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Member Practice Update

21 November 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 South
    Worcestershire news
  • No specific Wyre
    Forest news

Countywide Primary Care Development Day  

A reminder to all practices the Countywide Primary Care Development Day is 29 November 2018 at Sixways Stadium (Warriors Way, Worcester WR3 8ZE) with a light lunch served at 12:30 for a 1pm start.

If you have not already done so, please sign up via Eventbrite using this link to ensure we have accurate numbers. If there are any specific dietary needs please contact Denise Horton.  As in previous years, we are encouraging practices to send a GP and PM representative from each practice. Funding for backfill will be reimbursed as part of the PCE contract (As outlined in Sections 1.1 Best Practice – education, development & engagement – CCG study day).  Practices are welcome to send additional delegates but we are unable to provide backfill support beyond what is outlined above.

The agenda for the day can be found here.

As part of the afternoon there will be discussion on the workforce challenges within Worcestershire. The information recently published form the Quarterly Primary Care Workforce Survey taken in August may be useful to review prior to the Development Day, a link to the report can be found here.

New EMIS TIA Referral Form  

A new TIA referral form has been developed in line with best practice guidelines. Please ensure this version of the referral form is uploaded on to your systems as soon as possible and all previous versions deleted. Many thanks for your co-operation in this matter.

Download the form.

Help Us Help You Update 

The Help Us, Help You Update, aims to keep you up-to-speed with everything that’s happening with the campaign.
The emphasis of the campaign is to encourage people to take responsibility for their own health and wellbeing and tackle conditions earlier to prevent illnesses getting worse. Helping to reduce the need for admission to hospital.

The campaign has now moved into the Stay Well This Winter phase to provide the public with the key messages to help them stay well over the winter months. This includes seeking support from pharmacy, getting the flu jab (particularly focussing on the over 65s), calling 111 and checking up on vulnerable friends, family and neighbours.

Over the next couple of weeks, the CCGs will also be promoting Improved Access appointments, which offer patients the opportunity to access primary care services outside of standard operating hours (evenings and weekends).

Read the full HUHYU update here.

Top Ten Tips for Nurse Revalidation 

  1. Ensure you register with NMC online to get your revalidation date.
  2. Look at the revalidation step by step guide on the NMC website.
  3. Get to know your NMC code and keep a copy in your portfolio.
  4. Start your paper portfolio now ensuring you meet the requirements set out by the NMC website.
  5. Use the NMC/forms, templates in your portfolio as per the NMC website.
  6. Clarify with your employer who will be doing your reflective interviews and who will be your confirmer (these can be the same person)
  7. Identify any gaps in your requirements to revalidate and discuss with your employer.
  8. Ensure you are revalidation ready in plenty of time- 60 days prior to your revalidation date. DO NOT LET YOUR REVALIDATION LAPSE BY ONE DAY.
  9. Always check you have been revalidated several days prior to expiry of your previous registration.

The Requirements:

  • 450 practice hours
  • 35 hours of CPD requirements including 20 hours of participatory learning
  • Five pieces of practice-related feedback
  • Five written reflective accounts
  • Reflective discussion
  • Health and character declaration
  • Professional indemnity arrangement
  • Confirmation

Paying your fee:

  • Annual direct debit
  • Quarterly direct debit
  • Credit or debit card

, which means you must stop working as a nurse or midwife until you are readmitted to the register - a process that can take between two and six weeks

Details of your registration should be past to your employer, this can be in the form of a photocopy of the email that you receive from the NMC.
It should be then kept in your personal file as proof of registration.

GP Forward View  

Please download information regarding the upcoming PCDT regional conferences which are being held. They are aimed at GPs, practice staff (including nurses), commissioners, and digital health leads and people interested in the digitisation agenda.

Prescribing Top Tip 

Modified Release Metformin – Additional Preferred Brand

A second preferred brand of modified release metformin - Yaltormin SR® has now been approved by the Worcestershire Area Prescribing Committee, in addition to the existing brand of Sukkarto MR®. This gives practices another option that can be used ahead of less affordable presentations.

Price comparisons are given in the table below:

Metformin MR tablet preparation

Generic price as per Drug Tariff  Nov 18 (Cat C)

Glucophage® MR list price (Nov 18)

Sukkarto® MR list price (Nov 18)

Yaltormin® SR list price (Nov 18)

Metformin 500mg
MR tabs (56)


£4.00 *



Metformin 750mg
MR tabs (56)






1000mg MR tabs (56)





*Glucophage MR 500mg based on 2x28 –price for 1x56 is £5.32

Yaltormin SR® is closer to the reference brand Glucophage SR® with respect to its list of excipients than is Sukkarto SR® and it may therefore be suitable for patients who could not tolerate Sukkarto SR® because of  gastric side effects.

Yaltormin SR® is marketed in a 750mg MR strength giving opportunities for optimisation switches from Glucophage MR /metformin MR 750mg that have not been hitherto possible due to the absence of this strength in the Sukkarto SR® range.

Based on 12 months prescribing to the end of August 18, the potential annual savings of a switch from metformin MR/Glucophage® MR to Yaltormin® SR (all strengths)  are given below:


12 month spend metformin MR tabs/Glucophage® MR tabs

12 month spend if 100% switch to Yaltormin® SR

Savings based on an 80% switch to Yaltormin ®SR


















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

Children's Social Care 

Can staff please make sure that their Children's Social Care contacts are up-to-date. The latest excel document is available to download, it lists contact details for Worcestershire Health and Care NHS Trust staff.

Download contact list.

Do you refer Children and Young People to Children's Social Care or make requests for support from Early Help Family Support?

Worcestershire County Council have been working with partner agencies to update the referral form for making a professional referral to Children's Services which is currently called "Cause for Concern".

From 26th November 2018 the new name for this will be "Referral to Children's Social Care" and this can be accessed via the Council's website and for those who have a Worcestershire Children's Portal account it will remain available through this also. Referrals to Children's Social Care will continue to be processed by an initial screening officer and a Social Worker will assess the levels of need and make a recommendation to a Team Manager. The decision will be made by the Team Manager and an outcome notification will go back to the referrer within three working days of the decision.

Alongside this is the development of the new "Request for Early Help, Family Support". This is a new service request form for children and young people who are identified as needing early help and support from within the levels of need 2 or 3 (See WSCB Levels of Need), and are only seeking a service from Early Intervention Family Support (EIFS) or Targeted Family Support service (TFS ).

This new request for service will be open to professionals, parents and carers and young people over the age of 13 years to request specific family support from these teams in their local community. This request form will be available via the Council's website. These requests will be considered by the Team Leaders for those services and the outcome decision shared within three working days of their decision.

HIV Outbreak  

We are writing to inform you that PHE West Midlands has been alerted to an apparent increase in the number of cases of HIV among Persons Who Inject Drugs and/or Commercial Sex Workers, or people who pay for sex, since September 2015 in the Birmingham area. A number of these have had documented seroconversion in the last three years, indicating new infection.

We are currently investigating this to understand the factors that are driving this apparent increase in infections and are developing control measures in order to manage the situation. One initial control measure is to ensure that we raise awareness of this outbreak amongst relevant stakeholders.

We are communicating with local NHS Trusts to inform them of the situation and encourage them to continue to offer testing for blood borne viruses, and in addition to consider appropriate increased testing in A&E/ AMU/ Infectious Diseases/ HIV/ GUM and other relevant departments.
Many of those affected to date have low levels of engagement with support services and have presented acutely unwell to hospital where they have been diagnosed. We are aware that some of these patients will have been seen previously in General Practice. Therefore we are asking CCGs to cascade this information to local Practices and ask that GPs continue to offer testing for blood borne viruses to patients who fall within the risk groups identified or who present with symptoms/ clinical indicators suggestive of a seroconversion illness.

Your assistance in raising awareness of this outbreak and ensuring current testing continues in General Practice would be appreciated.
Should you wish to discuss this matter further please contact Dr Natalie Daley: natalie.daley@phe.gov.uk

MyCOPD app available for use in Worcestershire  

Over 11,500 patients have been diagnosed and recorded on the COPD disease management register, however it is recognised that there are many more across the county who are yet to be diagnosed.
Overall, people with COPD are managed in primary care, predominantly by practice nurses but also supported by specialist respiratory teams at local hospitals, the COPD team and community nursing teams.
Technology is changing how people access health care and manage ongoing conditions and with this in mind patients across Worcestershire with COPD are now able to access the MyCOPD app. The specialist app is full of useful advice on managing breathing difficulties associated with the condition including inhaler technique videos, education from experts and a complete online pulmonary rehabilitation programme. The clinically approved app can be downloaded onto any smart device such as phones, tablets, computers and smart TVs using a licence code. A number of free licences are available for COPD patients to access the app with a referral from a clinician, otherwise other patients are able to buy the app to help them self-manage their condition.
A public campaign is asking patients to speak to their Practice Nurse, Community Specialist Nurse or COPD Specialist Nurse for more information about accessing the app and please ensure that you’re raising awareness of the app in COPD patient reviews.
More information can be found on this leaflet and at mymhealth.com/mycopd

The Royal College of General Practitioners Research and Surveillance Centre  

The Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) has an excellent opportunity available for GP’s.  Practices within our network have been receiving feedback on data quality and have been receiving individual support from our dedicated team of practice liaison officers. Practices also have the opportunity to be actively involved in funded research studies and can determine the level of their involvement. Currently practices in our network benefit from:

  1. continuous feedback on coding and have access to an individual interactive dashboard. The feedback has the additional benefit of demonstrating a commitment to constant quality improvement during CQC visits
  2. the opportunity to participate in funded research without the hassle of signing additional paperwork. We advertise new research opportunities in our monthly newsletter
  3. a free Research Ready Advanced accreditation. The standard cost is £50 for a practice to Advanced-accredit for each year you are an RCGP RSC member
  4. a team of Practice Liaison Officers who actively support the network and train practices as needed

The Network, growing from under 100 practices to over 400 practices, has recently received funding by NHS England to double the size of the practice network and create a workload observatory (download more information).

You can find more information about our work and principal outputs here: www.rcgp.org.uk/rsc.

Redditch and Bromsgrove:    

Change in Ophthalmology Clinical Pathway

As of 19th November 2018 Worcestershire CCGs will be commissioning the Minor Eye Conditions service (previously known as PEARS) from the Worcestershire LOC (local optometrists) for Redditch and Bromsgrove patients in addition to South Worcestershire and Wyre Forest. Additionally the Community Ophthalmology service (The Practice Group Ltd) currently operating in Redditch and Bromsgrove will be extended across South Worcestershire and Wyre Forest; resulting in a countywide integrated three-tiered service model incorporating primary, community and secondary care eye health services.

Read more.