Happy New Year!


Welcome to this week's primary care bulletin

Key points this week include:

• IMPORTANT: More measles cases reported in NW London
• External HCP guidance - Healthcare professional admissions
• Imaging request forms have been updated
• Offer your extended diabetes care today
• Access to employment support via primary care
• Removal of local administrator rights for NHS mail
• Training, webinars and more

IMPORTANT: More measles cases reported in NW London

The NW London Health Protection Team (UKHSA) this week have reported a further cases of measles in NWL.  There have been 9 cases to date, 2 confirmed and 7 probable (awaiting laboratory confirmation) which are all linked to a school in Brent.  All cases are unvaccinated children of primary school age.

This started off with one case in a child in Ealing. In the last week, we have had a further eight cases reported as follows- Ealing (4 - in UB6, W7, two siblings in W13), Brent (2 - in HA9 and HA0), Hillingdon (1-  in UB4) and Westminster (2 in W9- siblings).  As evidenced from the cases, the catchment area is quite wide. There have not yet been any more cases that are not linked to the above school.

If a child or adult presents with signs and symptoms of measles please consider this a differential diagnosis and contact the NW London Health Protection Team as soon as you suspect or become aware of a suspected case of measles (9am-5pm Mon-Fri 0300 30 30 450 or out-of-hours on 0300 30 30 450)  

Do not wait for laboratory confirmation. Measles is a notifiable infection.

Action required: 
· Rerun searches for any children who have not received either one or both doses of the MMR vaccination as per the Routine UK Schedule. 
· Invite children with an uncertain or incomplete immunisation status for vaccination as soon as possible. 
· Check immunisation histories for all new entrants from abroad and newly registered patients of all ages.  Particularly those living in temporary accommodation.  Practices will receive an item of service fee for any vaccinations given.
· Maximise the ability to offer opportunistic vaccination when children visit the G.P Practice for any other reason (even when accompanying a parent to their appointment). 
· Ensure that appropriate triage and isolation procedures are in place so that those presenting with a fever and rash can be isolated immediately, to avoid exposing others.

Suggested wording for text message recall: 

“Measles is very contagious and is currently circulating locally. Our records show that your child is not up to date with their routine MMR vaccination and therefore are at an increased risk of contracting measles. Please contact your practice as soon as possible to book your child in for vaccination’’.

UKHSA's new winter communications toolkit also contains communications materials for MMR, including social media assets, suggested copy and inks to other useful information. The toolkit covers a range of issues relevant to winter but measles/MMR-specific materials are on pages 24-26.

Any communications from the NWL ICB and the Health Protection Agency to Primary Care/Parents/Schools staff will be added to the latest updates under this link: www.nwlondonicb.nhs.uk/professionals/children-and-young-people/childrens-vaccination-resources-professionals

LAS have updated their HCP admission guidance Pan London, click here to download the document. 

The front page is intended to be used as a poster with the rest of the document providing useful information. This information has been taken from the NHS E frameworks and from an LAS internal policy: OP060. 

Imaging request forms have been updated  

North West London (NWL) Trusts have revised the existing imaging referral forms for primary care to ensure they are clear, current and consistent across our services. They will be available for use from 8 January 2024.

These forms are intended for use only when it is not possible to send the referral via ICE – which remains the principle referral method for NWL. Trusts’ criteria for accepting requests via this form are laid out in Appendix B on the request form for each Trust.

The updated GP Imaging Requests Forms have been approved by the NW London Imaging Project Board in consultation with primary care and imaging department colleagues.

Please refer to the NHS NW London website for this documentation.

For any further queries please contact nhsnwl.nwlicesupport@nhs.net

To support improved outcomes for patients living with diabetes two new services have been rolled out across NW London. Offer these to your patients today.

1. Early Onset Type 2 Diabetes (EOT2D) Reviews– 20-30 minute reviews for patients aged 18 – 39 living with type 2 diabetes (£52 per patient)
2. Diabetes level 2 service:
   • PCN Diabetes MDT – patients who could benefit from a multi-disciplinary team discussion (£23.14 per patient)
   • Insulin / GLP-1 initiation and optimisation – (Initiation attracts £241.04 per patient while optimisation attracts £66.16 per patient)

This service is within the existing commissioned suite of services within the ‘North West London single enhanced services offer’. Clinical searches and templates have been developed for all three elements to support you in finding patients, deliver care and receive your payments.  Please use the NW London templates to ensure you get paid for this activity. 

NWL SystmOne Practices: The templates will automatically be uploaded into your system.
NWL EMIS Practices: The templates will automatically appear in NWL Resource Publisher. They can be accessed via NWL F12 template launcher.
NWL EMIS PCNs: The templates will need to be manually imported. If you do not have these please email the service desk (nhsnwl.servicedesk@nhs.net). 
 
To gain access to the service specification, FAQs, EMIS & SystmOne Cribsheets and other support please request to join the NW London Diabetes MS Teams channel by clicking here: NHS North West London Diabetes Transformation | PC Diabetes Enhanced Service | Microsoft Teams

Access to employment support via primary care

Increasingly NW London NHS and Local Authorities are working together to help their patients and residents become healthier, overcome barriers and gain greater financial independence.

There are a range of high quality employment support programmes which are free, voluntary and do not require participants to work full time. They are designed primarily for people with health conditions and disabilities.

These are provided by Shaw Trust in Brent, Ealing, Hammersmith and Fulham, Harrow, Hillingdon and Hounslow and Ingeus in Westminster and RBKC.

VIA provide a bespoke employment support service for people with substance misuse issues for all of the boroughs in the NW London NHS.

Attached are the flyers for these programmes and we would be grateful if you could ensure they are displayed in your primary care settings and available to your staff and social prescribers. These programmes really to do help people find and keep work which is key to aiding their recovery.

West London Works for you poster
IPS into work
Central London Works, work and health programme

The team are also working together on the NW London NHS Health Equality programme, ensuring that employment support is integral to the activities of the Integrated Neighbourhood Teams who are tackling health inequalities. In the next few months they will be looking to co-locate employment support services for 1 day per week in primary care settings serving communities in the poorest part of the boroughs.

There will be more information on this soon but if you are interested please contact Kim Archer archerk@ealing.gov.uk

Local administrator rights have been removed for all GP practices with immediate effect. The reasons for doing so include the following:

1. Increase in the number of duplicate accounts being created for staff members, including accounts being created under the same practice and duplicate accounts being created for the same staff member under different surgeries. This goes against the NHS Mail rules that each staff member is to only have one NHS mail account in their name.
2. Email addresses are being created in an incorrect format. We have found an increase in non-named accounts being set up as a standard account rather than a shared mailbox. 
3. Accounts being created for non NHS people and organisations. This is a breach of IG and could put NHS Mail at risk if non NHS companies have not been through the appropriate checks to ensure that their purpose for wanting to use NHS Mail is legitimate.

This decision has not been taken lightly and many different options have been explored to retain tight admin rights. 
 
For new NHS Mail accounts these can be requested through our new IT Self-Service portal which is also where you request for Windows accounts to be created.

Staff can set themselves up to enable themselves to perform their own password resets and account unlocks without the need to contact a local administrator. Guidance can be found here:

Unlocking accounts

Resetting passwords

A call can also be logged via our IT Self-Service portal to request an account unlock or password reset for NHS Mail.

Please be aware that we are currently in talks with NHS Mail and NHS England to work with them to get a level of access put into NHS Mail that allows practice managers to manage certain aspects of their practices accounts without compromising the security of N365. So far NHS Mail and NHS England have acknowledged this ask and are working with us to get it in place as soon as possible. We will update you with further details as they develop.

Cohort eleven - 24 January, 7 February and 28 February 2024
Cohort twelve - 25 January, 8 February and 22 February 2024 
Cohort thirteen - 6 March, 20 March and 3 April 2024 
Cohort fourteen 28 March, 11 April and 25 April 2024 

The National Polypharmacy Programme invites you to join the Action Learning Set (ALS) to help build GP and prescribing health care professionals’ confidence in, and understanding of, the complex issue surrounding and stopping inappropriate medicines safely. Delegates need to attend all three sessions. The ALS with also help PCNs deliver the medicines optimisation elements of the new Directed Enhanced Services contract and contributes to the QoF.

To learn more about the Polypharmacy ALS please click here, to register for either: 
Cohort 11 please click here
Cohort 12 please click here
Cohort 13 please click here
Cohort 14 please click here

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 or gill.francis@imperialcollegehealthpartners.com

Thursday 18 January 2024 12:00-13:00

This is a network bringing together clinicians working in primary care who have an interest in homeless/inclusion health, and aims to offer opportunities to clinicians to extend their skills, development and support in this area of care. 

The future direction of the community of practice can be shaped by its members, but in the first meeting, we intend to cover:

· A talk on Personality Disorder from a guest speaker - Dr Jacob King, ST4 Academic Clinical Fellow in General Adult Psychiatry, Division of Psychiatry, Imperial College London & Westminster Psychotherapy & Complex Emotional Needs pathway, CNWL

· Hear the results of a survey of NWL practices and their experiences caring for patients experiencing homelessness

· Identify future development that would support GPs working in this area

· Shape the future direction of care for this population
 
All clinicians working in primary care are welcome.

Click here to join the meeting 

Or email Claire Wilson to find out more information - claire.wilson49@nhs.net

A new eLearning package - Working together 

A new eLearning package, Working Together: Personality Disorder in Primary Care, is being launched for GPs and other primary care staff on Thursday 18 January 2024.

Anna Freud was commissioned to produce this package, which has been co-produced by clinicians, experts by experience and GPs. The eLearning aims to develop the skills and knowledge of primary care staff to support them in their work with patients who have Complex Emotional Needs, which is often associated with a diagnosis of ‘Personality Disorder’. 

The eLearning is comprised of short modules that can be accessed individually or sequentially and features films, animation and interactive content to enhance learning. It provides training to support the patient’s journey from initial contact, through to referrals and long-term support. The package will be freely available to all primary care staff on NHS England’s eLearning for Health Hub.

A launch event is taking place on Thursday 18 January 2024, 1-2pm, where the topics below will be discussed:

• Why the eLearning was commissioned and the aim of the training
• How the content was produced
• Feedback from the pilot
• How to access the training

The event will take place online over Microsoft Teams. To sign up please complete this form by 3pm on Wednesday 17th January 2024. 

For more information about the eLearning please visit this webpage. 

The higher development award is for support workers within primary care, social care and the NHS.

It is an opportunity to develop essential knowledge, skills, behaviours and values to progress careers or develop in a current role. 

Please share the attached flyer with any colleagues this may be relevant to. 

By Popular demand new in person Action Learning dates have been added for 2024!

You are invited to collaborate with clinical and non-clinical colleagues and sessions are now open for all staff using NWL Online Consultation Platforms.

Find out more here

Upcoming online consultation training and action learning opportunities - sign up now to secure your place

The action learning sets are designed to share lessons learnt, discuss scenarios, share practical tips and tricks and connect with colleagues in other PCNs and boroughs. Find out more about how online consultations are used/can be maximised.

The training session is designed to be a technical refresher of the online consultation platform, the features available and to give you a forum to ask experts questions about how to do something in the platform.  

Do you want to learn more about online consultation in North West London & the features available to you & your practice?

Register now and join in these practical online sessions with opportunity for Q&A included.

PATCHS 23 January 2024
12.30-13.15 Clinician Focus
Register @ https://bit.ly/3NwnUlw

13.15-14.00 Non-Clinician Focus
Register @ https://bit.ly/3RqEZOS

eConsult 24 January 2024

12.30-13.30
Register @ https://bit.ly/3uVPpyb

Ferguson House, 15 Marylebone Road
16 January 2024 @13.30-15.45
6 February 2024 @13.30-15.45

Perceval House, 14/16 Uxbridge Road

5 March 2024 @ 13.30-15.45
12 March 2024 @ 13.30-15.45

Sign up now to secure your place on the Learning Hub 
Or email: nhsnwl.oc@nhs.net with your name, role, practice and choice of date