping people across the country lead a more active lifestyle. Operating with great success for over 14 years, improving the mental and physical well-being of thousands of people.

If you think this could benefit your patients download the documents below: