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Member Practice Update

24 May 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.

Please Note: Following feedback from GP’s this update will now come out on Fridays rather than Wednesdays.

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:

  1. Approval for 11 Primary Care Netwrosk in Worcestershire
  2. NHS App Dashboard 
  3. West Midlands Familial Hypercholesterolaemia Service - How and Who to Refer 
  4. Mental Health of Veterans
  5. New Safeguarding Website
  6. Making decisions about your future 
  7. Prescribing Top Tip 
  8. Learning from Serious Case Review "Katie"
  9. Webinar: How Primary Care Networks can bring care closer to the community 
  10. Increasing vaccine uptake: Strategies for addressing barriers in primary care 


Find out about local and national events and training here.

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

Approval for 11 Primary Care Networks in Worcestershire

Thank you to everyone who has been involved in the emerging Primary Care Network discussions and process to date. We are pleased to confirm that all 11 Primary Care Network applications were reviewed by the Primary Care Network panel on 16 May, with approval taking place at the Primary Care Commissioning Committee 22nd May. The Panel members included the following representatives; CCG representatives, CCG Clinical Chairs, LMC and Patient representatives. The review panel positively highlighted that across Herefordshire and Worcestershire, there is 100% population coverage and all practices have opted to become a member of a PCN.

Congratulations to the Clinical Directors who have been nominated by their PCNs:

Primary Care Network Name

Clinical Director

Wyre Forest Network of Independent Practices

Dr Tony DeCothi

Wyre Forest Health Partnership PCN

Dr Roy Williams


Dr Sally Hetherington

Bromsgrove and District Primary Care Network (BaDPCN)

Dr Ian Morrey

Dr David Hughes


Dr Richard Burling

Malvern Town PC Network

Dr Jonathan Thorn

Dr Brenton Fisher 

The Rurals

Dr Kirsty Ward

Upton & Pershore

Dr Andy Havercroft

The Vale of Evesham Health Network (EBBI)

Dr Neill Bramble

Dr Chethan Reddy

Droitwich & Ombersley

Dr Gemma Moore

Worcester City GP Network

Dr Nicole Burger

Further communication will be sent to PCNs directly with feedback and next steps.

Our first meeting with the Clinical Directors, Alliance Board Chairs and members of the GP Provider Board took place on Thursday 23 May.  This was to explore any changes we need to make to existing structures given the wide-ranging responsibilities which sit with the Clinical Directors – whilst also recognising that we need to “protect” these local leaders from unnecessary meetings. We also discussed the proposed Maturity Matrix which will be used to support the development of PCNs and to identify development needs. Your Clinical Director will tell you more about how we intend to move forward these key priorities.  Please contact Lynda Dando if you want any further information in the meantime.

NHS App Dashboard

Sent on behalf of the NHS app dashboard team

We are really pleased to announce the beta release of the NHS App dashboard which is available here.

The dashboard was developed jointly between NHS Improvement, NHS England, NHS Digital with support from Tableau and presents the current state of NHS App implementation and uptake across England. The purpose of the dashboard is to communicate the programme status and inform strategic direction to ensure the successful roll-out of the NHS App. Dashboard development is on-going and KPIs related to usage, impact, satisfaction and product performance will be incorporated in upcoming phases.

Data is currently presented at National, Regional, STP and CCG level; practice level data will be available in next upcoming phase. Dashboard will be updated on weekly basis (every Wednesday, 2pm).

It would be great if you can send any feedback to us at NHSAppDashboardTeam for any further improvements or any queries on the dashboard. Any issues, please do not hesitate to contact us.
Instructions to register for OKTA to access the NHS App Tableau Dashboard

  1. You will need an Okta account - please go to section “Access and Registration” in this document for more information
  2. Once you have an Okta account- you should see the NHS App Dashboard appear under the Your products tab.

Please contact IT.Support@improvement.nhs.uk if you have issues with OKTA registration.

West Midlands Familial Hypercholesterolaemia Service – How and Who to Refer

Familial Hypercholesterolaemia (FH) is a common genetic condition that causes a high cholesterol concentration in the blood, leading to an increased risk of premature coronary heart disease and/or early death. Although management of FH with lipid-lowering therapy, e.g. statins, is highly effective, more than 85% of people with FH in the UK are unaware that they have the condition and are therefore untreated.

Untreated, people aged 20-39 with FH have a 100-fold increased risk of death from heart disease compared to those of a similar age without FH. Early identification of FH is important because if treatment is started early enough, it will give patients a life expectancy similar to the general population. Systematic searching of GP records to find those at high risk of FH is an important method of identifying affected individuals, and allows us to cascade test relatives. Cascade testing is the process of systematically offering DNA testing to the relatives of affected individuals because someone with FH has a 50:50 chance of passing the condition on to their children.

The benefits of cascade testing are early treatment and the avoidance of heart disease.

The West Midlands Familial Hypercholesterolaemia Service (WMFHS) was launched in November 2017. To date, over 240 patients have genetically confirmed FH and hundreds of family members including young children are now eligible for cascade testing. There is a designated FH specialist nurse for the CCG and the service is delivered from multiple GP practices across the area.

Patients can be referred opportunistically or following a systematic search of GP records. Referrals should also include patients with clinically diagnosed FH (based on the Simon Broome criteria) who have not had FH genetically confirmed.

Please download the referral criteria and referral form which should be emailed to Westmidlands.fhnurses@nhs.net.

For more information, please contact Elaine George, Clinical Programme Manager on 0121 371 8179 or via Westmidlands.fhnurses@nhs.net.


Mental Health of Veterans

As part of Mental Health Awareness Week last week, NHS England and NHS Improvement focused on veterans' mental health and how the NHS can best support their needs. An important element of this is understanding the health needs of this patient group and being aware of the dedicated services available to them. GPs have a key role in supporting these patients, as set out in this letter, which highlights the importance of identifying and recording veterans in their medical record. 

Please do take time to read this letter and share with member practices for their attention and action. To support with this, the letter includes a top tips document that provides useful advice and information, as well as learning resources.

Thank you in advance for helping to support the health commitments of the Armed Forces Covenant and ensuring we are providing the best possible care for those who have served their country.

For more information, or queries around referral pathways for Veterans contact Dr Jonathan Leach.

New Safeguarding Website

Worcestershire Safeguarding Children Board (soon to be replaced by the Worcestershire Safeguarding Children Partnership) and Worcestershire Safeguarding Adults Board are pleased to announce the launch of their new joint website. Having been in development for the past four months, the new site goes live on May 20th. 

With a fresh look and feel, the site affords a smoother, more intuitive user experience. The new site will replace the existing Board webpages hosted by Worcestershire County Council and sees everything rehoused in one central space with an easy to use search facility.

Independent Chair for both Safeguarding Boards, Derek Benson, said, "We are excited about the launch of our new site, we hope visitors will be able to find information with ease. We love the new look and believe it is a great improvement to have so much safeguarding content available in one place. The new site is testament to the ever closer collaboration and cooperation between the Boards. Our thanks go to all agencies and individuals who have supported this venture, especially the Worcestershire CCGs who have had a leading role in its development."

Work to develop the site is now nearing completion, but will continue for a period after the go live date. We would urge you to visit the site and provide any feedback to help us improve its functionality.

From the go live date there will be automatic redirection from the old web pages to the new website. Contact details for reporting abuse of adults/children and the West Midlands Inter-Agency Child Protection Procedures remain unaltered.

The web address will be www.safeguardingworcestershire.org.uk.

Making decisions about your future

Worcestershire County Council will be launching their ‘Making decisions about your future’ campaign on Friday 24 May. The campaign aims to promote measures people of any age can take to help them stay independent for longer.

The campaign is based around the LifeCurve™, which has been developed by ADL Research, founded by Professor Peter Gore at Newcastle University. It shows the daily tasks people lose their ability to perform and the expected order in which they lose this independence. Looking at this curve enables people to plan for older age.

Read more about Peter Gore and the LifeCurve™ here.

As part of the campaign, it would be great if you could display this poster in your practice, to enable your patients to find out more.

Prescribing Top Tip

Discontinuation of Creon 40000 Capsules

Creon 40000 (pancreatin) will be discontinued from June 2019, due to difficulties in sourcing the raw materials. Creon 10000 and Creon 25000 will still be available in the UK and the manufacturer has committed to providing increased compensatory quantities of these strengths.

Creon capsules are interchangeable so patients can be advised to take more of the lower strength capsules to achieve the higher dose required, without affecting efficacy of treatment. Use of the 25000 capsules are recommended to avoid patients having to take excessive numbers of capsules.

The manufacturers have suggested reference to the following dosage table when reviewing patients currently receiving Creon 40000:



Starting dose

Increase dose if required (e.g.)

Titrated dose

Increase dose if required (e.g.)

Titrated dose

Patients with PEI


2 x Creon 25,000

4 x Creon 25,000

5 x Creon 25,000


1 x Creon 25,000

2 x Creon 25,000

3 x Creon 25,000

There are still currently 51 patients at 35 Worcestershire practices receiving a current course of Creon 40000 units who will require a review of their current treatment.

An EMIS search that identifies these patients can be found at: Worcs PCT Search & Reports – Medicines Management Countywide – Top Tip Searches and is entitled “Creon 40000 current course”

Any medical information requests concerning the discontinuation should be directed to the Mylan Medical Information department at info.uk@mylan.co.uk

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

Learning from Serious Case Review "Katie"

Herefordshire Safeguarding Children Board are holding a series of hour-long briefings to disseminate the learnings from a Serious Case Review, which has recently been published anonymously on the NSPCC website, to protect the identity of the child.

The learnings are focussed around child sexual exploitation, neglect and effective partnership working.

The issues identified in this review are relevant to everyone who works with children and young people and, therefore, have the opportunity to identify those who may be being neglected or at risk of exploitation.

Due to the confidential nature of the details disclosed in the sessions, it is essential that you book a place.

Learning event dates:

  • Tuesday 4th june – 2.30pm- 3.30pm lecture hall, hereford county hospital
  • Wednesday 5th june – 1.30pm -2.30pm lecture hall, hereford county hospital
  • Wednesday 19th june – 3.3pm – 4.30pm, Council chamber, hereford shire hall
  • Monday 1st july – 12.30pm- 1.30pm assembly room, hereford town hall

Read the full Serious Case Review here.

To book your free place e-mail: admin.hscb@herefordshire.gov.uk


Webinar: How Primary Care Networks can bring care closer to the community

2pm - 3pm - Wednesday 19 June 2019

Join Elemental Software on June 19th as they uncover:

  • How social prescribing can support PCNs to deliver on the following service specifications: anticipatory care (with community services), personalised care, tackling inequalities
  • How PCNs can strengthen their footprint around which integrated community-based teams will develop
  • Where digital fits in and how it supports the successful delivery of service specifications and PCN objectives
  • How PCNs can take a proactive approach to managing population health through social prescribing and tackle the wider health needs of their local populations

Find out more and book your place here.

Increasing vaccine uptake: Strategies for addressing barriers in primary care

England is a world leader in childhood vaccinations, with one of the most comprehensive programmes in the world. PHE data show that, although coverage remains high, children’s vaccine uptake has been slowly decreasing since 2012-13. This means that some children have missed out and may remain vulnerable to serious or even fatal infections that are vaccine-preventable.

Despite media speculation that anti-vaccine groups and social media messaging may be damaging the immunisation programme, there is currently no evidence of a major impact on parental confidence in England.

Read the full post on PHE's blog here.

NHS Hearing Aids

The NHS is the largest provider of hearing aids in the UK, with up to 80% of all instruments being fi tted, free at the point of delivery, via NHS clinics.

As the largest service provider, our experience is immense. The NHS currently delivers high end technology instruments alongside high quality counselling, and also has long-standing working relationships with a framework of support services.

Read more about NHS Hearing Aids here.