DDLMC WEEKLY UPDATE ISSUE 2/23

SAFER WORKING IN GENERAL PRACTICE

We are acutely aware of the ongoing pressures In General Practice. Whilst overall the system has come out of the recent critical incident demand for GP appointments continues to be extremely high. An increasing number of practices are reporting that they are on OPEL level 3 or 4 and are being offered support from the LMC/GPPB/ICB accordingly (again this is voluntary on the part of the practice and is not a performance management tool).

We have previously promoted the BMA guidance on safe working in General Practice Safe working in general practice (bma.org.uk), and this week's LMC Committee meeting gave significant time to looking at the issue. The BMA are looking to put out updated guidance but this is not expected until March now so we will share the outputs of the work done by the committee and also an LMC support Network event attended this week in the near future.

In the meantime please contact us at ddlmc.office@nhs.net with any concerns or queries.

ACCESS TO RECORDS UPDATE 12.01.2023 TPP PRACTICES

Access to records developments are still ongoing. The ICB have been instructed by NHSE to request that all practices with over 50% of patients coded with the 104 code complete a survey.

General Practice is under immense pressure, and we will support practices pushing back or not completing this request. DDLMC are working with DDICB to push back on the request with a joint letter which will be sent to NHSE shortly.

Further communication will be coming out from DDICB on actions required, we would like to highlight that these requests are not coming from the ICB but NHSE.

We have recently been advised that TPP practices will be enabled for prospective access on 01 February 2023 unless opted out.

IMPORTANT: If a practice does NOT wish for the change to be applied on 01 February 2023, they must take immediate action by emailing RecordAccess@tpp-uk.com by 27 January 2023 at the latest, including their instruction, practice name, address and ODS code. If opt-out is not registered with TPP by 27 January 2023, the practices will be enabled.

 bma-template-letter-for-system-suppliers-oct-2022.docx

LMC BUYING GROUP

All Derby & Derbyshire levy paying practice can sign up to the LMC Buying group.

Buying Group membership is completely free and there is no compulsion to use all our suppliers. We do the hard work associated with finding the most competitive suppliers in cost and customer service, so we save you time as well as money on your purchasing!

Although the Buying Group was originally set up to help GP practices save money on the products and services they regularly buy, membership is now also open to GP Federations, Primary Care Networks, Dental Practices, independent pharmacies and other health and social care providers in the UK.

You can click on the boxes below to see an overview of what is available to your sector through the Buying Group. Once registered and logged in you’ll be able to see the sector specific information and offers on the individual supplier pages. Trusted to Save Healthcare Providers Time & Money | LMC Buying Group (lmcbuyinggroups.co.uk)

PATIENTS ENTERING THE UK FOR THE FIRST TIME

We have recently been helping a practice with duplicated records for a patient arriving from overseas.

In their latest newsletter, PCSE advise the following:
If you have a patient registering in the UK for the first time you should register as an immigrant and see if there is a match to the spine, confirm with the patient if the address details are known to them.

When registering patients whose previous address was outside of the country, GP practices do not need to provide this information. If entering an address is mandated, then Address Unknown can be used in the previous address field.

If an existing NHS number is traced on Spine and the previous address is populated automatically but contains over 50 characters you may see an error on the clinical system. To overcome this, you can edit the foreign address, or replace with Address Unknown whilst retaining the patient's place of birth. You will then be able to submit the registration via the GP links in the normal way.

''THE NHS IS FAILING'': BURNT-OUT GPS WORKING ALL HOURS TO KEEP HEALTH SYSTEM AFLOAT

Dr Shehla Imtiaz-Umer, a GP at Wilson Street Surgery in Derby, speaking to the Local Democracy Reporter at the Derby Evening telegraph , said Derbyshire's healthcare system is facing a "perfect storm" of winter illnesses, a crippling waiting list. For the full story please click the link here.

NHS 111 URGENT CARE SERVICE HEALTH PROFESSIONAL FEEDBACK FORM

Please see attached the form to complete for inappropriate referrals from 111 Urgent Care Service at Derbyshire Health United. The form should be sent to Feedback111.Derbyshire@nhs.net or telephone the DHU Clinical Governance Office on 0300 1000 407 for assistance.

UPDATE ON PLANNED 18-19 JANUARY RCN INDUSTRIAL ACTION

Message from Derbyshire Community Health Services NHS Foundation Trust (DCHS) and Derbyshire Healthcare NHS Foundation Trust (DHCFT)

Further to the communication that was shared yesterday, a request to share any further information for general practice was made at an industrial action system planning meeting this morning. Further communication was originally planned for Monday as it is hoped the full set of derogations will be made then. However, following the request this morning, there is some additional information we can share with you at this stage with the caveat that this is an ever-changing situation so may change as we head closer to the days of industrial action.

Additional general points worth noting

• We anticipate that the RCN industrial action will have a greater impact on primary care than the recent industrial action taken by East Midlands Ambulance Service.
• It is not possible to say what the full impact of the industrial action will be as we will not know how many members of the RCN will be taking industrial action until the day itself. That said, we are doing everything we can to help identify what our likely resource on the day will be.
• We will be trying to get ahead of work on Monday and Tuesday if possible and we anticipate a lag after that as services resume on Friday.

Additional points from Derbyshire Healthcare NHS Foundation Trust

Derbyshire Healthcare NHS Foundation Trust’s crisis mental health services will remain open but with a reduced service on 18 and 19 January. Services that will be open but operating at a reduced capacity will include the Derbyshire Mental Health Helpline (0800 028 0077) and the Crisis Resolution and Home Treatment Teams. GP referrals to the Crisis teams on and around 18 and 19 January will be reviewed by the teams and dealt with in order of priority. The teams will endeavour to communicate with GPs about any delays in responding to urgent referrals.

Additional points from Derbyshire Community Health Services NHS Foundation Trust

• Please prioritise and minimise referrals on the two days of industrial action. This will help stretched teams prioritise from a lower volume.
• We cannot request derogation for our advanced and enhanced clinical practitioners as they do not normally work on Christmas Day (we anticipate running the equivalent of Christmas Day staffing levels). Please be mindful that this could impact community wards and P2a bed cover, as well as our home visiting and care home services. It could also impact primary care, out-of-hours services and DHU.

We hope you have found this additional information helpful. Please share with all staff. As stated above, we hope derogations will be agreed by the end of the day and further communication will follow from us once they are known.

MESSAGE FROM DR RICHARD VAN MELLAERTS, DEPUTY CHAIR – GP COMMITTEE ENGLAND OF BMA

Last week GPC England officer team wrote to the CQC to suspend routine inspections of general practice during this time of unprecedented pressures. I include their response for your information.

As you can see, they acknowledge the circumstances under which we are working, but propose to continue targeted inspections. Whilst fine words butter no parsnips, it is at least helpful to see the new inspection regime being paused and a reactive approach being adopted currently. We will continue to discuss the risks that practices and GPs are having to manage currently, and how this adversely effects patients despite practices very best efforts. Practices and GPs cannot be held accountable for system wide issues.

We will also be lobbying NHSE, DHSC and the secretary of state for legislative change in line with conference policy on CQC.

We will continue to update you on our efforts to support general practice during this very difficult time. You and your practices continue to have our full support.

NEW DIRECTLY BOOKABLE APPOINTMENT GUIDANCE TO SUPPORT GENERAL PRACTICES

New guidance has been published on requirements for online appointment booking following changes to General Medical Services (GMS) in October 2022. The guidance explains to GP practices what kinds of appointments could be included for online appointment booking and what methods can be used to categorise them. For any questions, contact england.digitalfirstprimarycare@nhs.net.