BEST Events – Held @ Shaw Lane Sports Club, Barnsley
For further information the BEST Portal Website can be accessed at http://best.barnsleycc.nhs.uk/
Medicines Management
Shared care and Amber-G guidelines can be found at the following link: http://best.barnsleyccg.nhs.uk/clinical-support/medicines/shared-care-guidelines/ An overview of Shared Care guidelines, including the Principles of Shared Care is available to read here.
Prescribers (including secondary care clinicians) are encouraged to report any problems they experience with shared care or other medicines related issue, particularly where guidelines are not being complied with, to the following email address: BarnsleyAPCReport@nhs.net.
With secondary care opening up activity and undertaking remote consultations, it has been reported that there has been increased pressure in primary care to undertake things they wouldn’t normally. Due to this, the APC reporting has been temporarily expanded to capture any issues and these can be fed into the APC. The hospitals need this information so that issues can be addressed.
Practices can now report any interface issues they have, as much as possible, via Barnsley LMC, which will then be submitted to the hospitals.
A list of Prescribing Guidelines is available to view here.
The Barnsley Area Joint Formulary is available to view here.
Medicines Management monthly Newsletters are available to view here.
Workload Shift
Barnsley LMC would like to remind all practices it is important that we receive examples of any workload shift. Please provide examples of workload shift to barnsley.lmc@nhs.net in order that these can be taken to the meeting with Secondary Care.
We would also request that practices provide examples to Barnsley LMC of any patients who appear to have been waiting for an unreasonable amount of time for follow up appointments from the hospital that may be detrimental to patient care/outcome.
UKHSA – Urgent public health message: Actions Needed in Response to Health Protection Issues Identified In Asylum Seekers
62 cases of diphtheria have been notified in asylum seekers with recent arrival in the UK since the start of 2022, with the majority of these cases having been detected in the last 3 months. There have also been a range of other infectious disease notifications in asylum seekers. Please read this urgent public health message from UKHSA which highlights some key advice for clinicians when managing infectious diseases, including suspected diphtheria, in the asylum seeker population.
Thank you
Central Alerting System team, MHRA
South Yorkshire Partners Come Together To The Benefit of Mental Health Crisis Patients
Adults across South Yorkshire who need a health-based place of safety in a crisis will all receive the same consistent care and approach thanks to a collaboration between public sector organisations in South Yorkshire. Read more here.
New Ways of Working Allow Hospital Patients to Return Home
Approximately 80% of people who are assessed as no longer requiring acute level care are now being discharged from hospital on the same day. The discharge to assess model was first introduced in Barnsley during the COVID-19 pandemic when staff identified a greater need to ensure vulnerable patients could be discharged without delays and is now helping more people than ever. A new discharge hub has been introduced which operates seven days a week, allowing patients to be discharged and have an assessment of their needs completed, after leaving hospital. Those who require additional help, will receive support tailored to their individual needs, this could include reablement, neighbourhood rehabilitation services or adult social services. This means that, if a person no longer requires care from the hospital, they can be safely discharged and receive the right care for them at home or an appropriate setting to meet their needs. We will be sharing further details of this work in a future edition of the Barnsley Highlight.
South Yorkshire Partners Come Together To The Benefit of Mental Health Crisis Patients
Over 100 virtual ward beds will be available to people living in Barnsley by December 2023, meaning those who require additional support with respiratory infections or frailty can now receive the care they need safely and conveniently from their usual place of residence. The virtual ward provides acute level, consultant led care, in the preferred place of care, to people who would otherwise require a hospital bed. Those who are admitted to the virtual ward are given a range of support from face to face appointments to digital monitoring where dedicated staff are on hand to provide specialist advice, treatment and diagnostics. This allows people to receive more timely care, allowing them to live their life independently outside of hospital, whilst still having the right support on hand to manage their acute condition. Patients admitted to the virtual ward will receive dedicated care led by Barnsley Hospital with support in the community from South West Yorkshire Partnership Foundation Trust and Barnsley Metropolitan Borough Council. Since the launch of the virtual wards in June, the team has been working hard on increasing the numbers being treated there with 17 being seen in November. This will rise sharply in December where we will have 20 virtual ward patients being seen at any one time. Feedback from those who have been treated as part of the virtual ward has been positive. The care closer to home board are working to deliver the virtual ward programme.
INDUSTRIAL ACTION – PRIMARY CARE COMMUNICATION 9 JANUARY 2023
FOR GENERAL PRACTICE, COMMUNITY PHARMACY, DENTISTRY AND CARE HOMES
Current planned Industrial Action:
- Wednesday 11 January: Unison (for 12 hours) and GMB staff (for 24 hours) at Yorkshire Ambulance Service.
- Tuesday 18 and Wednesday 19 January: Royal College of Nursing staff at Sheffield Teaching Hospitals, Sheffield Children’s Hospitals, Sheffield Health and Social Care and Barnsley Hospitals between 08.00 – 20.00 each day.
- Monday 23 January: Unison and GMB staff at Yorkshire Ambulance Service. Duration to be confirmed.
For General Practice
For the industrial action taking place this month by Unison and GMB, ambulance staff, including patient transport services, paramedics, crews and call handlers, including those covering 111, will be involved. Whilst Primary care services are not directly involved, we recognise that there may be consequences for primary care, if support, particularly in relation to ambulance services or 111 call services, is not available. Routine and planned PTS journeys will be limited, with the following patient journeys as exceptions and will still be undertaken:
- Patients who need essential life-saving treatment such as renal dialysis, chemotherapy, radiotherapy and other cancer treatment.
- Patients at end-of-life and requiring palliative care transport.
- A limited service for in-patients who are medically fit for discharge; (as discharge transport arrangements vary by Trust, this relates to PTS provided by YAS).
Yorkshire Ambulance Service are urgently contacting patients with existing bookings, to ask them to make other arrangements and advising any patients who have any concerns about their transport to contact our reservations team via email in the first instance at yas.ptssystems@nhs.net or on 0300 330 2000. Yorkshire Ambulance Service expect that PTS will experience disruption on the days following the industrial action.
Current information suggests that similarly to the December action calls to ambulance services from general practice teams for Cat 2, 3 and 4 may not be responded to. In addition, 111 call services are likely to be significantly impacted, although the online service will remain in place.
Advice
On days where there is ambulance industrial action (11 and 23 January) general practice staff calling on behalf of patients should only call 999 if it is a life threatening medical or mental health emergency. NHS 111 call handling services will be impacted by the industrial action. For that reason, please can you ensure all staff are directing patients to the 111 online service, community pharmacy and alternative local services, for advice, where appropriate rather than 111 phone line.
Given the likely pressure on the system, and the number of patients who may contact general practice rather than 111 on days of ambulance industrial action, practices are encouraged to:
- Ensure robust telephone triage is in place on the days of the strike, including use of digital solutions
- Consider appointment ledgers and the mix of urgent, same day and routine appointments depending upon capacity within the practice to deal with anticipated increased demand on strike days.
- Update messaging on out of hours arrangements, if current practice arrangements are to signpost to 111 call services (e.g. 111 online, or an alternative out of hour provision, such as directly to the GP Out of hours service)
Communication with patients
You may want to update your practice answerphone messages, websites and social media accounts, particularly if it currently signposts to call 111 as follows:
- NHS services across the region are experiencing extremely high demand at the moment – this includes GP practices which are extremely busy
- If you need advice for a minor/mild illness or injury, in the first instance, please either contact your local pharmacy for help or look at the self-care advice that’s available on-line from the NHS at nhs.uk
- If you want to check your symptoms, there is an on-line symptom checker available at 111.nhs.uk, which will re-direct you to a health professional if you need to be consulted by someone.
- The 111 online service is effective and efficient and endorsed by your GP. You will be dealt with more quickly using 111 online than calling 111. Go to 111.nhs.uk
Please reassure patients that they should attend their appointments on strike day with the GP team unless contacted and told otherwise.
Planning for additional transport options
Given the impact of the strike it may be that additional transport options are needed. It is suggested that primary care providers consider alternative options and put these in place where possible.
Pathway discussion and documentation
If ambulance services are not available, for example ‘non-life threatening illness or injury’ calls from general practice are not responded to and a practice needs to recommend non-ambulance transport when an ambulance would have usually been called, we suggest the following takes place:
- Discuss the situation with the patient/carer/family and mutually agree the most appropriate form of ‘non-ambulance’ transport given the circumstances.
- Document as follows in the patient’s notes:
“I am reviewing this patient who requires admission to hospital. There is currently industrial action which is affecting ambulance services in this area. I have ascertained that there is no ambulance available within an appropriate time frame to transport this patient to hospital. In line with guidance from my Responsible Officer and ICB Medical Director I have considered the risks and benefits of suggesting alternative transport such as private vehicles or taxis and have advised the patient/carer/family that in this case the risks of delayed transfer would outweigh the risks of clinically unsupervised transport. They have therefore been advised and have agreed to use a private vehicle/alternative transport.”
LMC Buying Group
Barnsley LMC has been a member of the LMC Buying Groups Federation since 2013. This means that practices can access the discounts the Buying Group has negotiated on a wide range of products and services. If you’re not sure what the Buying Group is all about then this short video explains what they do: https://www.youtube.com/watch?v=FekMwFI5ILg.
By registering with the Buying Group: www.lmcbuyinggroups.co.uk/members/, you can view all the suppliers’ pricing, contact details and request quotes. The Buying Group also offers any member practice a free cost analysis which demonstrates how much money your practice could save just by swapping to buying group suppliers. Tel: 0115 979 6910 Email: info@lmcbuyinggroups.co.uk Website: www.lmcbuyinggroups.co.uk