GP Bulletin

For Action

  • ‘Save the Date!’

On Thursday 3rd December 2015 there will be a Primary Care event on the Minor Eye Conditions Service (MECS). This is an opportunity to present the successful evaluation of the MECS model and how it has improved services for your patients. The event will cover the scope of the service and its benefits and will also be an opportunity for Commissioners and Providers to comment and feedback on the MECS Service.

For more information contact Sylvia Curtis, Lambeth CCG ( )

*******************************

  • New E-mail for Interpreting Service - Urgent

Please note that the email address for booking an Interpreter has changed to with immediate effect. Please ensure that you use this email address from now on for all bookings or queries.

As from 30th November we will not be able to access the ‘’ email address so bookings will not be processed.

Could you please disseminate this information to any member of staff who may be required to book an interpreter for your practice and if you have any queries please contact Kim Frith on 0203 049 3913.

*******************************

  • CCG Cancer lead post (please see JD attached (1))

The CCG is currently recruiting to a Cancer lead. Please have a look at the attached JD if you wish to expand your knowledge of Cancer and working at a strategic level. Nurses are eligible to apply – willingness to become involved is the main thing. Closing date 30th September 2015

  • Cancer Decision Support tools in General Practice Study(Please see attachments (2a-b))

We are recruiting interested EMIS Web practices, across London, to build on the work already undertaken by GPs working with Macmillan Cancer Support and the Department of Health to develop the ‘RATs’ into an electronic version.
QCancer sits behind the GP computer system and uses structured data entered in the course of a normal consultation to identify those patients at risk of having an undiagnosed cancer and who may therefore benefit from further assessment or investigation.
This project is part of the national Cancer ACE Programme, (Accelerating Progress , Co-Ordinating learning and implementation across the country and Evaluating the effectiveness), supported by Cancer Research UK and Macmillan.
The Transforming Cancer Services Team- London is co-ordinating and leading this initiative.
Our aim is to recruit up to 125 GPs across London, by 2nd October, into the project which will fully support GPs in using electronic versions of QCancer, which is already available as a EMIS Template.
What will it involve?
Identify a lead GP within the Practice to coordinate use of the tool within the Practice (this may be a single GP or several GPs working together).
• Participation in training to use the tool
• Active use of the tool in practice and promotion with colleague
• Participation in the evaluation

We will provide

• £400 for each GP to sign up and participate
• Administrative support throughout the project
• Training and aftercare support in the use of these tools

We would be grateful if you would cascade the information attached to your clinicians who may be interested in supporting this project.

For further information about the project please contact the Transforming Cancer Services Team for London at

*******************************

  • New E-mail address for GSTT Maternity Services

The maternity services at Guy’s and St Thomas have now a direct email address for bookings:

GPs can make referrals by emailing r by using theNHS e-Referral Service

For full information on how to refer your patients please visit our website

For Information

  • Leg Ulcer Review Survey for Action

TheCCG has instigated a task and finish group with Lambeth CCG and Guy's and St Thomas' NHS Foundation Trust to review demand on wound management services working with our Federations. The first meeting took place in July and we agreed that we need to fully understand the demand of leg ulcers in primary care. Therefore we are undertaking an audit on non-complex leg ulcer demand with practices based on defined non-complex - in terms of healing and size, but also time to treat. We would ask all our practice based nursed to complete the following audit by Friday 2 October 2015. This can be found at

*******************************

  • E – Referral Service:

Following a period of instability, the National NHS e-Referral Service has now improved considerably. Due to the improvements seen and the assurance from HSCIC of ongoing system fixes and enhancements, we have now been reassured by GSTT that the e-referral Service can be your preferred method of referral once again.

All practices will have received a letter from GSTT requesting that referrers revert back to using the e-referral service where possible. This letter also informs you from Monday 28th September GSTT will no longer accept emailed referrals sent to the GSTT e-RS team generic email: . This mailbox will revert back to being used for e-RS queries and Appointment Slot Issues (deferred to provider) letter requests only.

Please do let us know if do not receive the letter or if you have any further queries.

If you continue to experience any problems please contact Sylvia Curtis at Lambeth CCG who will raise matters directly with the relevant local Trust. Service Redesign Manager

*******************************

  • Update from ViaPath (please see attached flyers (3a-d))

Malaria testing – when requesting a malaria test Viapth have requested that it would be of value to submit a travel history along with the samples.

Sample acceptable criteria for cytology requests - when requesting cytology requests there is now sample acceptable criteria that was released by NHS England. A high number of requests are not meeting this criteria and therefore are not able to be processed. In particular this relates to a minimum of three legible and correct patient identifiers to link a form and vial that arrive together:

  • Patient’s NHS number
  • Patient’s full name i.e. first name and surname
  • Patient’s date of birth
  • Acceptable third identifier: patient address; Hospital number, clinic number

For a full set of criteria please the attached cytology sample acceptable criteria.

Coagulation screening - - Viapath have received a number of incorrectly filled tubes for routine haemostasis. Samples that are not adequately filled will generate unreliable and inconsistent results. The laboratory will not be able to analyse these samples! Please find attached the link toSamples Requirement Poster for routine haemostasis testing.

TSH (thyroid stimulating hormone) there has been a change in the TSH receptor antibody testing. The aim of making this change is to prevent inappropriate requesting of this test, forexample in patients with hypothyroidism or thyroiditis. UK guidelines for the use ofthyroid function tests are available online through the British Thyroid Association( Section 7.9.3 (page 63)specifically relates to TSH Receptor Antibody (TSH-RAb) testing and states that this testis not an essential diagnostic investigation in most patients but may be useful in thefollowing scenarios:

  • The measurement of TSH-RAb is particularly useful in pregnancy
  • To investigate hyperthyroidism of uncertain aetiology.
  • To investigate patients with suspected ‘euthyroid Graves’ opthalmopathy.
  • For pregnant women with a past or present history of Graves Disease.
  • To identify neonates with transient hypothyroidism due to TSH blocking antibodies.

When ordering this test on t-Quest, a pop-up screen will appear prompting you to contact the Reference Chemistry Laboratory (0207 188 1264) to discuss the clinical indications. If none of the situations above apply to your patient, then the test is not indicated and should not be ordered. If the test is clearly appropriate, then select “Yes” to proceed with the order. If you are unsure, please contact the laboratory to discuss further before processing the order. Please see attached for screenshot for steps for booking TSH and request letter from Viapath.

*******************************

  • Rheumatology GP Survey

The Rheumatologists based at King’s College Hospital want to find out how they can help you to keep up to date with the rapidly advancing field of Rheumatology. We would be very grateful if you would take the time to complete this very short survey to help us understand how we can help each other

*******************************

  • Transforming Outcomes and Health Economics Through Imaging – TOHETI (please see attached newsletter (4))

The first year of Phase 2 of the TOHETI programme has flown by, and we will be pulling together a roundup of the year to share with you, as well as looking forwards to the programme’s next steps.

Ahead of that, we wanted to share with you some of the things that have been happening over the Summer.

In July, working together with Guy’s and St Thomas’, we hosted colleagues from the Virginia Mason Institute, Seattle, to share a different perspective on how to deliver healthcare in a continuously improving model. Many of you may have attended one or more of these sessions which included overview sessions as well as specialised sessions for Cancer Services, Primary Care, Evelina Children’s Hospital and Transformation services. The visit sparked many new conversations and ideas, and you can read more about the visit in our newsletter.

In this newsletter, we also feature progress around our research around clinical applications enabled by the new imaging technology of PET-MR, and report back on our work with Emergency Nurse Practitioners in preparation for the roll out of our pilot study on scaphoid (wrist) fractures.

As always please do get in touch with any thoughts or comments – we would love to hear from you.

*******************************

  • Love Vauxhall

Vauxhall is changing but what will it look and feel like? See the latest ideas about the future of Vauxhall brought to life and let us know what you think.

This Visioning Vauxhall event will include the latest images and plans based on feedback we’ve received so far. There will also be fun family activities and refreshments provided.

The exhibition dates are:

  • Friday 2 October, 12noon to 4pm
  • Saturday 3 October, 10.30am to 3pm

Come along to:Vauxhall Gardens Community Centre, 5 Glasshouse Walk, SE11 5ES

*******************************

  • Lambeth Carers Forum& Newsletter (please see attached flyer (5a-b))

The next Lambeth Carers Forum will be held on the 22nd October 2015, between 11.00am – 3.00pm at Hideaway in Streatham. Further details can be found on the attached flyer. Please advertise within your reception areas.

*******************************

  • Mums plus Mum

Mums plus Mum, is a charity that provide peer support and mentoring to pregnant and new mums where each mother is paired with an experienced volunteer mother. Mum plus Mum is particularly helpful for women who are depressed or suffer from mild mental ill health. Currently volunteer mums are available in Clapham and Streatham and parts of the SE Lambeth locality .The charity is recruiting volunteer mothers with a view to cover a wider area. The charity supports mothers and encourages them to link into community services that they may have not been aware of. There is no strict criterion for mothers to bereferred into this service. Referrals can be made directly online via the Mums plus Mums website at Clinicians are welcome to contact the charity at further information

*******************************

  • Quality Alerts

The way in which GPs are being asked to report Incidents that affect patient safety and clinical care has changed. For more information about these changes please follow the link below

The reporting of quality alerts remains the same, via the QUIC system.

For more information on what has been done following your recent Quality Alert reports please follow the link below

*******************************

  • CQC takes action to protect patients using PCP Clapham substance misuse service

The Care Quality Commission (CQC) has taken enforcement action to prevent a substance misuse service in south west London from offering treatment for detoxification to patients withdrawing from opiate drugs or alcohol until adequate arrangements are in place to provide safe care.
PCP Clapham Ltd provides a day therapy service for people with substance misuse problems, including rehabilitation and alcohol and opiate detoxification where needed.
CQC inspectors visited the service during May and July 2015, and identified serious concerns regarding the care and treatment of patients withdrawing from opiate drugs or from alcohol.
Inspectors found that management did not provide staff with the appropriate support, training or supervision to enable them to care for patients safely.
The majority of staff had not been trained in how to recognise or manage the potentially dangerous complications of withdrawal from alcohol and drugs, and only had superficial knowledge of the signs and symptoms they needed to look for. Between January 2014 and May 2015 there were three incidents of patients suffering seizures during withdrawal from alcohol.
Using its enforcement powers, CQC has restricted the provider from admitting patients who require assisted withdrawal from alcohol or opiate drugs until appropriate systems and procedures are established.
CQC has also told the provider that it must take action to ensure safe care and treatment is provided to patients, effective governance systems and staff procedures are implemented and fully embedded, and that the skills and experience of people offered employment is checked before they start work.
A full report of the inspection has been published on the CQC website:
Dr Paul Lelliott, Deputy Chief Inspector of Hospitals and CQC lead for mental health, said:
"Our inspection at PCP Clapham identified an unacceptable level of risk to patients. We have taken enforcement action to protect the welfare of patients and the public.
“We found that most staff, other than the recently-appointed nurse, had not been trained in the complications of withdrawal from alcohol or opiates and had only a superficial knowledge of the signs and symptoms they needed to look out for.
“It is clear that the service was not safe enough and did not ensure that its staff had the appropriate support, training, supervision or appraisal to enable them to carry out their duties safely and effectively.
“It is essential that PCP Clapham takes urgent and sustained action to ensure the safety of patients that come under its care.
“We will return to check that the necessary improvements have been made before we consider lifting this restriction and allowing PCP Clapham to once again offer treatment for detoxification.”

*******************************

  • Easy Read Guides to Health Conditions

These are a range of guides produced by the Foundation for People with Learning Disabilitieson key medical conditions in an Easy Read format for people with learning disabilities.

The Foundation for People with Learning Disabilities has worked with easyhealth.org.uk to produce a range of Easy Read guides on key medical conditions and concepts. We know that people with learning disabilities often experience worse health and worse health care than the rest of the population, and research shows that people with moderate or severe learning disabilities are three times more likely to die early.

Read Health Inequalities and People with Learning Disabilities in the UK: 2011(PDF) for more information.

Key factors influencing health inequalities (Emerson et al., 2011) include:

  1. Greater risk of poverty, poor housing, unemployment and social disconnectedness, which are known to be linked to poor health
  2. Increased risk of health problems associated with specific genetic and biological causes of learning disabilities
  3. Communication difficulties and low levels of knowledge about health and looking after your health
  4. Personal health risks and behaviours such as poor diet and lack of exercise
  5. Difficulties in access to health care

As part of one of our previous health projects, Better Health, Better Metrics we commissioned the Easyhealth team to translate some patient information leaflets into an Easy Read format. Topics include common conditions such as epilepsy, diabetes, obesity and tooth decay.

We hope that these materials will make it easier for doctors and nurses to help their patients with learning disabilities (or indeed anyone who struggles with written information) to understand some common health problems.

The leaflets were translated from the original clinical summaries on the PRODIGY website and were subjected to the same rigorous clinical quality checks as all the other information published by PRODIGY.

The booklets are all available to download for free below:

  • Acute Bronchitis Easy Read Guide (PDF)
  • Attention Deficit Hyperactivity Disorder (ADHD) Easy Read Guide (PDF)
  • Breast Screening Easy Read Guide (PDF)
  • Contraceptive Injection Easy Read Guide (PDF)
  • Dental Abscesses Easy Read Guide (PDF)
  • Diabetes Easy Read Guide (PDF)
  • Earwax Easy Read Guide (PDF)
  • Epilepsy Easy Read Guide (PDF)
  • Incontinence in Women Easy Read Guide (PDF)
  • Obesity Easy Read Guide (PDF)
  • Parkinson's Disease Easy Read Guide (PDF)
  • Pneumonia Easy Read Guide (PDF)
  • Tooth Decay Easy Read Guide (PDF)

*******************************