Cornwall & Isles of Scilly LMC Newsletter

August/September 2018
Report from Emma:
If I did not know it already, I am sure of it now: the more time passes, the faster it flies.

It has been a month since I arrived at the LMC office and August has been overflowing with variety: I
have had the great pleasure of meeting many of you, discovering more about your roles, learning
more about your hopes, your ideas and your issues and answering as many of your questions as I
can.

Judging by September’s calendar, there will be many more opportunities for me to engage with the
immense variety of work that is going on across Kernow and to help your LMC to shape and develop
its support for you all. I am really looking forward to working together with our new Executive Team
and our Committee to achieve that on your behalf.

Just a couple of updates from me:

Cervical Screening Sample Takers - a new register

All current sample-takers and Practice Managers should receive a letter from Public Health England
(SW Team) this week, letting you know about a change to the current register arrangements. At
present there are disparate registers held across several south west CCG areas: these will be unified
into one web-based register with effect from 10th September 2018 and aims to improve and
simplify processes for sample takers and for their employing Practices.

Some practical points of interest:

· On receipt of PHE’s letter, Practice Managers will be asked to check their register of sample takers
for their Practice, to ensure accuracy. This is a one-off sense check to ensure the system is working
correctly at the point of its introduction.

· Sample takers will only be able to review their own records online; the primary contact for your
Practice (usually your Practice Manager) will be able to view all staff
· In future, when new sample-takers start employment with your Practice then their details will need
to be added to the web register/transferred across from their previous Practice: I am assured this is
a quick and simple exercise and should improve the current process.

· At the point where a sample-taker’s training needs to be updated, the following process will occur:

a. An automated letter reminding them that their training is due will be sent at the ‘six months to
go’ mark

b. A second letter will be sent to the sample taker at the ‘one month to go’ mark, if they have not
completed their update training by that point

c. Thereafter, a third letter will be sent to the sample taker and to the Practice Manager/Primary
contact, notifying temporary suspension, as necessary. Reinstatement will take place once training
has been completed – it may be subject to further Ts&Cs if the gap between suspension and
completed training is significant (eg perhaps the result of maternity leave)

Kernow LMC has asked that all three letters (not just the suspension letter!) should be sent to your
Practice Manager as well as to the sample taker and PHE has assured us that that this will be
implemented.

· There is no change made to the current training regime, only to the way the register itself is
managed. If you have any questions, then please do get in touch.
Report from the Chair
I have officially taken over from Pete Merrin as Chair this month and I would like to thank him for his
support in the handover period as well as his determination in the many battles he has fought for
GPs in Cornwall over the years. I am happy to say that he remains on the Committee and will be
taking a lead in performance issues and assisting with pastoral care.

Emma Ridgewell-Howard has taken up her position as CEO of Kernow LMC and is the first port of call
for all things LMC (emma@kernowlmc.co.uk). She is a very competent human being with a
background in law and practice management. I am confident that she will be transformative and am
certain that you will all find her delightful and benefit from her appointment. Emma continues to be
ably supported by Nicky Sherry in the offices at Roche.

The Committee is an elected body of GPs with some co-opted members and a practice manager
representative. Members are up for re-election next year and we always benefit from new blood –
more anon. As a reminder, the Executive members of the Committee comprise myself, Nick Rogers
(Vice-Chair), Phil Trevail (Treasurer) and Emma Ridgewell-Howard. We are all new to these roles and
are in the process of appraisal and planning to see if there are things we could do better for those
we represent (you). It might be worth reminding you that the LMC is the only statutory body that
represents all GPs, be they partners, sessional or locums and if there is a perceived role lacking it
would be helpful if you could let Emma know so we can add it to the “first year plan”. If you are
reading this because it was sent to someone else and you would like to go on the emailing list please
forward your email to admin@kernowlmc.co.uk .

Now for a couple of bits of extra business/info:

Coroners and Certification

As a follow on from the notice in a previous LMC newsletter I would like to add a few clarifications.
There are really two bits of work afoot:

1. If an unexpected or notifiable death has occurred and the coroner’s officer is involved they
are keen not to be a nuisance to the GP or have the GP trying to hit the sweet spot on the
phone queue all day. One solution proposed was that the coroner’s officer would contact
the practice admin staff and request a patient profile to be emailed to them. They have
agreed the profile should include the last 6/12 consults and be redacted for 3rd party
mentions. The thinking is this can be forwarded to the pathologist to aid a PM, reduce the
need for reports or on occasions may avoid a PM. This may not completely remove the need
for a phone conversation but should hopefully reduce it. This is likely to start happening here
on in so your staff need to know that the coroner’s officer is allowed to have this
information and someone needs to do the redacting. As a by-the-by there are redaction
software programs out there (eg iGPR) that may reduce workload again.

2. The other workstream is piloting electronic death notification. This would be used at times
when a GP thinks they might be able to certify a death but would need to discuss it with the
coroner first (e.g. old age, dementia, non-contributory falls etc). This is a national roll out but
it has been agreed that it will be trialled in selected practices with the different GP IT
systems in Cornwall for 3/12 before being launched across the county in an attempt to iron
out any wrinkles. The LMC will keep you posted if you need to do anything new.
Health Visitor Services

Some concern has been raised about the vanishing and more removed feel to the Health Visiting
service over recent years. For many of us the in-practice clinics have been re-located outside the
practice and our contact with “our” health visitor feels less close/existent.

I have raised this with the service and perhaps unsurprisingly the answer is that they are doing their
best with reduced funding. There is a spread of child clinics across the county and their location and
frequency has been approximately mapped to the concentration of the population and perceived
need.

The consequence of this is that if you have new parents in a sparsely populated area with few
children they will not have the same equity of access to health visitor services locally as someone in
a town. This does not seem to me to be fair and I have pointed this out to the Council who are
commissioning the service. Unfortunately, no money seems to be no money.

However, one assurance that I have been given via CFT, who provide the service, is that any parents
who cannot access HV services due to transport issues will be visited by a health visitor instead. It
would be helpful if you have examples where this is not happening to funnel them to the LMC office
(admin@kernowlmc.co.uk).

I have also reinforced the importance of health visitors and school nurses being available for practice
safeguarding meetings and it was agreed these would be prioritised. There is a lot of talk about
primary care MDTs at present so this may actually happen. We would be keen to hear about any
problems experienced with either service.

Will Hynds

Kernow LMC Chair

 CQC Myth Busters

CQC have updated their myth busters info and this can be found on the link below:

https://www.cqc.org.uk/guidance-providers/gps/nigels-surgery-full-list-tips-mythbusters-latest-
update

Bug and Drug Project: UTI Education Road Show

Please find attached the poster for the Winter 2018 UTI Education Road Show. This will run from the
end of October into November 2018 and will be the same as previous workshops. Topics include: UTI
diagnosis and management, AMR, Sepsis, Hydration, IPC, Catheters and Continence.

For further information, please contact Louisa Forbes (louisa.forbes@nhs.net).

New PGDs authorised for practices in the South West (includes flu)

The following new PGDs that have been authorised for the vaccination of patients registered with
practices in the South West of England and can be downloaded via this link:

https://www.england.nhs.uk/south/info-professional/pgd/south-west/downloads/

Two new PGDs have been added:

➢ Administration of pneumococcal polysaccharide vaccine (PPV) by nurses, midwives,

pharmacists, paramedics, and physiotherapists
➢ Administration of intramuscular influenza vaccine by nurses, midwives, pharmacists,
paramedics, physiotherapists, and radiographers

These PGDs are valid from 1 September 2018.

Here is the latest edition of the Sessional GPC Newsletter.

https://bma-mail.org.uk/JVX-5SSS9-D83MCLZ17D/cr.aspx

This month also includes the next instalment of my blog (Krishan Aggarwal, Deputy Chair of the
Sessional GP’s Subcommittee GPC UK) "Capita and the NHS Pension fiasco - What is going on....7!"

https://www.bma.org.uk/connecting-doctors/the_practice/b/weblog/posts/capita-and-the-nhs-
pension-fiasco-what-is-going-on-part-
7?utm_source=The%20British%20Medical%20Association&utm_medium=email&utm_campaign=97
41753_NEW16A1%20SESSIONAL%20GP%20ENEWSLETTER%20090818&utm_content=Krishans%20bl
og%20heading&dm_i=JVX,5SSS9,3MCLZ1,MN34U,1

Increase in Global Sum payment

NHS England have advised that there will be an increase in the Global Sum payment from 87.92 per
patient to 88.96 per patient. The payment will be made in your usual monthly practice payment and
will be back-dated to April 2018 for any practices in receipt of Global Sum at this time.

(PCSE August 2018)

The latest report on GP earnings is now available:

https://digital.nhs.uk/data-and-information/publications/statistical/gp-earnings-and-expenses-
estimates/2016-17
 GDPR Queries

We are getting quite a lot of GDPR queries and we thought that the following link on the BMA
website may be of help to you in the first instance.

https://www.bma.org.uk/advice/employment/ethics/confidentiality-and-health-records/general-
data-protection-regulation-gdpr.

We are now planning our 2019 workshops and so if there are any areas that Practices would
especially like us to cover now is the time to email and let us know – admin@kernowlmc.co.uk

Managing Pressure at Work Workshop

Date – Weds 10th October 2018

Venue – Victoria, Roche

Full Day, lunch included in price

Price - £35.00 per delegate

I still have a few places left so please email me admin@kernowlmc.co.uk to book a place

Practice Changes
Please can I request that you please let the LMC know of any changes in the GP’s in your practice.
We need to know name, if salaried or partner and email address please. The only way we find out
any changes is by you telling us.

Many Thanks
 SAVE THE DATE!

The NHSE is hosting a Primary Care Networks meeting on 17th October 2018 at Sandy Park in Exeter.
At the moment we have no more details – they are due out next week. If you are interested in
attending please contact our office – admin@kernowlmc.co.uk.

August Vacancies

Salaried GP with view to Partnership – Cape Cornwall Surgery, St Just

Practice Nurse, Launceston

Out of Hours Sessional GP for Urgent Care Service

Salaried GP or Partner, Tamar Valley Health – C/D 30th September 2018

Strategic Manager, Liskeard – C/D 17th September 2018

GP, Salaried or Partner, Narrowcliff Surgery, Newquay

Further details of the above and other vacancies can be found on our website:
www.kernowlmc.co.uk