New Ankylosing Spondylitis clinic at Leicester Ankylosing spondylitis (AS) is a chronic inflammatory, painful condition affecting young men and women at their productive age. Recent research in UK showing up to 8years delay in diagnosis and management of this condition. Very few centres offer a dedicated AS service in UK. To address this issue in Leicester we have set up a dedicated AS service with the aim of and delivering high quality care for patients suffering from this painful, debilitating condition.

This new dedicated MDT is consultant lead by Dr A Moorthy Consultant Rheumatologist; the clinic runs every second Monday of the month at the LRI. Specialist Physiotherapist Ms Fiona Glover attends the clinic and assesses any newly diagnosed patient on the same day and a physiotherapy programme is initiated. The clinic also has direct access to specially protocol AS MRI Scan and Orthopaedic surgeon service.

Any patient with back pain suggestive of inflammatory type – can be referred directly by referral letter addressed to:

Dr Moorthy

Leicester General Hospital

OPD1 Back Office

Gwendolen Road

Leicester

LE5 4PW

Moorthy Arumugam Consultant Rheumatologist

Paul Smalley, Pathology IT Manager on 0116 258 6707 or paul.smalley@uhl-tr.nhs.uk

NHS Trust

University Hospitals of Leicester

GP NewsletterWelcome to September’s edition of GP latest news…

September

GP hotline callsThe GP hotline received 179 calls in August

Number of patients who received no UHL intervention following discussion with a consultant

125

Number of patients admitted into the hospitals

11

Number of patients diverted to a routine or urgent clinic

9

Totals 145

What happened to the patient?

Cardiology 11 Dermatology 5 Diabetes & Endocrinology 4 ENT 7 Gastroenterology 15

Geriatrics 2

Haematology 8 Max Fax 1 Medicine 7 Nephrology 3Neurology 19 Orthopaedics 13

Paediatrics 1

Radiology 2 Respiratory 6 Rheumatology 11Stroke 7 Surgery 7Urology 12 Vascular 4Totals 145

I need to speak to - by service area

I need to speak to 145

When will my patient be seen 9

I would like a copy of 6 Information I have received is unclear 13 Other 4 I cannot find 2Totals 179

Calls by category

The price of an outpatient appointment or admission can vary considerably depending on the specialty and condition of the patient, the following are some approximate costings to give an indication of potential savings the hotline has generated:

Total savings to the health economy of anywhere between £20,375 and £264,500 during August.

The average cost per call this month was £13.29

Potential savings generated by the hotline

An emergency admission costs £2,116A short stay admission costs £800An urgent outpatient appointment costs £704A routine outpatient appointment costs £163Emergency admission x125 patients £264,500Short stay admission x125 patients £100,000Urgent outpatient appointment x125 patients £88,000Routine outpatient appointment x125 patients £20,375

Admission avoidance We have revamped our offering of <48 and >48 hour admission avoidance / ambulatory clinics for GPs, you can find the information by clicking here:

Invitation

705 Aylestone Road 1Ashby Health Centre 1Asquith Surgery 2Barwell & Hollycroft Medical Centre 13Broom Leys Surgery 1Bushloe End Surgery 5Clarendon Park Surgery 1Countesthorpe Health Centre 2Desford Medical Practice 1Dishley Grange Medical Practice 2Downing Drive Surgery 5East Leicester Medical Practice 1East Park Medical Centre 4Evington Medical Centre 1Forest House Surgery 3Fosse Medical Centre 1Freeman’s Common Health Centre 3Glenfield Surgery 3Groby Road Medical Centre 2Hazlemere Medical Centre 6Heath Lane Surgery 3Heatherbrook Surgery 1Highfield Medical Centre 1Highfields Surgery 4Highgate Medical Centre 3Hockley Farm Medical Practice 3Hugglescote Surgery 1Humberstone Medical Practice 4Ibstock House Surgery 1Johnson Medical Practice 7Latham House Medical Practice 1Leicester Prison 1Long Lane Surgery 5Long Street Surgery 1Loughborough Walk in centre 1Market Harborough Medical Centre 1

Merridale Medical Centre 1Northfield Medical Centre 1Oakham Medical Practice 3Oakmeadow Surgery 1Old School Surgery – Kibworth 2Pasley Road Health Centre 1Petworth Drive Surgery 1Pinfold Gate Medical Practice 2Quorn Medical Centre 3Ratby Surgery 1Saffron Group Practice 1Sayeed Medical Centre 1Severn Surgery 2South Wigston Health Centre 2St Elizabeth’s Medical Centre 2St Matthews Health Centre 4Student Health Centre 2Syston Health Centre 1The Central Surgery 6The Centre Surgery 1The Charnwood Practice 1The County Practice 3The Hedges Medical Centre 1The Limes Medical Centre 9The Melbourne Centre 1The Orchard Medical Practice 1The Practice - Beaumont Leys 1The Surgery – 2 Baxter’s Close 2The Uppingham Surgery 1The Wycliffe Medical Practice 3Westcotes Health Centre 1Whittack Health Centre 3Wigston Central Surgery 1Willowbrook Medical Centre 15Woodbrook Medical Centre 2Totals 157

GP hotline calls...Following GP feedback you can now log a request for help on our website. Your request is submitted and will be actioned in real time between the hours of 09.00-18.00 (Monday to Friday).

GP hotline on line

As previously communicated we are experiencing high numbers of primary care users setting up new test patients on ICE, every time this occurs numerous systems within the hospital recognise a new patient and in turn a new patient record is generated which in then looks to match to an NHS number, this all requires timely manual intervention to delete.

Users should only use test patients: those which have been set up are:

Systm1

Golden (girl) Phoenix

Emis and other suppliersEDITEST or those with the surname of TESTLHIS.

Any practice that has previously created a test patient in error – please do not call up this patient again as it starts the matching process from scratch and these entries will have to be picked repeatedly and deleted – currently there are over 150 test patients practices have set up on the system. Please refrain from using your practice created test patients and use the ones listed above.

The data quality team will continue to ring practices where test patients have been created / re used in error.

The patients could potentially be created on all of the systems below:

Test patients on ICE

Total calls made to GP hotline by practice

You now have two options available to you:1. GPs can ring 0116 258 48 58 (press

option 2)

2. Use the online form, which can be found by clicking here: http://www.leicestershospitals.nhs.uk/professionals/gp-hotline-online-request-for-help/

We hope you find this useful.

Best Wishes

Kevin HarrisMedical Director

• HISS–PatientAdministrationSystem

• CRIS–RadiologyInformationSystem

ILAB – Laboratory Information Management System

• PACS–PictureArchivingandCommunication System

• EPMA-ElectronicPrescribingand Medicines Management

• ICE–Pathologyrequestingand reporting. UHL Inpatient and Outpatient letters

• ICM

• EDIS–EDSystem

• ORMIS

• PATS(Cardiology/Cancer)

• TRACKIT(MedicalRecords)

• Aria(Radiotherapy)

• Chemocare(Chemotherapy)

• Eclipse(Diabetes)

• Tiara(Therapy)

• Proton(Renal)

• E3(Maternity)

• Viewpoint(Ultrasound)

• JAC(Pharmacy)

• ICNET(InfectionControl)

• Badger(Neonatal)

• Trium(Maternity)

• Wristbands

• ClinicalHandover

• BereavementServices

My time as Head of Services for GPs comes to an end on Thursday 20th September.

Pathology is ready to dual report Haemoglobin results, however there is a specific issue that has cropped up when trying to implement this with regards to the PMIP (Path Links).

Currently we report Haemoglobin Read Coded as 423. Haemoglobin estimation with units of g/dL.

For an interim period and in preparation for the switch over to the new standard units of g/L ,we will also be reporting a second Haemoglobin result in the new units. e.g. Haemoglobin Estimation 10.8 g/dL (11.5-16.5)

Haemoglobin (New Units) 108 g/L (115-165)

In making these changes we have picked up that it is not possible to report 2 tests with the same Read Code for the same specimen, hence we will continue to send Haemoglobin results as currently mapped but will need to send the “new” Haemoglobin without a Read Code i.e. just the local Pathology Test Code of HGB which expands to Haemoglobin (New Units).

We have explored all avenues to avoid the need to send the “New Haemoglobin” uncoded but unfortunately this is not possible. In order to not cause confusion out in primary care there will be the need for a

period of dual reporting. For this period the new haemoglobin (g/L) will appear un-coded provided with just the local ilab descriptor code.

Local coding at the practice level will be required.

We have discussed this locally with the LMC and with added input from some GPs and together agreed the following:

Monday 1st October until Monday 3rd Dec 2012, we will dual report with:

coded entry in g/dL as currently, with the new units un-coded

Monday 3rd December 2012 until Monday 25th February 2013 , we will dual report with:

new units coded (and sent using the same code as present), with old units un-coded

Dual Haemoglobin reportingAs many of you will be aware we have been communicating for some time the change in reporting of Haemoglobin.

Monday 1st October until Monday 3rd Dec 2012, we will dual report with:coded entry in g/dL as currently, with the new units un-codedMonday 3rd December 2012 until Monday 25th February 2013 , we will dual report with:new units coded (and sent using the same code as present), with old units un-coded

And its goodbye from me...

I wanted to say a huge thanks to all of you in primary care for making the role so enjoyable and working with me and my UHL colleagues to genuinely try and improve relationships for the benefit of our patients and hopefully together we have cracked some of the age old problems!

We have appointed a new Head of ServicesforGPs,Jadewillbejoining the Trust at some point towards the back end of October, I am sure she will be in

touch as soon as she arrives.

Until that point please can I ask that any queries that you would have usually directed my way please log with the GP hotline on 0116 258 48 58 (option 2).

Wishing you all the very best for the future.

Marina

PodcastsThis month’s podcast sees Local GP Leslie Borrill chatting with Frances Bullock – Consultant Paediatric Cardiologist. Paediatric Cardiology

And finally…For general information such as referring to us, GP education and previous editions of the GP newsletter, you can find it all (home or at work) by clicking here:

• EndocrineDiseaseinPregnancy• SafeSurgeryinPrimaryCare• PalliativeCareforOut-of-hoursClinicians

For further details and booking please click here:

http://www.leicestershospitals.nhs.uk/professionals/gp-education/

GP EducationCurrently available for GP booking:

NHS Trust

University Hospitals of Leicester

http://www.leicestershospitals .nhs.uk/professionals/

To watch and download (print / save) your CPD reflection form and certificate, please click here: http://www.leicester-shospitals.nhs.uk/EasySiteWeb/static/videos/GP%20Podcast%20-%20Paediatric%20Cardiology.wmv

The NHS spends just under £1 billion a year on respiratory inhalers, yet many people’s inhaler technique is so poor that they are not making the most of their inhalers. Like patients, many healthcare professionals are unsure on how each type of inhaler device should be used.

The 7-Steps to Success Inhaler Reminder Cards are an easy-to-use and highly portable reference source to help remind healthcare professionals on how to use each different type of inhaler device. The reminder cards provide a simple ‘7-step’ guide to achieve optimal technique for all the different types of respiratory inhalers

The cards are produced as a heavy-duty ring bound set with a card for each

different type of inhaler. To cover costs, the cards cost £4.95 for each set and are available via the Leicester’s Hospitals website: http://www.leicestershospitals.nhs.uk/7steps/

Click here to see Anna talking about the inhaler cards.: http://www.leicestershospitals.nhs.uk/EasySiteWeb/static/videos/inhaler_cards_promo.wmv

A new product is available to help support healthcare professionals in providing the correct instruction of inhaler device technique during patient consultations.

‘7-Steps to Success’ guide to respiratory inhalers

Although Cardiac Rehabilitation is recommended for all patients who have had a heart attack uptake is not as popular as it should be. The reasons for many with difficulties in transport and having the time available being among them. ‘Activate Your Heart™’ is an online cardiac rehabilitation programme that has been designed by cardiac rehabilitation specialists and patients at UHL supported by CLAHRC for LNR .The aim of the programme is to help those people who have had a recent cardiac event or have an existing cardiac problem, manage their condition more

effectively. By being available 24/7 it overcomes many of the previous access difficulties with traditional CR although being based very firmly on their principles.

http://www.clahrc-lnr.nihr.ac.uk/images/CLAHRC%20Bite_CR%20draft3.pdf

On-Line Cardiac Rehab Programme Released

These reminder cards were put together by a team at the Glenfield Hospital, Consultant Pharmacist Anna Murphy in conjunction withAsthmaandAllergynursespecialistJanChantrell.

Saturday September 22nd in the restaurant Leicester Royal Infirmary

Health Fair 9.30am – 11.15am Public Meeting 11.30am – 1pm

Annual Public Meeting2012

NHS Trust

University Hospitals of Leicester

LEI

CEST

ER ROYAL INFIRMARY

100 YEARSHelp us celebrate100 years of being “Royal”

It was 100 years ago that the Leicester Infirmary was granted permission to use the prefix “Royal” in its title. To celebrate, we are bringing a historical theme to our annual public meeting this year. Please join us as we look back at how things used to be, reflect on how much our services have changed and look forward to the future.

Health Fair 9.30am – 11.15amVisit the health fair to find out more about our services and meet with our staff and partner organisations. We will also be exhibiting artefacts and photographs from the Hospital Museum.

Public Meeting 11.30am – 1.00pm

Come along to the public meeting to learn more about our performance over the last year and our plans for the future. You will also have an opportunity to put your questions to our senior team.