OCCG Weekly Bulletin
Wednesday 13 December 2017
Included in this bulletin:
- SCAS – Consider Your Referral Route During Adverse Weather
- FOR ACTION: MHRA drug alert for Buccolam® (midazolam)
- Update and Reminder on the Use of Direction to Administer Forms for District Nurses
- Duplicate Hospital Letters – Action to Address
- MSK Laminate Cards for GPs
- Warfarin TTR Results – Change in Format
- Safeguarding Information: FGM Resource for GPs
- Registration Available for GP Update and Working at Scale Courses
Information for Practices
SCAS – Consider Your Referral Route During Adverse Weather:
Over the last couple of days service levels from SCAS have been under considerable pressure due to the adverse weather. Whilst we are pleased to see that, in the main, members of the public are using our services wisely, we are finding the process of just reaching people challenging, especially in the most rural and hilly areas. On some occasions crews have had to leave their ambulance and continue the journey on foot. This of course means that our journeys are slow and lengthy.
Could we please therefore encourage you to consider your route of referral before calling SCAS to organise transport to hospital.
Our Emergency Operations Centres and our frontline staff are trying to take and respond to emergency calls as quickly and as safely as they can. Please consider alternatives to admission, and also the response timeframes. Should you require our services please advise your patients our response is likely to be longer than usual.
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FOR ACTION: MHRA drug alert for Buccolam® (midazolam):
Please see the attached letter for important actions to take for patient safety.
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Update and Reminder on the Use of Direction to Administer Forms for District Nurses:
Electronic Direction to Administer (DTA) forms permit GPs to give instructions to District Nurses (DNs) to administer drugs. This is the only way which DNs now accept these instructions. To reduce errors it is important that you use the most up to date version and include only those drugs which you want the DN to administer (uncheck all the others). The form has been part of the OCCG library for several years, and is available at
Not all drugs require DTA forms and the diagram at the end of the Standard Operating Procedure gives you information as to what does/does not need including. Full details of the standard operating procedures are available at (only accessible via NHS networks).
Enquiries about where to get a form, how to install it / troubleshooting (if necessary) should come to
Queries about the clinical procedure should go to
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Duplicate Hospital Letters – Action to Address:
The OUH Trust have successfully completed testing the duplicate checker algorithm changes to ensure that only true updates to outbound documents get messaged out of the Trust’s electronic patient record.
In analysing the cause of the problem they found that the vast majority of duplicates getting out were A&E summaries due to post discharge activity re-triggering identical summaries save for the time of day embedded into the summary. As a result the duplicate checking algorithms were seeing these as real updates and letting the documents out. The change we have made essentially works out whether the only difference in the document is the date/time, and if all else is identical now blocks the outbound message.
The solution is now live and appears to be working. More than 20 erstwhile duplicates were blocked in the first 2-3 hours of operation.
It would be really useful if practices report any documents thought to be duplicate:through the usual Datix route, but also direct to Dr Paul Altman (). Please e-mail him scanned copies of the actual documents in question detailing the route via which they were received within 9 days of the message being received. The reason they need this information within 9 days of the duplicate message being generated is that they keep a video log of everything that any of our 10,500 EPR users do in the system, but only for 9 days. Whilst a complete audit trail remains embedded within the Millennium EPR, the video-log is really helpful when carrying database forensics, as they can “dial-up” the user in question and watch exactly what they were doing at a particular date and time within the system.
Dr Merlin Dunlop (OCCG Deputy Clinical Lead)
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MSK Laminate Cards for GPs:
A reminder that when booking an MSK appointment on eRS, the appointment shown is an internal process and NOT a real appointment. Please see attached card here.
Please do not take any note of the date or time of this, and please DO NOT give this information to the patient. Healthshare will contact the patient to arrange an appointment.
The e-Referral Service has a very detailed Help section, or alternatively you can contact the Healthshare Administration team on 01865 238108 for assistance. All referrals must be on the new pro-forma which can be downloaded via this link
Full guidance and FAQs below:
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Warfarin TTR Results – Change in Format:
Please find attached a letter about a change in the format by which INR Time In Therapeutic Range (TTR) information will be published to practices.
The teams involved in the preparation of these comms and who have approved the content are:
The OUH lab IT support service
The OUH labs clinical lea
The Prescribing Advisers at the OCCG
The OUH anticoagulation service
The CSU data analytics team
The OCCG datasets service (my team
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Safeguarding Information: FGM Resource for GPs:
This very helpful website has been designed for Oxford Health to support conversations about FGM with patients. It is also available as an iPad app, (though not available on Android).
Please put it on your safeguarding intranet if appropriate.
Meriel Raine, named GP for safeguarding.
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Registration Available for GP Update and Working at Scale Courses:
As in last week’s email to Practice Managers, we have confirmed the dates for the GP Update training Courses for 2018, funded by Oxfordshire GPs.
To register please click here:
All training events take place in the Kings Centre, Oxford.
GP Update Course
- Wednesday 24th January 10am-4pm
- Tuesday 20th February 1-7pm
- Thursday 8th March 10am-4pm
Saturday 17th March 10am-4pm
Are you worried about the sustainability of your practice?
Are you being encouraged to think about working at a larger scale but don’t know which option to choose? Are you concerned it might make things worse rather than better?
Through interactive presentations using case studies to aid discussion, this one day course gives you a broad overview of the working at scale options whilst going into more depth about specific important issues. This course is aimed at all GPs, Practice Managers and other primary care practitioners who are facing these choices and would like to have a better understanding of the options and what to do.
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To give us your feedback please email: