Primary care bulletin - 30 October 2024
Bulletin:
'Register with a GP Surgery' service; New urgent suspected referral forms; Fire safety; and more.

Welcome to this week's primary care bulletin

Key points this week include:
  • 'Register with a GP Surgery’ service 
  • Fireworks and fire safety
  • Multi-region cluster of Burkholderia stabilis ST1565 suspected to be associated with non-sterile ultrasound gel - update
  • Improving the quality of an urgent suspected cancer referral
  • New urgent suspected cancer referral forms
  • SMS GP practice dashboard for August 
  • Subscribe to the NW London Kidney Care podcast
  • Updated Mpox pathway action cards
  • Read the latest diabetes bulletin
  • OneLondon newsletter - updates on the Universal Care Plan (UCP) and the London Care Record
  • Stress Awareness Week - Keeping Well 
  • Technical issues with Sonar platform
  • Western Eye Hospital - Multiple copies of clinic letters
  • The referral criteria for Harrow Community #Children’s Asthma Nurse service
Webinars and training, including:
  • Newly diagnosed Parkinson's information session
  • London NHS cervical screening webinar
  • Join a free webinar on supporting trans health in primary care
  • Primary care workshop for Living Wage Week
  • ICHP CVD Education Series – heart failure in primary care
  • Chronic pain in primary care and opioid harm reduction programme MDT for Brent, Harrow and Hammersmith and Fulham patients 
  • ICHP polypharmacy masterclass - oral nutritional supplements (ONS)
  • The referral criteria for Harrow Community #Children’s Asthma Nurse service

If you have any submissions for this bulletin please email them to the communications inbox - nhsnwl.communications.nwl@nhs.net

Deadline for content is 3pm Monday

To view any previous editions click here
‘Register with a GP Surgery’ service - 31 October 2024 deadline

Over 75% of practices in North West London are already using the free NHS England ‘Register with a GP Surgery’ (RGS) service to allow patients to register with their practice online. The GP Contract 2024/2025 requires practices to solely use this product for registrations in both online and paper versions by 31 October 2024.

It only takes minutes to set up and the ‘Register with a GP Surgery’ service is linked to the ‘Find a GP’ webpage, NHS App and can be linked to your practice website. The service helps reduce the administrative burden for your practice as well as making GP registration easier for patients.  

You can activate the service for your practice by completing the form using this link (or via NHS Profile Manager).

Please see attached slides for more guidance and here is a link to a recording of a recent NW London Primary Care webinar covering it.

For more information, you can also visit the NHS England/Digital page. 
Fireworks and fire safety

Over the next few months, a variety religious and cultural festival will be celebrated, often involving the use of fireworks. Fireworks, and sparklers, may be beautiful and fun but are dangerous and must be used safely and correctly. See the attached tips from London Fire Brigade.
Multi-region cluster of Burkholderia stabilis ST1565 suspected to be associated with non-sterile ultrasound gel

See the UK Health Security Agency update attached.
Improving the quality of an urgent suspected cancer (USC) referral

A new video on how to send a good quality USC referral, developed in conjunction with GatewayC, has been published.

The video goes through components of the USC referral forms helping clinicians make high quality USC referrals, which in turn support the Faster Diagnosis Standard. Feel free to forward the video to colleagues who may be new to the referral forms, or some may just want to have a refresher.

Watch the video here. 

If you have any questions or concerns, please email england.tcstlondon@nhs.net.
New Urgent Suspected Cancer referral forms

The pan London Urgent Suspected Cancer (USC) referral forms have recently been updated taking into account comments from specialists, GPs and other stakeholders, and any changes in national referral guidance. In particular, changes have been made in the following forms:
  • Gynaecological Cancer: incorporating new BMS guidelines for post-menopausal bleeding
  • Sarcoma: following launch of the new soft tissue sarcoma diagnostic pathway
  • Skin Cancer: adaptations made for teledermatology, to be used according to local pathway where these exist.   
Other generic changes include: 
  • New top tips have been developed for Gynaecological, Haematology, Sarcoma and Urology, to add to the existing suite of Top Tips of Breast, Lower GI, Upper GI, with more to come in the next few months
  • Wording in the forms and patient information have been modified to reflect the latest Faster Diagnosis Standard
  • The NHS Service Finder website has been added for finding practice bypass numbers, available to those with NHS email addresses
  • In some forms, minor modifications to wording were made to make referral requirements or arrangements clearer
  • Boxes added under ‘Other access needs’ for referrers to provide more information about learning disabilities.  
The new referral forms will be uploaded to the IT system that you use by your ICB IT service providers, your IT Leads or by DXS. If you encounter problems using the forms please contact your borough’s Cancer / IT lead or your IT service desk in the first instance.

It is important that only the new, updated USC referral forms are used after 25 October 2024. Please could you ensure that any old forms or templates are removed from your IT system and are no longer used for patient referrals.
SMS GP practice dashboard for August

The SMS fragment allocation for April - August 24/25 is attached. This data shows the usage of both Accurx and all messages sent via your clinical system, which includes online consultations suppliers. Please note that there is also information about the number of messages that have been sent via the NHS App.

You can find further background here.
Updated Mpox pathway action cards

NHS England updates materials on its response to the outbreak of Clade, Mpox in Eastern and Central Africa. On this page you can find various materials, including updated Mpox pathway actions cards.
OneLondon Newsletter - updates on the Universal Care Plan (UCP) and the London Care Record

The attached newsletter features updates on the work of the OneLondon partnership.
The latest diabetes bulletin is out now

This diabetes bulletin contains updates for primary care colleagues on the following:
  • The September 2024 diabetes dashboard is released
  • To ensure your care planning efforts are coded please complete 3 things on the L1 template in EMIS/SystmOne
  • The Level 1 and NDH service specifications are updated for clarity and circulated last week with the other specs in the Single Offer updated in-year
  • Level 2 MDT FAQs been updated to clarify that consultant level support is not needed for every MDT discussion
  • NW London’s NDPP provider, Thrive Tribe, is being supported to ensure more NDPP referrals convert into patients starting the programme 
  • Following ICBs’ recent organisational redesign there is no longer a discreet dedicated NWL diabetes programme team and the diabetes inbox has closed. For any enquiries contact us at nhsnwl.ipplannedcare@nhs.net
  • If you are not already a member of our ‘NHS North West London Diabetes Transformation’ MS Teams channel please click here to request access guidance inc FAQs, dashboards etc.
Subscribe to the NW London Kidney Care podcast – a bitesize podcast where chronic kidney disease management is made easy for health care professionals working in primary care

To listen and subscribe click on the following link and select your preference to follow the show (e.g. apple podcast, Spotify).

1. Bananas are not the problem! Hyperkalaemia and CKD No one wants to deal with a raised potassium on a Friday evening! But how severe is a potassium of 6 and how quickly do we need to act? Should we recommend strict diets? What about medication, when should we consider stopping RAASi agents or when should instead consider adding potassium binders?

2.  Lifestyle, CVD and CKD: spot the differences - Should we be more liberal with glycaemic control in in diabetic kidney disease? How should we adjust the blood pressure targets in according to albuminuria and frailty? 

3. “Chronic” is not wicked or awful as your teenager might tell you - CKD is common in diabetes, hypertension and cardiovascular disease. How can you confidently presume that is the cause of the abnormal results? When should you consider other investigations and referral to nephrology?

Ask us a question here to be answered on our 10th episode! 

To be directly notified of upcoming episodes or other education events organised the NW London kidney care team complete this form.
Stress Awareness Week - Keeping Well staff support 

4-8 November marks Stress Awareness Week.

The 2023 NHS annual survey revealed that 41.7 per cent of staff report feeling unwell as a result of work-related stress.   

Taking action on your mental wellbeing can often feel overwhelming, or you simply may not have the time to make big commitments for your wellbeing.  

You can find simple tips to help cope with stress, information about recognising signs of stress and accessing support on our website.

The Keeping Well NW London website has short, quick self-assessment questionnaires that can be helpful if you are unsure about whether to seek support for low mood or anxiety. 

All scores are anonymous and no data is saved.

As a reminder, events are taking place for Black History Month to celebrate the stories of the black pioneers who have made, and continue to make, vital contributions to building our NHS. As a staff support service it is important we recognise the unique experiences our staff may have.

We are here to support you. Get in touch with us by:      

Telephone: 0300 123 1705   

Email: keepingwell.nwl@nhs.net      

Complete a self-referral form.
Technical issues with Sonar platform

We have been informed that the Sonar platform used by pharmacies to record, upload and transfer flu and COVID-19 vaccination information to GP practices has not been optimally functioning this month.  A number of pharmacy sites have reported issues utilising the software and some practices are reporting delays receiving information regarding vaccinations given by pharmacies.

Practices are asked to be aware that there may be delays in patient vaccination information reaching them and to double check with patient if they have had a flu and/or COVID vaccinations recently i.e. perhaps at a local community pharmacy to reduce risk of double jabbing.  This is particularly relevant to SystmOne practices as we believe them to be more affected than EMIS.

NHSE London Region team have been working with Sonar to urgently resolve these issues experienced by some sites, a summary of which is shown below.
·
Access issues experienced week of 21 October 2024: Difficulty accessing Sonar to enter data, this was linked to system issues preventing sites from making patient entries. This has since been resolved with a system update completed within the standard 4-hour timeframe. As a contingency plan, all sites are advised to have a blank form (which can be downloaded when sites are logged in)  on hand to address any unexpected issues, whether system – or connectivity-related issues.
  • Flow of Patient-GP data: Regarding the delay in flow of data to GP records, Sonar is continuing to update and checking with GPs to ensure they have received updates. There is a safety net functionality that allows GPs to double-check patient records ahead of any vaccination in case of technical difficulties, to avoid administration errors. Please see the attached GP user guide for further details. Sites should contact info@sonarinformatics.com for log in details if required.
  • For sites receiving blank notification letters/ notifications from previous campaigns, please send GP details via escalation route for Sonar team to conduct an audit to identify the issues and resolve them.
  • VVE/FDP data issues: We are also aware that the VVE issues at some sites have now been resolved, and we are following up with other outstanding sites as per advice from ICB colleagues. Please continue to flag sites experiencing issues with VVE visibility on supply dashboard 
We kindly ask that all sites ensure they are reporting any clinical incident to Immunisation Clinical Advice Response Service (ICARS) using the Incident form and that site colleagues familiarise themselves with the incident reporting process available on FutureNHS London ICARS Workspace.

For issue reporting, please continue to notify the regional team of any difficulties as soon as they arise via the standard Site – ICB – Region escalation route. Please send any initial queries to nhsnwl.immunisations@nhs.net for escalation.

Lastly, Sonar have conducted an audit and will continue to do so to ensure ongoing oversight, addressing issues that continue to affect certain sites.
Western Eye Hospital - Multiple copies of clinic letters

Due to a glitch in the installation of a new electronic patient records (EPR) system, your GP practice may have received multiple copies of clinic letters from the Western Eye Hospital.

The situation has now been resolved and the team would like to offer their sincere apologies for any inconvenience this may have caused.
The referral criteria for Harrow Community #Children’s Asthma Nurse service

The referral criteria for Harrow Community #Children’s Asthma Nurse service is as follows:
  • Children/Young People aged 5-17 years old with a confirmed diagnosis of asthma and a Harrow GP with either one or more of the following:
  • 1 or more A&E, UCC, hospital admissions
  • 2 or more GP presentations with asthma exacerbations
  • Prescribed 2 or more courses of oral steroids in the last 12 months
  • Prescribed 6 or more Salbutamol inhalers in the last 12 months
  • Poorly controlled asthma affecting school attendance/participation in school activities
Referral can also be made for Children/young people aged 5-17 with ‘suspected asthma’ who have been commenced on treatment. Support can be given and advice offered but this is not a diagnostic service.

Viral induced or multi-trigger wheeze is not included within this service
For more information around how to use your inhaler, please visit the Asthma and Lung UK website.

Education and training
Newly diagnosed Parkinson's information session

The session will take place on Monday 11 November 2024, 12.30 - 3pm. Please complete the sign-up form again if you signed up for the October session. The room will be available before 12.30pm, if you wish to arrive early.

You will hear from various healthcare professionals, including doctors, PD nurse, physios and pharmacists. There will be refreshments and we will have time for a break in the middle of the session. There will also be lots of written information from Parkinson's UK which you will be able to take away. There will be time for questions throughout, though we will not be able to answer questions about individual care.

The session will be held in the Boardroom (Ground Floor) at Charing Cross Hospital on Fulham Palace Road in Hammersmith. After entering the main entrance to the hospital, walk towards the main block of lifts and turn right just before you reach the lifts (after Costa). Walk to the end of this corridor then turn right at the end. The Boardroom is at the end of this corridor, on the right-hand side. If you have any trouble finding the room, the staff at the main reception will be able to help direct you. You are more than welcome to attend with a friend/family member.

You are also able to join the event online if you wish. The link for this will be sent out nearer the time. The session will be recorded on MS Teams and I will send out the recording after the event.

 To sign-up link, please click here.

A further session will be scheduled for April 2025.
Please contact Bradley Lonergan with any questions.
Primary care workshop for Living Wage Week

It will take place 12 - 1:30pm on Wednesday 6 November 2024 via Zoom. To secure your spot, please make sure to register here

During the workshop we will be covering...
  • What the real Living Wage is
  • The context in London to support Local communities to thrive and survive
  • The context in primary care and future aspirations
  • Worker, business, patient and public health benefits to paying the real Living Wage
  • Workshop challenges and solutions to becoming a Living Wage Employer together, splitting into different ICS areas
  • Hear from Living Wage Employers in primary care and look at case studies of primary care employers that have implemented the real Living Wage
  • Hear from workers on how being paid the real Living Wage has impacted their lives
  • Hear from key players in primary care and London on why they support the real Living Wage.
Please register by 3 November 2024 so that we can sort out breakout rooms and accommodate any accessibility requirements. 
London NHS cervical screening webinar

NHS England London Commissioners are holding a webinar event on Wednesday 6 November 2024, 1 - 2pm for everyone working within cervical cancer screening.

The webinar will present two important topics including upcoming crucial information for cervical sample takers:

Implementation of ‘zero tolerance’ regarding the use of the London Cervical Sample Taker Database Personal Identification Number (LonCSTD PIN).

NHS England London, Implementation of Cervical Screening HPV Self Sampling for non-responders.

Please forward this invite to all your team members involved with cervical sample taking. Please note, the webinar will be recorded and shared for those who are unable to attend on the day.

Join here at the start of the webinar.
Join a free webinar on supporting trans health in primary care

To coincide with Transgender Awareness Week, Healthcare Central London (HCL) is running a free taster session on 13 November 2024 of its ‘Supporting Trans Health in Primary Care’ training.

In the 30 minute virtual session, led by Dr Joanna Lovett, a SPIN fellow for Central London on Trans Health and salaried GP working in a Central London practice, you’ll learn more about gender identity and problems currently faced by these patients.

Find out more here.
ICHP CVD Education Series – heart failure in primary care

On behalf of Dr Carla Plymen (Heart Failure Lead, Imperial College Healthcare NHS Trust), we would like to invite you to the upcoming CVD webinar on “Heart Failure in Primary Care” on Tuesday 19 November 2024, 12 - 1pm. 

In this interactive session, we will provide a comprehensive overview of heart failure, its importance in clinical practice. Review referrals pathways to NW London Heart Failure services and medications utilised. Additionally, we will introduce the Heart Failure Pages on the MyHealth LDN site, a valuable resource for both patients and healthcare professionals. You will have the opportunity to put forward any questions to the panel in a Q&A. 

Please click here to register for the session.  

Feel free to circulate to other colleagues who may be interested.  

For further information and/or to get involved with the ICHP CVD education series please contact  

chanelle.corena@imperialcollegehealthpartners.com or catherine.caldwell@imperialcollegehealthpartners.com 
Chronic pain in primary care and opioid harm reduction programme MDT for Brent, Harrow and Hammersmith and Fulham patients 

On behalf of Dr Ian Bernstein (Responsible Officer and Musculoskeletal Physician Connect Health), we would like to invite you to the upcoming chronic pain in Primary care and opioid harm reduction programme MDT meeting on November 28 2024, 12 - 1.30pm. You are welcome to refer patients even if formal reviews have not yet begun or simply attend to listen to the discussions or theoretical cases presented by others.  

Please click here to register for the session. 

Feel free to circulate to other colleagues who may be interested.  

We hope to have attendance from practice and PCN clinical pharmacists, social prescribing link workers, health coaches, care coordinators, GPs, the community MSK pain team, and Imperial College Health Partners. Please forward this invitation to your practice and PCN teams, as well as the invitees listed above, as we do not have their contact details. Even if you do not have a case to discuss, there is much to be learned from hearing how others are managing chronic pain. Feel free to join or leave the meeting as your schedule permits; we understand your time is valuable.

For further information and/or to get involved with the Chronic Pain in Primary Care & Opioid Harm Reduction Programme please contact catherine.caldwell@imperialcollegehealthpartners.com  
ICHP polypharmacy masterclass - oral nutritional supplements (ONS)

John Adams, Vittoria Romano and Imperial College Health Partners would like to invite you to attend our upcoming Polypharmacy Masterclass - Oral Nutritional Supplements (ONS) on Wednesday 27 November 2024, 12 - 2pm.  

This session will focus on improving understanding and prescribing practices for ONS, with a special emphasis on the impact of polypharmacy and the importance of appropriate use for healthcare professionals across all settings, not just dietitians.  

Please click here to register for the session.   

Feel free to circulate this invite to other colleagues who may be interested.  

For further information and/or to get involved with the ICHP Polypharmacy Programme please contact   

catherine.caldwell@imperialcollegehealthpartners.com