Acute Kidney Injury (AKI)
OCCG Weekly Bulletin
Wednesday 19 October 2016
Included in this bulletin:
- Acute Kidney Injury (AKI)
- Opthalmology: MECs and GOS18
- New Clinical Commissioning Policies – Lavender Statements
- Retained Doctor Scheme – New Guidance
- OCCG AreaPrescribing Committee (APC) – Meeting 13 September 2016
- Dementia Training
- Free Online Course - Talking about Cancer
- Oxfordshire Healthcare Transformation Consultation Update
Information for Practices
Acute Kidney Injury (AKI)
It is estimated that 1 in 5 emergency admissions to hospital are associated with AKI and up to 25% to 33% have the potential to be avoided.” Think kidneys” is the NHS national campaign programme to improve the care of people at risk of, or with acute kidney injury. There has also been a national patient safety alert to NHS organisations to prevent, identify and manage AKI.
The Oxford University Hospital NHS Foundation Trust biochemistry laboratory will be reporting AKI alerts with patient’s creatinine results from 7th November. Clinical management pathways (AKI bundles) have been developed in conjunction with the OUH renal physicians, primary care, out of hours and the Oxford academichealth and science network.
The AKI bundles for AKI stages 1, 2, 3 and no previous results are attached here.
PLEASE NOTE AKI STAGES 3 HAS NOW BEEN ADDED.
Templates for EMIS and Vision will be released in the next few months for GPs to code their management. The renal physicians Dr David Lewis and Dr Ed Sharples are speaking at AKI training events across the localities in October and November
To note the GP training is:
- North: 19th October 1330-1600 (light buffet at 1300. Dr David Lewis will be speaking 1515-1600), Horton Post Graduate Centre, Contact to reserve a place
- South : 1st November (evening – venue tbc)
- OOHs/City: 10th November 1900-2100 (light buffet at 1830), Unipart Conference Centre, Oxford – contact reserve a place (all GPs welcome from all areas)
- West –Date tbc
Dr Meenu
Or Katie
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Opthalmology: MECs and GOS18:
The new Minor Eye Conditions Serviceis designed to relieve the pressure on GPs for conditions that can be seen and treated by specialised optometrists in their practices.
OCCG has also requested that GOS18 requests for onward referral are supervised by these specialised optometrists. So, if a GP receives a GOS18 from a participating optometrist, it should now have been reviewed by the specialised optometrist to confirm that it requires onward referral; it can then be sent straight through to the secondary care provider in lieu of a referral.
When it is possible to establish a direct line to secondary care, from the MECS optometrists, this step will be removed altogether and the GP will simply be copied into the referral.
The current system will remain the same for non-participating optometrists so GPs may wish to query those referrals.
However until secondary care accepts the electronic referral forms directly, this step will remain with the GP to forward on.
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New Clinical Commissioning Policies Lavender Statements:
New and updated Clinical Commissioning Policies (Lavender Statements) have been added to OCCGs website here
Particular interest to General Practice are:
- 205a Surgery for painful big toes (bunion) - It lists the conservative measures which should have been tried for 3 months before referral. Please click here to view this lavender statement.
- 188a Total knee replacement surgery – It brings OCCG into line with other Thames Valley CCGs. The requirement for an Oxford Knee Score before referral has been removed and the statement has been simplified. Two further statements with similar wording (264 and 265) clarify that the new criteria cover partial knee replacements and patellofemoral joint replacements. Please click here to view this lavender statement.
If you have any queries, please contact Linda Collins OCCGs NICE Lead –
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Retained Doctor Scheme – New Guidance:
TheRetained Doctor Schemeis a package of support which includes financial incentives and development support to help GPs who might otherwise leave the profession to remain in clinical general practice. NHS England has announced improvements to the scheme as part of the General Practice Forward View. Please clickhere to view the guidance.
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OCCG Area Prescribing Committee (APCO) – Meeting 13 September 2016:
A summary of the minutes from the September APCO meeting can be found here. Highlights from the APCO meeting can be seen in the October edition of the Prescribing Points newsletter here
Melatonin - Shared Care Protocol (SCP):
A new shared care protocol for melatonin was approved at the September APCO meeting. The protocol covers sleep disorders in children and young people with complex neurological / neurodevelopmental disorders (age 1-18 years) and is for use alongside the community paediatrics and paediatric neurology teams only. The consultant will initiate melatonin in appropriate patients and the GP will be asked to take over prescribing once it has been confirmed that the melatonin is effective and the dose has been stabilised. This is the only approved sharedcare protocol in Oxfordshire, no other requests from secondary care for GPs to prescribe should be accepted. Patients under the care of Oxford Health will continue to receive their prescription and supply of melatonin from Oxford Health.
It may be appropriate to review the formulation of melatonin given to current patients, as the majority of patients can use the most cost effective formulation, Circadin® 2mg MR Tabs (30 tabs for £15.39) (unlicensed use). If the patient is unable to swallow tablets, Circadin® tablets can be halved (using a tablet cutter) or crushed if necessary. If melatonin is to be given via an enteral feeding tube Circadin® can be crushed to a fine powder and added to 5 - 10ml of water. For patients with fine-bore enteral feeding tubes (gauge < 9), where there is risk of tube occlusion, melatonin oral solution 5mg/5ml in 200ml can be prescribed.
For further information please click here to view the SCP available on OCCGs intranet.
If you have any comments please contact Jane Bennett or Odelia Eke, Medicines Optimisation Pharmacists, Medicines Optimisation Team:
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Dementia Training:
Please click here to view details of dementia training opportunities for practice staff.
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Free Online Course – Talking About Cancer:
Cancer Research UK’s Talking about Cancer online course, taken by more than 2,000 people, has proven a huge success in building confidence to discuss cancer facts and prevention.
To access the course please click here . The course starts on 10 October and is open for three weeks and takes three hours to complete at your own pace.
Talking About Cancer is led by CRUK’s cancer awareness trainers, and features videos, quizzes and actors demonstrating effective conversations. The course has been praised by health workers, nurses, doctors, volunteers and the public. It is a quick and engaging way to review cancer facts and increase comfort in encouraging prevention and early diagnosis.
Please invite friends, colleagues and contacts to take the Talking about Cancer course.
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Oxfordshire Healthcare Transformation Consultation Update:
The Oxfordshire Healthcare Transformation Programme has issued a briefing about public consultation on the future of the county's health services.
The Transformation Board has announced that the three month consultation on changes to the ways health services are delivered will begin in January 2017.The full briefing can be found here
Oxfordshire’s Transformation Board wants to ensure proposals for change are rigorously tested before options are finalised for patients and the public to have their say.
Public engagement, in the form of the ongoing Big Health and Care Conversation,will continue until the end of December to help inform and shape the final proposals
The Transformation Programme Board has stressed that no decisions will be made until the full consultation is completed.
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