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Authority to Administer forms

Sent to all Lincolnshire GPs, Nurses, and Practice Managers Dear %recipient.firstname%, In the past when we requested a community nurse to administer medication to a patient, the community nurse would request that we document this request on an Authority to Administer (A2A) form. The LMC and...

Outpatient prescription requests

Dear %recipient.firstname%, For many years GPs and the LMC have requested that hospital specialist provide legible and comprehensive information when making requests for GPs to prescribe following outpatient attendances. Unfortunately, hospital specialists have continued to provide inadequate...

End of Life Care- updated guidelines and paperwork

Dear %recipient.firstname%, End of Life Care- updated guidelines and paperwork Identifying patients who are End of Life, and providing anticipatory medications for symptom management, are important roles for general practice. The LMC has been working with St Barnabas Hospice, MacMillan...

April / May newsletter

This newsletter includes articles on; General Practice Forward View Performance Matters - Prescribing to Vulnerable Adults PCSE Contact Details Out of Area Registrations Global Sum Funding & Uplift Revalidation Guidance for GPs Electronic Discharge Summaries - ULHT Backlog Learning Disabilities...

Back Pain in the Older Patient

Back pain is a very common problem for general practice patients, and most of the time it does not have a sinister cause. However, at recent serious case reviews there have been a number of cases where back pain in older patients has been the first presentation of more sinister diagnoses. When...

Becton-Dickinson blood bottle shortage

Practices will have received notice that they can resume blood tests, however there is still a shortage of blood bottles. NHSEI have requested that practices continue to be cautious with their blood bottle usage. Lincolnshire CCG has asked that practices inform them of any shortages by...

Blood Test Results

We all receive, deal with, and file, hundreds of blood test results every week. In the vast majority of cases this is a seamless and uncomplicated process. However, over recent months a number of cases have been discussed at performance panels where the main concern has been due to incorrectly...

Cancer Care Webinars

Please see below our 'Cancer Care' Webinars. If you would like a copy of the slides from this session please email: info@lincslmc.co.uk. Don't forget to check out our other Educational Webinars and Podcast Episodes. One of our Macmillan GPs Dr James Howarth has produced a short video on how to...

Cardiology Webinars

Please see below our 'Cardiology' Webinars. If you would like a copy of the slides from this session please email: info@lincslmc.co.uk. Don't forget to check out our other Educational Webinars and Podcast Episodes. Our first episode in our Cardiology Series is presented by Dr James Howarth,...

Christmas newsletter

This newsletter includes articles on; Practice Manager's conference Recent LMC work Requests from schools Mental capacity assessments Transitional care / Home First Flu vaccinations Firearms update Dental problems Safeguarding guidance Requests for branded drugs Winter indemnity schemes for...

Commonly Missed Diagnoses

We all know that we make mistakes, and we learn from these mistakes. We also know that we are likely to miss certain diagnoses. The Practitioner Performance Team is, thankfully, realistic about this, and supports GPs who miss uncommon diagnoses. However, when doctors miss common diagnoses they...

Completing Fit Notes/Med 3

Completing Fit Notes/Med 3 The LMC has recently received several enquiries regarding when Fit Notes can be completed, especially whether a Fit note can or should be completed before another Fit Note has expired. Government guidance on completing Fit Notes explains that the fit note is...

Confirmation of Life Extinct

When a patient dies it is expected by relatives and carers that a doctor or other health professional will attend the deceased to confirm that the patient has died. BMA guidance states that English law: does not require a doctor to confirm death has occurred or that 'life is extinct' does not...

Consent

Not getting adequate consent is the fourth most common cause for medical indemnity claims[1]. It also accounts for high proportion of the cases which are taken to the GMC and local Performance Groups. When consent is not adequately obtained, and a claim arises, 75% of claims are settled...

Contract Change- Immunisation Lead

Contract changes made in April 2021 have reformed the way practices are reimbursed for immunisations and vaccinations. As part of these changes, practices must have a nominated Practice Immunisation Lead (PIL). Practice Immunisation Leads are responsible for ensuring contractual requirements...

Contract Change- Immunisation Lead

Contract changes made in April 2021 have reformed the way practices are reimbursed for immunisations and vaccinations. As part of these changes, practices must have a nominated Practice Immunisation Lead (PIL). Practice Immunisation Leads are responsible for ensuring contractual requirements...

Contract Compliance Week Update

Lincolnshire LMC has met with representatives of ULHT, NWAFT, and CCG to review the outcomes of the Contract Compliance Week data collection. We plan to also discuss this with LPFT, LCHS, and NLAG. The main findings of the data collection were that compliance with the NHS Standard Contract...

CQC – New Dementia Pathway

A new dementia pathway has been developed by Primary Care in conjunction with the LMC, Lincolnshire Partnership Foundation Trust (LPFT) and other care providers. It is for over 65yr olds presenting with symptoms suggestive of dementia and is intended to act as a guide to navigate the...

December newsletter

Articles in this newsletter include; International Recruitment Call for Special Conference Improving Communication between General Practice & ULHT Performance Matters - Firearms held ny patients Safeguarding Children Conference Government e-petition to save general practice BMA Survey of GP...

Duty of Candour

The duty of candour came into effect for GP practices on 1 April 2015. This is Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which sets out fundamental standards. It aims to ensure that providers are open and transparent with people who use...

Educational Webinars

The Lincolnshire LMC run short educational webinars aimed at GPs and other practice staff who find it a challenge to take time away from their practice to travel to training. window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new...

End of Life Care - Updated Guidelines

End of Life Care- updated guidelines and paperwork Identifying patients who are End of Life, and providing anticipatory medications for symptom management, are important roles for general practice. The LMC has been working with St Barnabas Hospice, MacMillan nursing, Marie curie, and other...

EPaCCS Webinar

The EPaCCS webinar on Tuesday 19th October will help practices to: Save time and improve efficiencies with the updated Gold Standards Framework (GSF) Meeting Tools. Streamline communication using the GSF Report and new EPaCCS Automate administration for your GSF/MDT Meetings Automate your...

Fit Notes Update - Letter To Hospital Regarding Med 3

From April 17 the Standard NHS contract for hospital explicitly requires hospital clinicians to provide fit notes for patients who are; admitted to hospital, discharged from hospital, or seen in outpatients. Clause 11.11 of the contact states: 'The Provider must, where appropriate under and in...

Flu and Pneumococcal Vaccination by LCHS staff

Flu and Pneumococcal Vaccination by LCHS staff- it is time to sign the Vaccination Agency Agreement (VAA) As in previous years, we want to ensure that there is maximum uptake of flu and pneumococcal vaccination. To facilitate this LCHS staff will be able to administer the vaccines on behalf of...

Gillick-Fraser Competence

GPs frequently see patients who are aged under 18 years of age without the parents being present. If the GP decides to treat these patients without parental knowledge or consent parents may complain about the doctor's actions. It is thus essential that all GPs understand the rules and guidelines...

GP as Occupational Health Physician

GPs are increasingly being asked to act as occupation health physicians (OHP). Patients attend the surgery with a request from and employer to complete paperwork relating to the patient's ability to per-form various duties. Similarly, other organisations request that GPs complete forms or write...

Guidance for Doctors who offer Cosmetic Interventions

This guidance came into force on the 1 June 2016 and applies to all doctors who carry out both surgical and non-surgical cosmetic procedures including those who may be responsible for supervising others. The GMC defines a cosmetic procedure as ''any intervention, procedure or treatment carried...

Handwritten Prescription Requests

Patients frequently attend practices with hand written prescription requests which were issued to them in outpatient clinics. These requests are often illegible, and rarely have enough information for us to safely prescribe. To this end practices have to delay prescribing to get clarity. The...

Hepatitis B Immunisation

GPs are often requested to give hepatitis B immunisation covering three broad areas; for travel for occupational health lifestyle risk or medical conditions Travel Hepatitis B immunisation for travel is not remunerated by the NHS as part of additional services. However, the regulations do not...

Home Visiting

Visiting patients at home is a part of the GMS contract. The GMS contract states; 7.6.1 In the case of a patient whose medical condition is such that in the reasonable opinion of the Contractor attendance on the patient is required and it would be inappropriate for the patient to attend at a...

ICON- “Babies cry, you can cope”

ICON 'Babies Cry, You Can Cope', is an evidenced-based programme designed to help parents and carers understand the normal crying pattern of young infants and to help them develop successful coping mechanisms. ICON stands for: I - Infant crying is normal; C - Comforting methods can help; O...

Improving 2-week-wait Referrals

Improving 2-week-wait referrals During the pandemic the way in which 2-week-wait (2WW) referrals have been managed by secondary care providers has had to change, as many diagnostic procedures could not be carried out due to infection risk. 2WW referrals which previously may have gone direct to...

Interruptions

It is well documented that interruptions during consultations are upsetting to both doctors and patients. About 10% of GP consultations are interrupted for one reason or another. When surveyed, patients felt that over 50% of these interruptions were unnecessary, and 20% felt that the...

Item of Service for giving flu vaccine to practice staff

This year practices will receive an IoS fee for providing a flu vaccine to their own practice staff in patient-facing roles. The Enhanced Service specification has been updated to reflect this change.

June / July newsletter

This newsletter includes articles on; LMC Conference Performamce Matters - Gillick-Fraser Competence LHAC Care Portal Quality First - Managing workload GPC Update on Capita/PCSE SystmOne QRISK error Firearms update Coroners office GPC Newsletter GPs as Occupational Health Physicians Articles...

Lessons Learnt

The LMC have been asked to share some lessons learnt from recent Serious Incidents which have affected Lincolnshire patients. Missed diabetes in a child A parent contacted a surgery using an online consultation platform advising that her child had started to wet the bed after having been 'dry'...

Lincolnshire 0 - 19 Service

NOTE: We are not the 0-19 Service, please see attachments for contact information regarding referrals. The LMC has heard many concerns from practices that the level of service for children has significantly reduced since the development of the 0-19 Service. We have been working with the County...

Lincolnshire Managed Care Network

Lincolnshire's Managed Care Network for mental health aims to help people who have already experienced mental health problems, or who are having their first experience of mental ill health. The Managed Care Network is an alliance of groups and organisations that provide a range of activities...

Managing Patients With Eye Problems

(written by: Dr Kieran Sharrock) When patients present to general practices with eye problems, we may not be the best people to assess and treat their problems. Optometrists are more experienced in dealing with eye problems and are usually able to assess and treat these problems. The LMC is...

March newsletter

This newsletter includes articles on; General Practice Crisis Meetings Private Administration of Men B Vaccinations Performance Matters - Sepsis GMS Contract Changes 2016/17 Publication of GP Earnings DNA-CPR Countywide Policy Zika Guidance for Primary Care Improving Communications between...

Medical Examiner role in the community

Medical examiners are senior doctors who scrutinise the cause of death of individuals to support learning and improve registration of death processes. MEs also liaise with families of the deceased and provide them with support and feedback. Many hospital trusts, including ULHT, have utilised...

Medication Administration Forms - update

Over recent times the LMC has worked to reduce the administrative burden for GPs and other practice staff. One of the changes which we have been able to instigate is regarding Medication Administration Forms (MAF). We had agreed with LCHS that when medication needed to be administered to a...

Medication for Schools

From 1st Oct 2017, schools can purchase their own supply of an Epi-Pen to use in an emergency when the child's own injector is not working. Schools have been able to purchase their own supply of a Salbutamol Inhaler for a couple of years now. Please click on the attachments above to view the...

Medication Reviews & Repeat Prescribing of Potentially Harmful Drugs

Medication Reviews Medication and prescribing errors can cause significant patient harm, and thus can lead to complaints and referral to the Practitioner Performance Team (PPT) or GMC. When these complaints are investigated, the PPT will look at the index case, and also at the records of...

Mental Capacity Act and Deprivation of Liberty - FAQs

What is the Mental Capacity Act 2005? The MCA is an Act of Parliament which provides a framework by which people who may not be able to make choices about their own welfare, can be assessed, and cared for safely. How do we decide if a patient has capacity? If a patient is believed to not have...

Mental Health Webinars

Please see below our 'Mental Health' Webinars. All attachments can be found below the descriptions of each webinar. Don't forget to check out our other Educational Webinars and Podcast Episodes. An evening with: Consultant psychiatrists, Adaeze Bradshaw & Suneetha Siddabattuni. Managing Eating...

MICROGUIDE APP

An easy way to access antimicrobial guidance Have you ever wanted easy access to local antibiotic prescribing advice? This is now available from the Microguide App. This app can be downloaded from Apple and Google app stores. When you have downloaded the app, register using 'Lincolnshire STP'...

National Protocol for Influenza Vaccination

Public Health England have published a National Protocol for inactivated influenza vaccine which sets out how flu vaccines can be administered by registered and un-registered health professionals. Practices can use this protocol to enable un-registered staff to administer the flu vaccine...

News

Lincoln Medical School Research Projects Lincoln Medical School students are currently developing research projects for their BMedSci qualifications. Lincolnshire LMC is working with some of these students to perform research in general practice. Please help these students by completing...

Newsletter

Practice In Touch Practice In Touch is the Lincolnshire LMC newsletter. The newsletter is sent out on a regular basis to all GPs & practices in the county. If you do not currently receive a copy of our newsletter & would like to subscribe, please email rosa.larner-peet@lpft.nhs.uk to be added...

Non-specific Symptoms 2-week-wait pathway

A new 2-week-wait pathway has been developed for patients who present with non-specific symptoms (NSS). This NSS pathway should be used for patients with the following non-specific symptoms Appetite loss or early satiety Unexplained deep vein thrombosis Diabetes with weight loss age...

North West Anglia NHS Foundation Trust - Rapid Diagnostic Service Plus (RDS+)

Rapid Diagnostic Service Plus (RDS+) - Internal and External (CCG) Comms release - 28.06.21: The PEDAS clinic transition period will stop with effect from 30 June 2021. Rapid Diagnostic Service (RDS+) NWAngliaFT is introducing a new service called the Rapid Diagnostic Service (RDS+) for...

November newsletter

This newsletter includes articles on; Marketing Lincolnshire General Practice - BMJ Careers Fair Performance Matters - Back Pain in Older Patients Department of Works & Pensions (DWP) Consent Patient Registration for GP Practices CQC Registration Doctors Health Intranasal Influenza...

Onward referral from Emergency Departments

Onward referral from Emergency Departments Emergency Departments do not have the ability to safely make or follow-up onward referrals. It has been agreed though that patients seen in ULHT EDs who require urgent assessment, but do not require admission, will be referred on by the ED...

Paediatric referrals from GPs

When you have concerns about a child and want to make an urgent referral to paediatrics, this should be done by calling switchboard and asking for the paediatric SHO on call. The paediatric SHO should then take details of the patient and what your concerns are. The SHOs fulfill this role as the...

Parental Responsibility

A recent safeguarding Serious Case Review (SCR Family V, published on the Lincolnshire LSCB website) highlighted the importance of knowing who has parental responsibility for a child. In this case, a man had repeatedly taken a child to multiple medical appointments, and the child had received...

Performance Matters

The LMC is regularly involved in representing and supporting doctors who have been identified as having 'performance' issues. The LMC has identified a number of themes which recur, and this regular feature from our newsletter will highlight these, so that our members can avoid these...

Performance Matters- palliative care and pre-emptive planning

Performance Matters- palliative care and pre-emptive planning The LMC is regularly involved in representing and supporting doctors who have been identified as having 'performance' issues. The LMC has identified themes which recur, and this regular feature from our newsletter will highlight...

Performance Matters- Patient Safety Alerts

Performance Matters- Patient Safety Alerts What you need to know: All practices must have a system in place to review, share, and act upon patient safety alerts MHRA and other organisations send practices patient safety alerts regarding medications and devices which could cause harm to...

Personalised Asthma Action Plans

Personalised Asthma Action Plans As part of QOF, patients should have a Personalised Asthma Action Plan agreed when the patient attends for their annual asthma review. The PAAP should include information about how to step-up and step-down inhalers, and how to respond to acute exacerbations....

Pharmacy Contract Changes

Pharmacy Contract Changes There have been some recent changes to the pharmacy contract which will possibly impact GP practices. These changes include New Medicines Service Pharmacists will offer a medication review to patients who have been started on medications for certain conditions such...

Practice Call-Back Policy

Practice Call-Back Policy Healthwatch Lincolnshire have recently surveyed patients about their experiences when contacting GP surgeries. One of the issues raised by patients in this survey was the uncertainty about when a clinician will call the patient back when a telephone appointment...

Prescribing Antivirals to Patients in Care Homes

Practices are NOT required to prescribe antivirals to patients in care homes at risk of influenza The LMC has provided guidance regarding antivirals in care homes in the past, and we understand that some practices have again been asked by Public Health to do this. Our advice remains the same,...

Prescribing of cannabis-based products

The new regulations to widen the availability of cannabis-based medicinal within the NHS came into effect today, 1 November 2018. Prescribing is restricted to a doctor on the GMC specialist register prescribing within their field of expertise where the cannabis-based product is an unlicensed...

Prescribing to Vulnerable Adults

A vulnerable adult is defined in 'No Secrets‟ Governments Guidance of Adult Abuse as: 'someone who is aged 18 and over, who is or may be in need of community care services by reason of mental or other disability, age, or illness and who is or may be unable to take care of him/herself and...

Primary Care Networks (PCN)- what is expected from October 2021?

NHSEI have published their expectation for PCNs for 2021/22 and 2022/23. Full details of this can be found at the NHSEI web pages. This article aims to summarise these for practices so that you know what will be expected from October 2021 onwards. LMC plan to run a webinar about this...

Prostate Specific Antigen (PSA) changes to NICE guidance

Prostate Specific Antigen (PSA) changes to NICE guidance NICE have recently amended their guidance with regard to referral thresholds for abnormal PSA. Old NICE guidance said to refer asymptomatic patients depending upon their age-related PSA (50-59 ≥ 3, 60-69 ≥ 4). The new guidance...

Rapid Response Respiratory Service Lincolnshire

The Children's Rapid Response Respiratory Service launched in February 2019. It is a countywide service that provides specialist assessment, treatment and management of children with complex physical disabilities with additional respiratory problems in the community. To refer to the...

Reducing the burden of Appraisal

NHSE have recently changed the focus of GP Appraisal. The new focus is aimed at being more developmental and less bureaucratic, so that less time needs to be spent preparing for appraisal. NHSE has circulated a document which sets out the changes; this document can also be found in the...

Requests from Schools

Schools frequently request information from GPs regarding a child’s health conditions, their absence from school, or to certify that they were ill when sitting an exam. Parents often are put under pressure from schools to get this information from practices, even though they themselves would be...

Safeguarding Collaborative Arrangements

Collaborative arrangements The NHS Act obliges NHS bodies to provide advice to statutory bodies in relation to social services, education and public health functions. Thus NHS England and CCGs, as NHS bodies, have to enable the Local Authority to carry out is safeguarding duties. This is...

Safeguarding Children & Young People Roles & Responsibilities

All staff who come into contact with children and young people have a responsibility to safeguard and promote their welfare and should know what to do if they have concerns about safeguarding issues, including child protection. The intercollegiate document 'Safeguarding children and young...

Temporary Emergency Registered GPs - Continuation of Support

The temporary emergency registration provided by the GMC to doctors, as part of the response to the COVID-19 pandemic, will remain until the Secretary of State for Health and Social Care declares the emergency over. The GMC is currently contacting doctors on the temporary register to ask...

Treatment of Dental Problems

Patients presenting with possible dental problems This guidance informs GPs of their obligations to patients either requesting emergency dental treatment or asking for an NHS prescription for drugs recommended by private or NHS dentists. It is aimed at all GP’s including out of hours...

Two new enhanced services available from 1 July 2021

NHS England is offering practices the voluntary opportunity to participate in two new enhanced services from 1 July 2021. These focus on two areas which are a priority to support recovery from the pandemic: long COVID and weight management. Long COVID is an increasingly widespread condition,...