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Member Practice Update

3 April 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:

  1. GP Contract Reform: Primary Care Network DES & Associated documents
  2. GP Contract Reform: Clinical Negligence Scheme for General Practice
  3. Herefordshire & Worcestershire CCGs
  4. Workforce: Community Practice Nurse Role Opportunity
  5. ICT Event 1st May 12.30 – 16.30 -  Book your place now
  6. Stock Shortages of Elleste® HRT Product Range
  7. Pathology GP user meeting - 9th April  
  8. Outstanding Work in Great Witley Surgery
  9. Interim Service - Adult ADHD: Diagnostic assessment now available
  10. National Thrombosis Conferences

Find out about local and national events and training here.

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

GP Contract Reform: Primary Care Network DES & Associated documents  

We hope that you have received these key documents. A number of us attended the excellent GPC\LMC event yesterday and heard Dr Richard Vautrey describe in detail the changes to the current GMS contract and the intent behind these and the PCN DES. The service specification and associated materials gives us the clarity we need to better understand and quantify the extent of any duplication with the local PCE contract.   We are meeting with the PCE Clinical Advisors on Monday 15 April to discuss how to refocus those elements of PCE which are now part of national framework. Our aim is to finalise these by the end of April and then to begin the process of engagement with practices.

The Promoting Clinical Excellence 19\20 contract will continue to be funded at the agreed £11 per patient figure. 

Whilst the changes to the GMS contract provide a unique opportunity for practices to lead, shape and influence their Integrated Care System; primary care allocations do not reflect the full costs of implementation.  The estimated gap across Herefordshire and Worcestershire is £3.2m. This is a similar story across the country and is unsustainable.  We don’t as yet have plans in place to address this cost pressure but thought it important that we share this with you at the earliest opportunity.  It is our statutory responsibility to fund all costs associated with the 2019\20 GMS contract and also to remain in financial balance.  We will keep you informed of proposals and progress.

GP Contract Reform: Clinical Negligence Scheme for General Practice   

From 1st April 2019, NHS Resolution will be operating a new state-backed indemnity scheme for general practice in England called the Clinical Negligence Scheme for General Practice (CNSGP).

The announcement on general practice indemnity is included in Investment and evolution: A five-year framework for GP contract reform, agreed by NHS England and the British Medical Association, and published on 31 January 2019.

The scheme covers liabilities:

  1. Incurred on or after 1 April 2019; and
  2. Arising from an act (or an omission to act) on the part of a GP or any other person working in a general practice setting where that act (or omission):is connected to the diagnosis, care or treatment of a patient; and results in personal injury or loss to the patient.

From 1 April 2019 everyone working in general practice will be automatically covered in relation to NHS services.

For more information visit the NHS Resolution website.

Herefordshire & Worcestershire CCGs   

The NHS Long Term Plan includes a stipulation that typically there will need to only be one CCG per Integrated Care System/STP area and that CCGs should look to manage within their reduced running cost allowance (that had previously been announced as reducing by 20% in 2020/21) by seeking to merge at this level to create new larger and more strategic commissioning organisations.

Following the announcements in Herefordshire of their Director of Primary Care and Chief Finance Officer – Lesley Woakes and Jill Sinclair respectively – I am pleased to announce the appointment of Lynda Dando as the Director of Primary Care and Mark Dutton as Chief Financial Officer for Herefordshire and Worcestershire CCGs. Transitional arrangements for both of these roles will begin April 1 2019.

In addition, Scott Parker, the new Director of Performance across the STP will be joining us at the end of April. Scott will be working closely with partners across Herefordshire and Worcestershire to ensure we strengthen our focus on key performance areas.

April also brings the move to a single HR and OD function, Communication and Engagement team, and the increased two county approach to digital and technology programmes. These moves all now sit alongside our shared Safeguarding Team and joint governance arrangements which includes the Herefordshire & Worcestershire Joint Commissioning Committee and the Primary Care Commissioning Committee in Common.

We will continue to update you as we progress our plans into the new financial year and next 12-18 months.

Workforce: Community Practice Nurse Role Opportunity  

A new professional integrative role - Herefordshire & Worcestershire STP

This exciting new project is hosted by the Worcestershire Health and Care NHS Trust. The project is a pilot backed by Health Education England and will see the creation of a new adaptable, interdisciplinary nursing workforce.

If you have any vacancies available, upcoming availability or if you would like to second a current junior member of the nursing team into this development role this project may be of interest to you.

Find out more.

ICT Event 1st May 12.30 – 16.30 -  Book your place now   

The agenda for this event has now been finalised and can be found below. Please confirm your attendance and any dietary requirements by e-mail to sowoccg.worcestershireprimarycare@nhs.net by Wednesday 17th April.

The aim of this event is to support GPs and practice staff in working smarter through greater use of IT. Throughout the afternoon there will be the opportunity to hear about the latest digital requirements set out in the new GP Contract Framework and to learn how local practices have embraced new technologies to help reduce workload and release capacity. We strongly encourage practices to attend as this will be a very informative and interactive afternoon. 

Download Agenda

Stock Shortages of Elleste® HRT Product Range   

The Elleste® range (Elleste Solo®, Elleste Duet®, Elleste Duet Conti®) are the 1st line formulary choices of HRT in Worcestershire. This product range is currently out of stock until at least the middle of May 2019.

The table below gives suggested alternative products that could therefore be considered. The suggested alternatives contain equivalent strengths of estradiol but may contain a different progestogen, where this is applicable. Prices stated are from MIMS, April 19:

Elleste HRT product


NHS List Price

Type of HRT

Suggested Alternatives


NHS List Price

Elleste Solo® 1mg


£5.06 (84)

Unopposed estrogen

Zumenon® 1mg



£6.89 (84)

Progynova® 1mg*


£7.30 (84)

Elleste Solo® 2mg


£5.06 (84)

Unopposed estrogen

Zumenon® 2mg



£6.89 (84)

Bedol® 2mg


£5.07 (84)



£7.30 (84)

Elleste Duet® 1mg

norethisterone 1mg

£9.20 (84)

Sequential combined

Femoston® 1/10

dydrogesterone 10mg

£16.60 (84)


norethisterone 1mg

£11.43 (84)

Elleste Duet® 2mg

norethisterone 1mg

£9.20 (84)

Sequential combined

Clinorette® 2mg

norethisterone 1mg

£9.23 (84)


norethisterone 1mg

£11.10 (84)

Femoston® 2/10

dydrogesterone 10mg

£16.60 (84)

Cyclo-Progynova® 2mg*

norgestrel 0.5mg

£3.11 (21)

Elleste Duet Conti®

norethisterone 1mg

£17.02 (84)

Continuous combined


norethisterone 1mg

£11.43 (84)

* Progynova 1mg & 2mg & Cyclo-Progynova contains estradiol as estradiol valerate.

Note that:

  • Unopposed estrogen products used as monotherapy are only suitable for hysterectomised patients.
  • Sequential combined products are suitable for patients with an intact uterus who are peri-menopausal (amenorrhoeic <1 year).
  • Continuous combined products are suitable for patients with an intact uterus who are post-menopausal (amenorrhoeic>1 year or >54yrs or >3yrs on sequential).

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

Pathology GP user meeting - 9th April   

The next Pathology GP user meeting in is on Tuesday 9th April at 9:30am in the Board Room, Education Centre, Alexandra Hospital.

Any questions, please email wah-tr.dutyBMS@nhs.net

Outstanding Work in Great Witley Surgery  

Many congratulations to all at Great Witley Surgery who have just received a rating of "Outstanding" from the CQC!

Huge praise to all involved!

Interim Service - Adult ADHD: Diagnostic assessment now available 

This is the service that currently provides prescribing advice for patients with an existing diagnosis for ADHD.

GPs should refer patients to The Adult Neurodevelopmental Service at Dudley and Walsall MH Partnership Trust for the following;

  • Patients aged 18 years and above with an existing diagnosis of ADHD for prescribing and care plan advice.
  • A diagnostic assessment for adult patients presenting with signs and symptoms consistent with the diagnosis of ADHD

Email referrals to: neurodevelopmental.service@nhs.net or call 01384 325055

The service is based at:

Old Hill House
High Street

The service is also able to provide telephone advice to GPs about the management of adult patients with ADHD.

Please note that Patients will be expected to transition to the local service provided by WHCT once operational.

National Thrombosis Conferences  

Thrombosis UK, will be holding their annual National Thrombosis Conferences, in Manchester, Bristol and London and each are open to all healthcare and allied professionals providing a day of learning and professional development which has been accredited with 5 CPD points by the Royal College of Pathologists.
Local and national leads have brought the excellent agendas together to provide and national topics presented by a diverse faculty covering local champions, national leads and specialist leaders.
The charity would welcome your support in alerting all healthcare and allied professionals to this opportunity to:

  • Extend learning
  • Update on new data, research and national guidelines
  • Discuss thrombosis in high risk patients, including patients with cancer and surgical patients
  • Share examples of managing anticoagulation therapy in complex patients
  • Network with fellow colleagues from across the South West to improve awareness and management in the prevention and management of blood clots

The link to the agenda and registration is: www.thrombosisuk.org/lets-talk-clots.php