Important information for GP practices across Kent and Medway
Thursday, 7 October 2021
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Protected Learning Time (PLT) update
The CCG and LMC have made changes to improve the arrangements for PLTs in October and November. These are outlined in this letter from CCG clinical chair Dr Navin Kumta, LMC medical director Dr Caroline Rickard, and the leads from the training hubs. Please also see the flow chart for MedOCC and an updated IC24 flowchart, which should clarify the process.
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Vaccinations and immunisation
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Clinicians needed for inequality work
In the vaccine inequalities programme, we are supporting local ethnic minority communities to increase Covid-19 vaccinations. In particular, where we have identified low uptake in a certain area or community, we hold information events in various locations including faith settings, community groups and locally organised events. The aim is to reassure people on the safety of the vaccination, answer questions and dispel some of the myths that lead to vaccine hesitancy.
We have found that having a clinician provide a talk at these events to be very successful at encouraging positive engagement – so far we have received support from pharmacists, GPs and hospital consultants.
We are looking for clinicians, from any healthcare setting, with an ethnic minority background to volunteer to talk at future events as we work with different communities across Kent and Medway. We have a slide deck available for you to use and a standard set of FAQs. You will be fully supported by the vaccine inequalities team in any talk you provide.
If you are willing to take part could you please email Shelley Johnston, Programme Manager: shelley.johnston2@nhs.net. We would very much welcome your support. Please also share this message with your colleagues.
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Clinical advice and support
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Latest general practice appointment data released
We recently let you know that we’d be running a joint communication campaign with the LMC to support GP teams through this difficult time and to help patients understand the pressures in general practice.
At the end of last week, we produced a press release which can be found here: General practice appointments in August and a graphic giving the updated appointment data for August. The graphic can be used on your own channels if helpful, or you can share from our social media channels - Facebook: @KMCCG Twitter: @NHSKMCCG.
Showing the number of appointments taking place helps us evidence that general practice is working harder than ever and that people are being seen when they need to be. We will continue to release this data each month.
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Removal of ethnicity adjustment for kidney function testing and NICE Chronic Kidney Disease (CKD) guideline
The National Institute for Health and Care Excellence (NICE) Chronic Kidney Disease (CKD) guideline was recently updated. A major change from the previous guideline is the removal of the recommendation to adjust for ethnicity when calculating the estimated glomerular filtration rate (eGFR) in people from black ethnic groups.
NICE highlight that eGFR has not been well validated in certain ethnic groups and that adjusting eGFR for different ethnicities may not be valid or accurate. In keeping with this revised guidance, the Kent and Medway clinical biochemistry service no longer recommends adjusting eGFR for black ethnicity.
Further information may be obtained from the NICE website, from the United Kingdom Kidney Association website, from your local duty biochemist or renal department.
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Breast cancer lunch and learn - 20 October
Please join us for a virtual learning event during breast cancer awareness month (October) to explore breast cancer prevention, screening, signs and symptoms and living with and beyond the long-term effects of breast cancer and its treatment, including lymphodema.
Find out about support on offer for each element discussed and identify useful resources. This event, on 20 October from 1.30pm to 2.30pm, will be brought to you in collaboration with Macmillan, NHS England, Kent and Medway Cancer Alliance and Cancer Research UK. Please register via Eventbrite.
The session will be delivered by MS Teams. A link will be sent to you the day before the event, once you have registered. If you have any questions please do not hesitate to contact: kateregan@nhs.net
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GP representatives required for Dartford, Gravesham and Swanley, and the Canterbury area
We are looking to recruit two GP representatives - one for the DGS area and one for the Canterbury and Coastal area to attend both the Primary Care Commissioning Committee (PCCC) and the respective Primary Care Commissioning Operational Group (PCCOG) for the area. Both committees meet monthly. The commitment is for three sessions a month (which includes attendance at both monthly meetings) and remuneration would be via the CCG payroll. At the moment we are only looking for representatives to attend the January, February and March meetings but this may change once new committee arrangements become clearer.
The purpose of the role is to represent the GP membership in the commissioning of primary medical care services working with other PCCOG members in providing the necessary independent scrutiny, challenge and support to ensure robust and effective delivery of sub-committee’s Terms of Reference.
In particular this will involve:
- Providing clinical expertise and leadership for the primary care elements of the health improvement directorate portfolio.
- Acting as the GP membership representative at PCCOG meetings and PCCC meetings.
- Representing the GP membership in the commissioning of high quality, effective primary medical care services across Kent and Medway.
Further information is provided in this role description. If you are interested in the role, please contact Louise Matthews, Associate Director of Primary Care Contracting by emailing louise.matthews5@nhs.net for an informal chat.
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Paracetamol
We have been asked to make you aware of an apparent increase in overdoses in children and young people, especially involving paracetamol.
Whilst we take into consideration the widespread availability of paracetamol, we are asking pharmacy staff to be particularly vigilant around the identification of any suspicious purchasing. This includes those involving repeat purchases or attempts to purchases larger quantities.
Please make sure that your team knows how to raise a safeguarding concern and how to signpost to mental health first aiders or other local support. Discuss with your teams the best way to offer advice and support to any potentially vulnerable individuals or any suspicious purchasing, in particular by children or young adults which raises concerns.
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Tackling county lines criminal exploitation
The Eyes Open website features content from Kent and Medway to help young people, parents and professionals spot the signs of criminal exploitation and resources for professionals and useful contacts to get help or report concerns.
Fegans is working with the Violence Reduction Unit to offer counselling to young people in Kent who are involved in violence, have the potential to become involved in violence or have suffered trauma from violence or violent home situations. For more information, call 01892 538288 or click here.
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Child sexual abuse
Stop It Now is a child protection charity, working to prevent child sexual abuse. There is a confidential helpline, live chat and secure messaging for anyone with concerns about child sexual abuse and its prevention – whether they’re worried about their own thoughts, feelings and behaviour, or about another adult or young person.
There are various resources to support professionals including a helpful guide on how to tell if a child’s sexual behaviour is age appropriate.
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Prohibition on charging for medical evidence of domestic abuse
The Domestic Abuse Bill (2020) places prohibiting charging for medical evidence of domestic abuse from 1 October 2021 on a statutory footing. This means it will no longer be to the discretion of an individual GP for any charge for the preparation and provision of domestic abuse legal aid letters by health professionals in general practice. This provision also ensures patients cannot be charged for these letters by a GP practice in its capacity as a company or partnership. Further information can be found in the Domestic Abuse Bill fact sheet in relation to this provision.
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Domestic Homicide Review
The review for Connie (2018) has been published on Kent County Council and Medway Council’s websites. A briefing outlining the learning from the review is available.
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Prevent strategy
The Home Office has produced a useful document Family and Friends Factsheet: supporting people vulnerable to radicalisation. This is designed to provide information on how Prevent can help and support individuals and their families. It can be used to provide further information following a referral or if you are made aware of concerns about radicalisation.
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National Safeguarding Adults Awareness Week: 15-21 November
The Kent and Medway Safeguarding Adults Board (KMSAB) will be using this time to raise awareness of adult safeguarding and there are daily themes for the week hosted by the Ann Craft Trust.
You can share the key messages with the public on how to recognise abuse and report concerns using these resources.
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Training
A Multi-Agency Public Protection Arrangements (MAPPA) virtual course will provide a general introduction to the principles, purpose, and procedures of MAPPA. Available on 18 October 2021 on Microsoft Teams.
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Extension to block payment protection
As pressures on primary care from Covid-19 are expected to remain for the coming months, the CCG is proposing to extend the current income protection for block payments until the end of December 2021.
This extension takes into account the following factors:
- continued operational restrictions due to infection control
- delivering the demands of the vaccination programme
- winter pressures
- the continued delivery of care to patients as part of recovery.
The CCG needs to continue to understand activity levels for all services covered by the block payment protection so we will continue to work with you to collate your service activity data each month. Therefore we ask that:
- you will return your monthly service activity returns (each of you now has a bespoke activity return sheet for the services you deliver)
- you identify any needs you have to support your return to routine service delivery, including any backlog.
Your monthly activity returns must continue until such time as we have your signed Information Sharing Protocol Agreement back. Thank you to all those that have returned this so far. This allows us to work on automated extraction, reducing the workload burden.
We appreciate how busy practices are and thank you for your commitment in providing these data returns as we move towards a streamlined data collection and claims processing system. If you have any questions about this please email: kmccg.pchealthoutcomes@nhs.net.
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Pay transparency guidance
New guidance has been published following changes brought in by the Government around pay transparency.
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North Kent
Historical reports: North Kent Pathology Service
Please see this letter from the North Kent Pathology Service about reviewing and clearing the pathology IT system.
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Medway and Swale
Nutrition and dietetics service
There are currently some staffing gaps within the nutrition and dietetics service at Medway Community Healthcare (MCH), and whilst MCH is beginning to recruit successfully to key posts within the team, they would like to request support from primary care partners in order to safely manage patient referrals.
- Please consider only referring patients with a Malnutrition Universal Screening Tool (MUST) score of two or above, or those you feel require specialist input from our service. Guidance attached which may be useful.
- Weight loss support:
- Eating disorders: patients should be referred to Kent and Medway Eating Disorder Service run by NELFT NHS Foundation Trust.
- Oral nutrition supplements (ONS): patients requiring ONS can be provided with Food First strategies. If this is not successful, then please prescribe supplements using the ONS prescribing guidelines for our area.
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Please share this update with colleagues who are welcome to subscribe to the mailing list.
Previous issues of the GP Practice Update are available online
If you have any feedback or ideas to make the updates more useful to you please email.
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Useful links
Produced by the communications team, NHS Kent and Medway Clinical Commissioning Group
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