Avon LMCs Newsletter on 16-10-24

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The ALMC Newsletter

Welcome to our weekly newsletter, sharing the latest news and topics of interest for practices.

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– LATEST NEWS –

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This week, I received my first rejection of my rejection letter for workload transfer, and I’m sure it won’t be the last! With good communication and collaboration, what transpired was the fact that that both primary and secondary care are operating within multiple areas of commissioning vacuum, which tend to default to general practice. We would welcome practices informing us of any commissioning gaps they encounter, so the LMC can raise this at an ICB level.

I’m looking forward to attending an Educator’s Conference tomorrow, which is when GP Training Programme Directors across Severn and Peninsula come together to discuss GP Training. I’ve been in this role for over ten years now and the pace of change leaves you breathless. We’ve gone from training expansions and golden handshakes to fill holes in the workforce, to a landscape of GP under-employment. This is likely to be the consequence of the PCN DES, which has ringfenced funding for ARRS staff but not GPs or nurses.

The repercussions of the expansion of the ARRS roles within the PCN DES are being experienced not just by individual GPs looking for employment, but also the PAs embedded within practices, who now face uncertainty following the publication of the RCGP scope of practice. Avon LMC is aware of the challenges many practices face following this guidance, so we are sharing some updated guidance on PAs to help practices with their decisions.

“Exploring the unknown requires tolerating uncertainty” – Brian Greene

Dr Shaba Nabi
Chair Avon LMC

We are very keen to hear from you regarding your questions/comments to the LMC, but we need to triage these requests appropriately, so they go the correct person. (think of your care navigators signposting calls and on-line requests!) So, we would be grateful if you could email all queries to:

info@almc.co.uk
 

All our resources are hosted on the Collective Action page of the Avon LMC website. Although we are sharing them within the newsletter, the most up to date version can be found through this web page.

Data Sharing Guidance
The LMC and One Care have collaborated to produce the following guidance for practices:
Collective Action and Data Sharing Agreements

Safe working round table discussions from members’ event of 10/09/24
There is a huge variation in practice, and we are sharing a high-level summary as follows:
Please see the document here. 

Single Generic Referral Form
The LMC has developed a RAG rating for all referrals which lists all the referral forms in use within BNSSG. This document outlines specific criteria which may be required for referral and offers an LMC steer on when to use a specific referral form, according to the risks of the required criteria being omitted. This list may change over time following feedback from practices and providers, so it is important to reference the updated document hosted on the website.

The current RAG rating document can be found here:
Avon LMC RAG rating for BNSSG Referral Forms

We are also sharing the following letter with all providers:
Please see the document here.

Whilst using the generic referral form, it is important the all the relevant clinical information is documented within the consultation, which can be imported into the referral form. This would include a robust handover of risk, safeguarding issues, and communication difficulties. Paragraph 21 of Good Medical Practice on Delegation and Referral states that:
You must pass on to the medical, health, or social care professional or service provider involved:

1. relevant information about the patient’s condition and history
2. the purpose of transferring care and/or the investigation, care or treatment the patient needs. 

Workload Transfer Template letters
We are hoping that One Care is able to download these to EMIS via resource publisher within the next week.

Regarding the prescribing for end-of-life care patients, Avon LMC has been in communication with specialist teams, and we recommend that GPs continue to support specialist nurses with prescribing for end of life care patients.

Avon LMC has previously published guidance on the role of Physician Associates within general practice in the newsletter dated 12/06/24. In view of the RCGP Scope Of Practice published on 09/10/24, we are updating this guidance.  We would like to acknowledge the uncertainty facing PAs following the publication of this guidance, and the consequent emotional toll this is having on individuals. NHS England has shared some wellbeing resources for all staff working within the NHS.

As an LMC, we are unable to make decisions on behalf of practices about how they utilise PAs, but we can share guidance from various organisations, to enable practices to reach their own decisions.

Please find attachment here.

Question: We have been approached by a private weight loss clinic (with the patient’s consent) requesting we validate a long list of exclusion criteria for a weight loss injection they are offering. We are concerned about the workload associated with this, as well as any medico-legal liability attached to this request.

Answer: These types of requests are becoming more common, and we would always encourage patient self-declaration for them. The best strategy is to ask the patient to download the NHS app to gain access to their on-line medical records, which can be shared with any provider. Failing this, they can request a medical summary printout via a subject access request (SAR)

Avon LMC is aware that practices have not yet received the templates for this. We have collaborated with One Care who has raised this with the ICB.

However, we would like to draw your attention to  BMA advice on this matter, which advises practices to defer sign-up for the better digital telephony and simpler on-line requests, until 2025. This is to enable the BMA to negotiate further on these matters as practices can always sign up next year.

The October survey has been published today (Monday 14 October) and will close at 5pm on Sunday 20 October. Links have been sent to GP partner members via SMS asking them to provide information of collective action that they are currently undertaking. We would be grateful if you could please share this link with your practice managers/GP partners and encourage them to fill the survey.

Dr Katie Bramall-Stainer, Chair of GPC England

On October 18th, we mark Menopause Awareness Day, a time to acknowledge the impact menopause has on the lives of many women. As healthcare professionals, it’s important that we take this opportunity to engage in open conversations with both our patients and colleagues about the physical and emotional challenges menopause can bring.

Additionally, menopause may affect not only women but also individuals assigned female at birth, who may face similar challenges.

By fostering greater understanding and awareness, we can ensure that everyone feels supported in navigating this stage of life, whether it’s through medical advice, symptom management, or simply being available for discussion.

Creating a supportive environment is key to helping people feel empowered and informed.

Let’s use this day to reflect on how we can better support our patients and colleagues in managing menopause with care and compassion.

For more information and resources, you can visit the official Menopause Awareness Month website here.

Make savings on products and services by utilising the Buying Group approved suppliers
 
The LMC Buying Group has an impressive list of suppliers that cover a variety of products and services, from stationery and office equipment to medical consumables and confidential information shredding.
 
We regularly identify savings between 20% and 45% made on office items from our supplier, Whittaker Workplace Solutions. They can supply your practice with everything it needs to run smoothly, including stationery and office products, catering and cleaning supplies and printer cartridges. To order from them, you can phone, email, fax or order online at all times.
 
If you are looking for a company that can provide confidential information protection and secure document shredding, hard-drive destruction and associated recycling services, the Buying Group have the perfect supplier for you. Through Shred-it’s partnership with the Buying Group, all members can access 50% off standard rates. Shred-it supplies their services to organizations of all sizes in the private, public and third sectors.
 
To access the discounts, you would have to sign up with the Buying Group. Membership is completely free for practices. For those of you who are already members, accessing these discounts is incredibly simple, all you have to do is visit the Buying Group’s website and click onto the supplier page you are interested in.

AstraZeneca Medical are supporting GP Practices & PCNs by offering a fully funded Non-promotional, Clinical Pharmacist Review Service through a third-party provider – Interface Clinical Services

I am currently taking appointments with PCN/practice managers in BNSSG ICB to register their interest in securing the additional support for their practices.

What’s on Offer?

The disease therapy areas currently available are:

• Cardiovascular Risk Reduction
• Type 2 Diabetes
• Chronic Kidney Disease

Am I Eligible?

In order to qualify for one or more of the above services. The practice or PCN will need to evidence either; national or above national average disease register % prevalence.

The services are only available to be offered on a first come first serve basis, as the allocated budget is set at a national offering to primary care. To manage expectations, there is currently a 4-6 weeks lead time for the pharmacist to start arranging clinics.

How Do I Apply?

If you would like to apply for one or more of these pharmacist support services. Please respond to this email with the following information to proceed:

• Proposed date & time to schedule a virtual Teams meeting with myself
• Service disease area(s) of interest
• Related disease register prevalence
• Participating GP practice(s) or PCN name
• Is Pharmacist Clinic Mentorship Support an option you would like to add to the service for a named HCP staff member?

What Next?

Next, I will send you a Teams meeting invitation to schedule into your calendar. I will also attach a Service Introduction Document which outlines the scope of the service you are interested in.

*If you do not meet the disease prevalence % medical criteria and would like to apply for the service. Please respond to register your interest in order for me to clarify your local subsidiary criteria requirements internally.

• 12th November 2024: Virtual LMC drop in, 13.00 – 14.00
• 22nd November 2024: England LMC Conference – London, all day
• 14th January 2025: Virtual LMC drop in, 13.00 – 14.00
• 11th March 2025: Virtual LMC drop in, 13.00 – 14.00

• Tuesday 15 October General practice bulletin (mailchi.mp)
• Thursday 10 October General practice bulletin (mailchi.mp)

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– LATEST TRAINING AND EVENTS –

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• 17th October – Understanding the use of FIT – testing for blood in poo
  Signup Form
• 24th October – BNSSG Cancer Lead Education Day 2024
  Signup Form
• 24th October – Dermoscopy Training – Part 2
  Signup Form
• 24th October – Blood Interpretation in Primary Care (Day 1 of 4)
  Signup Form

Please see here for full event details.
For further information please contact Bnssg.training.hub@nhs.net

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