Dear Colleague,
Chair’s introduction
Happy New Year! We started the year as we intend to go on in our first LMC meeting. We know how crucial General Practice will be to the success of any future neighbourhood model of working and we will continue to ensure, with others, that your voice is heard as things change. The loss of our clinical leads will be significant, and we have written to the ICB to express our profound concerns about their proposed changes which disproportionately affect General Practice. We know that General Practice is the best place to deliver most of the care outside the hospital setting and therefore we continue to make the case to the ICB to commission sensibly funded, clinically sound, patient oriented, local enhanced services. We are preparing for an extremely difficult year ahead but we know that Tower Hamlets General Practice has risen to challenges before and can do so again.
Tower Hamlets LMC membership and contact info
Member spotlight – Dr Kate Nicholson
I have been a GP Partner at St Stephens health centre in Network 5 for many years and the relatively newly elected vice chair of the LMC. I have worked in Tower Hamlets since I qualified and am motivated by the desire to protect general practice and support my colleagues who serve the people of Tower Hamlets.
We as a committee want to hear your voices and build a unified approach to the difficulties that we are all facing. I hope that you feel able to approach us directly and please do come along to our unified voice meetings which are upcoming to represent your views.
What has Tower Hamlets LMC been working on recently?
DOAC monitoring
We continue to challenge to the medicines commissioning team in relation to the transfer of responsibility for DOAC monitoring to practices without a funded enhanced service. The LMC’s position is that neither initiating nor monitoring DOAC is core GP work and it should be commissioned under a local enhanced service. The commissioners confirmed this issue has been escalated internally and will provide an update as soon as possible.
Practices are reminded that this work is currently funded through a LES until the end of March 2026; and may need to consider whether to continue this unfunded work or provide a notice of withdrawal from unfunded work, unless an appropriate LES is introduced for DOAC monitoring. Please do approach your LMC rep if you want to discuss this issue.
Secondary Interface
The interface group meets quarterly with representatives from Barts Health, ELFT (mental health and CHS) in attendance. The focus remains on secondary care providing fit notes, that they complete referrals their service deems necessary and GPs aren’t asked to provide urgent prescriptions, follow up or do tests recommended by the specialist service. There is also a big piece of work to ensure all departments have a single email contact.
We have had ongoing discussions with colleagues about work that is and isn’t contractual. ELFT have agreed that they should be providing prescriptions for e.g. titration of antipsychotics. We are having ongoing discussions around other areas of work that traditionally we may have done but we are not contractually obliged to do.
Quality alerts remain an important part of monitoring workload transfer so please do ensure you fill them out as often as possible. Every quality alert to the Royal London gets reviewed by the Medical Director so there is senior oversight and he welcomes the fact that we have increased quality alerts from 338 to 550 over the last year.
School nursing
The LMC Chair has been continuing to liaise with Compass after speaking with them at the November LMC meeting.
GPs will hopefully get to know the named nurses for schools serving their catchment but are advised to contact/copy the general email address (compass.towerhamletsyphws@nhs.net) to ensure that things are picked up during absence. For new referrals to the service, there is a form on the website – on that page scroll down to the Professional button. The phone line is 020 3954 0091, Mon-Fri 9-5.
NHS Health Checks – Health Diagnostics
Public Health is proposing to move NHS Health Checks onto a web-based tool (“Health Diagnostics”) that is not directly integrated with EMIS (although it will code data back into EMIS). They believe this will improve population searches and recall, support more appropriate referrals, help HCAs give clearer patient advice, and generate a better-looking patient report.
We have raised concerns about adding “another system” alongside EMIS and the risk of confusion and duplicated workflows. QRISK is calculated during the check and determines whether bloods are needed; without point-of-care testing, practices will still need a consistent post-appointment review process where bloods are taken, and the current approaches vary across practices. It may also be harder to record additional items as free text, sexual health screening or latent TB work without switching platforms.
We have asked Public Health to first explore what improvements can be achieved within the existing EMIS-based Health Check approach (including any support from EMIS/CEG/Care Group) before introducing a separate standalone system.
Doctor’s notes for schools
Following queries from a few GPs, we would like to remind that a GP note is not required to administer over-the-counter medications to children in a school setting. We should not be providing sick notes and we should not be asked to provide evidence of appointments for school. We wrote to the Director of Education of Tower Hamlets and she agreed to pass this information on to Tower Hamlets schools. Please find guidance at these links: Londonwide LMCs, DfE (see paras 365-366), NHSE.
North East London sector issues
Many issues affecting Tower Hamlets are sector-wide and we work closely with our counterparts in other boroughs. There is also a newsletter for the sector work – the latest editions cover issues including contractual compliance guidance, Enhanced Services review, community anticoagulation service, secondary interface, local engagement and Londonwide LMCs’ refreshed Buying Group for general practice. You can read it here.
Exclusive deals for practices
Our substantially updated Buying Group offer provides a range of opportunities to save money and improve the quality of products and services you use.
- Get excellent prices and next day delivery on consumables, with a supplier who can respond quickly to your practice needs.
- Access a comprehensive online learning platform, plus packages to manage HR, finance, compliance and rotas.
- Let a specialist GP insurer make sure you have the right cover, with knowledge on developing areas like cyber security, AI scribes and contract holding at PCN level.
- Our records digitisation partners can help free up premises space and recent changes with the National Document Repository have improved practices’ options.
- Intelligent, end-to-end call-and-recall automation does more than simply send reminders, it tailors messages and helps to improve QOF.
- The latest in cloud telephony integrates with clinical systems, provides stats on patient contacts and automates many tasks.
- Reward yourself and your colleagues with free and discounted tickets to concerts, theatre shows, sports and more!
Tower Hamlets LMC
You can find contact information, meeting dates and membership information for Tower Hamlets LMC here.
Yours faithfully,
Dr Emma Radcliffe, Chair, Tower Hamlets LMC