North East Essex Clinical Commissioning Group (NEE CCG) General Practitioners (GP) newsletter - Winter wELCOME TO THE LATEST EDITION OF THE nee ccg gp NEWSLETTER

Looking at the Long Term Plan

THE NHS is one of our nation’s greatest achievements and for 70 years dedicated NHS staff have been there for us in north east Essex and across the country. But more people are living longer, many with complex health conditions, so the NHS needs to plan so it can work more smartly and effectively, deliver excellent care and attract and retain the best staff.

Last summer the Prime Minister committed an extra £20.5 billion a year going into the NHS in England by 2023/2024. That’s why the NHS nationally has written a Long Term Plan, developed in partnership with those who know the NHS best - frontline health and care staff, patients and their families.

The NHS Long Term Plan will make sure the NHS is fit for the future, providing high-quality care and better health outcomes for patients and their families, through every stage of life.

Giving everyone the best start in life;

• ... through better maternity services, including a dedicated midwife looking after a mother throughout her pregnancy.

by joining up services from birth through to age 25, particularly improving care for children with long term conditions like asthma, epilepsy and diabetes and revolutionising how the NHS cares for children and young people with poor mental health with more services in schools and colleges.

Delivering world-class care for major health problems to help people live well;

… with faster and better diagnosis, treatment and care for the most common killers, including cancer, heart disease, stroke and lung disease, achieving survival rates that are among the best in the world.

... supporting families and individuals with mental health problems, making it easier to access talking therapies and transforming how the NHS responds to people experiencing a mental health crisis.

And helping people age well;

… with fast and appropriate care in the community, including in care homes, to prevent avoidable hospital admissions for frail and older people.

… by significantly increasing the numbers of people who can take control of their healthcare through personal budgets.

The NHS Long Term Plan also describes the actions that will need to be taken, at local, regional and national level, to make this ambitious vision a reality.

1. Joining up the NHS so patients don’t fall through the cracks, such as by breaking down the barriers between GP services and those in the community.

2. Helping individuals and families to help themselves, by taking a more active role in preventing ill-health, such as offering dedicated support to people to stop smoking, lose weight and cut down on alcohol.

3. Tackling health inequalities by working with specific groups who are vulnerable to poor health, with targeted support to help homeless people, black and minority ethnic (BAME) groups and those with mental illnesses or learning disabilities.

4. Backing our workforce by increasing the number of people working in the NHS, particularly in mental health, primary care and community services. We will also create a better working environment by offering better training, support and career progression and we’ll crack down on bullying and violence at all levels.

5. Bringing the NHS into the digital age, rolling out technology such as new digital GP services that will improve access and help patients make appointments, manage prescriptions and view health records online.

6. Spending this extra investment wisely, making sure money goes where it matters most. The NHS will continue to reduce waste, tackle variations and improve the effectiveness of treatments.

Speaking following the publication of the plan, acting lead for the North East Essex Health and Wellbeing Alliance (NEE H&W), Mark Jarman-Howe, said: “The NHS Long Term Plan lists a number of important ambitions for the next few years, but central to the delivery of all of them will be the need for people to work together – whether that’s GP surgeries teaming up so they can provide more appointments and services, or whole health and care systems coming together to plan and deliver real improvements for patients in crucial areas like mental health, cancer or stroke care.

Mark Jarman-Howe, acting Lead of the NEE H&W

“As an Alliance we will continue working together over the coming months to determine what the NHS Long Term Plan will mean for people in north east Essex, building on progress we have already made together, and in partnership with those who know the NHS best – patients, staff and the public. We particularly welcome the emphasis in the plan on integrated care as in north east Essex we’re convinced the NHS can only continue to thrive within a wider partnership of health, social care, local authorities and the voluntary sector working with and for local people.”

“Now the national plan has been published, we need to decide how best to take the ambitions it contains and turn them into real improvements in services over the next few years, building on the progress we have already made by working more closely together.

“And just as the national plan was developed in partnership with patients, staff, local councils and others, so will be our own local plans.”

More details about opportunities to help shape those plans will be shared shortly. In the meantime to read a copy of the national plan and find out more please visit the Long Term Plan website.

If you would like to learn more about the Long Term Plan, the NEE CCG Communications would love to meet you.

Members of the Communications team will travel to your surgery and hold a face-to-face meeting to discuss the Long Term Plan. If you're interested please email NEECCG.comms@nhs.net.

New five-year contract for general practice

A NEW five-year contract for general practice across England is likely to see billions of extra investment for improved access to family doctors, expanded services at local practices and longer appointments for patients who need them.

The deal – the biggest reform to GP services in fifteen years – saw NHS England chief executive, Simon Stevens, state that it is the first major pillar implementing the NHS Long Term Plan, coming just three weeks after the Plan was published.

NHS England will fund an army of 20,000 more staff to help GP practices work together as part of a local ‘primary care network’. The new recruits – pharmacists, physios, paramedics, physician associates and social prescribing support workers – will free up GPs' to spend more time with patients who need them as well as ensuring patients have access to a wide range of services at their local practice.

Patient access will continue to improve, including the introduction of digital appointments, backed by a new patient right to web and video consultations by 2021.

It means GP practices will be able to drive further action on killer conditions such as cancer and heart disease as well as doing more to tackle obesity, diabetes and mental ill health, and support older people at home and in care homes.

Analyser update

POSSIBLE delays are likely to occur following an issue with an analyser Public Health England East of England have announced.

This analyser is used for the routine testing of a number of serological markers including; HIV, Hepatitis B surface antigen, Hepatitis C, Syphilis, Hepatitis B antibodies and H. pylori antigen.

As of today (Wednesday 6 February 2019) it is expected that the issue will be resolved by the middle of next week and that the backlog will be cleared by Friday 8 February 2019.

In the meantime, a clinical assessment of urgency of samples will be made and those considered urgent will be tested on an alternative platform.

If you have a request that is pending and you consider it to be urgent, please contact the laboratory and they will endeavour to test it as soon as possible.

Lab looks at seasonal operations

THE North East Essex Health and Wellbeing (NEE H&W) Alliance recently hosted a one day ‘Seasonal Operations Challenge Lab’ and were joined by system partners and academics from the University of Essex.

The workshop - called ‘AGILE’ - gave Alliance partners and university academics the opportunity to explore new initiatives, ideas and analyse whole system improvements so that sustainable public services can be offered throughout the seasons.

Some of the ideas put forward included using apps and making use of virtual assistants (for example ‘Alexa’ and ‘Siri’) for health and care information, while discussions took place about shared challenges across the system - such as prevention, risk and governance.

By working together, the NEE H&W Alliance will conduct research and use the findings to put forward solutions which will not only provide a system-wide transformation but will also build improved system resilience into the seasonal planning process.

To reduce pressures on key public services – such as transport, education, health and care etc. - the Challenge Lab identified opportunities for whole-system change and looked at how to agree health and care projects that transform both service provision and patients experiences.

After identifying ‘pinch points’ for Essex, the delegates highlighted opportunities for work to start, by using 2017/2018 statistics from patient data, along with how to improve system resilience using current knowledge.

Mark Jarman-Howe, CEO of St Helena Hospice

Speaking after the event, Mark Jarman-Howe, CEO of St Helena Hospice, said: "I’m really encouraged at the range and quality of the discussions we've had. Our friends from the University of Essex really helped us to push through issues, think differently and remove blockages.

"It’s something I’m very keen to repeat - the fresh perspective, the sharing of winter plans and subsequent discussions with voluntary sector, commissioners, acute trusts and emergency services."

Improving ways of working

FEEDBACK from an event for General Practice (GP) surgery staff to share best practice and improve ways of working in primary care found that 97% of those attending thought it was an “excellent event” and “full of useful information”.

Held at the Colchester Weston Homes Community Stadium and hosted by North East Essex Clinical Commissioning Group (NEE CCG) and NHS England’s National General Practice Development team, the ‘Releasing Capacity in General Practice Showcase Event’ saw surgery staff from across north east Essex attend.

On the day attendees took part in a programme of discussions to help them learn from each other as well as look at some of the national initiatives that have been implemented to help release capacity and free up GPs time. They also focused on NHS England’s ‘Releasing Time for Care’ initiative and the 10 high-impact actions that form part of the GP Forward View.

The GP Forward View saw practice staff discuss active signposting; new consultation types; reducing ‘Did Not Attends’; developing the team; productive work flows; personal productivity; partnership working; social prescribing; supporting self-care and developing Quality Improvement expertise.

During the feedback and breakaway sessions GPs and practice staff voiced the most prominent topics to them which included the frequency of visits to care homes; working collaboratively, training receptionists to ask about patents illnesses and conditions as they can see the right healthcare professional. Also, improved use of technology was discussed such as cancelling appointments via text message.

Imogen Witt, NEE CCG GP Engagement Lead, said: “We were delighted with how many practices attended the event. On the day we had practice managers, GPs and other surgery staff cone along and share their views. Those attending were really engaging and conversations continued well after the event finished.

“We hope practices and partnerships will build on the actions created from the event and take advantage of the support offered by NHS England and the CCG.”

The GP Engagement team also held a very successful event at Colchester Weston Homes Stadium recently which focused on dementia. We'll bring you all the news and feedback from the event in the next newsletter.

New Health Coaching service launched

THE NEE CCG is pleased to announce that a new Chronic Obstructive Pulmonary Disease (COPD) Health Coaching Service is to be offered by Provide.

The new service will complement the NEE CCG’s existing COPD services, including its pulmonary rehabilitation facility, and not only aims to increase the uptake of pulmonary rehabilitation but to also improve the ability of patients to self-manage and encourage them to take control of their lifestyles.

An experienced clinical lead - who has worked in the COPD field for a number of years - will run the service along with trained health coaches who have a vast understanding of the disease and are experienced in using evidence-based techniques to make and sustain changes to improve self-management.

The programme is mostly beneficial for people classified as ‘B’ according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy, as these are patients who are symptomatic but are not likely to exacerbate.

Those classified with a different rating could also benefit from the programme provided they are capable and motivated to make changes. The service team will work with GPs to identify suitable clients and provide support reaching Qualitative Outcome Framework (QOF) targets.

The service team are experienced in reclassifying patients according to GOLD and can work with patients on a GPs behalf and support with QOF.

From a patients point of view the service will include:

Assessments that not only focus on the stage of the disease but also how they manage in daily life and the impact of the lifestyle choices that they make;

o The assessment could cover: the use of their inhalator; adherence to medication including the flu vaccination; accessing local support and pulmonary rehabilitation; physical and social activities; diet and nutrition and relationships with carers, friends, family and professionals;

Depending on a patients need, they can attend a number of group sessions or individual face-to-face sessions to create an action plan covering all or some of the assessment areas listed above;

Support for their carers to ensure they feel confident, can discuss their fears and how to access additional support;

Regular follow-up calls for up to one year to see how well patients are doing in achieving their goals and actions.

Currently, the service has an open referral system. Adults aged 18 years or older who have been diagnosed with COPD can self-refer into the service. Additionally, GPs can refer patients to the service by telephoning 0300 303 9988 and contacting Ruth Barlow or Ellen Van Gemmert. Alternatively, please email neecopdhealthcoaching@nhs.net via SystmOne.

New app launched for COPD patients

A NEW health self-management app to help patients COPD has been launched by the North East Essex Clinical Commissioning Group (NEE CCG).

Working with fellow healthcare providers, such as Anglian Community Enterprise, the myCOPD app is now available to purchase or is free for those who meet the criteria.

Designed to support patients at any stage of the disease, the myCOPD app offers users training techniques for every type of inhaler device; prescription assessment which identifies if an inhaler medication conflicts with what the patient has been subscribed and a self-management plan to help people understand what medication to take and when.

It also features a six-week pulmonary rehabilitation programme; symptom and assessment tracking; weather and pollution forecasting - as poor air quality can have an adverse effect - and a facility to help patients monitor lung function.

Lianne Jongepier, NEE CCG Head of Clinical Quality Transformation – Planned Care, said: “The myCOPD app offers patients a one-stop-shop at the tip of their fingers and has many innovative features but the main aim is to help improve patient awareness and self-management skills.”

For more information or to download the myCOPD app please visit MyCOPD.

Specialist service transfers to new provider

A SPECIALIST service which supports children and their families through the process of assessment for Autism Spectrum Disorder will now be managed by the children’s team at East Suffolk and North Essex NHS Foundation Trust (ESNEFT).

The Child Assessment and Development Unit (CADU) service is to be integrated into the paediatric service at Colchester Hospital from next month.

The service transferred from being managed by Virgin Care to ESNEFT, which runs Colchester Hospital, on Friday 1 February 2019. CADU is to remain in the same location, at the Primary Care Centre in Colchester.

Virgin Care agreed to deliver the service on a temporary basis in October 2017 while the CCG found a long-term arrangement. During this time, it has assessed more than 250 children and the waiting time from referral to being seen by the team has reduced by almost three quarters - from 18 months to five.

Elizabeth Kingsford, North East Quadrant Manager for Virgin Care, said: “We were very happy to be able to look after this valuable service over the last few months. The CADU team have worked ever so hard, going above and beyond, seeing hundreds of families and supporting them through what can be a difficult time. We’re very pleased to be able to transfer the service to its long-term home with a record of 100% positive feedback from families and much shorter waits for families.”

The integration into ESNEFT’s paediatric services is to be seamless, with the Trust working alongside Virgin Care to ensure that children remain supported throughout their journey without disruption.

The assessments carried out by CADU include specialist health visitors and nursery nurses conducting detailed observations in the home, nursery and pre-school setting.

Specialist health visitors and specialist speech and language therapists also conduct the Autism Diagnostic Observation Schedule (ADOS). The final assessment - led by a paediatrician - considers all of these observations to assess whether a child reaches the criteria for a diagnosis of Autism Spectrum Disorder. Families are then offered a support group with a positive diagnosis and signposted with relevant information once discharged from CADU back to community services, whether a positive or negative diagnosis is received.

Pam Green, NEE CCG Director of Transformation and Strategy, said: “Transferring the CADU service to ESNEFT gives us the opportunity to streamline the services offered to children and their families, providing care alongside the Trust’s pediatric services.

“We have been pleased to see that Virgin Care have had 100% positive client feedback on the CADU service and they are working with ESNEFT to ensure that the same high-level of service is maintained ahead of the transfer next month.”

Minor Eye Conditions Service now available

PEOPLE suffering minor eye problems in the Colchester and Tendring area are able to receive a free NHS optical check-up at a local participating optician.

The Minor Eye Conditions Service (MECS) - available at a number of high-street settings in the Colchester and Tendring districts - can treat patients with eye problems such as red, sore or watery eyes, ingrowing eyelashes, visual disturbances and much more.

The eye check-ups - which are different and separate from a sight test - offer people the convenience of receiving treatment in their local high street without needing a doctor’s appointment or attending Accident and Emergency (A&E).

Depending on the condition, many people can be seen for minor treatment within 24 hours in urgent cases and within a few days for routine appointments.

Dr Hasan Chowhan, NEE CCG Chairman, said: “We are delighted that the new MECS service can now become the first port of call for anyone with a minor eye condition.

Dr Hasan Chowhan, NEE CCG Chairman
“Local opticians have the skills, equipment and qualified staff to ensure that people are quickly assessed and treated - or in some cases referred to hospital if there is a more serious problem. Obviously this will be more convenient for people but it will also help reduce the pressure on the NHS at the same time.”

For more information about the service and participating practices please visit the NEE CCG website.

100 Days Challenge for NEE CCG

AS part of the 100 Days Challenge, the NEE CCG is aiming to reduce the overall waiting time for patients refereed to a neurologist at Colchester Hospital University NHS Foundation Trust from 28 weeks to 26 while ensuring patients get the right care, in the right place, at the right time.

During the 100 Days Challenge, there has been collaboration between the NEE CCG, neurologists at the East Suffolk and North Essex Foundation Trust (ESNEFT) and the GP with Special Interests (GPwSI) from Community Headache clinic to streamline referrals for Neurology and the Headache clinic. They have also agreed a referral form which has been shared with GP practices across the NEE CCG, Community Headache clinic and secondary care.

GPs have been encouraged to use Consultant Connect Service as additional resources have been put in place to answer GP calls to Neurology consultants to reduce waiting lists and improve the patients experience. Also, the health questionnaire has been co-produced for patients at the Neurology clinic at ESNEFT as well as patients at the community Headache clinic to ascertain the success of this project.

Since starting the 100 Days Challenge, the team have introduced clear and standardised pathways for referrals to hospitals and the Headache clinic with the aim of reducing inappropriate referrals and shorten waiting times; effective booking of appointments; improved alignment between capacity and demand as well as increased efficiency and ultimately improved patient experience.

It has demonstrated that the 100 Day Challenge work has positively impacted the overall Neurology and Headache services and has proven to deliver better experience and a more effective and efficient service to the patients and staff.

If you need to refer to Neurology clinic, please use this pre-referral form and if appropriate refer first to the headache clinic where the waiting time is much shorter.

More information about the outcome of the 100 Days Challenge will be in forthcoming newsletters.

ENT educational programme for primary care clinicians coming

AN Ear, Nose and Throat (ENT) enhanced educational programme for primary care clinicians is to start this month (February 2019).

The programme - run by NEE CCG and in association with East Suffolk and North Essex Foundation Trust (ESNEFT) - is designed to provide patients with comprehensive care closer to and home while improving job satisfaction amongst primary care clinicians.

Practices which participate will receive a backfill payment and the programme will count towards Continuous Professional Development. Royal College General Practitioners accreditation is also being applied for.

The programme will consist of four half-day modules held during the afternoons. These will take place on Tuesday 12 February and Tuesday 26 February as well as Tuesday 12 March and Tuesday 26 March. The training will be based at the Weston Homes Community Stadium in Colchester. Preferably, practitioners should attend all four modules.

The programme - which includes theoretical and practical sessions - has been developed to achieve a better understanding of the management of ENT conditions for clinicians within primary care settings. Dr Elmer van der Hoek GPwSI ENT, who has out the programme together, will focus on the management of ENT conditions within primary care, whilst local ENT consultants will discuss management within secondary care. On the day there will also be presentations from consultants in specialities such as neurology and respiratory medicine along with specialists from the allied professions of speech and language therapy, vestibular physiotherapy and audiology.

The practical sessions will include ENT examination techniques as well as procedures including the Dix-Hallpike and Epley manoeuvre.

Ideally one representative clinician of each surgery should receive this enhanced ENT training – in order to become a port of call for ENT conditions at their location – so they can pass their knowledge on to their clinician colleagues.

If you would like a full programme, more information or wish to book your place, please contact Sarah Esson, Business Delivery Manager, either by emailing Sarah.esson@nhs.net or calling (01206) 918 672.

Lower Leg Pathway launch event

AN education event to launch a lower leg pathway based on recommended best practice is to take place during the evening of Thursday 14 February 2019.

As part of the NEE CCG’s ongoing commitment to nursing development and engagement, the event is for Healthcare Assistants, along with Community and Practice Nurses, and will enable consistent standards of care as well standardised approaches and partnership working across north east Essex.

The evening is designed to share what best practice looks like and the importance of identifying patients at risk of developing a lower leg wound. Topics of discussion will include the importance of assessment and diagnosis; wound and skin management; compression; holistic management and prevention of recurrence with self-care. Attendees will also have the opportunity to meet and share experiences with colleagues.

Full details will be available shortly, but in the meantime please hold the date. In the meantime, if you require more information please contact Jill Thurston, NEE CCG Urgent Care Project Support Officer, on (01206) 918667 or email jillian.thurston@nhs.net.

TARGET training is live

TARGET training courses covering a range of topics commenced from the end of last month (January).

With a new subject every seven weeks, topics covered will include: Introduction to Antimicrobial Resistance in Primary Care; Prescribing in Urinary Tract Infections; Assessing the Need for Antibiotics; Managing Patient Expectations; Back-up prescriptions; Antibiotics for Children and Common Practice Approach.

TARGET has been working with the British Society of Antimicrobial Chemotherapy (BSAC) to develop a TARGET online course on the Future Learn platform.

The course aims to help primary care professionals to target the use of antibiotics to help towards the reduction in antimicrobial resistance. By the end of the course individuals will have an understanding of how to apply practical antimicrobial stewardship strategies in their practice. TARGET will also be using some of the pre-recorded videos and resources that were developed for the TARGET/BSAC webinars and embedding them into the Future Learn training.

The development and intended implementation of the Diagnostic flowchart for women under-65 years with suspected UTI webinar will occur on Tuesday 26 February 2019 from 12:00 pm - 13:00 pm. If you have any queries that you would like answered in the webinar please send them to this email address.

If you wish to take part in the webinars you will be sent an invitation to them with a link to the platform which you simply click to join on the day.

New support team to increase digital skills

A NEW support team is now available at Creffield Medical Group, Colchester, and is offering digital skills to patients.

Since November 2018, the Digital Access Support team project – which was jointly funded by the NEE CCG and Colchester Borough Council (CBC) – has been offering patients advice on how to digitally book and cancel appointments, order repeat prescriptions (based on their online records) and help set up email accounts. Designed by Silicon Practice Ltd, the project has been designed to not only give patients new skills but also help support reception staff.

“Digital access has a big role to play in the future of the NHS so we’re really excited to be able to work with the council to increase awareness,” stated Doctor Hasan Chowhan, NEE CCG Chairman and GP at Creffield Medical Group.

Councilor Beverley Oxford, CBC Portfolio Holder for Customers, said: “This kind of partnership work is invaluable to us and demonstrates our commitment to be forward thinking and resourceful for our residents and for a Better Colchester.”

“This innovative partnership will actively guide patients who may not traditionally use the web,” commented Jane Oddy, Operations Director at Silicon Practice. “It will be a huge step to helping all patients to capitalise on the benefits of using digital services.”

NHS Healthy Ageing guides available

TWO new guides, which are free to order (including delivery), are now available.

NHS England, along with Age UK, has created the guides which focus on Healthy Ageing and Healthy Caring. Aimed at the over-70s', the guides are designed to help older people stay physically and mentally well, with tips on how to keep fit and independent.

To order the free guides through Prolog (there is no cap on order numbers) please call 0300 123 1002 or order online at www.orderline.dh.gov.uk quoting reference HA2.

After Monday 1 April 2019, the guide will be available to download.

Hazardous waste latest

BOTH Colchester and Tendring District Councils have put into place arrangements for the collection of used sharps clinical bins as well as offensive (non-infectious) and hazardous (infectious) waste.

Following the announcement by NHS England that it will cease routine collections of sharps waste from community pharmacies as of the beginning of this month (Tuesday January 1 2019), both Colchester and Tendring councils have now published disposal details.

Please visit Colchester Borough Council and Tendring District Council websites for a full list of what is collected as well as booking times.

GP access campaign goes live

A CAMPAIGN to promote access to evening and weekend General Practitioner (GP) appointments has been launched by NHS England.

The campaign – part of NHS England’s Help Us Help You – aims to raise awareness among the general public of the availability of appointments with GPs, nurses and other healthcare professionals outside of working hours.

To promote the campaign a range of materials have been produced and can be downloaded for free from Public Health England. For more information regarding in general please visit the NHS England website.

New support group launched

FOLLOWING a large engagement event last year, the first Breathe Easy support group meeting was held in Clacton-on-Sea last month (January 2019).

Led by the British Lung Foundation, the Breathe Easy project offers people the chance to make new friends while learning more about living with a lung condition.

The meeting are held on the last Wednesday of every month in the Brotherhood Hall, 28 St. Osyth Road, Clacton-on-Sea, CO15 3BW.

For more information please visit the Breathe Easy website.

Looking to advertise a vacancy?

Have you thought about advertising on the Essex Primary Care Careers (EPCC) website?

Launched in November 2018, the website has 3,500 page views every month and is your first port of call to advertise any vacancies for free.

Also, if you have a practice website the EPCC want to work with you. The EPCC would like to work with you to develop a ‘working for us’ page. The webpage will redirect anyone interested in working in your practice to the EPCC website. Currently, the EPCC already feature in CCG webpages in which they direct candidates to your vacancies on its website

Finally, if you are interested in finding out more about multidisciplinary teams and new roles in primary care, then head over to the EPCC website. There you can hear from a Physician Associate, Emergency Care Practitioner, Clinical Pharmacist, Physiotherapist and many others talking about their roles and how they make a difference in primary care. The videos can be watched in full on the website.

For more information, or if you would like to work with the EPCC to develop a ‘working for us’ page, please email Essex Primary Care Careers.

New appointment in MOCH team

THE Medicines Optimisation in Care Homes (MOCH) team has recruited Nicola Dowley as one of its new technicians.

Nicola has joined the team

Nicola will share north east Essex with Technician, Michael Sturgeon-Comte, who will also be covering part of IPs&E as well. The MOCH team - hosted by St Helena – also has two pharmacists joining in during the next few months.

Nicola will be working directly with care hones and is currently building relationships with GP practices. Her working hours are Monday (09:30 am – 2:30 pm), Tuesday (09:00 am – 17:00 pm), Wednesday (09:00 am – 17:00 pm) and Thursday (09:00 am – 17:00 pm).

The MOCH technicians and pharmacists offer free support in: Optimising medicines – such as stopping inappropriate or unsafe medicines and ensuring that they add value to a patient’s health and well-being; Patient centered care – based on shared decision making about which medicines care home residents take (and stop); Creating better medicine systems for care homes to reduce waste and inefficiency; Training and supporting care home staff to enhance safer administration of medicines; Medicine management – including MAR chart reviews and guidance on PRN protocol and audits; Homely remedies policies and self-care; Compliance with Care Quality Commission standards.

If you require assistance or would like more information please email ndowley@sthelena.org.uk or Nicola.dowley@nhs.net.

Recruitment fairs spring into action

RECRUITMENT fairs which will showcase the wide variety of career roles in primary care are being planned for the spring.

The recruitment fairs - which will be held in South East, South West, West, Mid and North East Essex - will give prospective candidates the chance to talk to employers about their current vacancies.

Currently, dates and venues are to be confirmed, however, more information will be available in the next GP newsletter if you wish to set up a stall at one of the fairs.

Sign-up for minor surgery course

A ROYAL College of General Practitioners (RCGP) minor surgery course is to be held in May at the Holiday Inn, in Waterfront Walk in Basildon.

The two-day event - which takes place on Thursday 23 and Friday 24 May 2019 from 09:00am - 17:00pm - costs £500 for a RCGP member and £550 for non-members.

The course, which is suitable for all GPs including trainees and Firsts, includes:

• Simple rules for confident lesion recognition;

Avoid common risks by being prepared;

Seek valid consent and avoid the stress of complaints;

Impress patients with comfortable and effective local anaesthesia;

• Cryotherapy, curettage and cautery with small group practical sessions and much more.

Topics covered will also include: ingrowing toenail surgery without tears; skin closure to minimise suture marks; DOPS assessment to document how good you will be; good note keeping and audit.

To book your place, please visit the RCGP website.

Consultation events taking place

HEALTHCARE professionals and patients are invited to take part in a number of events as part of a NHS England consultation.

They will outline proposals for a number of items - including blood glucose testing strips and needles - and offer people an opportunity to share their views.

More information about the consolation is available, as well as dates and booking details, on the NHS England website.

In the meantime if you have any questions about the consultation or these events please email england.medicines@nhs.net or visit the NHS England website.

Advice and information now available

ADVICE and information covering a wired range of subjects from Emollients to Urinary Incontinence is now available.

Emollients (fire risk in those on medical oxygen): Products continuing paraffin - in the presence of medical oxygen – are highly combustible and could lead to burns or even death in house fires. Patients who use medical oxygen should be advised not to apply emollients containing any concentration of paraffin. If an emollient is required the following guideline gives recommended non-paraffin based emollients. For more information please visit the NEE CCG website.

Emollients (fire risk in general): There is a fire risk with all paraffin-containing emollients. Patients who use these products should be advised not to smoke or go near naked flames and warned about the easy ignition of clothing, bedding, dressings and other fabric that have dried residue of an emollient product on them. To view the guidance, please see the following information.

Ostomy Accessories Formulary: A formulary for stoma accessories can be found here .It also includes advice on quantities to prescribe.

MHRA Drug Safety Alert (Hydrochlorothiazide): The Medicines and Healthcare Regulatory Agency (MHRA) has issued an alert on hydrochlorothiazide stating that there is a risk of non-melanoma skin cancer, particularly in long-term use. The MHRA advice is available on the following website.

Pregabalin or Gabapentin trial withdrawal in Neuropathic Pain: Guidance on reviewing the effectiveness of pregabalin or gabapentin in patients who have been taking it for more than 12 months for neuropathic pain has been published. An example of a gradual trial withdrawal is available here.

Management of Lower Urinary Tract Symptoms (LUTS) in Men: These guidelines have been updated and can be found via the following link.

Urinary Incontinence in Women: These guidelines have been updated. For more information please view the following advice.

Please remember the process

PLEASE adhere to the following process when referring patients to hospital, while this applies throughout the year it is all the more important during the winter season.

The NEE CCG has been receiving reports that patients have been attending Accident and Emergency (A&E) with no paperwork and claiming that their GP has told them to go to hospital. Please note: if it continues to occur its likely individual practices will be identified as we want the patient to have a positive experience.

As the winter season is now in effect, the procedure for referring patients should be as follows:

In the first instance, the GP calls either, the on-call Medical, Surgical or Gynaecology registrar depending in the nature of the case;

The case is then discussed by the two medical professionals;

If it is agreed that the patient is required to attend hospital; arrangements will be made for immediate attendance to either the Medical Day Unit (MDU), Surgical Assessment Unit (SAU) or the gynaecology ward;

The patient should also take a letter from their GP with them when they attend.

If you need to contact the Medical, Surgical or Gynaecology registrars the contact numbers are: Surgical registrar: 01206 747474 (Main Switchboard) and ask for bleep 924; Medical registrar: 01206 744200 (Direct number); Gynae Registrar: 01206 742035 (Stanway Ward) and ask for the Gynaecology registrar.

Pop along to a perinatal or postnatal group

A POSTNATAL treatment group for mothers experiencing anxiety and depression as well as for those who have suffered a traumatic birth has been launched by Health in Mind.

The group offers talking therapy treatments for adults with common mental health problems and is part of the national initiative Improving Access to Psychological Therapies (IAPT).

The perinatal ‘Open Arms’ group is a ten week cognitive behavioural therapy (CBT) course which focuses on the impact and experience of becoming a parent and aims to treat associated anxiety, depression and adjustment problems.

The ‘Post Birth Recovery’ group is a five week psychoeducational course which focuses on raising awareness about the symptoms of birth trauma and normalising traumatic birth experiences.

For more information about either group please visit www.northessexiapt.nhs.uk or call Health in Mind on 0300 330 5455.

Colchester Hospital Cancer Services User Group

MEMBERS from the Cancer Services User Group (CSUG) at Colchester Hospital gave a presentation at the NEE CCG General Practice ‘shut down’ Cancer Education Event, held at the Weston Homes Community Stadium in Colchester.

The main aims were to highlight key messages that CSUG felt were important for GPs to share with their patients – especially at the point the GP decides to refer that patient on an urgent two-week referral.

The motivation for asking GPs to share these key messages with their patients came from some powerful ‘real-life’ cancer patient stories that formed part of the presentation. The CSUG also presented some documentation (an A4 explanatory leaflet and accompanying ‘business card’) which reinforced the key messages. It was recommended that GPs could explain and then pass these to their patients at the point of an urgent cancer referral.

CSUG would like to remind you of these key messages and promote the use of our supporting documentation. At the point of deciding to refer a patient on an urgent two-week cancer pathway:

1. Tell the patient that they have been referred on an URGENT basis and should see a specialist within two weeks (feedback suggests that many patients are not aware that they have been referred for further investigation to rule out cancer or that they should be seen within two weeks).

2. Stress the importance of attending/making themselves available for the first appointment they are offered, as it could be cancer.

3. Tell them to be prepared for the fact that their initial appointment may involve diagnostic tests.

4. Recommend that ideally, they should take someone with them to this appointment.

5. Check the patient’s contact details are up-to-date (so that the hospital has all the correct information to facilitate making that first appointment).

6. Explain who and where to call if an appointment does not come through within a two-week period.

7. Pass them a copy of both the CSUG leaflet and card about the referral. These summarise the points listed above (and more).

CSUG would like to thank NEE CCG for inviting them to present at the cancer education event and for agreeing to fund the cost of printing the A4 leaflet and accompanying ‘business card’.

For more information relating to either the key messages or the use and supplies of the documentation, please contact Claire Corbett, NEE CCG Business Manager, on (01206) 918 677 or email Claire.Corbett3@nhs.net.


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