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Newsletter for staff of the City & Hackney Clinical Commissioning Group
September2014
City and Hackney CCG IntranetChair's Welcome
Autumn is here and with it a sense of many plans coming to fruition. Many practices are finding the duty doctor system is very popular with patients and helping with workload and overflow from our hard pressed appointments. I know how lovely it is to have another 4 sessions of a great young doctor employed through the confederation in our practice, and hope all practices are feeling the benefit of the extra £5 per patient.We hope practices are also able to get in more support for the extended hours now on offer, as this too will make a real difference to our workload and patients access to appointments.
Our prioritisation subcommittee is meeting again at the end of October, and thanks to our team especially finance we have about £6 million more non recurrent money to plan to spend.
Please remember we consult you, our members, through the consortia meetings and the Clinical Commissioning Forum (CCF), as well as via the LMC meetings, so it is really important practice leads feedback to everyone in the practice when we are making decisions about what to spend money on, so it is genuinely owned by all, clinically sensible and will benefit our patients.
Once the specification has been agreed the CCG can contract with the confederation to implement the specification, but it is too late to change anything other than details. When it is a new service there are always unforeseen problems and we have a chance to correct them for the following year. That time is now! So PLEASE feedback your ideas for improvement of existing services and new ones.
Please do come to our Clinical Senate
Wednesday 8th October | 6pm | Homerton Education Centre |Refreshments will be provided
Meet Martin Kuper, the new Medical Director at Homerton and our consultant colleagues.
We will debate clinical pathways, new and old, making care plans work within and without the hospital, and how far to take integration.
Martin is an enthusiast for forming an integrated care organisation across primary and secondary care. We are lucky in City &Hackney with the organisations and resources we have, so should we think radical? Be part of the debate!
Please also support our commissioning intentions consultation with our public and patients
Wednesday 12th November - more details to follow on the events page of the CCG website.
Clare Highton
Clinical Lead Vacancies
Diabetes Lead Vacancy
We are recruiting a new CCG Clinical Lead for Diabetes now that the current post holder David Keene has resigned to take up a role as one of the new Quadrant Leads in the Confederation.The commitment is 2 sessions a month, for 6 months initially. If you are interested and would like more information please contact Dr Clare Highton (CCG LTC Lead) nd/or Richard Bull (CCG LTC Director) .
To apply, please send your CV and covering letter to y 8th October 2014
Click here for :LTC Clinical Lead Role Outline: Diabetes
Prescribing Lead Vacancy
There will be two vacancies for GP Prescribing Leads to join the Joint Prescribing & Medicines ManagementGroup (JPG) and the Prescribing Programme Board (PPB) membership. The first vacancy will be available from November 2014. The second from. January 2015.
The JPG is an advisory and decision making group which supports the safe and cost effective use of
medicines across a health community to improve health outcomes for patients.
The PPB is an advisory group which monitors and advises on the evidence base and cost effective use
of medicines within City & Hackney CCG and commissioned services. It has an overarching
responsibility for...read more
CCG Intranet
Do all of your staff know how to access the CCG intranet? Please share the link amongst your practice and ask your staff to bookmark the websiteDementia Diagnosis Rates
Please find a letter from NHS England explaining that City and Hackney's estimated dementiadiagnosis rate is 60.0% and estimated prevalence for people with dementia is 1386. Further analysis positions NHS City and Hackney CCG in comparison to other CCGs. We are doing well!Details of the dementia diagnosis rates of all practices within City and Hackney can be found at Annex B. The letter outlines advice to helpimprove the care of people with dementia including increasing the diagnosis rate both at CCG and practice level. This information can be found in Annex C.
The Alzheimer's society are here to help and the memory clinic are available to support you with diagnosis and management. You can contact the memory clinic by emailing Dr Evans at or the local Alzheimer's society service by using the referral form here
Diagnosis rates per GP practice within City & Hackney CCG
LES Payments
Following on from the communication last month, of all the validated claims, only one claim remains outstanding.The CCG is liaising with the GP practice in question to ensure payment is made as soon as possible.
City and Hackney Clinical Commissioning Group Clinical Executive Committee (CEC): Key Issues - September
Feedback from the members and CCG Programme BoardsThe CEC discussed the proposals for the formation of an area wide education network, noting that both the GP Confederation and Homerton University Hospital NHS Foundation Trust (HUHFT) were making bids to the Learning and Education Training Board (LETB). It was noted that any final service would need to be collaborative and integrated across primary and secondary care.
The CCG Programme Boards updated the CEC on recent work, including that local urgent care services were performing worse than 2013/14, with 8 weeks of A&E targets missed this year so far. It was noted that the admissions per attendance rate was...read more
Personal Health Budgets the ‘right to have’
From October 2014 adults on NHS Continuing Healthcare who had the ‘right to ask’ for a personal health budget (PHB) will have the ‘right to have’ a PHB. People with a PHB will be in control of a budget and can buy goods and services, this can include employing carers, giving them more control so that they can better manage their health and care needs. This means for example that someone with a PHB can choose who comes to their home, the hours that these staff work and the types of tasks that they do.NHS City and Hackney Clinical Commissioning Group has let patients, who are eligible, know about the changes and what they mean, and has been working with carers and patients to increase their awareness of PHBs. A leaflet called Introduction to Personal Health Budgets has been developed by the CCG and will be sent out to health and social care agencies across the City and Hackney.
Currently there are around 160 people across east London with the ‘right to have’ a PHB. This will increase next year as more groups of people receiving continuing healthcare will be added to the scheme.
We now have a page on our website dedicated to providing more information about PHBs
NHS England also has a PHB web page with ‘everything you need to know about PHBs’. It has a great set of FAQs and other information useful for clinicians and patients alike:
Education & Training
A list of current mandatory Friday education session can be found on the education page of the intranet.Level 3 Safeguarding Updates and Physiotherapy and Pain consortium education events start in October. Please check with your practice manager if you have not received an email advert with dates.
Upcoming education events:
GP/PN/HCA: Mandatory -Prostate cancer – from public health pilot to GP referral, Fri 3rd Oct 2014
GP:Impact of parental personality disorders on children and young people, Wed 22nd Oct 2014
GP: Foot and ankle problems and sports injuries, Thu 6th Nov 2014
GP/PN/HCA:Practical Asthma Study, Fri 14th Nov 2014
GP:Joint Examination & Injection Course, Sat 29th Nov 2014
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Children's Services Update
The commissioning / provider arrangements for some children’s health services have changed. The Local Authority have commissioned Whittington Health to deliver the following services in City & Hackney.For more about these services please access the information leaflets via the links:
Hackney New LAC Health Service Leaflet
LBH CoL School Health Services Summary Sheet
Family nurse partnership leaflet
Referral criteria for Family Nurse Partnership
Managing Patients with Complex Needs
Earlier this year, the City and Hackney Primary Care Psychotherapy Consultation Service (PCPCS) launched its report on ‘Managing patients with complex needs’ in collaboration with the Centre for Mental Health. Please click here to view the digital publication as well as a video explaining the Primary Care Psychotherapy Consultation Service.This new report sets out the findings of an evaluation of the PCPCS: the outreach service provided by the Tavistock & Portman NHS Foundation Trust, which supports City and Hackney GPs in managing patients with complex mental health and other needs that result in frequent health service use.
The report finds that service improves health outcomes and leads to a reduction in health service use in both primary and secondary care settings:
It has been found to improve the mental health of 75% of its patients and to help more than half to recover significantly. It also helps to reduce the number of GP consultations (by 25%), A&E visits, outpatient appointments and hospital admissions among its patients.
The resulting financial savings are equivalent to about a third of PCPCS treatment costs. And the report finds that the service costs just £10,900 per ‘quality adjusted life year’ (QALY) it improves. That is less than half of the threshold for cost-effectiveness in the NHS.
The service also achieves very high satisfaction ratings among local GPs.
Anticoagulation Local Enhanced Service (LES)
Practices that currently offer the anticoagulation LES are reminded that as of 1st of April 2014 the external quality assurance testing of anticoagulation machines changed over to WEQAS (replacing NEQAS). WEQAS will monitor the performance of the Practices’ anticoagulation machines used for INR testing bimonthly.Each practice must ensure they undertake the test bimonthly and return the results to WEQAS. Practices are reminded that if this is not carried out within the requested timescales they will forfeit any payment as it will be noted that NO quality assurance results have been recorded against that practice.
All GP practices offering the anticoagulation LES are reminded that there are two performance monitoring criteria which practices must adhere to:
1.Bimonthly submission of WEQAS samples. (NB: samples must be submitted back to WEQAS directly as per the instructions sent by WEQAS)
2.Each Quarter practices must demonstrate that 60% of test results are within target INR range
Practices will need to generate reports from INRStar and submit to the Medicines Management Team using the generic team address:
Please note the specific information required to be submitted each quarter is as follows:
A.activity by patient numbers
B.point prevalence
C.number of home visits
Please note practices that do not fulfil BOTH criteria as stipulated above will forfeit payments for the Quarter.
This policy has been approved by the Prescribing Programme Board and the Clinical Executive Committee.
Dr Haren Patel.
Prescribing Programme Board
Recording FGM How the New Rules Affect General Practitioners
As of 1 April 2014, the ‘ISB 1610 Female Genital Mutilation Prevalence Dataset’ was published. Within it are rules for healthcare professionals. This includes General Practitioners and other primary healthcare staff.“All clinical staff MUST record in patient healthcare records when it is identified that a patient has had FGM”
- If it can be determined what type of FGM the patient has, (according to the WHO classifications as outlined below) this MUST be recorded.
- Where it is not possible to determine the type of FGM, then ‘Female Genital Mutilation’ MUST still be recorded within the clinical notes.
New PPI Lay Member
I am delighted to be the new lay member of the CCG Board with responsibility for Patient and Public Involvement. I have a long-standing personal and professional interest in health and wellbeing and a commitment to improving health outcomes for individuals and for society as a whole.I have a particular interest in supporting carers and people with hidden disabilities to achieve success and in supporting people to self-care and take control of their lives.
I have lived in Hackney for 27+ years and have used local health services as a patient myself, a parent and carer for my mother. My father was a GP in South London and various members of my family currently work in the NHS or health-related jobs...read full story
Primary Care Quality Leaver and Starter
Sebastian Bowen leaves the CCG on 26th Sep and we are delighted to announce that Laurie Sutton-Teague replaces him as the Primary Care Quality Board’s Support Officer, starting 6 October.Laurie’s email is
Congratulations to all GP practices in Hackney
Congratulations to all GP practices in Hackney: we are the first London Borough where all practices have had their full IRIS training!We are now embarking on making sure that those surgeries who were amongst the first to have had their initial training, now more than
several years ago, are having essential refresher training, rolling this out to all surgeries by the end of 2015.
In spite of this we cannot be complacent.
Sadly three women living in Hackney have been murdered in the last four months, two as a direct result of domestic homicide by partners.
Both these women were registered with GP practices in Hackney. In addition Hackney now has the highest prevalence of reported...read full story
City & Hackney Safeguarding Children Board News Bulletin - Summer 2014
Download the Summer 2014 edition of the CHSCB News Bulletin which includes the following sections:•Key Safeguarding Lessons
•Children should be seen, heard and helped
•City of London notice the signs campaign
•Neglect
•Are you confident in escalating your concerns?
•Are you participating in the child protection process?
•Children & Young People Services Resource Guide
•NSPCC “At a Glance Briefings”
•New members of the CHSCB Team and the CHSCB
•CHSCB Training
•Recently released news, reports and resources
As always, the news bulletin is available on the CHSCB newsletter at
Care Review Service for Patients at Risk of Admission
The CCG has commissioned the Tavi to assist GPs to do care plan reviews of patients with a mental health or medically unexplained symptoms component for the next year - see below for a guide as to who is suitable.The Tavi will be able to do follow up reviews of patients in surgeries or at home.
Please contact Carolyn Walker Please note the NEW EMAIL- which is an nhs.net one for patient confidentiality.
The following guide may help practices identify these patients:
• Do you feel that there is an element of emotional distress or mental ill health affecting this person's physical health significantly?
• Do you feel this person has some medically unexplained symptoms?
• Does this person have a complex family structure or issues affecting their physical wellbeing?
• Has this person had many investigations/OPDs etc but still is unhelped?
• Is the level of physical disability out of proportion to the diagnosis?
Practices are asked to generate their lists of patients that most fit these clinical parameters and to make contact with Carolyn Walker at Tavistock and Portman who can discuss the care planning needs of this cohort, see patients and complete care plans where appropriate. Carolyn is available on:
Volunteer and Befriending Service
New service in City and Hackney to help dementia patients get to their appointments - please use the service!Volunteer and Befriending service now has The Targeted Preventative Service, a new way of meeting people’s (aged 18+ or 16+ for Floating support) needs before they need a social care package which has been developed within the London Borough of Hackney. It has three elements – Health and Wellbeing, Floating Support and Volunteering and befriending. Outward is the single point of entry for all referrals to the whole service as well as delivering the Volunteer & Befriending service.
You can send referrals via the referral form to and the telephone number is 0207 249 9004.
The Volunteer and Befriending (V&B) service aims...read more
What's On For Your Patients