Managing Diabetes During Ramadan

GP Bulletin

For Action

• Managing Diabetes During Ramadan

Ramadan will be taking place during the months of June and July this year. Diabetes UK has produced patient information leaflets in English, Arabic, Bengali and Urdu to support patients with managing their diabetes during Ramadan if they wish to fast.

Practices may like to display these in surgery waiting areas and/or discuss them with patients during consultations.

These resources can be accessed from

*******************************

• Healthcare Assistants course this September

Lambeth is running a third Healthcare Assistants course this September for 6 days - 1,7,14,21,28,29.

The first two courses provided a basic training to all existing HCAs - 30 in all.

I know that some practices are recruiting or have new HCAs who may be in post since I first met with everyone. There is now a Care certificate in place for all new HCAs and this course will cover the elements of this. The CQC standards 18/19 expect that practices will be compliant with the Care Cert

If you would likea place on this fully funded course or wish to discussitthen please contact Nurse Practitioner/Lambeth CCG Nurse Lead HCAs, telephone 0207 622 1424

This is on a first come, first served basis

*******************************

• Southwark and Lambeth Population Health Improvement Fellows

Development opportunities for newly qualified GPs June 2015

Would you like to be part of a unique fellowship giving participants the opportunity to develop their clinical practice, learn how to commission services for a population and participate in a Masters in Public Health?

We want to appoint six recently qualified GPs with a passion for excellence who are looking for their next challenge.

In collaboration with Kings College London and Health Education South London we have developed a unique fellowship in General Practice working in Lambeth or Southwark. This is a new scheme; set up to support the on-going education and development needs of recently qualified GPs and to provide them with new skills and knowledge to support a wide range of career opportunities in the future.

Our hope is that the fellowship will attract applicants interested in the challenges of delivering care, and commissioning services, in two diverse inner city boroughs in South London. At a time when the NHS faces unprecedented challenges this scheme will offer the opportunity for Fellows to participate in radical and innovative transformation of the way in which health services are delivered locally.

The fellowship will offer participants:

• an extended period of supported learning and development in a forward thinking primary care and commissioning environment,
• peer support and networking with local clinicians and health professionals,
• career development through the acquisition of a wider portfolio of skills and experience such as commissioning, leadership and negotiating skills.
• further education and research through participation in a Master’s degree.

Practically this will mean that you will work jointly in a local practice and as a CCG commissioner with dedicated time for peer support and development. There is also the opportunity to spend one day a week working towards the completion of a master’s in Public Health (Primary Care).

For a recruitment pack please email Una Dalton, Director of Governance and Development at or you can go to or

For an informal discussion please contact either:

Dr Jonty Heaversedge, Chair, Southwark CCG at r 07717815501

Dr Adrian McLachlan, Chair, Lambeth CCG at or 07973614943

To apply for this fellowship please submit a CV along with a covering letter setting out why you should be selected for this opportunity to Una Dalton at

The closing date for applications is Tuesday 30th June 2015

*******************************

• Message from theICT department at King’s College Hospital

After investigating the issues with sending electronic documents (discharge summaries, clinic letters,A&E reports, Respiratory test results etc) to GP's we have decided to revert back to sending documents via email.This does NOT affect pathology/Radiology results. We will be using this method until further notice once the issue is resolved.

What practices need to do;

Please check you are receiving your electronic correspondence via email

If yes – then please make sure yourDocman scheduler is collecting from the email account. If the scheduler is working your electronic documents will appear inDocman and can be processed as usual. IfDocman is not collecting from the scheduler then please contactDocman Support(0844 967 0 967) to resolve this.

If no – then this could be because we do not have an updatedDocmanemail address for the practice. Please contact our data quality team ( -Sandra Webb – 01689 863039 / LisaHeselden 01689 863042) to update your practice email address.

In order to make sure we have not missed any correspondences we will be resending all documents; however, this may mean there are a few duplicates. We are working to reduce the number of duplicates you receive, but it will take a few days’ to resend the backlog. We hope to clear this backlog by Friday.

We apologise for any inconvenience this may cause.

Steve Groves & Richard Jordan –ICT King’s College Hospital

/

*******************************

• Referrals for the Paediatric Dietician Outpatient Service (Please see attached guidance(1))

We have been experiencing a high number of referrals for the Paediatric Dietician Outpatient Service at Denmark Hill and you may have noticed that our waiting times are very long for both new appointments and follow ups.

We aim to optimise the treatment we give to all of our patients by offering services which we know are evidence based and effective. We would therefore like to ensure that patients who would benefit form first-line advice, self-management or other services, are signposted to these, and therefore we have created referral criteria for you to use when referring a child which can be found in the attached guidance

For Information

• Pertussis Vaccination in pregnancy to prevent neonatal infection – Practice update:

A recent quality alert and separate serious incident at KCH involving an infected neonate has indicated that there may be a lack of clarity with regards to responsibility for advising and providing pertussis vaccination in pregnancy. This was discussed at a recent maternity meeting at KCH and it was confirmed that any health professional caring for a pregnant woman should provide advice about the benefits of pertussis vaccine at booking and at subsequent visits. The vaccine should be given between 28 and 38 weeks of pregnancy and it is the GP who is contracted to provide this role if they have signed up for this national enhanced service. In view of the potential serious nature of such an incident we agreed share this message with both Lambeth and Southwark CCG members.

*******************************

• Lambeth & Southwark Patient Diabetes Forum (please see attached flyer (2))

The Diabetes UK Lambeth and Southwark Group offer support and information for everyone with diabetes and their carers at our Patient Forum.

Anyone is welcome to come to our bi-monthly meetings, where we share experiences with others and listen to presentations by healthcare professionals, as well as ask questions.

*******************************

• Medicines waste survey – tell us what you think

As part of the CCG’s new medicines waste campaign, we are looking at how we can better support patients with the medicines they are taking. We are asking local GPs and pharmacists to help us by completing a short survey about how you think health services in Lambeth could better help patients to use their medicines properly and order responsibly. The feedback we gather from you will help us ensure patients get the most out of their medicines and reduce the amount of medicines wasted. They survey consists of nine questions and we are not asking for personal detailsso you can not be identified from the survey.
*******************************

• Local Eye Service

MECS Lambeth CCG commissions a service to deliver eye care in the community, known as MECS (Minor Eye Conditions Scheme).The service is highly rated by patients (100% satisfaction; 99% would recommend it to friends and family).

WHICH MINOR EYE CONDITIONS? Optometrists (based in 8 local optician practices, soon to be 10) see patients referred to them by a GP, or who self-refer; to examine them for certain conditions (red eye, dry eye, watery eye, in-growing eyelashes, foreign bodies, flashes/floaters etc.). Prior to MECS being set up, these conditions would often be referred on to secondary care.

GLAUCOMA AND CATARACTS. The optometrists also “refine” glaucoma and cataract referrals, reducing the number of patients referred to secondary care with suspected glaucoma (but who do not actually have it) and the number referred for cataract surgery (but who do not actually want it, once they have had the opportunity to discuss it in more depth with the optometrist).

DOES EVERYONE IN YOUR PRACTICE KNOW ABOUT MECS? Referral rates to MECS vary enormously across practices. This may be because not all GPs are aware of the service. Some practices do not refer to MECS at all.

SUSPECTED RETINAL TEAR If a retinal tear is suspected by the GP or patient, they will be seen by the optometrist on the same day. The optometrists providing MECS are qualified to decide whether there is a risk that needs to be addressed at secondary care or whether the patient can be safely discharged or monitored at a follow-up MECS appointment. Many other patients are seen on the same day, and nearly all within 2 days (a contractual requirement).

MEET YOUR LOCAL MECS OPTOMETRIST Your local optometrists are keen to attend practice meetings to discuss their service with the clinical team.

MECS LEAFLETS Newly printed leaflets about the service will be sent to practices in the next few weeks. It would be useful if the practice receptionists understood the service so that they might signpost the patient to the leaflet, if appropriate. The patient can then decide if their symptoms suggest that a MECS consultation is required, rather than a GP appointment.

CURRENT PROVIDERS

If you have any enquiries about the service, please do not hesitate to contact .

*******************************

• Paediatric Short Stay Unit 1st Birthday Party - Friday 3rd July, 2.30 - 4.30pm (Please see attached invite (3))

We would like to invite you to the first birthday party of the Paediatric Short Stay Unit. Please put it in your diaries now: 3rd of July at2:30pm in the Boardroom, Denmark Hill!

There will be a short presentation near the start at about 2:45pm, plenty of food and drink, and some entertainment for the children and families who we have invited to join us all.

Thank you for your support of this fantastic new service in Child Health at Kings which has already had a huge impact on the care that we as a hospital provide for a local population.

*******************************

• Norwood Pensioners’ Group: Promoting the health & well-being of the over 55’s

The Norwood Pensioners’ Group was established in response to a need for local services for older people in the Norwood area. All activities take place On Tuesdays during Term Time at the Old Library, Knights Hill, West Norwood, SE27 0BY.

The current programme of activities are:

• Flower Arranging10–12.30 pm
• Tai Chi 11.30 – 12.30 pm
• Zumba Chair Exercise 2 – 3pm
• Line Dancing, (improvers) 3.30 – 4.30pm

All classes are £3. For further details call 020 8670 9558.

*******************************

• The Area Prescribing Committee (APC)

“Please find below a link to a survey that has been developed to understand what the current profile is of the Area Prescribing Committee (APC) within its partner organisations across SEL.

The survey will help to identify:

• Whether local healthcare professionals are aware of the Committee
• Whether they are using the guidance the Committee develops and if it’s helpful
• How we can develop our Committee further

The survey can be found at:

*******************************

• Lambeth mental health services praised in national assessment

You may hear news today of a CQC report about mental health crisis services across the country.

We’re pleased to share with you that Lambeth has been praised in the report which can be found on the CQC website.

We have issued the following media release to the local press and it is also on our website.

Well done to everyone who contributes to the commissioning and delivery of mental health services in Lambeth. This national recognition is something for us to all be proud of and to continue to build on.

A Care Quality Commission (CQC) report out today (12 June) holds Lambeth’s mental health service up as an example of how to support people experiencing a mental health crisis.
The national report follows a review of mental health crisis care and support services in 12 areas across the country including Lambeth.
The report raises concerns nationally that crisis care is not available around the clock and that healthcare professionals, such as those in A&E, can appear to lack training in how to care for and speak to people who are having a crisis.
However, it names Lambeth as an area where services are supporting people in mental health crisis well, saying: “CQC found crisis care and support arrangements within the London borough of Lambeth to be particularly commendable; for example, inspectors noted the way that primary and social care services, voluntary organisations and housing advice services in the area worked together to provide appropriate support, referral and triage for people in need.”
Inspectors praised the joint commissioning of preventative services between Lambeth Clinical Commissioning Group and South London and Maudsley NHS Foundation Trust and its setting up of a ‘crisis house’ at Mosaic Clubhouse in Brixton, in response to the lack of available beds for people experiencing a crisis who needed inpatient care.
Dr Adrian McLachlan, Chair of NHS Lambeth CCG, said: “We’re very proud that Lambeth’s hard work to support people with mental health issues has been recognised in this report and held up as an example of good practice.
“It’s vital people experiencing a mental health crisis receive the support they need when they need it.
“We have been working closely with all our partners in the Lambeth Living Well Collaborative, local hospitals and the police to ensure people can access the support they need.
“We have commissioned a number of initiatives which are supporting people with mental health issues including peer support services in the community such as the Living Well Partnership hosted by Mosaic Clubhouse. We also have Solidarity in a Crisis - an out of hours peer support service run by Certitude.
“The Living Well Network Hub is the new front door to mental healthcare for people in the north of the borough and will be extended to the south of Lambeth at the end of June. We also have clear care pathways for patients who are experiencing a mental health crisis and attend A&E.
“A&E staff work closely with counsellors and local community mental health teams, and the mental health liaison team provides on-going training and support for doctors and nurses as part of their induction.
“Lambeth also has a successful street triage team which works closely with the police and a 24 hour telephone advice line for police officers which enables a mental health nurse to offer advice tailored to individuals who are known to the service."
Cllr Jim Dickson, Lambeth council Cabinet Member for Health and Wellbeing, said: “We are working hard in Lambeth to provide the best services we can, and I welcome the CQC’s positive findings on examining the borough’s mental health crisis care and support arrangements.
“Our health partners are taking new approaches and working hard to best meet the pressing need of the community. The council is supporting this work, and we are also running a commission on improving mental health amongst Black and Minority Ethnic communities.
“Despite the CQC’s positive assessment, we remain on a journey – in partnership with residents - to reorganise services, focusing on keeping people well and improving accessibility for all communities so that we can start to reduce our rates of mental illness in Lambeth.”
Dr Matthew Patrick, Chief Executive South London and Maudsley NHS Foundation Trust, said: “We are pleased to see that the CQC’s report recognises the positive collaborative work that is being achieved across Lambeth to improve care for patients in crisis.
“Working in this joined up way requires real commitment and an ability to focus on the bigger picture and what is right for our patients, not just our individual organisations. I would like to say thank you to all our local partners for working so closely with us. Having said that, we still have much improvement to make and must continue to work collaboratively in the future.
“The ultimate goal must of course be to keep people well and prevent them from reaching crisis in the first place. This is why we are working to provide support at an earlier stage in people’s difficulties. We are doing this by changing how we work and how people access our care. We are providing people with a ‘one stop shop’ place to go for assessment, treatment and support as part of the Lambeth Living Well Hub. For those who are in crisis, our dedicated psychiatric liaison teams treat patients who visit local A&E departments, and we also run a 24/7 support telephone line to provide police officers on the street with access to clinical advice.”
Dr McLachlan added: “Although pleased that our hard work is being recognised, we won’t rest on our laurels. There is always room for improving services and we will continue to work with patients to do so. One area we’re currently working on is to improve access to services from black and minority ethnic patients, and we will continue to strive to provide services which meet the needs of the whole population in Lambeth.”
The CQC has reviewed the quality of services in England to identify what is working well and what must improve, based on inspections of a sample of areas; a survey of around 1,800 people who have experienced a crisis; and on published evidence.
The CQC report Right here, right now is part of CQC’s commitment to the Mental Health Concordat. The full report and summary can be viewed on the CQC website.