Avon LMCs Newsletter on 20-11-24

---

The ALMC Newsletter

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

---

– LATEST NEWS –

---

It’s been another busy week at the LMC offices and it’s not stopping this week. I have been meeting with Provider Leads to discuss GP Collective Action and to maintain collaborative relationships to ensure there are no unintended consequences.

Yesterday I was interviewed by ITV News West to discuss why GPs in the area are taking collective action, and what these changes will mean for patients. It’s crucial to get the public on side and understand our funding challenges. An apple a day, may or may not keep the doctor away, but practices are paid less than the cost of a daily apple, at only 31p per patient per day. This is shockingly low in comparison to our annual spend on coffee consumption, pet insurance, and a TV license; all of which are more costly than the £112.50 which makes up our global sum. This is why we are taking collective action: to fund our practices to provide the care that patients deserve.

Last week I attended a GPC England Meeting where the Budget and Collective Action were the main talking points. We had some excellent break-out room discussions in the afternoon on Integrated Neighbourhood Teams, and I must say, I am none the wiser on this elusive concept!

At the end of this week, representatives of Avon LMC will be attending the annual conference of England LMCs in London. This is a chance for LMCs around the country to debate motions within the agenda, which will then form GPC England policy for future negotiations with the government. We already have an extensive policy database; the problem lies with the implementation of this within the contract. This is what we have to decide as a profession – what steps are you willing to take to ensure that NHSE policy aligns with GPC England policy?

“Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world.” – Joel Barker

Dr Shaba Nabi
Chair Avon LMC

Communication to Providers about Collective Action
This week we are sending out letters to all Providers to remind them of the implementation and timeline for collective action, and to ensure this is cascaded throughout their Trust. This is in response to feedback we have received that the message isn’t always reaching clinicians at the coal face.

DSA for Stoma products to be prescribed by Stoma nurses
Some practices have been contacted by the ICB Medicines Optimisation Team to agree to a data sharing agreement for implementation of this project. Avon LMC encourages you to agree to this DSA as it will reduce the prescribing workload for general practice.

This is also a reminder that both Avon LMC and One Care are happy to be contacted for all requests for new DSAs to ensure you are not declining those which benefit your practice.

Generic Referral Form
To assist with the triaging of referrals by Providers, Avon LMC strongly recommends that you use the ICB BNSSG Standard Referral Form, rather than a free text letter. This Referral Form was developed by One Care and the LMC in collaboration with secondary care providers, and self populates all the important information required for a safe referral.

We have also updated the RAG rating document to include a referral to DANS which we have included as Amber, due to the extensive inclusion/exclusion criteria. As always, please refer to the LMC Collective Action web page for the latest guidance.

Prescribing Workload Transfer
Avon LMC has previously advised that any prescribing recommendation involving a consultation (as opposed to advice or a test) requires the Provider to take responsibility for the initiation of this medication and supply 28 days.

We have been advised by the ICB Medicines Optimisation Team that there are significant challenges with the implementation of this for some departments, and we are working collaboratively towards a solution for this.

The Committee met this week and discussed the following topics:

• Collective Action
• Board succession planning
• Organisational structure
• Membership Levy payments

A list of committee members for Avon LMC can be found here.

Following recent changes to the constitution agreed at the AGM, Avon LMC has started the process of recruiting a practice manager from each of the three areas within BNSSG. We have not received any applicants from North Somerset, the South Gloucestershire role is uncontested, and we have started an election process for Bristol. Once the election process is concluded, we will update you with the new appointments.

Question: We have been asked to prescribe H pylori eradication following an endoscopy. Should we directing back to the endoscopy department or, given we requested the test, should we prescribe?

Answer: If the patient is referred to an out-patient team, then the prescribing following the result of an investigation they have requested, lies with them
If you have sent a patient direct to test (endoscopy), it is greyer, because although the investigation hasn’t been requested by you, the patient is still under your care. In these circumstances, it is reasonable for a GP to prescribe the H-pylori eradication therapy. 

You may have seen the news that the generic version of Varenicline is due to be re-launched by NHS England to assist with smoking cessation, and practices have already received patient queries about this.

Avon LMC reminds you that smoking cessation is not part of the core GP contract, and a service has been commissioned through each of the three local authorities. As such, GPs are under no obligation to fulfil any prescribing requests for this, either directly from patients or from the local authority.

Read the latest GPC England bulletin here. 

• 22nd November 2024: England LMC Conference – London, all day
• 17th December 2024: Virtual LMC drop in, 13.00 – 14.00
• 14th January 2025: Virtual LMC drop in, 13.00 – 14.00
• 11th March 2025: Virtual LMC drop in, 13.00 – 14.00

Lung cancer is the most common cancer type and the most common cause of cancer death in the world. The most recent global estimates from the International Agency for Research on Cancer (IARC) indicate that in 2022 almost 2.5 million people were diagnosed with lung cancer and more than 1.8 million people died from the disease. Lung cancer causes more than twice as many deaths as colorectal cancer, which is the second most common cause of cancer death.
 
The enormous burden of lung cancer obscures the fact that most cases are avoidable. The principal risk factor for developing lung cancer remains tobacco smoking, which is responsible for approximately 85% of all cases, according to the World Health Organization (WHO). Other common causes include exposure to contaminants such as second-hand tobacco smoke, outdoor and indoor air pollution, diesel engine exhaust, welding fumes, and asbestos.

• Tuesday 19 November General practice bulletin (mailchi.mp)
• Friday 15 November General practice bulletin (mailchi.mp)
• Thursday 14 November General practice bulletin (mailchi.mp)

---

– LATEST TRAINING AND EVENTS –

---

You are invited to an online webinar to discuss Imaging Requesting and associated updates for Non-Medical Referrers (NMR) in BNSSG General Practice.

Topics on the agenda:

• Updated protocol and entitlements for all roles
• Responsibilities – employers and staff
• SOP for subcontracted staff
• Relevant documents
• Onboarding process
• Audit
• FAQ
• ICE & IRMER training
• Where to access information

Please submit any questions you have prior to the meeting to kerri@almc.co.uk

Date: Wednesday 27th November 2024
Time: 12.00 – 12.45
Online: MS Teams – Join the meeting
Meeting ID: 313 480 516 138
Passcode: S28hEk

The webinar will be record and available after the event.

• Menopause Learning Event for Clinical Pharmacists and Pharmacy Technicians
  Thursday, 21st November from 13.00-14.00
  Sign-up Form
• BNSSG Cancer Lead GP Forum
  Thursday, 21st November from 12.45-14.00
  Sign-up Form
• Dermoscopy Training – Part 3
  Thursday, 21st November from 13.00-17.00
  Sign-up Form
• Breast Awareness session for Primary Care Clinicians
  Tuesday, 26th November from 13.00-14.00
  Sign-up Form
• Prosthetic Joint Infection – IFORM Study
  Wednesday, 27th November from 12.30-13.00
  Sign-up Form
• Antimicrobial Stewardship in BNSSG
  Wednesday, 27th November from 13.00-14.00
  Sign-up Form
• General Practice & Community Pharmacy Independent Prescribers Forum
  Thursday, 28th November from 13.00-13.30
  Sign-up Form

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

---

---