No.

314

December 2017
Cornwall & Isles of Scilly

As this will be the last LMC Newsletter of 2017

Dawn and Nicky at the office would like to wish all
our readers a very happy Christmas and a
prosperous ad healthy New Year.
LMC Newsletter

Inside this issue:

Your Chairman writes. 2

Vacancy Adverts in the LMC
Newsletter and Website
Anticoagulation 3
Extension of seasonal flu
programme
PHE Hep A & A/B PGDs 4
TPP Data Sharing

School Immunisations 5
Non-attendance at Courses
Events 6 Items for the Newsletter should be
sent to the Editor, Dawn Molenkamp
7-11 at Victoria Beacon Place, Room
Vacancies
B314, Station Approach, Victoria,
Roche, St Austell, PL26 8LG
Dr Basil Bile 12 Tel :01726 210141
e-mail dawn@kernowlmc.co.uk
Your Chairman writes ..

As if we werent busy enough, the government is keen on pressing ahead with its extended GP access
scheme. By now you should have heard from the CCG, your localities or Kernow Health CIC about the
sort of service that the CCG has to commission. It is important to remember that this is a CCG ask and not
an individual practice responsibility. However, we will impacted one way or another by whatever the final
scheme or schemes look like. Firstly our patients should have more access to routine General Practice
and secondly this will be delivered by GPs and other Primary Care professionals. This is going to be a
challenge but we believe also an opportunity. Cornish Healthcare is on the national radar for all of the
wrong reasons (overspent, overdrawn, poor A/E 4 hour waits) - this is our chance to redress the balance
of negative press. The good news is that we have an organisation, owned by practices that is in the ideal
position to provide this service - Kernow Health CIC. If the CCG decides to commission this service from
our CIC, we believe that this would be the best result for practices whilst at the same time signaling to
government that Cornwall can provide Cornish solutions to its own problems at a scale and pace that
could be ahead of other CCG areas. This would give our nascent Accountable Care System (ACS) some
headspace to create solutions to its current system difficulties.

What about the ACS ? Much of what we wrote in our myth buster earlier in the year still holds true - the
system is evolving and Primary Care is crucial to its success. Whilst the system cannot make us do any-
thing we have a responsibility to ensure it is successful or we will earn the wrath of the Department of
Health (this is not an empty threat, as mentioned above we are well and truly on their radar as a system
and that includes us in Primary Care). To this end we are developing a joint committee structure with the
CIC and also with the CCG and localities (a primary care compact). These committees will enable the
LMC to interface better with the ACS whilst at the same time maintaining the LMCs independence in its
statutory role of representing practices and ALL GPs whatever their employment status. Despite GP diffi-
culties both locally and nationally, Primary Care and General Practice is assuming a pre-eminent role in
shaping the future of our services. We believe this is good news and hope you will continue to support us
in our efforts on your behalf.

Merry Christmas !

Vacancy Adverts on the LMC Website and Newsletter

As we are now receiving a large number of vacancies from January 2018 we will no longer be publishing the whole
advert in the LMC Newsletter, just basic details. The full adverts will be on the website and on Twitter.

It will be our policy to remove adverts once the closing date has been reached and if there is no closing date then it
will be removed from the website 6 weeks after the date it was entered on the website.

If you wish an advert to continue after the closing date or the 6-week period, you will need to resend the advert to us.

Apologies for any inconvenience caused over this but we are becoming a bit overwhelmed by the amount of vacancy
adverts on the website and in the newsletter.

NO . 3 1 4 Page 2
 Identifying Current Anticoagulation
My name is Tamsyn and I am one of the anticoagulation specialist nurses based at Treliske hospital. As a
service we instigate a significant proportion of anticoagulation for DVT/P.E and the patients are then dis-
charged back into primary care. The Haematology clinic is currently only able to offer very limited follow
up for this patient group which means long term management is currently in the hands of primary care.

With this in mind I have written a survey to try and establish current GP's practice around reviewing this
patient group and how they make decisions about duration of treatment. The aim of this is to identify
whether GP's require further information to assist with this but also to identify whether creating more ca-
pacity to follow up some of the less straightforward patients within the hospital is needed/ would be appre-
ciated.
Link to survey: http://www.surveymonkey.co.uk/r/QPLLWM8.

Your assistance would be greatly appreciated.

Tamsyn Keeves
Anticoagulation Nurse
DVT Clinic
01872 253597
Please note our team bleep is 3219.

Extension of the seasonal flu programme to

include social care workers
NHS England has announced that for the 2017/18 flu season, the delivery of flu immunisation will be extended
to include social care workers that offer direct patient care.

The influenza vaccine PGD template has been amended to include the vaccination of health and social care
staff, employed by a registered residential care/nursing home or registered domiciliary care provider, who are
directly involved in the care of vulnerable patients/clients who are at increased risk from exposure to influenza,
meaning those patients/clients in a clinical risk group (see Appendix A) or aged 65 years and over.

Note that the previous version (v04.00) is not being formally withdrawn in order to ensure continuity of service
and may still be used this season (until 31 March 2018). However, this new version of the PGD will be needed
to vaccinate health and social care staff in line with the NHS commissioned service when it is commenced.

A GP enhanced service specification will be published shortly on the NHS England website, and we will notify
LMCs as soon as it has been published.

Care workers can also access the flu vaccine via their community pharmacy, further information is available on
the NHS England website.

The GPCs vaccinations and immunisations page has been updated with links to the PGD and enhanced
service.

NO . 3 1 4 Page 3
 PHE Hepatitis A and Hepatitis A/B vaccine PGDs

Public Health England has published the following PGD templates on their website:

Hep A, which supports the provision of hepatitis A vaccine to individuals considered at high risk
of exposure to hepatitis A or post exposure to hepatitis A virus.
Hep A/B vaccine, which supports the provision of Hep A/B vaccine to individuals over one year of
age requiring pre-exposure immunisation against hepatitis A and B virus.
Hep A/B vaccine (Temp) PGD, which has been issued for use during the global shortage of hep-
atitis vaccine affecting UK supply. It supports the administration of Hep A/B vaccine to individuals requir-
ing pre-exposure or post-exposure immunisation against hepatitis A or B virus in accordance with PHE
temporary dose sparing advice, to preserve and prioritise monovalent hepatitis vaccine stock for those
with the greatest ability to benefit and highest immediate need.

These PGD templates require organisational authorisation in line with HMR2012 before they are legally
valid PGDs. It is advised that PHE PGD templates are organisationally authorised in accordance with local
procedures before sharing with providers.

These, along with all the other immunisation PGD templates, are available on the PHE website, and a link
has also been added to the GPCs PGD guidance page.

Clinicians Statement - TPP Data Sharing

This statement is an update for GPs on the issue of TPPs SystmOne and the DPA. As Representatives
of the British Medical Association and the Royal College of GPs we have been working closely with NHS
England, NHS Digital, TPP and their user group to address our concerns regarding the ability of GP data
controllers using SystmOne to comply with the DPA.

We are now at a point where the BMA and RCGP believe that new functionality developed by TPP, when
finalised and fully implemented, will allow GP Data Controllers to meet their obligations under the DPA.
We expect these tools to be available to all GPs using SystmOne by the end of February 2018.

This new functionality is currently being piloted and we are continuing to monitor progress.

We continue to keep the ICO informed and involved as necessary and they remain supportive of the ac-
tions and plans to date.

Signed:

Dr Paul Cundy Dr Manpreet Pujara

GPC Co-Chair of the Joint GP IT Committee RCGP Co-Chair of the Joint GP IT Committee

NO . 3 1 4 Page 4
School Immunisations Notification of Vaccines Administered

Kernow Health is now coming to the end of year 2 of the nasal flu vaccinations for Reception to year 4 pri-
mary school children. Last year Cornwall CHIS notified practices with the information regarding which
children had received Fluenz Tetra. To bring Cornwall in line with other areas NHS England has now stip-
ulated that this data must come from Kernow Health as the provider of the School Immunisations service.
We will start this process from the week beginning Monday 4th December.

The nasal flu programme within primary schools will end on 8th December but from 11th December
we will be running catch-up clinics in the community. You will find all the venues and dates on our
website http://www.kernowhealthcic.org.uk/service-delivery/school-immunisation/schools

Practices will receive the information in an excel spreadsheet format which will contain the following infor-
mation:

Name
Date of birth
Address
GP surgery
Date of vaccine given
Refusals (only where consent had been given)

We are reliant on parents completing the consent forms with all information requested. Some parents
have not given the name of the practice their child is registered with therefore we will contact you sepa-
rately with details of children we believe could be registered at a practice in your area.

If you have any questions, please do not hesitate to contact us at Ker-

nowhealth.schoolimmunisation@nhs.net or telephone us on 01872 221105/ 221106/ 221107. We are al-
ways happy to help.

Non-Attendance at Staff Courses

Please can I ask if you have any staff booked on our courses that are unable to attend at the last minute
that you let us know as most of the courses now have waiting lists and we can then offer a place to some-
body else.

If you just email admin@kernowkmc.co.uk that will be fine.

Many Thanks

Page 5 C O R NW A LL & I S LE S O F S C I LL Y LM C NE W S LE T TE R
 Events
GPC Roadshowsave the date
The GPC will hold a local roadshow about the 2018/19 contract changes and provide an update about national de-
velopments in general practice early next year and local GPs are encouraged to save the date.
Dr Mark Sanford-Wood, Deputy Chair at the GPC, will be presenting and there will be plenty of opportunities for local
GPs to ask him questions.
The event will take place at Plymouth Science Park on Wednesday, 21 February. Doors open at 6:30pm for a light
buffet and networking, with the main event taking place from 7-9:30pm. A final agenda and further details will be
communicated in due course.
Please confirm your attendance via email to admin@devonlmc.org by noon on Friday, 19 January. Places are availa-
ble on a first come first serve basis, as we will be joined by GP colleagues from Cornwall on the night, hence why the
event is being held on the Devon-Cornwall border.

Spring Update Meeting of the Devon & Cornwall Branch

of the Faculty of Sexual & Reproductive Health

Plymouth Medical Centre Derriford Hospital Plymouth

Saturday 3rd March 2018
Sexual Health from Menarche to Menopause
Course Organisers: Dr Katie Conway & Dr Dianna Sells

Please see details attached to this newsletter

Page 6 C O R NW A LL & I S LE S O F S C I LL Y LM C NE W S LE T TE R
 GP (partner or salaried considered)
Old Bridge Surgery, Looe
Situated in the beautiful Cornish seaside town of Looe, we are a friendly and supportive semi-rural 4 WTE
partner practice serving circa 9,500 patients. With a partner owned harbourside surgery overlooking the
beautiful Looe River estuary, plus two smaller surgeries nearby (one dispensing), we are looking for a
partner or salaried GP to join our team.

What we offer
4-6 sessions a week with generous holiday
A high achieving environment 100% QOF and CQC Good
Encouragement in developing your medical interests
Established training practice at all grades
Average partner age of 43 years
GMS partnership actively engaged with shaping the future of general practice in Cornwall

What we need
Commitment, enthusiasm and a team orientated approach
A flexible and positive approach to forthcoming changes in General Practice

Contact our Practice Manager, Mark Allen, for more information: markallen3@nhs.net or 01503 266960 or
send your CV and covering letter to Old Bridge Surgery, Station Road, Looe, Cornwall PL13 1HA.
Closing date: Thursday, December 21, 2017

Salaried GP Vacancy St. Agnes surgery

Having just recruited three new GP partners due to retirement we are now in a position to recruit a sala-
ried GP for 2 sessions to our friendly, evolving practice. Our ideal candidate would be an enthusiastic, in-
novative and committed team player. The position is on a short-term rolling contract to cover CCG com-
mitments by one of the partners.
St. Agnes surgery is a supportive partnership of five WTE GPs, all passionate about providing high quality
local care to its 8000 patients. It is a semi-rural, dispensing practice in a beautiful part of the county with a
branch surgery at Mount Hawke.
As well as offering the usual GMS services we also run contraception clinics, minor ops and offer aural
micro-suction.

The surgery is actively involved in GP training, research, and the CCG.

Dynamic working relationship with all the community teams and neighbouring practices.

Good CQC rating and excellent patient feedback.

Microtest Evolution computer system with electronic prescribing.

Flexible approach to session timings if required (for example due to child care responsibilities).

Start date mid-January 2018 but would be willing to wait for the right candidate.

NO . 3 1 4 Page 7
 Salaried GP with Potential view to Partnership
Cape Cornwall Surgery, St Just, Penzance, Cornwall.
Situated at St Just in West Cornwall we are a small rural practice in close proximity to Lands End, surrounded by
spectacular beaches and stunning coastal scenery.

You would join a very friendly and supportive 3 Partner rural GMS Dispensing Practice which will provide the life/work bal-
ance sought after by many GPs. Our GPs are supported by an excellent administration and nursing team working in mod-
ernised well equipped premises.
Practice summary:
4850 patients and growing.
On-site Dispensary.
Nurse Led Chronic Disease Management Clinics.
Enhanced serves including minor surgery, minor injuries service & extended hours.
Substance misuse clinics.
100% QOF record.
GP Training Practice.
Clinical Research Practice.

The job:
4 to 8 clinical sessions, job share or flexible working considered.
Competitive Salary.
6 weeks annual leave
One week study leave.
Weekly clinical meetings, regular governance/MDT meetings.
Partnership interest welcomed.

Please apply with a CV and covering letter to: ian.cary@nhs.net or by post to:

Ian Cary FCCA.

Practice Manager
Cape Cornwall Surgery
St Just,
Penzance,
Cornwall.
TR19 7HX.

Informal contact/visits welcome - telephone Ian Cary (Practice Manager 01736 786924).

Phoenix SurgeryGP Vacancy

Phoenix Surgery are looking for an enthusiastic and motivated GP to join our committed and friendly team at Phoe-
nix Surgery in Camborne, Cornwall. We are especially looking for a GP who shares our aims of delivering personal-
ized, patient-centered care, whilst providing a happy and healthy working atmosphere for our team.

Initially this will be a salaried post for four to six clinical sessions a week. There are no building buy-in costs as the
surgery in located rented premises.

Practice Summary:-
List size of 5856 patients
Team consisting of 5 GP partners (4 WTE), 3 GP Registrars, 2 practice nurses, 1 AP, 1 HCA, 1 phlebotomist and
associated administration and reception staff
Clinical system used EmisWeb
High QOF achieving and recent CQC overall rating of good
Medical student teaching and VTS Training Practice, with three approved trainers including one of the local Training
Programme Directors
Very well supported by skilled on-site district nursing team, community matron, palliative care nurse and health visi-
tors

Prospective candidates are very welcome to visit the practice on an informal basis, and/or to speak to a member of
the medical team. Please call 01209 714876 to arrange.

NO . 3 1 4 Page 8
Are you a General Practitioner who is keen to develop a special
interest in Oncology?
If so, we are looking for you to join our team at the Sunrise Centre, Royal Cornwall NHS Trust. We are aiming to find
more GPs to complement our multidisciplinary team, with a number of flexible sessions from one up to full-time for
the right candidates.

The successful appointees will be offered a period of training in all aspects of the oncology pathway including man-
agement of active chemotherapy and radiotherapy patients, as well as dealing with side-effects of treatment. This
will incorporate initial shadowing of established clinicians and gradual clinical exposure leading to independent, but
supervised practice. You will be working alongside consultants and junior doctors in a multidisciplinary setting with
our team of radiotherapists, and supported by our site specific Clinical Nurse Specialists.

Our new patient clinics see over 2,000 patients a year with a range of cancers requiring personalised treatment
plans. In addition to radiotherapy and chemotherapy treatments, the team is very active in research. Working close-
ly with the Research Department the team are constantly reviewing the most appropriate and cutting edge develop-
ments for cancer patients including immunotherapy and treatment based on genetic markers.

You would be joining a department supported by a first class radiotherapy service, providing new patients with im-
mediate access to two TrueBeam linear accelerators for treatment such as image guided radiotherapy (IGRT) and
intensity modulated radiotherapy (IMRT). We offer chemotherapy via a dedicated daycase unit (Headland) as well
as through our charitably funded mobile chemotherapy unit. Next to the Sunrise is The Cove, a purpose built cancer
support centre which opened in Autumn 2016.

The successful candidates will be offered one or more sessions a week, either in the morning or the afternoon, with
their exact schedules being negotiable and mutually agreed. Use of GPwSI within the Trust including the Mermaid
Breast Unit has been a very successful new initiative with the GPs who have joined enhancing teams enormously. In
developing this collaborative and progressive approach to joint working and training in the management of cancer as
well as living with and beyond initial treatment, we hope to further promote ever closer working relations and
strengthened links between specialty services and primary care.

To apply for this role and to view further information please visit www.jobs.NHS.uk job ref: 156-MS-983.

Interviews are likely to be in December 2017.

If you require further information please contact Louise Hunt on 01872 256346 or email l.hunt@nhs.net

The Royal Cornwall Hospital is an equal opportunities employer

Petroc Group Practice Cornwall

GP Salaried Vacancy

We are a large friendly training practice located in Mid Cornwall delivering services through two purpose built medi-
cal centres in Padstow and St. Columb Major. We have a vacancy for a part time, three days a week, salaried doc-
tor. We have a list size of over 16,000, have consistently high QOF achievement an excellent nursing team and de-
liver an extensive range of enhanced services.

For informal enquiries contact Ian Gibson, Practice Manager/Managing Partner on 01637 880262

Application is by CV to ian.gibson5@nhs.net

NO . 3 1 4 Page 9
 Manor Surgery, Redruth
Advanced Nurse Practitioner or Urgent Care Practitioner

We are seeking to employ a second Practitioner, either from a nursing or paramedic background to work alongside
the GPs in our friendly team. Long-established and well organised GMS training practice achieving consistent high
QOF levels and CQC Good.

We require:

Sound clinical knowledge and clinical skills.

Ability to work independently in an organised fashion.

Caring, empathetic attitude.

Independent prescriber.

In return we offer a supportive environment and encourage ongoing personal development.

Hours to suit (will consider a job share) between 20 34/week. Pay according to experience and qualifications.

12,000 patient list, based in purpose-built premises.

For application form, job description and person specification please contact:

Alison Gain on 01209 313313 or e-mail: alison.gain@nhs.net

Manor Surgery, Forth Noweth, Redruth, TR15 1AU

Closing date: 31 December 2017

Practice Nurse Required at Marazion Surgery

Twelve Months to cover Maternity Leave

Full time or job share

Applicant must have suitable qualifications and experience to manage Chronic Disease, and to provide Childhood
Immunisations and Travel Vaccinations.

To start February 2018, exact date to be confirmed

Please contact Mrs J Brown, Practice Manager

Marazion Surgery, Gwallon Lane, Marazion, Cornwall, TR17 0HW
Jackie.brown23@nhs.net

NO . 3 1 4 Page 10
 Practice Nurse Saltash

Port View Surgery is looking for an experienced Practice Nurse to become part of our existing team of 2
practice nurses and 3 HCAs. Ideally you will be able to provide the full range of general practice nursing
care, Chronic Disease Management skills would be an additional bonus.

We are a small friendly team and we pride ourselves in the continuity of personal care we are able to pro-
vide for our 6500 patients.

The post is initially for 16 hours per week, to be worked on Wednesdays and Fridays; however there will
be a requirement to cover the absence of your nursing colleagues so flexibility is a key requirement.

Rate of pay will depend upon experience.

Expected Start date: Feb 2018
tina.seedhouse2@nhs.net Tel: 01752 840115

Nurse PractitionerLooe
6 to 8 Session Nurse Practitioner Vacancy, Looe, Cornwall

The vacancy we seek an enthusiastic Nurse Practitioner or Advanced Nurse Practitioner to join our
team for six to eight sessions per week. The role will comprise a mixture of minor illness and chronic dis-
ease consulting and home visits, depending on the experience of the candidate appointed.

The practice based in Looe, South East Cornwall, Old Bridge Surgery is semi-rural with approx. 9,500
patients. We have a team of 7 GPs in a busy but friendly teaching practice. Our nurse team comprises
three nurses, four HCAs and an Advanced Nurse Practitioner as well as the vacant post.
In addition to the main, harbourside, practice, in the charming seaside town of Looe, we have two branch-
es and dispense from one of these. We use Microtest Evolution.

Flexibility and Support we are willing to consider suitable proposals for working patterns to suit the right
candidate and have a culture of education and support for those developing their careers.

Contact the Practice Manager, Mark Allen, for more information: markallen3@nhs.net or 01503 266960
or send your CV and covering letter if interested in the position.

NO . 3 1 4 Page 11
Dr Basil Bile
This Practice has gone to the dogs, Basil, Dr Hilda Bunnytunnel informed me, fixing me with her
steely eyes.
I thought things were going rather well, I protested. Its at least three weeks since we had a re-
ceptionist resign, and more than six months since any of the Partners were referred to the GMC.
Five months, she corrected me.
Well, if youre going to split hairs
Practice meetings are an utter shambles. And you keep nodding off in them. Just like President
Mugabe.
For a start, President Mugabe has never been to one of our Practice Meetings. And anyway, sure-
ly youre not comparing me to that out of touch old despot? I protested.
If the cap fits
I was hurt to the quick. Nonetheless, I snatched a quick peek out of the staff room window to en-
sure that the Surgery wasnt surrounded by Army tanks.
You keep blocking exciting innovative ideas, she accused.
Such as?
Video consultations. Patients could be put in front of their GP on their smartphone within minutes.
Its been set up in a practice in West London after a pilot scheme involving three thousand patients. It us-
es a symptom-checking smartphone App, or Chatbot, which can prioritise calls according to urgency.
A Chatbot?! What a perfectly ghastly idea. Most of the blighters get better while theyre waiting a
couple of weeks for an appointment, which saves a lot of unnecessary hassle. On top of which I can see a
very definite problem. Fred Pascoe.
Fred Pascoe?
Our resident hypochondriac. Hed lie by telling the Chatbot he had severe chest pains, and then
once he got on screen would really want to talk endlessly, yet again, about the growths over his eyes. I
keep telling him theyre his eyebrows.
Darling Clint and I were having a little chat yesterday.
How cosy, I observed, immediately sensing danger.
Ye Gods, shes referring to our Junior Partner Dr Clint Thrust as Darling Clint. A shiver ran down
my spine. Our female patients and staff are all madly in love with him. On Valentines Day he got twenty-
seven cards. I got one, offering me a cut-price funeral. And that was almost certainly from my wife.
We think there arent enough female partners in the practice.
Have you taken leave of your senses, Hilda? We only have two male partners as it is, myself and
young Clint. Were already sitting on an oestrogen time bomb.
I am the only female partner, Basil.
Precisely.
Have you considered retiring, Basil? After all, you are getting on a bit. You could spend more pre-
cious time with Belinda. And on pastimes. What is your favourite hobby by the way? I dont think youve
ever told me.
Picking fluff out of my belly button

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