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Member Practice Update

 5 September 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 Redditch and
    Bromsgrove news
  • No specific South Worcestershire  news
  •  No specific Wyre Forest news


Worcestershire Acute Hospitals NHS Trust - Process update for rejected letters via Docman   

As you may be aware, Worcestershire Acute Hospital NHS Trust currently sends letters which have been rejected on the Docman system back in paper form to the correct practice, after checking information against the Spine.
From 25 September onwards, it has been agreed that we will begin to attach these documents electronically to an email and return to the practices choice of nhs.net address.
It is hoped that this system change will allow for quicker transfer of patient information and avoid unnecessary use of resources. A trust employee will be calling all practices to ensure the nhs.net email addresses recorded are correct prior to the new process roll-out. 
If there are any questions regarding the transition, please do not hesitate to contact a member of Worcestershire Acute Hospitals NHS Trusts Data Quality Team who are:

Hayley Wharton - hayley.wharton@nhs.net
Mia Franks - m.franks@nhs.net

Pharmacy2U – Advertising

Practices have highlighted to the CCGs that Pharmacy2U is using practice names on their marketing material. What they include does not contravene the NHS code of conduct for advertising because they are being factual about practices who use the NHS Electronic Prescription Service. The LMC legal team has provided the following statement which we suggest practices use on their websites and social media:

It has come to our attention that the organisation Pharmacy2U has used the practice's name on its marketing material. Please note, the practice does not utilise, promote, engage with, or otherwise have any dealings with Pharmacy2U, and, furthermore has not given, nor has been asked, for consent for the practice name to appear on any advertising material.

Practices may wish to contact Pharmacy2U and ask for their name to be removed from this and any future marketing material.

National Diabetes Prevention Programme - Relaunch  

From 1 September, the delivery of the local diabetes prevention programme is being managed by Herefordshire, with a single delivery pathway being adopted across the STP. Practices are being asked to work within their Neighbourhood Team to meet referral targets, and practices will receive a payment per referral. Targets have been calculated based on list size against the monthly referral target set by NHS England for Herefordshire & Worcestershire. Practices are encouraged to work together so that any practice under referring can be identified and, where appropriate, other practices within the Neighbourhood Team can increase their referrals to meet the Neighbourhood Team target.

A sample Memorandum of Understanding (MoU) is attached which gives details of what is required to qualify for payment. Practices will be paid £7 per referral, with referrals capped annually as laid out in the MoU. Associated paperwork is also attached, including patient information leaflet, referral form (+ EMIS template), patient letter (+ EMIS template – check merge fields prior to using), read codes to be used, and referral targets.

Access all documents here

If your Neighbourhood Team wishes to take part in the programme, please reply to the Primary Care team at sowoccg.worcestershireprimarycare@nhs.net when a completed MoU will be sent. If you have any queries, please contact Jo Hall at jo.hall@nhs.net

Prescribing Top Tip

Prescribing & Reimbursement of Unlicensed Pharmaceutical “Specials”

Pharmaceutical “specials” are unlicensed medicinal products manufactured for human use which have been specially prepared to meet a prescription ordered for an individual patient without the need for the manufacturer to hold a marketing authorisation for the medicinal product concerned. Such products will not have an applicable summary of product characteristics (SPC) for prescribers to consult.

When an unlicensed “Special” is prescribed, the prescriber is fully accountable professionally for the quality of the product and any adverse effects experienced by the patient.

Consideration should always be given to prescribing a licensed alternative such as soluble tablets or a drug in the same class that is available in a suitable formulation. However, it is recognised that in some situations, such as paediatric prescribing, a special may be the only available option to meet the specific needs of the patient. GMC Good Prescribing Guidance states that specials can be prescribed if the prescriber concludes it is necessary to do so to meet these individual medical needs. The guidance recommends documenting the decision clearly in the patient’s notes.

Secondary care should not routinely request GPs to prescribe specials unless there is a recognised evidence base and/or it is considered a standard treatment. The NHSE document Responsibility for Prescribing Between Primary & Secondary/Tertiary Care states that, for paediatric medicines, inclusion of dosage guidance in the Children’s BNF provides a suitable evidence base.

Specials formulations tend to be very expensive. The prices of commonly prescribed specials are listed in Drug Tariff part VIIIB “Arrangements for payment for specials and imported unlicensed medicines” which sets a price for a defined minimum volume, and the additional price for extra mls or grams above the minimum volume. EMIS should display these prices, and where possible the list prices should inform the selection (for example, bisoprolol 2.5mg/5ml solution is listed as £19.44 for 150ml, bisoprolol 2.5mg/5ml suspension is listed as £80.96 for 100ml).

Prices of specials products that are NOT listed in DT part VIIIB are completely deregulated, and therefore there is no tariff to limit the price that manufacturers can charge. Such special products may still be listed on the GP EMIS computer system, but the price listed for these will be £0.00. This is because the system cannot link the product to a known price. Prescribers are therefore alerted to the fact that a product with such a list price will invariably be an expensive, deregulated special and should not be routinely selected.                                                  

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

Mandatory Training  

Safeguarding Adults, MCA and DOLS

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. Each session will be held from 1pm-5pm unless stated otherwise.

11 October 2018 - Northumberland House, DY11 6SF  
8 November 2018 - venue TBC
6 December 2018  Bewdley Medical Centre, DY12 2EF, 2.30-6.30pm 
10 January 2019 - venue TBC
7 February 2019 - venue TBC  
7 March 2019 - venue TBC

Prevent (WRAP) and Domestic Abuse

Prevent and Domestic Abuse, 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.
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. Each session will run from 1pm – 5pm unless otherwise stated.

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).

17 September 2018 - Haresfield Surgery, WR5 1HG, 3.30 – 6.30pm Limited Spaces
20 September 2018 - Merstow Green Medical Practice, WR11 4BS       
1 November 2018 - Kidderminster Health Centre, DY10 1BG
22 November 2018 - venue TBC
13 December 2018 - Bewdley Medical Centre, DY12 2EF, 2.30 – 6.30pm 
24 January 2019 - venue TBC
21 February 2019 - venue TBC
14 March 2019 - Upton Surgery, WR8 0QL

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

GP Career Support Pack   

NHS England has produced a new GP Career Support Pack which contains easy-to-access information on the national and local support available for GPs at all stages of their career, whether in their first five years, mid-career, nearing retirement or after taking a career break. It will be particularly relevant for GPs who are thinking of leaving general practice, as it highlights the options and support available to them to enable to stay. As well as this national pack, over the coming weeks NHS England will be working with STPs and CCGs to develop local versions which will signpost GPs to local contacts and initiatives.

Forensic Pathologist - A Wasted Life?  

The next meeting of the Worcestershire Medico-Legal Society will take place on 18 September, The Courtroom, School of Law, Jenny Lind Building, Farrier Street, WR1 3BZ at 7.30pm.

More information about the meeting can be found here.