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Member Practice Update

13 March 2019

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 & Bromsgrove news 
  • No specific South Worcestershire news
  • No specific Wyre Forest news 

Faecal Immunochemical Tests for Faecal Occult Blood (FIT FOB)

As covered in the MPU on 16 January, the Worcestershire Biochemistry Laboratory is now offering Faecal Immunochemical Tests for Faecal Occult Blood (FIT FOB) testing. This commenced on 1 of January 2019.

A reminder of this update, including full details of the changes can be found here.

As part of this update, we informed you that patient packs would be made available by the end of January. Following a few delays, we can confirm that these packs will be distributed to practices early next week. 

New Acute Frailty Specialty at the Alexandra Hospital 

There is a new Acute Frailty Specialty at the Alexandra Hospital, Redditch.

The specialty benefits from:

  • A Frailty Assessment Unit (FAU) – Six chairs operating 12hrs per day / 7 days a week, 8am – 8pm
  • A Frailty Decisions Unit (FDU) – Six beds for 24hr maximum use
  • Acute Frailty Wards (Ward 11 & 12)

Patients should be referred to the Acute Frailty Specialty in line with other existing specialties.

The Frailty Assessment Unit can be contacted on 07525 922 215, between the hours of 8am – 8pm for advice or referral.

Prescribing Top Tip 

Prescribing of Higher Strength Buprenorphine Patches 

High strength, twice-weekly buprenorphine patches (35mcg/hr, 52.5mcg/hr & 70mcg/hr) are indicated for moderate to severe cancer pain and severe pain which does not respond to non-opioid analgesics. The Worcestershire formulary restricts prescribing to palliative care, where patients are unable to swallow.

The prescribing of high-strength buprenorphine patches has the potential to cause confusion. Some high-strength patches are licensed for use over 72hrs and some for use over 96hrs. 

If patients were to receive a 72hr patch against a generic buprenorphine prescription and were to change it every 96 hours, this could result in breakthrough pain. If patients were to receive a 96hr patch and change it every 72hrs, this would result in unnecessary wastage and increased prescribing costs. 

The higher strength patches are therefore not interchangeable and should be prescribed by brand. The dosage directions should also be clearly written to indicate the change frequency to the patient.

Both the acute and community trusts will ensure that the dosage instructions for patients initiated on high strength buprenorphine patches will be clear and appropriate to the licensed duration of use, to ensure that appropriate and optimised ongoing prescribing in primary care is facilitated.

The table below lists the preferred Worcestershire brands of both 72hr and 96hr high-strength, twice-weekly patches in primary care and are interchangeable with the alternative brands of the same strength that may be dispensed in secondary care: 

Buprenorphine Patch Type

Preferred Brand

Available Strengths (mcg/hr)

Pack size

NHS List Price

(Mims March 19)

High Strength 96hr patch





High Strength 72hr patch





A more detailed UKMI prescribing resource, which also includes information on prescribing the more commonly encountered lower- strength once-weekly patches, can be found here: Minimising Errors With Buprenorphine Patches

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

Re-launch of the SEND Local Offer website  

The SEND Local Offer is a website that provides information about what support and services families can expect to be available across education, health and social care in Worcestershire for children and young people with a special educational need and/or disability (SEND).

The SEND Local Offer is available at: www.worcestershire.gov.uk/SENDlocaloffer 

As you may be aware; Worcestershire's CCGs, Worcestershire Health and Care NHS Trust and Worcestershire County Council have been working together, alongside parent carers, children and young people and other professionals, to improve the information available on the SEND Local Offer. The aim is that families will be able to find the information, service and support they need to support them or their child/young person.

We know that many families access their GP as a first point of contact if their child has additional needs or a disability so we hope that by accessing the SEND Local Offer, families will better understand the different services available to meet their needs and avoid inappropriate visits to their GP.

We hope you find this information useful. If you have any questions about the SEND Local Offer, please email localoffer@worcestershire.gov.uk 

Promotional packs, should arrive at practices soon, if they've not already. The pack includes a range of materials to help promote the re-launch to your patients.

Healthier You: NHS Diabetes Prevention Programme Update 

There are currently 5,000,000 people in England at high risk of developing Type 2 diabetes. If these trends persist, 1 in 3 people will be obese by 2034 and 1 in 10 will develop Type 2 diabetes. Type 2 diabetes is a leading cause of preventable sight loss in people of working age and is a major contributor to kidney failure, heart attack, and stroke, of which treatment accounts for just under 9% of the annual NHS budget. This is around £8.8 billion a year.

Healthier You: NHS Diabetes Prevention Programme is part of the national programme which identifies those at high risk and refers them onto a behaviour change programme. By 2020 it is expected to provide support up to 100,000 individuals each year. ICS Health and Wellbeing provide the service across Herefordshire and Worcestershire STP. Since the initial roll out of the programme in Worcestershire in Summer 2016 the programme has received: 

  • Referrals to date:  4,712
  • Individual Assessment’s to date: 3,322
  • Groups to date: 140 

Find out more information here, including how your practice can get more involved in the programme and some case studies, detailing some of the success stories so far.

SAR Learning Briefings  

Please see the links below to three SAR Learning Briefings recently published by the Worcestershire Safeguarding Adults Board (WSAB). The briefings set out the lessons that were learnt which have implications for current practice within Worcestershire.  




Perinatal Psychiatry Relaunch Event  

Worcestershire Perinatal Psychiatry Team invite you to join them for ‘An Introduction to Perinatal Psychiatry’ on Friday 3 May 2019, Worcestershire County Cricket Club, 9.30am-4.30pm.

Find out more here.

Association of Surgeons in Primary Care - Annual Conference

The Annual Conference will take place on 10-11 May in Stratford-Upon-Avon, with tickets available from £50.

Find out more here.

First 5 Women's Health Course  

An informative course is taking place to help First 5 GPs deal with complex women’s health issues.

The course will take place on Saturday 30 March, Lion Heath, Stourbridge, DY8 3SS from 8.30am-12.30pm.

Find out more here.