Lincolnshire WestNews Update September

2009 – Issue 4This is the fourth issue of our news update which summarises the activities within the Cluster. It is designed to ensure everyone is kept up to date about the Cluster developments and that relevant information is provided in one document.

As you know we are keen to engage and involve as many practices as possible in the activities of the Cluster and so if there are any projects you would like to know more about, suggest or get involved with then please contact the relevant person. It would also be appreciated if you could find a moment in order to give feedback on the usefulness of these news updates. If you could send this to either Lisa Sharpe or Gill Flowers that would be most helpful. Contact details are listed below:

Chairman’s Update

Chairman’s UpdateDr Sunil Hindocha

This summer the Professional Executive Committee (PEC) meetings have focussed on the following two main areas:

Transforming Community Services, a National process designed to identify the most effective way to deliver community services locally. It is important to note this is not just about district nursing services but is about ‘transforming’ the way a whole range of community services are delivered. The PEC’s opinion was that a redesign of long term condition services should be a priority, in particular the ‘system’ in which people are managed eg ensuring integrated working between professionals and services. The areas for action have been agreed as dementia, end of life and older people’s services.

Whilst the district nursing debate rages on around the county, my own view is that we should wait for the outcome of the process mentioned above. We will then bring these proposals back to our own Strategy group to discuss further.

The Mental Health Trust and PEC have agreed a change in the way in which the primary mental health care services are delivered. Instead of the current system of all patients waiting to be assessed, the Trust will divert a significant proportion of patients directly to therapy. The referrer would indicate on a form (groans and moans!!) including either a HADS or PHQ-9 score if they thought that this was appropriate for a particular patient.

Sadly, the Trust cannot offer a directly bookable appointment service as yet, but look out for the forms hitting your desks. The hope is to reduce the waiting times for therapy and cope with the increasing demands.

If you have any thoughts about these or other issues, please e mail myself or Carol.

Dr Sunil Hindocha

Chairman

Service Developments

A pilot, involving 4 practices, for the pathway is currently underway and aims to run from beginning of July to the end of November 2009. One key area the four practices are piloting which is working well is the newly commenced admission alert system where the pilot practices are being notified electronically twice a day by ULH of any over 75 year old admissions (scheduled or emergency) registered with their practice.  Work is now progressing to have this extended to include all age groups and then rolled out to all GP practices. The timescale for this is yet to be determined. Practices are also undertaking ‘frailty scoring’ on all patients over 75 year of age to try and identify those

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Carol Cottingham 07909 993097PBC Cluster ManagerLisa Sharpe 07920 246015PBC Cluster Support ManagerAileen Sellars 07775 948685Service Improvement ManagerSarah Button 07717 541348Service Improvement ManagerHeather Charles 01529 416000Service Development Manager StrokeCarl Tyrrel & Bernice Tauber 01522 513355InformaticsKate Tabor 01529 416042Finance ManagerGill Flowers 01522 574172Cluster Secretary

REMINDERS

North and South Education sessions- 20 October at Hemswell and Bentley

Frail Older People’s Service – Implementation Session

- 22 October, Bishop Grossette CollegeNext Strategy Group Meeting - 10 December 2009 at Oak House

FRAIL OLDER PEOPLES SERVICE (FOPS)

people who may require more support to keep them at home, to further aid the identification of older people at risk Practices are using the PARR tool and this is also proving a useful tool to support the establishment of multi-disciplinary team meetings.

Work is being finalised to ensure additional support within the Community Response and Rehabilitation Team and Single Point of Access (SPA) to ensure a rapid response to calls from Practices are available.  To learn more about all elements of the FOPS pathway there is to be a FOPS Implementation Workshop on Thursday 22nd October when a number of workshops will be delivered giving you more detail and information about each service. A flyer went out about this workshop to all practices a week or two ago and to date there are still about 20 spaces available. We would urge all Practices to send a GP’s and a Practice Nurse to the afternoon to ensure everyone is aware of this work – reimbursement for attendance is available (same rate as PLT). If you are interested please contact Gill Flowers as we are still able to take bookings (latest date for this would be the week before 22 October).

If you would like to know more about this pathway or get involved then please contact Carol Cottingham.

United Lincolnshire Hospitals NHS Trust (ULHT) is working toward implementing One Stop Rapid Access services for high risk TIA referrals during 2010.

There is currently a national requirement for all acute trusts to report on the numbers of high risk patients seen within 24 hours. In order to comply with this reporting requirement ULHT is requesting that all GPs use the attached referral form for TIA referrals. There is a requirement to assess the patient’s risk score prior to referral using the ABCD2 - patients with a score of 4 or more should be referred to Lincoln County Hospital or Pilgrim Hospital, Boston. Low risk patient will continue to be seen on the smaller sites eg Louth Hospital.

If you require any further information about this or any other part of Stroke Services, please contact Heather Charles.

We are nearing the end of the procurement process and soon hope to identify a preferred provider. It is hoped that a paper will be produced for the October board with a recommendation from the procurement project group.

If you would like to have more details about this service then please contact Sarah Button.

Scoping work is about to get underway to identify future utilisation of John Coupland Hospital. There is a lot of potential and it is hoped that over the next 6 months we can work with key stakeholders to develop a strategy that sets out a clear indication of the types of services that will be developed and delivered from the site in the coming years.

4 MONTH PILOT OF EMERGENCY MEDICINE CLINICS - COMMENCING 7th SEPTEMBER 2009

The Emergency Care Directorate recognises that rapid access to a consultant medical opinion and diagnostics can prevent a patient requiring admission to hospital. The Directorate, in partnership with the Lincolnshire West Practice Based Commissioning Cluster, will run Emergency Clinics Pilot for 4 months, commencing 7 September 2009. The clinics will receive patients referred by GP’s for urgent advice on a range of conditions where patients would traditionally have been admitted for assessment.

The full document providing information about this pilot was sent out to practices at the beginning of September but is also attached here.

Further information, both clinical and managerial contact details is available from:Dr Rashaad Gossiel, Consultant in Emergency Medicine: (01522) 512512 & BleepMrs Becky Shaw, Clinical Services Manager: (01522) 573302

Please find attached direct access for Occupational Therapy, Physiotherapy & Dietetics.

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MUSCULOSKELETAL (MSK) SERVICE PATHWAY DEVELOPMENT

ULHT NEWS

JOHN COUPLAND HOSPITAL (JCH)

TIA REFERRAL FORM

NEW SERVICES

A new service provided by Lincolnshire County Council Adult Social Care Services called the Lincolnshire Assessment and Reablement Service (LARS) has recently started in the West Cluster Area after a successful roll out of the service across other areas of the county. The County Council’s in-house home care service will work alongside social work assessment and care management teams to provide a rapid response to help people through a crisis and help them get back on their feet as soon as possible. For many people this will mean they are going to be less dependent and need fewer services from Adult Social Care in the longer term. However for some people they will need ongoing longer term support following their period of reablement and this will be arranged via personal budgets and personalised support plans.

For more information about what is happening with LARS please contact one of the locality implementation team members:

Stuart Clarke (Assessment and Care Management) 01522 554188 or Jacquie Harrison (Home Support) 01522 554570.

PUBLIC HEALTH

Cluster Total Screens

Population (15-24)

Screened (%) Rank

LincsWest 953 32500 2.93 % 1

This excerpt was taken from a performance table for Chlamydia screening for the County as at the end of August (September’s figures are not available as yet). As you can see our Cluster is currently ranked at the top of the league and certainly deserves a well done to all of you who have helped put Lincolnshire West there by diligently screening their practice population.

There are SafeTALK ½ day Suicide Awareness courses running in Lincoln on 27th October and 12th

November.  Attached is the SafeTALK poster with all of the dates that there are so far in Lincoln Grantham and Sleaford.

There are also various 2 day ASIST (Applied Suicide Intervention Skills Training) courses in Lincoln, Louth and Sleaford.  Again there is a list of course dates attached for your information.

If you are interested in either of these courses please can you either email or call Sue Broadbent on 01529 416251. 

UPDATES

There is a temporary reduction in the capacity of the diabetic retinopathy screening service. This is to enable a review to take place and actions to improve the service to be implemented. Those patients that currently have an appointment will still be screened, as will pregnant women who have diabetes.

Additional services available on Choose and Book are:

Paediatric Neurology - slots were available early August 2009

Paediatric Epilepsy - slots were available July 2009

Choose and Book Training

Training meetings are held for secretaries at practices or for anyone in GP practice who uses the C&B system. 

They are held bi-monthly and have proved to be very helpful with the C&B Team as well as users.  The next meetings are to be held at the Crossroads Medical Practice 10am until 2pm with lunch on:

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LINCOLNSHIRE ASSESSMENT AND REABLEMENT SERVICE (LARS)

CHLAMYDIA SCREENING

SUICIDE AWARENESS TRAINING COURSE

CHOOSE AND BOOK

Diabetic Retinopathy Screening

14 October09 December

Please call Joan Tweedley on 01529 416103 if you have any more queries around these meetings or email her at Joan.Tweedley@lpct.nhs.ukHint

If a patient chooses to attend a hospital and there are no slots available on the C&B system, they can contact the Telephone Appointment Line (TAL) who will then follow the national guidelines. The TAL phone number is 0845 6088888.

Independent Sector Treatment Centres (ISTCs)

Have you checked the ISTC centres on Choose and Book when referring your patient?

Ramsay Health at Gainsborough, Boston and Fitzwilliam at Peterborough, Barlborough at Chesterfield and the Nuffield BMI Hospital at Lincoln all have a wide choice of slots available. The centres will provide free transport for patients requiring it with the exception of BMI Lincoln and the Fitzwilliam at Peterborough.

The attached documents give details on orthopaedic services available from alternative providers to ULHT. Also attached is a document with has details regarding the Primary Care Surgical Scheme. Given the waiting time for these services at ULHT – these alternatives are definitely worth making a note of.

Extra capacity for Hernia and Urology clinics has been purchased at the BMI Lincoln Hospital (formerly Nuffield). Slots will be available on Choose and Book shortly.

The PBC LES was sent out to practices towards the end of September. If any practice has not received theirs please contact Charmaine Docherty for North practices and Sarah McMillan who has responsibility for the South practices.

The topics for September’s education sessions were Orthopaedics at the Bentley Hotel and Urology at Hemswell Court. Both sessions were well received and attended.

Please note on the list of dates for the PLT sessions, at the bottom of this news update, that there will no longer be a “joint” meeting in December. Phil Fairchild asked the audience in September if they would be interested in a “Christmas” session and the vote was to go ahead as previously planned. It is anticipated that we will receive confirmation for this session from Nigel Chapman, Coroner in Nottingham, in the next week or two. Nigel is by all accounts a fun and lively speaker. Although this event has been planned by the North side of the Cluster please be aware that you are more than welcome from the South side if you are interested in attending. Hemswell are planning on providing some kind of Christmas Menu for the occasion. As this event will be open to all – can you let Gill Flowers know if you plan to attend so that the venue can be informed for catering purposes please. There is no longer to be a meeting in April on either side of the Cluster.

If you would like more information regarding these sessions please contact Lisa Sharpe.

The new Finance Managers have now been allocated to Clusters and as of 21 September Kate Tabor has responsibility for Lincolnshire West PBC Cluster.

It is our intention to pay all outstanding invoices for the period April – Aug by the end of October. Payment for future attendance at PLT and Strategy meetings will be paid from the signed attendance sheet at these events only and therefore we will no longer require claim forms to be submitted.

The updated schedule of forthcoming PLT events in both the North and South of the cluster are attached for your information.

If anyone has difficulty in opening any of the attached Word documents, please contact Gill Flowers and she will forward the appropriate document via email.

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GENERAL ADMINISTRATION

ALTERNATIVE PROVIDERS TO ULHT

HERNIA AND UROLOGY CLINICS

PBC LES

PROTECTED LEARNING TIME (PLT) – GP EDUCATION SESSIONS

FINANCE MANAGERS

LINCOLN NW PBC GP TRAINING EVENTS

DATE 22 09 09 20 10 09 17 11 09 15 12 09 19 01 10 16 02 10 16 03 10 18 05 10 15 06 10

VENUE Hemswell Court

Hemswell Court

Hemswell Court Hemswell

CourtHemswell

Court

Hemswell Court

Hemswell Court

Hemswell Court

Bentley Hotel

SUBJECTUrology Cardiology Ophthalmolog

y Coroner Revalidation Neurology Respirator

yDermatolog

yMental Health

SPEAKER Dr Mike Henley

Confirmed

Dr David Gray

Confirmed

Mr Andrew Castillo

Confirmed

Nigel Chapman

TBC

Professor Pringle

Confirmed

Dr John Bowen

Confirmed

Tim Harrison

TBC

Neil Hepburn

TBC

Caroline Chew-

GrahamTBC

TITLE Consultant Neurologis

t

Combined

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LINCOLN SOUTH PBC GP TRAINING EVENTS

DATE 15 09 09 20 10 09 17 11 09 19 01 10 16 02 10 16 03 10 18 05 10 15 06 10

VENUE Bentley Hotel Bentley Hotel Bentley Hotel Lawress HallRiseholme

Bentley Hotel Bentley Hotel Bentley Hotel Lawress Hall

SUBJECT Advances in Orthopaedics Child

Protection I Neurology Revalidation Dermatology Child Protection II Osteoporosis Mental

Health

SPEAKERMr Maqsood Vindi Bhandal

David Oldman Dr Bowen

Professor Pringle

Neil HepburnTBC Dr Thomas

Professor Masud

Caroline Chew-

GrahamTBC

TITLE Consultant Orthopaedic

Surgeon LCH CONFIRMED

Lincolnshire Child

Protection Leads

CONFIRMED

Consultant Neurologist

LCHCONFIRMED

Professor of General

Practice Notts University

CONFIRMED

Consultant Paediatrician

LCH CONFIRMED

Consultant Endocrinologist

NCH CONFIRMED

Combined

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