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Member Practice Update

5 July 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. Implementing the Long Term Plan in Primary and Community Services 
  2. Merger Update 
  3. April 2019 Workforce Survey Summary 
  4. Read Codes for Bariatric reg & EMIS search  
  5. General Practice Improvement Leads programme - applications open for Midlands and East of England regional cohorts 
  6. Prescribing Top Tip 
  7. REQUIRED - Midwives and GPs needed for pilot - Comms Support 
  8. Modern Slavery campaign 
  9. End of Life Care Strategic Planning Action Learning Set Workshops, London 27th September, 17th October, 12th November 
  10. Salaried GP Advert 
  11. Clinical Safety Issue CHA2DS2-VASc Calculator

Find out about local and national events and training here

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


Implementing the Long Term Plan in Primary and Community Services 

The NHSE\I Board has a number of implications for all of us. We are working through these over the new few weeks. Please read and let us have any comments.

Merger Update 

Thank you to everyone who has responded. We are still waiting for a few more forms from practices but we can confirm a very positive response in favour of the merger. If you haven’t as yet  expressed your view, please follow the link to the voting form.  We will notify practices of the final outcome shortly

April 2019 Workforce Survey Summary 

Thank you to all 83 practices across Herefordshire and Worcestershire for completing the April Quarterly Workforce Survey. The data each practice has submitted was compiled and assessed. Based on the trends found, the CCGs formulated responses to challenges noted in the workforce. The full summary of data and responses can be found within the summary report.

Key Headlines

There is an increase of 8 GP Headcount across the STP since December, however we have also seen an increase in GP vacancies. We know, despite some practices successfully recruiting GPs there are some practices that are struggling to recruit and we are working closely with these practices to identify solutions.

Apprenticeships have increased  (5) which is a positive increase.

Our national workforce trajectories reported that at the end of March 2019, we were only one of two STPs in the whole Midlands region who are achieving our GP workforce plan numbers.

Since the last report the following local and national programmes have been put in place or are in the process of being implemented to support our GP workforce, details of these programmes can be found in the report:

  • GP Clinical Lead/Champion
  • First 5 Clinical Lead
  • Next Generation GP programme coming soon
  • GP Trainer capacity
  • GP Mentoring
  • HWGP Workforce twitter account


The local programmes of work have been developed based on feedback received from our GPs at various events and interactions across the STP. This information has been fed into the GP Retention Task and Finish Group. The team made up of GPs, members of NHSE, the CCGs, the Training Hub and HEE work through the feedback provided to develop and implement the programmes which are deemed to be most likely to have a positive impact on the workforce. The following programmes are currently with the team for future consideration:

  • Introduction of a GP Retention Protocol
  • GP Pre-retirement Forum
  • GP Advantage website  
  • Return to Practice Nursing 

Read codes for Bariatric reg & EMIS search

On behalf of Dr George Henry, Worcs IQSP Clinical Lead

'Dear All

We’re now halfway through the Spring and Summer IQSP meetings. 

I hope those of you who have joined the IQSP/PCN meetings are finding the content and guidance helpful and supportive. 

The agenda as usual covers a broad number of topics including a clinical focus on Obesity and Bariatrics. We’ve included these 2 areas in this round of meetings as the autumn/winter IQSP evaluation highlighted a need for further guidance and top tips to help promote best practice.  

The feedback we’re receiving so far confirms that our decision to include bariatric guidance on the agenda, was timely and appropriate. Firstly, we know there is a bariatric panel on ICE but unfortunately this is only visible in the hospital view and not in Primary Care, to correct this we’ve asked that it is moved onto the Primary Care view. We also know that the Tier 4 service maintains responsibility for 2 years post-surgery. This 2-year period includes close supervision and any necessary procedures including annual blood tests and an assessment of medication. The follow up for these patients includes 6 weeks, 3 months and then every 6 months up to the end of the 2-year period. During this time GPs can seek advice at any point via Advice and Guidance, as they would for any other patient, but it is important that you let us know if patients are not being followed-up appropriately in secondary care. I’m sure you will agree by definition, many of these patients remain at risk of diabetes and are likely to be on other chronic disease registers, so a bariatric review can be included in their annual review schedule. 

One of the IQSP actions is to create a bariatric register. To help you do this a set of codes and an EMIS search have been uploaded onto the IQSP topic page on TeamNet. Over time this will help us build a picture of actual numbers involved, both private and NHS and the impact this may be having on primary care workload.

Finally, we know that the group IQSP format means that many colleagues are not present at the meetings, again your feedback is helping us respond to this. To support colleagues who are not attending we have uploaded the full suite of IQSP documents onto TeamNet. Dr Rachael Pryke and Dr Maggie Keeble, authors of the Obesity, Bariatrics and End of Life slides, have added a narrative which provides further background information on content and resources, these also on TeamNet for individual clinicians to view.

Dr George Henry

Worcs IQSP Clinical Lead'

General Practice Improvement Leads programme – applications open for Midlands and East of England regional cohorts

Applications are open for the Midlands (starting with an introductory webinar on 3 September and the first module on 17 and 18 September 2019) for the Midlands regional cohort of the General Practice Improvement Leads programme. The programme is designed for GPs, practice managers, nurses, reception managers and senior administrators. It incorporates interactive training workshops, personal reading and reflection, and action learning as participants lead a change project in their own workplace. Participants gain new perspectives, skills and confidence in using improvement science in general practice, and leading colleagues and teams through change.

For more information and details on how to register visit https://www.england.nhs.uk/gp/gpfv/redesign/gpdp/capability/

Prescribing Top Tip 

This week's Prescribing Top Tip regarding High Dose ICS

REQUIRED – Midwives and GPs needed for pilot – Comms Support

NHS Business Services Authority is running a campaign to raise awareness of its digital maternity exemption certificates for mothers. The aim is to get as many midwives and GPs signing up to the digital service as possible.

Quick overview

NHS BSA currently receive approx. 460,000 Maternity Exemption applications a year. 90% of these are submitted manually using the FW8 paper application form and 10% are received through a new digital application route.

The digital service makes it quicker for mothers to get their exemption and entitlement to free dental care and prescriptions. It saves the midwife / GP time from filling out a postal FW8. On the digital scheme, exemption is instant! There are a few other benefits too which are explained in these social media posts.

How to sign up

Midwives and GPs can sign up via our website.

They just need to provide their name, NMC / GMC number and their nhs.net email address.

Modern Slavery campaign

Do you know the signs of modern slavery?

The Home Office estimates that there are about 10-13,000 victims of modern slavery in the UK, trapped in situations such as forced labour, domestic servitude or sex exploitation.

In reality, the number could be far higher.

To tackle this issue the government have launched a campaign to raise awareness of the signs of modern slavery and how to raise a concern.

End of Life Care Strategic Planning Action Learning Set Workshops, London 27th September, 17th October, 12th November

'On behalf of the GSF team'

'The recent encouraging focus on end of life care in the NHSE Long Term Plan (sect 1.42), GP practices/Primary Care Networks, QOF and forthcoming NICE Guidance all confirm the importance of end of life care as key parts of future planning. The recommendation for strategic planners is to take a more proactive personalised approach, with earlier identification, more advance care planning and improved coordination of care.

The recent NHSE Implementation Framework https://www.longtermplan.nhs.uk/implementation-framework/ set tight milestones of autumn 2019 for submission of plans.

To make best use of these opportunities amidst this tight time frame, and to be as ambitious, effective and transformationaas possible, we are bringing together EOLC leads from across the country to debate with national experts  and strategic thinkers, share examples of best practice and take time out to develop the key areas and tasks for each local area.  We want to explore what this means in practice to EOLC Leads and commissioners in CCGs/STPs/ICSs, share challenges and successes of what works on the ground and inspire others to raise the bar in end of life care in their area, to be able to develop their own ambitious effective strategic plans in their local areas. See our letter of invitation and registration form.

The first of these workshops was on 25th June and was a very successful and fruitful day, with many strongly recommending that their colleagues in other ICS/STPs attend further workshops in future.  Comments from Workshop 1 include:-

“First class day, programme of excellent speakers - really fruitful day”, “This is a brilliant way to learn, be inspired, informed and improve our own local strategy plans“, “ A great number of ICS/STP Leads need to be coming“, “Thanks for an excellent day - I have managed to create a great action list today”, ”Great to network and hear about other ideas that have worked“ and “It’s an invaluable opportunity – anyone interested in improving EOLC should come - highly recommended”

We would therefore like to invite you to join others for the remaining EOLC Action Learning Set Workshops on 27th September, 17th October, 12th November, preferably as ICS teams attending all workshops together or if not, as separate representatives coming to any available workshops. Attendance is now at a reduced rate of £95/per person/per workshop. The second ALS workshop on 27th September includes attendance at the GSF London Autumn Conference in the morning with keynote speakers and showcasing examples of good practice (see conference draft programme) followed by the workshop in the afternoon 1.30pm - 4.30pm, but the other workshops will be 10am - 4.30pm as usual.

The programme includes contributions from senior EOLC policy leads and experts and many front running exemplars experienced in putting top quality EOLC into local practice – see our action-packed programme for the first workshop in June, (See page 2 for future speakers and contributors). Some films and PowerPoints are available from Workshop 1, so others unable to attend could catch up.

Do contact us for more information on info@gsfcentre.co.uk or phone 01743 291897. 

We look forward to seeing you there.

In addition, if you’d like to hear directly about the difference made on the ground by any of the 10 integrated cross boundary care sites who have successfully implemented GSF, from any GSF Accredited GP practices (see new updated QOF support offers for GPs and PCNs – (http://www.goldstandardsframework.org.uk/primary-care-training-programme) of GSF bronze, silver and gold and other resources, or from over 3000 GSF care homes improving care, 100s of hospital wards or any of the others leading to better quality proactive personalised care – http://www.goldstandardsframework.org.uk/We’d be happy to send you information, discuss further or put you in touch with our frontrunners in these areas.  

We hope these initiatives can help you improve EOLC in your area and look forward to hearing from you soon.

All good wishes

The GSF team' 

Salaried GP Advert 

Great Witley Surgery is a rural dispensing practice situated in the beautiful Teme Valley in Worcestershire. We are a friendly, forward thinking, cohesive and supportive team. Due to our expanding list size we are looking to recruit a Salaried GP for 4 sessions per week.

Clinical Safety Issue CHA2DS2-VASc Calculator

Sent on behalf of Faye Edwards, National Programme Manager 

'For your information, we are aware that there has been an issue with the CHA2DS2VASc scoring calculator on EMIS and Vision systems (other GP information systems may also have been affected) this may result in patients having these scores calculated incorrectly. 

We would advise that clinicians double check any computer generated CHA2DS2VASc scores manually before making any treatment decisions. Your local stakeholders should be aware of this clinical safety issue.

Best wishes


Faye Edwards | National Programme Manager | Atrial Fibrillation Stroke Prevention Programme | AHSN Network

faye.edwards3@nhs.net| 07918 338725 | @fayeedwards_HIN'