Avon LMCs Newsletter on 29-01-25

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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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It was great to attend a regional LMCs meeting last week and connect with LMC leaders across the South West. We are all facing similar challenges with unfunded interface work and it is helpful to hear about the work taking place in other areas so we can learn from this. There was a lot of regional interest in our new enhanced service for the physical monitoring of eating disorders which was shared with practices last week. I am grateful to all the people who made this happen, including (but not restricted to) Natasha Ward, Jenny Bowker, Geeta Iyer and Victoria Bleazard.  

GP Collective action has been an opportunity for all stakeholders to reflect on patient pathways and where responsibility lies for them. Over many years, there has been an insidious move towards specialist care being substituted with community providers, whose contract specifications may not replicate those of out-patient clinics. This has created a commissioning gap within the interface space and led to the inevitable workload transfer to general practice. Examples of this can be seen within pathways mandating direct access to tests instead of clinic referrals, which has led to post-diagnostic work to be handed to general practice. Avon LMC is working with system partners to navigate this minefield, but it will take time, so we are grateful for your patience.

“Collaboration is a multilane highway, going in all directions. If there isn’t reciprocity, it fails, and it’s unsatisfying.” –  Jeffrey Wright

Shaba Nabi

Chair: Avon LMC

Prescribing initiation

Avon LMC was disappointed to learn that BNSSG trusts will continue to take a reactive approach to initiating their own recommended medications. This means that there will be no change in their prescribing behaviour unless they receive a prescribing template letter from practices pushing back on this workload transfer.

We have highlighted the unnecessary delay this may create for patients, as well as the impact on the GP-patient relationship, but we are encouraging all practices you to continue using the workload transfer template letters to push back on this work.

Prescribing Workload Transfer Template Letters

Owing to the clinical nature of some of these requests, Avon LMC recommends that these practice pushback letters are approved by a staff member with a clinical or prescribing background (this may include a trained prescribing clerk), rather than an administrator outside of these roles.

ADHD Medicines Monitoring in under 18s

The specialist medicines monitoring LES, which has now included the monitoring of ADHD medication (as well as Lithium and Mesalazine) is for adults only.

All monitoring of ADHD medications for patients under the age of 18 is the responsibility of the specialist provider, as per the shared care protocols for these medications.

Question: We have been asked by oncology to refer a couple for fertility treatment a year after chemotherapy completion. Whose responsibility is this?

Answer: This is a tricky area as fertility referrals are attached to a commissioning policy, with certain criteria needing to be met. They also require investigations for both partners, when only one partner is the hospital’s patient. Owing to these complexities, the LMC would advise a practice to complete the fertility referral.

As NHS waiting lists rise, more patients are seeking private healthcare, and there have been a growing number of requests from private providers to general practice. Avon LMC has received many practice queries relating to this, so guidance has been developed to help you navigate this private interface.

Please find this here.

Please find here.

• 11th March 2025: Virtual LMC drop in, 13.00 – 14.00
• 6th May 2025: Virtual LMC drop in, 13.00 – 14.00
• 1st July 2025: Virtual LMC drop in, 13.00 – 14.00

Mental health can be impacted by a number of factors, including environmental and social. There is evidence that the pandemic has impacted significantly on parent and carer mental health. Increasing severity, new emerging psychological issues, and lack of access to stretched mental health services has also generated ongoing worries on how to also support their child / young person’s mental health. The cost of living crisis, which has so closely followed the pandemic, and increased concerns about digital harms have further increased parent and carer anxiety and, in some cases, helplessness and hopelessness.

Parent Mental Health Day on 30th Jan 2025 is here to shine a light on parents/carers who are continuing to parent under unprecedented circumstances and may be struggling in the face of adversity. By getting parents, carers, and employers engaged in discussions, PMHD aims to challenge the stigmas surrounding parents’ and carers’ mental health, start a discussion, and provide some resilience tips.

• Tuesday 28 January General practice bulletin (mailchi.mp)
• Thursday 23 January General practice bulletin (mailchi.mp)

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– LATEST TRAINING AND EVENTS –

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• Frailty and Type 2 Diabetes – Practical Tips for Management
  4^th February from 13.00-14.00
  Signup Form
• Raring to Return – GP Refresher
  5^th February from 9.00-17.00
  Signup Form
• General Practice & Community Pharmacy Independent Prescribers Forum
  5^th February from 13.00-13.30
  Signup Form
• Getting the Best out of your Laboratory Tests: Blood and Science Session
  6^th February from 12.30-13.30
  Signup Form
• Late Career GP Group: Inspirations from Literature
  11^th February 19.00-21.00
  Signup Form
• Advanced Practice Event – The Greenway Centre
  12^th February from 9.00-12.00
  Signup Form
• The 6-8 week GP check – what to consider from a pelvic health perspective
  19^th February from 12.30-13.30
  Signup Form
• BCYP EduForum: Paediatric Cardiology
  15^th February from 13.00-13.30
  Signup Form

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

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