GP Bulletin
For Action
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******** Communication from your Emerging Leaders ***********
Dear Colleagues,
Important Meeting - GPs of Southwark and Lambeth Unite- we have nothing to lose but our burdens!!!
Securing the Future of General Practice in Southwark & Lambeth : Primary Care Event on Wednesday evening - are
you coming?
26th November 7-9pm with food and mingling from 6.30pm at Millwall
Book here: http://l-s-securingthefutureofgeneralpractice.eventbrite.co.uk
It is probably the last thing you want after another hectic day but WHY SHOULD ANYONE BOTHER TO ATTEND?
General Practice/Primary care is in crisis and we want to be players, not victims.
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We are gathering strength in locality groups (QHS/IHL in Southwark, N/SW/SE in Lambeth) but we want to
build on this.
The CCG's have plans about what they ask us to do- How can WE TAKE INITIATIVE in discussions to make the
plans workable for us and truly useful for patients? The other providers (GSTT/Kings/SLAM/community
trusts) are busy making plans we should and can have a bigger input into these.
There is potentially a large fund of money (few million from GST charity) to support us in gearing up
for primary care to be a leader and not a follower in these developments. To get hold of this money
depends on US convincing the charity that we are serious about making changes and have good
ideas.
There will be information from the CCG about what they are thinking and views from LMC leaders about why this is
important and their suggestions about the way forward, but only so YOU/US the GPs of Lambeth and Southwark can
get involved.
Our strengths depend on us working together and pooling our ideas. We need to grab control of the future and
work out way through this together but we need your views, your input and your support! Don’t opt out and hope
someone else will find a solution. We need everyone’s ideas and everyone’s input
We promise we are doing our best to plan an interesting evening that helps you to understand what's going on and
allows you to contribute to what comes next. To help it go well please watch out for some background information
that we will circulate in the next few days. It may be slightly dull reading but if we all arrive at Millwall with a bit of
background we can spend more time sharing ideas and have a voice that roars to be heard in West Ham!
19 November 2014
From
Di Aitken
Sandra Connolly
Ross Dyer-Smith
Tyrrell Evans
Justin Hayes
Michelle Izzo
Stephanie May
Tarek Radwan
Elaine Richmond
Catherine Arden
Louisa Dove
Martin Iu
Ade Salau
Tilly Wright
Carol McPaul
for Lambeth
for Southwark
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Invitation for your Patient Participation Groups, please share
PPG members in Lambeth are encouraged to attend the Lambeth Patient Participation Group Network meeting on
Tuesday 2 December 2014. This is an opportunity for your PPG to be involved or be part of the changes and
developments of the Network. The meeting will be held at 6 pm at 336 Brixton Road, SW9 7AA. Bus routes 3, 59,
133, 159. The building was formerly known as Lambeth Accord but is now called We are 336. There is disability
access. Please notify your PPGs. For more information please contact Healthwatch Lambeth on 0207 095 5761.
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Ebola Update (Please see attached flyer (1))
Please find enclosed the latest guidance for frontline staff
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Save the Date
Lambeth CCGs next All Practice Event is due to take place on the afternoon of 20th Jan 2015 at the Kia Oval.
Full details will be sent in the next few weeks, but in the meantime, please hold the date in your diaries. We look
forward to seeing you there
For Information
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Primary Care Contact List (Please find enclosed information sheet(2))
Please find attached the Primary Care Contact Information sheet for GP’s Dentist, Pharmacies and Opticians.
Please note that this directory is designed to help you contact the appropriate office/organisation to resolve your
queries and is NOT for distribution to the general public.
19 November 2014
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Update on Admission Avoidance
Good News!
Referrers to two of the key services in place to avoid hospital admissions will be able to access the services via one
number from the 1st December 2014. The Enhanced Rapid Response and @home services will be accessed via a
single point of access which GPs can use to refer patients who they think would benefit from the service and who
otherwise might be admitted to hospital.
Further details will follow in a special mail out to GPs later this month so please look out for the information.
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Your views on education and training
We want your views and ideas about the future of education and training for the crossover between
mental and physical healthcare, and for the health inequalities experienced by people with learning
disabilities.
All staff are asked to complete a 10 minute online survey by clicking on this link:
https://www.surveymonkey.com/s/W8WRY7K. Your answers will help us to shape the future of education
and training within King’s Health Partners to improve both staff and service user experience.
Dr Sean Cross, Consultant Liaison Psychiatrist at South London and Maudsley, leads the Physical and
Mental Health education workstream for King’s Health Partners. He said: “It is increasingly evident that to
provide high quality care we must focus on both the physical and mental health of our patients.
"This project aims to support King's Health Partners Mind & Body Programme Board in its goal of enabling
us to become a world leader in this area and give employees the chance to shape the future of training and
education relating to the interface between physical and mental health needs. We are really grateful for
you taking the time to fill out this questionnaire.”
Karina Marshall-Tate, Project Lead for Health Inequalities and People with Learning Disabilities at the Estia
Centre, is looking at how education and training can improve health outcomes and the experience of
people with learning disabilities using local health services.
Caught your interest?
If you or your colleagues would like to discuss this matter further please don’t hesitate to get in touch, we
are also running interviews and focus groups for these projects.
Mental/Physical Healthcare Interface – contact chris.attoe@kcl.ac.uk
Health Inequalities in Learning Disabilities – contact karina.marshall-tate@slam.nhs.uk
19 November 2014
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Update from Medicines Management
“Revised Summary Guidance for Phosphodiesterase type-5 (PDE5) Inhibitors for Erectile Dysfunction
can be downloaded from the Medicines Optimisation resources page – 2014/15 Medicines Optimisation Plan”
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Congratulations to Dr Raj Mitra – Lambeth Walk Practice
Please find enclosed an article by Dr Raj Mitra that has recently been published by NHS England
The NHS gets personal – Dr Raj Mitra
Posted: 12 Nov 2014 07:55 AM PST
A group of people with complex, long term health conditions recently gained the ‘right to have’ their care
delivered through a Personal Health Budget. Adults who are eligible for NHS Continuing Healthcare and children in
receipt of continuing care can now ask their CCG for more control over how they manage their chronic health
needs or disability. In the first of a series of blogs on the subject Dr Raj Mitra, a Lambeth GP and a member of the
NHS Lambeth CCG Governing Body, explains why he believes personal health budgets will be an important option
for his patients to better manage their long term health conditions:
I’m proud to work in Lambeth, both as a GP and as a Clinical Governing body lead for the CCG where we take the
idea of co-production very seriously. Not just as a theory, but as something we need to genuinely take on board if we
are to change the relationship between health professionals and patients: this is our NHS and we need to be in this
together.
This is one of the reasons that we have been looking in Lambeth at how people with mental health concerns can be
offered personal health budgets.
Supporting people to be ‘patients in control’ is particularly important for the ever-increasing number of people I see
in surgery who don’t come expecting a quick fix.
I’m sure like many other people in the medical profession I became a doctor with grand intentions to ‘cure sickness’
and ‘make people better’, but with more people living with complex long term conditions and disabilities that just
isn’t always an option. The truth is that there are limits to what I can offer someone with conditions such as chronic
obstructive pulmonary disorder (COPD) or a degenerative neurological condition such as multiple sclerosis (MS).
So why do these patients book an appointment with their GP?
For some it’s to sensibly monitor their condition, do what they can to manage their symptoms and make positive
lifestyle changes. More often though it’s because those conditions are incredibly difficult to live with, and they come
because, for example, they’re no longer coping with pain, experiencing more frequent chest pains or not sleeping.
Of course there are medications I can prescribe and treatments I can refer people to, but when it comes to living
with chronic conditions, as health professionals we don’t always know best. Yes, there are evidence based
treatments for managing pain, but the real evidence is ‘does it work for you?’
If a person remains in pain, I can expect to see them back in my surgery next week – or worse still, ending up in A&E
or being admitted urgently to hospital. That doesn’t work for anyone.
19 November 2014
I believe in the option of personal health budgets so that, where appropriate, people have real choice to direct their
care, particularly when it’s clear that what I have in my medicine chest isn’t enough.
If I know that a particular treatment hasn’t worked for someone, why waste more NHS funds referring people to
more of the same, when there may be alternatives that keep them out of hospital that?
As a GP, the time I have with people is limited, so the opportunity for people with complex health needs to spend
time co-creating their own care plan in partnership with their NHS team is really valuable. It’s about understanding
what matters to you, and not just “what’s the matter with you?”
Clearly personal health budgets wouldn’t work for acute care or for treating illnesses such as cancer. As a doctor
there’s no way I would want to see someone choosing to treat cancer with an unproven alternative therapy, but if
someone finds yoga can help them to cope with chronic pain better than traditional physiotherapy, then surely
that’s a sensible use of money?
Dr Raj Mitra has been a GP in Lambeth since 1995 and is a clinical member of the Governing Body at NHS Lambeth
CCG.
His specialist interests are mental health, dementia, cancer and end of life care, and patient engagement.
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Communication from King’s Hospital
A new CQUIN initiative has started at Kings College Hospital NHS Foundation Trust to document and communicate to
GPs, patients’ medication reviews undertaken during their admission. This project is being led by Professor Steve
Jackson, Consultant Clinical Gerontology.
Patients (from Lambeth, Southwark and Bromley) discharged from a geriatric medicine ward (Byron, Donne,
Marjorie Warren and Mary Ray wards at Denmark Hill; S1 and S2 wards at the PRUH) will be discharged with a
Clinical Medication Review letter (CMR), which will give GPs detailed information on medicines stopped, started,
changed and any follow up recommendations. It will be sent with the discharge summary and written by the
pharmacist and doctor responsible for the care of the patient. A copy will also be given to the patient on discharge to
give to their community pharmacist.
When you receive the CMR, please consider the recommendations and amend the medication records as
appropriate. We hope this initiative will ensure that information about medicines is effectively transferred and will
improve the experience and continuity of care for our patients. Please let us know if you have any concerns over our
recommendations.
Jill Solly, Head of Primary Care/Secondary care Interface Strategy Team
King’s College Hospital NHS Foundation Trust
Tel: 0203 299 7516
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National HIV Testing week is fast approaching (Please see attached flyer (3))
What is your organisation doing for National HIV Testing Week 22nd - 30th November?
HIV Prevention England have produced a range of resources to promote the event and these are available free to
you from http://www.hivpreventionengland.org.uk/Resources/National-HIV-Testing-Week
19 November 2014
London local authorities account for 18 out of the 20 local authorities with the highest diagnosed prevalence rate of
HIV in the country. The epicentre of this is Lambeth, with the highest prevalence of diagnosed HIV in the UK (14 per
1000 adults age 15-54. Southwark has the second highest prevalence (11.2 per 1000 adults age 15-54). (LSL Draft
sexual health strategy 2014).
Due to the effectiveness of antiretroviral medication, most people with an HIV diagnosis can expect a near normal
life expectancy if diagnosed promptly and they enter an established HIV Care pathway. Unfortunately some people
get diagnosed late, often when they present with serious illness.
It is therefore important that we increase awareness of the availability of HIV testing and promote the benefits of
early diagnosis and treatment.
You can support this by participating in National HIV Testing week.
For more information visit http://www.hivpreventionengland.org.uk/
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Smoking at Kings College Hospital
From 19 January 2015, the King’s College Hospital site at Denmark Hill will become completely smoke-free.
This is an important step for King’s, and will make our Denmark Hill site a safer, cleaner and healthier environment
for patients, visitors and staff.
Our new smoke-free policy means that from 19 January, smoking within the hospital grounds at Denmark Hill will
not be permitted for patients or visitors. King’s staff are already prohibited from smoking within the hospital grounds
at any of our sites.
As an organisation, we pride ourselves on caring for our local population, making a difference in our community, and
providing the very best care. This is why the main aim of our new smoke-free policy is to provide everybody who
wants to quit with the support, expert advice and treatment they need, whether they are an inpatient, outpatient,
visitor or member of staff.
We are making a concerted effort to ensure that we communicate the new policy to patients and visitors, as well as
the organisations that have key roles to play at King’s, as part of our preparations for what is to be a significant
change for the hospital.
The Princess Royal University Hospital, which is also part of King’s College Hospital NHS Foundation Trust, will
become smoke-free for patients and visitors later next year.
If you have any questions or queries about the change please contact 020 3299 2600 or email kchtr.stopsmokingkings@nhs.net.
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Guys and St Thomas’ Outpatient Improvement Programme- get involved!
This workshop is designed to draw out your views and ideas on the future of outpatient services at Guy's and St
Thomas' and how we can work together to achieve this. You are a major stakeholder in this process; by working
together we can significantly improve the way we have traditionally provided outpatient services for the benefit of
all of our patients.
19 November 2014
You may be aware of the other complementary transformation programmes such as SLIC, Local Services Programme
and other primary care transformation programmes that are already underway. Your familiarity with elements of
these programmes will help us to ensure that we don't duplicate work effort and ensure that our future strategy
aligns with these programmes and the changes that Simon Stevens has recently published.
How to get involved – Register your interest to attend an evening workshop on the 4th December. For Registration
and more details on the event please see link below:
http://www.eventbrite.co.uk/o/nina-paul-programme-manager-guys-amp-st-thomas-improving-outpatients7669917207?s=30856929
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Invitation
Invitation to grand opening of West Norwood Health and Leisure Centre
Friday 5 December 2014
3pm – 6.30pm
Venue: West Norwood Health and Leisure Centre, 25 Devane Way, London SE27 0DF
On behalf of NHS Lambeth Clinical Commissioning Group, we write to invite you to the grand opening of West
Norwood Health and Leisure Centre in collaboration with Lambeth Council
The event will include:
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Key Note Speech from Dame Tessa Jowell MP
Tours of the centre
Networking with colleagues over refreshments and light entertainment
The centre represents a ground-breaking approach to integrating health services with physical activity and Council
services and has been nominated in this year’s Health Service Journal Awards in the Improving Partnerships Between
Health and Local Government category.
Training Opportunities
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Under booked LSCB multi agency training Dec 14
Please note that the following LSCB training session is under booked and is at risk of being cancelled:
Understanding and Responding to child Sexual Exploitation (full day training, Barn ado’s have been commissioned
to provide) – 02nd Dec 2014
Bookings can be made via the learning pool website for the LSCB at http://lambethscb.learningpool.com/
Please could you encourage relevant staff attendance knowledge, skills and confidence of senior health professionals
in leading difficult decision making and communication surrounding end of life care
19 November 2014
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Management of Headaches
An evening event for GPs organised by Guy’s and St Thomas’ and the Royal College of General Practitioners.
Dr Giorgio Lambru - Consultant Neurologist, Guy’s and St Thomas’ & Dr Adnan Al-Kaisy Clinical Lead in Pain
Management Guy’s and St Thomas’
Will present on Primary headache diagnosis and differential diagnosis
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Red flags for secondary headaches
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When to scan and when not to scan a patient with headaches
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Management of primary headaches
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The use of opioids / Amitriptyline /novel treatments for pain management
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Headache pathways
Date: Monday 8 December
Time: Buffet from 7.00pm / lecture starts at 7.40pm
Venue: South Wing Lecture Theatre, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH
Bookings must be made online http://www.rcgp.org.uk/professional-development/london-and-southengland/south-london-faculty/ease-management-of-headache-related-conditions-in-primary-care-8-december2014.aspx
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Free Course on ‘Core skills on Musculoskeletal Care (Please see attached flyer(4))
For a limited time only, we are offering local GPs the opportunity to further improve their clinical skills and
confidence in managing the musculoskeletal conditions that are common in Primary Care. The course on offer, “Core
Skills in Musculoskeletal Care” has been jointly developed by Arthritis Research UK (ARUK) and the Royal College of
General Practitioners (RCGP) and consists of a half-day e-learning programme followed by a one-day face-to-face
taught workshop. We will be hosting the course in local South London venues and will be covering the course and
trainer fees, and providing lunch
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Free Cardiology Seminar for GP’s at Guy’s Hospital
The cardiovascular service at Guy’s and St Thomas' would like to invite all GPs to a free evening workshop
on Thursday 15 January 2015. Programme of the event includes:
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Challenging heart failure cases in primary care (5 cases with daily challenges)
An approach to identifying inherited cardiac conditions in primary care
What is new in heart failure
Emerging concepts in diastolic heart failure management.
Date: Thursday 15 January 2015, 7- 9pm
Venue : Robens Suite, Floor 29 Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT
19 November 2014
There will be clinical case discussions and attendance certificates provided on the day. This evening event
carries two CPD points.
Click here to book a place
Link:
https://www.eventbrite.co.uk/e/free-cardiology-seminar-for-gps-at-guys-and-st-thomas-tickets-13923745297
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Free Gynaecology and Assisted Reproduction update for GPs at Guy’s and St Thomas’
Women's services at Guy’s and St Thomas' would like to invite all GPs to a free evening workshop on Wednesday 26
November.
Topics include:
• Endometriosis
• Fertility assessment and treatment according to new NICE guidelines the referral process and eligibility for funding.
Date: Wednesday 26 November 7:00pm-9.00p
Venue: Robens Suite, Floor 29 Tower Wing, Guy’s Hospital, Great Maze Pond, London, SE1 9RT
There will be clinical case discussions and attendance certificates provided on the day. This evening event carries
two CPD points.
To book a place or request further information please email: Beverley.Payne@gstt.nhs.uk
19 November 2014