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Email sent by Wessex LMCs, on Tuesday, 21 Feb 2017

Date sent: Tuesday 21 February 2017

Email sent by Wessex LMCs, on Tuesday, 21 Feb 2017

At the last two Olympic Games, Great Britain has become a world dominating force in cycling.  When asked how this has happened, the reply has been that it is not been because of one significant development.  The whole principle came from the idea that if you broke down everything you could think of that goes into riding a bike, and then improved it by 1%, you will get a significant increase when you put them all together.

There is not a "silver bullet" that will solve all of our problems but we should learn from the experiences of others.  What will improve the situation for GPs, Practices and their staff is a number of changes to help address the challenges of workload, demand and workforce.

As described in my last email update about the contract changes for next year, I hope the positive impact on removing the AUA DES and reinvesting this resource within core funding, providing a scheme that funds sickness cover from 2-26 weeks, recognising and funding additional workload created by organisations such as Capita being recognised and costed with this resource being added to practices core funding, CQC fees being fully reimburses and a review of the process of CQC and additional funding to cover the increase costs of indemnity cover will all help but not solve the problem.

GPs have complained for years about the "dumping" of work from secondary. To help address this a number of measures were introduced to the 2016/7 NHS Standard Contract that applies to all NHS providers. (See below for more details).  For 2017/8 a further raft of changes will be introduced to the NHS Standard Contact and hopefully these measures will form part of the incremental improvements that are desperately needed.


1. Changes to hospital contracts 2016/7 and 2017/8

2. Prescribing - save time with electronic repeat prescribing

3. Clever Ideas/Solutions to make your job better and easier


1. Changes to hospital contracts 2016/7 - a review of what should have happened so far!

Local access policies – A new requirement was introduced for providers to publish local access policies. Hospitals were stopped for adopting a blanket policy under which all patients who do not attend a clinic are automatically discharged back to their GP. This is aimed particularly at first time offenders not repeat offenders.

Discharge summaries – these need to be electronically transmitted or emailed for inpatients, day cases or A/E care within 24 hours and enabling local standards to be agreed for discharge summaries from other providers. 

Discharge summaries must use Academy of Medical Colleges endorsed clinical headings.

OPD letters – there is a requirement that these should be received by G{s within 14 days, where there is information which the GP needs quickly in order to manage a patient’s care.

Onward referral – For non- urgent conditions directly related to the complaint or condition which caused the referral, onward referral to and treatment by another professional within the same provider is permitted, without reference to the patient’s GP – unless referral back to the GP is specifically required as a condition of a prior approval scheme in the local contract. (the condition remains that hospital clinicians cannot refer onwards for a non-urgent unrelated condition, they must refer back to the GP, it is then for the GP to determine whether onward referral is appropriate).

Communications and organisation of care – A requirement on providers to organise the different steps in the care pathway promptly and to communicate clearly with patients and GPs. This specifically includes notification to patients of the results of clinical investigations and treatments.

Changes to hospital contracts for 2017/8 - what should happen from April 2017

Fit notes – There is a new requirement on hospitals and community providers to issue fit notes to patients under their care.

Out patient clinic letters – OPD letters should reach the GP within 10 days from 1st April 2017 and 7 days from 1st April 2018. A new requirement for electronic transmission of clinic letters, as a structured message using standardised headings will take effect from October 2018.

Patient queries – the requirement for providers to communicate properly with patient about their care has been strengthened, adding new obligations to put in place efficient arrangements for handling patient queries promptly and publicise these arrangements top patients, on websites and appointment/admission letters.

Discharge summaries- following and in patient or day case admission must already be sent electronically as a structured message using standardised clinical headings. From 1st October 2018 this requirement applies to discharge summaries after A/E attendance. From 1st October 2018, transmission of clinic letters and discharge summaries to general practices must be via direct electronic transmission, not via email.

Outpatient prescribing – There is a new requirement that providers must supply medication following a patient’s attendance at clinic, where clinically indicated, for the period required in local protocols, but at least sufficient to meets the patient’s immediate needs.


2. Prescribing - save time with electronic repeat prescribing

Please see the excellent newsletter produced on Electronic Prescription Service (eRD) by the Hampshire and IoW Local Pharmaceutical Committee.

Repeat Dispensing  benefits surgeries because of the reduction in time and administration necessary to process repeat prescriptions and it benefits patients by making their regular medicines much more accessible, directly from their usual pharmacy.

Repeat Dispensing has also been shown to reduce waste and hence prescribing costs.


3. Clever Ideas/Solutions to make your job better and easier

Every time I visit a practice I come away with at least one good idea.  What we are not good at is sharing these ideas, many of which are simple and could benefit many practices.

So here is your chance, think about one thing you have done in your practice that has had a significant impact and then share it with us so we can share it with all practices in Wessex. We will attribute this to your practice unless you wish your contribution to remain unknown. 

Please click here for the Webpage and the form can easily be downloaded.  If each practice shared one idea, just imagine what a library we would have available.


Best wishes


Dr Nigel Watson

Chief Executive

Wessex LMCs

Churchill House, 122-124 Hursley Rd

Chandler's Ford, Eastleigh

Hants. SO53 1JB (Registered Office)

Tel: 02380253874

Mobile: 07825173326


Attached file: Repeat Dispensing Newsletter.pdf

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Updated on 21 February 2017 1053 views