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Member Practice Update

  4 July 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

Primary Care Update on e-referral service (eRS) for Worcestershire Acute Hospitals NHS Trust 

This is a weekly eRS update to all Practice Managers, to remind Practices of the changes, advise them of the key timelines and provide them with useful documentation on eRS processes and user tips. Communications will also be sent out weekly on the GP Practice Bulletin.

Further to previous communications the switch off of paper referrals starts today. From Monday 2nd July 2018 Worcestershire Acute NHS Hospital Trust no longer accept paper referrals from GP Practices for any Consultant led appointments and two week wait appointments, bar the ones listed as exclusions below.

See below important documents, which inform GP Practices on what to do when the E-referral system goes down and how Worcester Acute Trust will return paper referrals:


If your generic email address has recently changed please forward this to sandeep.purewal2@nhs.net so we can ensure that Worcester Acute Trust have the correct generic email address.

Services and Clinics excluded from e-Referral paper switch off programme:

Please continue to send the following as paper referrals to Worcestershire Acute Hospitals NHS Trust;

  • Ambulatory Clinics – All Specialties
  • Antenatal
  • Anaesthetics
  • Colposcopy and Hysteroscopy
  • Emergency Clinics – All Specialties
  • Non 2ww haematuria
  • Fracture Clinics
  • Obstetrics
  • TIA
  • Ward attenders and Day cases

Please note: Diagnostic Imaging should continue to be sent via ICE to WAHT

Help for e-referral issues:

Should GPs have issues regarding the management of the E-referral system, the point of contact to raise these issues will be:

WAHT Helpdesk: wah-tr.e-rsteam@nhs.net
Issues with the ERS System: sandeep.purewal2@nhs.net

Frailty Assessment Unit 

Some IQSP visits uncovered a misunderstanding that the Frailty Assessment Unit (FAU) is closed. This is not correct, the FAU is open Monday to Friday from 9am – 5pm with last referrals accepted at 4pm.

Due to nurse staffing challenges, at weekends the Consultants are operating an outreach model. This means they are reviewing patients in the Emergency Department rather than on the unit between the hours of 9am – 1pm. There have been occasions when the FAU has been used as a surge area when the urgent care system is under pressure, this has resulted in the unit being overtaken by patients in beds. When this happens, the staff revert to the outreach model, it may be this scenario been misinterpreted as the FAU being closed. While the physical space within the unit may not be available, the staff are continuing to implement an outreach model.

All patients who meet the Frailty Assessment Unit criteria should be conveyed to the Alexandra Hospital 24/7. During the times the FAU is open referrals can be made to the FAU by telephoning 01527 512102 or by using Consultant Connect.

Third Party Ordering by Homecare Companies 

As part of the PCE contract, practices are expected to implement robust systems of repeat prescription management. Repeat prescribing protocols should be reviewed annually using the Repeat Prescribing Protocol: Guidance for GP practices and should include detail on how third party ordering is to be managed. Practices should challenge third party ordering where the request is thought to be inappropriate.

Third party orders are commonly placed by community pharmacies and appliance contractors on behalf of patients. Out-of-hospital healthcare providers also offer managed repeat prescription services to primary care patients. Whilst these are often efficiently managed and can be of great benefit to patients, on some occasions the orders placed may not always match patient needs. We have been made aware of a recent example where a homecare company repeatedly requested multiple issues of growth hormone for a patient that was found not to be needed when a vigilant Practice Medicines Co-ordinator checked with the patient’s representative. This intervention prevented stockpiling and potential waste of a very high cost drug (approximately £680).

Practices are therefore asked to be aware of the need of prescription request challenge for all possible third parties where they are involved, including homecare providers. 

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

Worcester Alliance Programme Board IT interoperability update  

The development of local, integrated Neighbourhood Teams is a really important step in our strategic plans to join up health and care in the community.

Because the Neighbourhood Teams bring together a range of staff employed by different organisations within our local system, and for those professionals to work more effectively in a single team, they need access to up to date patient records and information.

This was identified early on in the development of the Neighbourhood Team model, with staff from the Health and Care Trust, the Acute Trust, Social Care and Primary Care recognising the need to have collective access to a patient’s medical history in order to provide the most informed and effective care. This would be particularly important during MDTs.

Read the rest of the update here.

TIA Referral Form  

The TIA Referral Form was revised back in January 2018 to be in line with the RCP Clinical Guidelines for Stroke (2016). Feedback from the Stroke Clinicians at Worcestershire Acute Hospital has identified that many TIA referrals continue to be made to the Trust using the old referral form. It is important that the new referral form is adopted by everyone as some as possible.

Please ensure the new TIA Referral Form is uploaded on to your system as soon as possible and all other versions are deleted/removed.

Many thanks for your co-operation in this matter.


New Primary Care Podcasts  

The Eastern Academic Health Science Network has released its latest #PrimaryCareTalks podcast featuring Dr Hasan Chowhan and St Albans GP and health consultant Dr Steve Laitner. This episode delves into some of Steve's innovative approaches to delivering more proactive primary care. Steve uses population management techniques to help create a more tailored approach that caters better for each individual patient's needs.

Download the podcast here: www.eahsn.org/resources/primary-care-talks-podcasts

Well-being Hub 

Worcestershire Well-being Hub is an information and signposting service for people over the age of 16 who are experiencing low mood, anxiety or stress, and feel that they would benefit from support from local community providers.

Extended Access Survey access extended  

Thanks to all staff who have helped to promote the 'Improved Access to Primary Care' Survey, we've had such a good response rate that we thought we'd extend it for an extra two weeks. The Deadline is now Friday 13th July.

Please keep up the good work promoting the link.

Safeguarding guidance reminder 

Following an Adult Safeguarding Review commissioned by Worcestershire Safeguarding Adults board, staff are reminded of the following policies:

  • NICE Guidance no 43. Transition from children’s to adults’ services for young people using health or social care services NICE guideline Published: 24 February 2016.This guideline covers the period before, during and after a young person moves from children's to adults' services. It aims to help young people and their carers have a better experience of transition by improving the way it's planned and carried out. It covers both health and social care. More information.

  • Multi-Agency Mental Capacity Act & Deprivation of Liberty Safeguards Competency Framework (Worcestershire Safeguarding Adults Board). This framework has been produced to support partner organisations in the development of a workforce that is competent and effectively trained in Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) practices and which is continuously improving. It outlines the sets of competencies required for particular categories of job roles. More information.

Mandatory training reminder 

MANDATORY: Safeguarding Adults, MCA & DOLS Training
These sessions are for Safeguarding Adults and Mental Capacity Act Training at Level 3, in order to satisfy the requirements under the Care Act of the CCG, CQC and NHS England. They are being held at the following venues on the dates shown. The sessions will take place from 13:00 until 17:00.

  • 11/10/18 – Northumberland House - DY11 6SF   
  • 13/09/18 – Merstow Green Medical Practice – WR11 4BS

To ensure your training is up to date please email Jessica Bryant via: rbccg.centralbusinesssupport@nhs.net to book a place.

Find out more about MCA here.

MANDATORY: Prevent (WRAP) & Domestic Abuse Training

Prevent, Domestic Abuse, Safeguarding Adults Level 3 training can all contribute to the total hours required for Safeguarding Adults competencies at Level 3 for GPs and other clinical staff over the three year period.

In addition, training in Mental Capacity Act/Deprivation of Liberty Safeguards will assist in evidencing the GP practices compliance with Regulation 11 of the Health &Social Care Act 2008, Regulations 2014. A further tranche of training in MCA/DoLS will be launched in the New Year, along with a link to a protocol which practices may wish to download to EMIS in order to evidence compliance with the Mental Capacity Act 2005.
The Prevent and Domestic Abuse sessions are schedules to take place from 13:00-17:00. If you have already attended Domestic Abuse Training you may wish to leave after the Prevent Training. Please indicate when booking which session/s you will be attending.

To achieve the required competences and in line with NHSE guidance, all clinicians with direct contact with patients must evidence attendance at the face to face WRAP (Prevent) training in addition to eLearning module which must bear completed by all non clinical practice staff www.elearning.prevent.homeoffice.gov.uk (Additional update requirements have yet to be determined by the UK Government).

  • 16/08/18 – POWCH - B61 0BB
  • 18/10/18 – Northumberland House - DY11 6SF
  • 20/09/18 – Merstow Green Medical Practice – WR11 4BS

To ensure your training is up to date please email Jessica Bryant via: rbccg.centralbusinesssupport@nhs.net to book a place.