Primary care bulletin - 24 September 2025

Primary care webinar recording

The recording of the 17 September 2025 webinar is now available. The session is focused on the training hub, the Joy App and digital topics.

Jess’s Rule: Three strikes and we rethink

On 23 September 2025, the Department of Health and Social Care and NHS England announced the implementation of Jess’s Rule: Three strikes and we rethink. Under Jess’s Rule, GP teams are encouraged to critically re-evaluate a diagnosis if a patient presents three times with the same or escalating symptoms or concerns and an existing treatment plan that is not working.

Jess’s Rule is in memory of Jessica Brady who passed away due to cancer in December 2020 at the age of 27. In the five months leading up to her death Jess had over 20 consultations with her GP practice, and her cancer had not been diagnosed. Please visit the Jess’s Rule website for more information and resources.

The Secretary of State of Health and Social Care, Wes Streeting MP, National Medical Director, Dr Clare Fuller, have written to professionals about the implementation of Jess's Rule.

Windows 11 compatibility for medical diagnostic devices - action required by practices and PCNs

From 14 October 2025, Microsoft will end support for Windows 10. We will continue to ensure north west London practice desktops and laptops migrate to Windows 11 over the next 7 weeks to ensure practices meet cybersecurity and NHSE technical standards. All diagnostic devices need to be Windows 11 compatible. Some manufacturers such as Welch Allyn and Seca Cardio 150 are not compatible. In preparation to keep systems secure and prevent disruption to providing services we ask all practices to:

Contact device suppliers to confirm Windows 11 compatibility.
Arrange upgrades, replacements, or rentals (hiring might be cheaper in the short-term) where needed.
Ensure supplier contracts cover upgrades and support.
Review the attached list of non-compatible devices (mainly Welch Allyn and Seca 150). For queries, email nhsnwl.medicaldevicesupport@nhs.net. See the slide deck.
Keep receipts/logs for any equipment purchased or replaced after June 2025 (may be relevant if future funding support becomes available).

For support:

Technical: nhsnwl.windows11@nhs.net | nhsnwl.medicaldevicesupport@nhs.net
Other queries: nhsnwl.localservices@nhs.net

Ambient scribe dcb160 free offer – deadline to register interest: deadline 26 September 2025

We understand that many practices & PCNs are exploring AI Scribe technologies.

An AI ambient scribe is software that records clinician–patient conversations and automatically generates structured clinical notes, summaries and can save documentation time. It is MHRA-regulated and classed as at least a Class 1 medical device.

To support practices interested in using these tools, NHS North West London has secured the support of Bordercross Health to help with the mandatory compliance activities, specifically the creation of the required DCB0160 clinical safety documentation.

The free offer is for the already approved and most utilised scribe tool across north west London.

For practices who wish to undertake this exercise for either Tortus or Anima, Bordercross Health will develop your DCB0160 at a cost to the practice of just £100

THIS OFFER IS TIME SENSITIVE – practices must register by close of play Friday 26 September 2025.

Register here

Find out more details and see a previous presentation about the software.

Make Your Voice Count — shape the future of general practice digital systems

Every day, practice teams rely on digital systems to support safe, efficient, and compassionate care. But too often, these tools slow you down, cause frustration, or add to workload — instead of easing it.

Now’s your chance to say what works, what doesn’t, and what needs to change.

Complete the Clinical Systems Experience Survey for General Practice now – it’s anonymous and takes less than 10 minutes.

Your feedback will help guide national thinking, highlight priority areas for supplier improvement, shape future investment in general practice digital systems and support ICBs to plan local improvement initiatives to support efficient and effective practice.

School aged flu provision commences

Vaccination UK, the school aged seasonal flu vaccination provider for Northwest London, has now commenced its school aged flu vaccination delivery this week. All information including consent forms, catch up clinics, information for parents etc can be found on their website.

As a reminder that this is for all schools in north west London including SEN and private schools and children that are of school age but not in mainstream education e.g. home schooled and includes all children in Reception to year 11.

Delivery will be happening simultaneously across all north west London boroughs with each school receiving a visit and in areas where uptake has historically been poor, a second or third visit.

It also runs local catch up clinics from October in each borough to mop up children who were absent in school on the day of vaccination, do not attend school or missed it for another reason. Dates and times for catch up clinics are now published for most boroughs, the rest will be confirmed shortly, on their website.

It is aiming to complete school delivery by the end of November and then catch up clinics by 19 December 2025.

The in school offer is the LAIV nasal spray vaccine and includes the IM alternative (TIVc) for those parents who wish for their child to have this option.

As a reminder, school aged children who fall under the at risk cohort are also eligible to be offered and can receive their flu vaccination at your practice.

Please signpost any parents who present or enquire with regards to school clinics to Vaccination UK. For ease their contact details are in a document.

It is World Pharmacy Week

In recognition of World Pharmacists Day on Thursday 25 September 2025, we would like to acknowledge the vital contribution of our pharmacy colleagues in improving health outcomes for our population.

In north west London, we have pharmacists working in numerous sectors, such as the ICB, practices, hospitals, community trusts, community pharmacies and care homes, all contributing to enhancing patient care.

They achieve this through a wide range of activities, from participating in hospital ward rounds and undertaking medication reviews in practices, to providing services within community pharmacies.

Find out more about our great work and access key resources.

New pathways for ENT, MSK and T&O

New guidelines have been developed with the Clinical Leadership Groups alongside relevant teams and have been approved by the London Region Leadership.

Orthopaedics

The Orthopaedic pathway is for the management of non-traumatic painful and or stiff shoulders. This pathway provides management guidance for primary care, secondary care, and MSK/APP professionals. The pathway has been developed in conjunction with the MSK, Trauma and Orthopaedic and diagnostic Clinical Leadership Groups and will provide standardisation of practice across the region, improving patient experience and supporting the move to greater care within the community

The guidelines are attached and also available on NHS Futures.

ENT

The Straight to Test (STT) pathway for patients experiencing hearing loss and tinnitus to have access to MRI IAM has been developed by the ENT and diagnostic CLG’s and will support secondary care referrals as well as utilisation of community ENT including Tele-Otology. The implementation of this pathway will improve patient and staff experiences through streamlining and accelerating the investigation of hearing loss and tinnitus on triage of referral.

The guidelines are attached and also available on NHS Futures.

Medicine Supply Notification

Admelog® (insulin lispro) 100 units/ml solution for injection cartridges, pre-filled pens and vials are being discontinued with supplies anticipated to be exhausted by mid-March 2026, late March 2026 and mid-June 2026, respectively.

Humalog® (insulin lispro) 100units/ml solution for injection cartridges, KwikPens® and vials remain available and can support increased demand.

Find out more.

Workwell update

There is an update on selecting sites for the WorkWell Primary Care Innovation Fund in north west London, which has been launched to help patients with health conditions return to employment and reduce pressure on doctors.

There is also a guide been produced for EMIS and SystmONE system tools.

Updated pan London urgent suspected cancer referral forms

The Pan London Urgent Suspected Cancer (USC) referral forms have recently been updated. The website hosting the forms, educational resources and support information has changed and they are all available on the NHS England website.

The following changes have been made to the forms:

All forms – embedded links within the forms have been updated to the new website. This includes links for clinical referral guides, top tips, hospital directory, RDC/NSS services and patient information.

All forms – new wording has been added to confirm patient should be available over the next 28 days, reflecting the Faster Diagnosis Standard (which replaced the Two Week Wait standard in 2023).

Breast Cancer – The link for management of gynaecomastia has been updated.

SMS/Messaging templates - Practices should check/amend any SMS/messaging templates for patients that include links for the patient information leaflets.

For NHS North West London, SystmOne practices have already these updated and set up for all languages within SystmOne’s Communication Annexe preset messages.

The new referral forms (version 1 June 2025) has already been published by NHS North West London for all EMIS and SystmOne practices to replace old versions, so no further action is required by practices. The new updated forms have also been updated in C the Signs.

It is important that only the new, updated USC referral forms are used going forward. Please could you ensure that any old forms or templates are removed from your local practice IT system and are no longer used for patient referrals. You should only use the versions that have been published to you by NHS North West London to ensure that you are using the latest version.

If you encounter problems using the forms please contact your borough’s Cancer / IT lead or the NHS North West London Servicedesk

If you have any questions or concerns, please email england.tcstlondon@nhs.net

Education and training

Events for Personalised Care Week 2025

Personalised Care Week 2025 is a national initiative focused on advancing digital innovation to enhance personalised healthcare delivery across the NHS. A highlight will be the free, half-day virtual conference with the Personalised Care Institute, called ‘Shaping the Future: The Role of Digital Health for Personalised Care’, on Thursday 25 September 2025.

Find out more, including about the agenda for the rest of the week.

Supporting safe deprescribing of antidepressants in primary care webinar

This webinar for all primary care will cover:

concise GP guidance to support conversations in primary care
patient information leaflets to aid shared decision-making
service user perspective videos to highlight lived experience.

This webinar will introduce the resources, share learning from the project, and provide a space to reflect on best practice in supporting patients who wish to reduce or stop antidepressants.

The session takes place on Tuesday 7 October 2025, 1 - 2pm. It will be recorded and made available on the NHS North West London mental health webpage alongside the resources. Find out more.

Join the Teams meeting at the start of the session.

Community of Practice for Homeless Health

NHS North West London are inviting you to the next North West London Community of Practice for Homeless Health taking place on Thursday 25 September 2025, 12 - 1pm.

Our guest speaker is Ashley Brown who leads on Hepatitis C elimination work and the topic will be ‘Viral hepatitis and liver cancer screening’.

Agenda as follows:

12.30pm – homeless health news / updates by chair Dr Natalie Miller

12.40pm – guest speaker presentation and Q&A by Ashley Brown

1:20pm – case study sharing / best practice / advice from colleagues – floor open to all

Join via Teams at the start of the session.

Antimicrobial stewardship for nurses across the continuum of care

Let’s work together to combat antimicrobial resistance and strengthen nursing practice through antimicrobial stewardship.

This interactive webinar will explore practical strategies for implementing AMS across primary, secondary, and community care settings.

The event takes place on Wednesday 5 November 2025, 9.30am - 12pm.

Find out more and book now.

Third North West London Integrated Kidney Care workshop: Cardio Renal Metabolic Disease - How early is early?

The agenda includes:

an operational update
early chronic kidney diseasmanagement with table top case discussions
integrated kidney care - new ways of working. This includes CRM models and single offer
debate GLP-1 receptor agonists should be used as a long-term solution for weight management.

The workshop takes place on Tuesday 14 October 2025 at W12 Conferences, Du Cane Road, London, W12 0TN.

Find out more and book now.

Please send any queries to Joana Teles, Kidney Nurse Specialist at Imperial Healthcare NHS Trust.