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Member Practice Update

4 April 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

Vaccine ordering for 2018-19 influenza season 

The clinical evidence available to GP practices and community pharmacists from the Joint Committee on Vaccination and Immunisation (JCVI) and published in the Green Book in October (for quadrivalent vaccine) and December (for adjuvanted trivalent vaccine), ahead of orders being placed for 2018/19, is clear that for the 2018-19 winter season. GP practices and Community Pharmacy providers should offer:

  • The adjuvanted trivalent vaccine (aTIV) for all 65s and over. Given aTIV was only licensed for use in the UK in August 2017, this was not an option for the 2017/18 season. However the JCVI advice is that this is now the best option for 2018/19 for 65+ age group
  • The quadrivalent vaccine (QIV) for 18 – under 65s at risk. In light of an independent cost-effectiveness study into QIV undertaken by Public Health England and considered by JCVI, the Green Book was updated in October 2017 to provide the advice that QIV is the best option for 18-65 at-risk groups in the 2018/19 season. It is also used for the childhood programme.

Read more about ordering here.

NHS Complaints Data Return: KO41b 

As you will be aware, the NHS has a statutory responsibility to collect service wide information on patient complaints so trends can be identified and we can demonstrate that the service is being responsive to patient feedback. It is a statutory and contractual requirement for primary care providers to declare brief details of complaints associated with their NHS care by submitting a K041b return.

Find out more about submitted a KO41b here.

Full Electronic Patient Record Requests 

Please be advised that when a GP Practice requests additional information from WMAS to that contained in the general Electronic Patient Record (EPR) summary, they will receive a copy of the full EPR. 
Please be aware that the EPR may contain photographs, some of which may be graphic in nature. Recently this has resulted in some practice staff being exposed to potentially upsetting images of wounds and deceased patients.
In the future, WMAS will ensure all correspondence of this nature will have the following on the front page:
“This is a full patient summary which has been supplied by West Midlands Ambulance Service NHS Foundation Trust.

This Electronic Patient Record (EPR) record does have the ability to store images of the scene, patient or injuries relating to the incident, as well as detailed descriptions which may be distressing to view/read.”

Epipen® Supply Issues  

We understand there are stock availability issues with Epipen® adrenaline auto-injectors. Supplies from wholesalers to pharmacies of Epipen® 0.3mg and Epipen® Twin Pack 2x 0.3mg are currently restricted; to assist in the stock management the manufacturers are allocating stock on a prescription-only basis and pharmacies will be able to place orders for up to a maximum of two EpiPen® 0.3mg Auto-Injectors per prescription.

There are no known issues with Epipen Junior 0.15mg at this time.

It is hoped that these measures will ensure continued supply, but if in the worst case scenario patients become unable to source an Epipen®, there are two other adult licensed adrenaline auto-injectors on the Worcestershire formulary, as detailed in the table below:


Cost/pack  (Mims, April 18)

Emerade® 0.3mg  prefilled pen


Emerade® 0.5mg prefilled pen


Jext® 0.3mg prefilled pen


If a switch to one of the above options is necessitated due to unavailability of Epipen®, patients must be shown how to use the new device as there are differences in the techniques required. Patient videos and relevant information-including how to obtain free of charge training devices- can be found on the manufacturer’s websites:

When prescribing, current MHRA advice is that 2 devices should be prescribed for patients to carry with them at all times.
If you have any suggestions for inclusion in the 'Top Tips' then please send them to akingham@nhs.net.

Paediatric Diabetes Network Referral Guidelines 

West Midlands Paediatric Diabetes Network’s referral guidelines for suspected newly diagnosed type 1 diabetes in children and young people (CYP) is now available to download. We hope that circulating the guideline will remind healthcare professionals of the presenting signs and symptoms of type 1 diabetes in CYP, prevent delays in diagnosis and will highlight the need for same day referral.

If a healthcare professional suspects a CYP may have type 1 diabetes they should call Worcestershire Royal Hospital on 01905 763333 and ask to speak to the on-call paediatrician. The patient will then be asked to attend Riverbank Ward the same day to confirm the diagnosis and to commence treatment and structured education.

If a healthcare professional is concerned that a CYP may have an alternative form of diabetes and they have excluded type 1 diabetes (i.e. no type 1 diabetes signs or symptoms and blood glucose ≤11mmol/l) they can contact me on the above number to discuss the case further.

Diabetes Prevention Week - 16 - 22 April 

The campaign aims to:

  • Raise awareness of the Healthier You: NHS Diabetes Prevention Programme (NDPP) with the public and healthcare professionals, specifically GPs and Practice Nurses – to increase referrals to the programme and reduce variation between sites.
  • Raise awareness of the causes of Type 2 diabetes and the complications associated with it; and raise awareness of at risk groups

If you haven’t already, you should soon receive a toolkit to support the week, this includes leaflets, posters, bunting and balloons.

More information about events/workshops taking place during the week, will be included in next week’s update.