Dear colleague,
Chair’s introduction
At a time when General Practice in Tower Hamlets is being negatively impacted by many external factors, this newsletter will outline what we are doing to defend you, challenge processes and raise awareness.
However, I also want to highlight that there are things within our control as GPs that we should be thinking about. Shared care has been a focus for the LMC for a very long time and this remains the case. The BMA/GPCE collective action aligns with work that we have already been doing in Tower Hamlets and NEL.
The LMC is here to help and represent you. Please stay in touch.
Best wishes,
Dr Emma Radcliffe
Chair
Tower Hamlets LMC
Tower Hamlets LMC contact details
What has Tower Hamlets LMC been working on recently?
Contract handover from CEG to PCIT (Primary Care IT)
The LMC, along with other leaders in Tower Hamlets, is extremely concerned about the transfer of contracts as we are not convinced that PCIT is in a position to take on all the functions of the CEG in Tower Hamlets and especially not at the beginning of August. We feel there are significant safety risks, workload issues and resource issues and we wrote a joint letter with key stakeholders in Tower Hamlets to the ICB asking for immediate action. Your Local LMC and Londonwide LMCs are continuing to press the ICB for a safe transition.
NHS England list cleansing (FP69)
The ramping up of the NHS England patient list validation exercise (FP69) is having a particularly significant impact in Tower Hamlets because of the borough’s highly mobile population. Practices are seeing substantial numbers of patients removed from their lists, with potential consequences for continuity of care and practice funding. Keep a close eye on FP69 notifications and review patient removals promptly to minimise inappropriate deregistrations.
We have written to Apsana Begum, MP for the borough’s most-affected constituency Poplar and Limehouse, to raise this issue, as part of a strategy alongside other borough committees supported by Londonwide LMCs.
DOACs prescribing and monitoring
We are aware that there is a London Executive Group statement coming down on DOACs, and will update further as soon as we can.
AI-generated communications
Artificial intelligence is increasingly being used to generate both clinical and patient correspondence. Practices are seeing examples of AI-generated hospital letters containing inaccuracies or insufficient clinical checking, alongside increasingly lengthy AI-generated complaint letters from patients. Poor-quality AI-generated clinical correspondence can be flagged using the normal Quality Alert process. You can also let your LMC rep know of any recurrent themes or issues and examples.
Link for NEL quality alerts.
Barts Health communications improvement
Barts Health is shifting some patient (or patient advocate) communication channels previously done via NHS email to structured online communication forms in Accurx. This follows the identification of a large number of unmonitored NHS mailboxes and aims to provide a safer and more dependable way for patients to contact the hospital, learning from the similar shift already underway in general practice. It is hoped that the form contacts will be easier for clinicians and NHS IT systems to read and use, and to improve response times and reliability. This is being piloted by the inflammatory bowel team with work underway to extend to around 15 more, and GP feedback will continue to shape the development of the new system.
The LMC are hugely supportive of this innovative project. We are well aware that practices field large numbers of contacts from patients that should be directed to the hospital. If you have any feedback on this process, pleased do not hesitate to contact your LMC reps.
Primary–secondary interface
Work continues to improve the interface between primary and secondary care. Alongside ongoing concerns about inappropriate transfer of unfunded work, there are positive examples of closer collaboration. Improvements to musculoskeletal pathways have already resulted in faster access for some urgent referrals, demonstrating the benefits of joint working between general practice and hospital services. Similar approaches are being encouraged in other clinical areas.
We have re-started the primary-secondary Interface meetings, involving ELFT community and mental health borough leads as well as Barts Health, and GP representation from the LMC and the GP Care Group.
As always you can raise individual quality alerts via this link for the attention of the provider and commissioner and raise recurrent or structural issues with your LMC rep.
Shared care
Please think carefully when you receive requests to share care. Make sure you accept or reject – the choice is yours!
At a time when we are under intense pressure, we need to think before we take on work which is not core General Practice. I would strongly urge you to ask:
- Is it safe/clinically sound?
- Do we have the capacity to take this on?
- Is this adequately resourced?
If the answer to any one of these questions is no, you might want to consider saying no. The system needs to respect General Practice and ensure we are not overwhelmed and that we are adequately resourced. We do need to stand up for ourselves.
More information from Londonwide LMCs here.
ADHD in Children
We want to alert you to a shared care agreement that was brought to our attention. It has apparently been around for many years but had no LMC involvement in its development. CAMHS have said they send it out to all GP practices when they start children on ADHD meds. Whilst the lead consultant says they are doing the physical monitoring in clinic, please be aware of the workload and safety implications of signing up to this agreement – ask yourself the three questions above. If no shared care agreement exists in the notes of children you are prescribing for, please be aware of what the expectations are around monitoring.
Data Sharing Agreements with school nurses
We are aware that practices are being requested to make DSAs with the Compass, school nurse service. Londonwide LMCs is reviewing the proposed agreement and we will advise further as soon as possible.
North East London sector issues
Many issues affecting Tower Hamlets also affect other boroughs in NEL and we work closely with our counterparts to address and resolve them at sector level. We produce a NEL newsletter for the sector work. The most recent issue contains important advice for practices on contractual issues to be aware of, plus the transition from CEG to the new provider Primary Care IT and other topics. You can read it here NEL Newsletters.
Well done to the prize draw winners from our Buying Group survey
Thank you to everyone that took part in our Buying Group survey, we plan to run another one in the autumn. The randomly selected winners of the gift vouchers were:
- Trudy Do, Havergal Surgery
- Karen Tobin, The Bromley Common Practice
- Anca Radulescu, St. Margarets Medical Practice
- Marian Negoita, Amersham Vale Practice
- Aparna Pal, Jubilee Garden Medical Centre
Our Buying Group suppliers are:
- Hillcroft Surgery Supplies – Get next day delivery and industry leading stock availability, thanks to their investment in substantial warehouse facilities.
- Practice Index – Pick and choose what you need out of their learning platform, or software to manage HR, finance, compliance and rotas.
- Hippo Labs – Have your call-and-recall work smarter, reach more patients and improve QOF attainment. Hippo Labs automatically customises many types of message.
- Equity Energies – Reduce energy costs, save time, become greener and remove the administrative burden of managing utilities by having experts do it all for you.
- Surgery Connect – Automates more tasks within your phone system, integrates with clinical records and seamlessly bridges in and out-of-hours.
- MIAB – You existing policies may have more gaps than you think, particularly in developing areas like cyber and ARRS employment. Rely on MIAB’s specialist expertise to ensure you are fully covered.
- Restore Information Management – Whether you need a room full of records doing or a steady flow of new registrations, Restore take the hassle out of digitising patient records.
- Tickets for Good – Reward yourself and your colleagues with free and discounted tickets to concerts, theatre shows, sports and more!
Engaging with Tower Hamlets LMC
We are keen to listen to practices, to understand the issues they are worried about and the challenges they are currently facing – let us know if you would like a call or for an LMC member to visit your practice for a conversation. Please email ian.williamson@lmc.org.uk.
Please also visit the Londonwide LMC website for a one-stop shop on our support for practices—details of our services, practical resources (including template letters and guidance), and details of your Newham LMC committee, including meeting dates and previous local and NEL newsletters.