Workshift From Community Providers

The LMC was alerted by South Gloucestershire practices that Sirona was no longer planning to tend to ambulant (non-housebound) patients with indwelling catheters and that practices nurses would instead be expected to carry out this work. Furthermore, they also informed practices, in a separate letter that Health Visitors would no longer be measuring Head Circumference in babies and that GPs would have to do it instead.

The LMC challenged both these assertions, simply pointing out that General Practice was not commissioned to do either of these tasks, so if Sirona was not planning to do them could they please explain who was going to be commissioned to do them instead.

We have since had a long and apologetic letter from Sirona accepting that it is indeed their responsibility to provide indwelling catheter care. With regard to Head Circumference measurement, they accept that it is the Health Visitors’ responsibility to provide “a holistic assessment of the child in the context of family and community within the psycho-social model of health” and furthermore, if the parents wish, or if there is professional concerns “an assessment of a baby’s growth should be carried out” The letter goes on to mention that the LMC may indeed have identified a gap in the service although it also says that the evidence for routine head circumference measurement providing any benefit is not clear. To the LMC’s mind, the wording in italics above firmly places the responsibility for measurement with the Health Visitor and not the GP.

Although these two issues specifically affected South Gloucestershire Practices, we would ask that North Somerset and Bristol practices be on the alert in case they receive similar letters from their Community Health Providers. If you do, please let us know.