Primary Care Bulletin - March 2024

Welcome 

Welcome to the March edition of the NHS South Yorkshire Primary Care Bulletin. 

We wanted to start by mentioning the GP contract. We will be working with LMCs and GP leaders as any final agreements become clearer. We await the recommendations of the Doctors and Dentist’s Review Body but we recognise the anxiety in practices that the pay award will be insufficient to meet the increased costs of minimum and living wage pay rises for practice staff with adverse consequences for practice financial positions and resilience. It is essential that we work collaboratively with the LMCs, the Primary Care Provider Alliance and GP practices to provide a pragmatic local response to the arrangements as they become clearer.

We also recently met with the South Yorkshire and Bassetlaw Acute Federation and presented a principle document on the primary and secondary care interface. As a result, we held a meeting for primary and secondary care clinicians from the Mental Health Alliance and Acute Federation to highlight the four responsibilities of NHS South Yorkshire and propose a way forward. We agreed to set up some regular task and finish groups to work on the issues and will provide updates in this bulletin as the work progresses.

Anthony Fitzgerald, Executive Place Director for Doncaster and Executive Lead for Primary Care, NHS South Yorkshire    
Dr Andy Hilton, Chair, NHS South Yorkshire Primary Care Alliance  

GP bulletin header 2024.jpg

In this edition we cover the following items:

Tell us what you think about our Primary Care Bulletin
Dental Board paper
Maternity and Neonatal Independent Senior Advocate
Referrals into the very high risk breast screening programme
Pharmacy First update
Get your blood pressure checked national campaign
e-Referral Service (e-RS) – browser address change
Peace of Mind – Cancer signs and symptoms campaign
Cancer Alliance - research into pancreatic diseases
Clinical and Professional Assembly
New study for people living with type 2 diabetes
Bringing health services to Barnsley high street
Montagu Hospital expansion of Community Diagnostic Centre services

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NEWS UPDATES

Dental Board paper

As you will know dentistry continues to have significant challenges, not just locally but nationally and remains a significant concern for the people we serve, as well as professionals within the field.

A paper went to the NHS South Yorkshire Board meeting in March to provide our response to the Dental Recovery Plan that we mentioned last week and an update on the ongoing work across South Yorkshire in dentistry outlining the current position, challenges, and the developments that have been underway through system working.

In addition, to seek support from the Board on three key principles which will underpin the approach required to continue to improve patient access to dental services:

• Commitment to utilise the ring-fenced funding for dental services (as per National commitment) including non-recurrent monies (commonly known as clawback), with a proportion on a two-year basis.

• Commitment to take a level of risk on more innovative ways for commissioning of services, building on existing flexible commissioning approaches.

• Support for the priorities identified from the dental budget and outline of the principles of the investment plan for 2024/25

You can read the full paper here:

https://syics.co.uk/application/files/2717/0913/2672/Enc_10c_-_Dentistry_Plans_2024-2025.pdf

Maternity and Neonatal Independent Senior Advocate

The Maternity and Neonatal Independent Senior Advocate (also referred to as Maternity and Neonatal ISA or MNISA) is a new senior role being piloted to support women, birthing people and families in England. This follows the Immediate and Essential Actions identified in the Ockenden review into maternity care at Shrewsbury and Telford Hospital. The Independent Senior Advocate role is independent enough to have autonomy to act for others, senior enough to be able to effectively raise issues at Trust and LMNS board level and has the ability to advocate for women, birthing people and their families when they might benefit from additional support.

Abbey Harris is South Yorkshire and Bassetlaw’s Maternity and Neonatal Independent Senior Advocate. Her previous roles include midwifery, nursing, Freedom to Speak Up, and undertaking patient safety incident investigations through the PSIRF framework. She is new to South Yorkshire and Bassetlaw, and will be working full-time to support service users until the end of the pilot in March 2025.

For more information about this pilot please read the stakeholder briefing here.

PRACTICE SUPPORT  

Referrals into the very high risk breast screening programme

cancer screening.jpg NHS England recently advised breast screening services about the delayed referrals of some women who are eligible to be screened within the very high risk (VHR) NHS Breast Screening Programme. They have now provided further information and to set out some important next steps on this.

While communications are being sent to affected women and a dedicated helpline is being set up, colleagues working in GP practices may receive queries. NHS England have therefore included a supporting Q&A and would like to thank you for your support.

GPs cannot refer women to the breast screening very high risk programme. National guidance requires that referrals can only be accepted from an oncologist or from Breast Screening After Radiotherapy Dataset (BARD).

If a GP has a patient who had radiotherapy to above the waist for the treatment of Hodgkin lymphoma when aged 10 – 35 years who believes that they have been affected by this issue but have not received a letter then they can advise their patient to contact the Helpline who can arrange for her case to be reviewed.

To do this the patient will be asked for their NHS number and Date of Birth to accurately identify her case.

Pharmacy First

A big thank you to all those practices who are working with local pharmacies to refer patients into the Pharmacy First Service (which incorporates the previously commissioned Community Pharmacist Consultation Service (CPCS)). Working together on local referral and escalation processes will ensure patients with minor illnesses are managed effectively, evidencing engagement with the Primary Care Access Recovery Plan.

Information for practice teams can be found here

Do remember to ask the patient which pharmacy they would like referring to.

For advice/support on referring to pharmacies please contact: the ICB Community Pharmacy Clinical Lead: Claire.thomas47@nhs.net

Get your blood pressure checked national campaign

A national public facing campaign launched 11th March encouraging eligible people to visit a pharmacy to have their BP checked.  This may drive increased footfall into pharmacies.

All practices and pharmacies are encouraged to adopt this escalation protocol which has been approved by the SY Primary Care Provider Alliance. Top tips for practices about the NHS BP Check service can be found here.

e-Referral Service (e-RS) – browser address change  

e-RS users should change the browser address (URL) they use to access e-RS – to https://ers.nhs.uk – before Friday 12 April.  

Read our guidance on implementing this simple change. The system itself is not changing, just the URL you use to access it.   Click here to view this item

Peace of Mind – Cancer signs and symptoms campaign

South Yorkshire and Bassetlaw Cancer Alliance is launching a public awareness campaign at the end of March 2024.

The aim of the public campaign is to raise awareness of the signs and symptoms of five cancers – ovarian, womb, bladder, pancreatic and oesophageal - and encourage people to know what is right for their body and seek help from their GP if concerned about any new, or persistent symptoms.

The cancers the campaign is focussing on have been selected as local data shows these cancers are often diagnosed at a later stage or have a high incidence level.

The campaign is branded ‘Peace of Mind’. The phrasing of peace of mind shifts the focus from worst case scenario thinking, to understanding that, by seeing your GP as soon as possible, you could be given information and answers that make you feel better instead.

It helps people know that even if the outcome is the worst case scenario of a cancer diagnosis, they know that catching it at the earliest possible opportunity is better than further down the line. Together, we're looking for peace of mind that we're doing all we can to help people stay healthy.

It is not anticipated that there will be a large influx of people contacting their GP on the back of the campaign, but the Cancer Alliance is asking practices to be aware of the campaign in case patients refer to the ‘peace of mind check’.

Please see the following briefing for more details about the campaign. The Cancer Alliance will share materials with practices including web and social media posts, as well as videos for waiting room screens and ask you to considering using these where possible/appropriate.

Cancer Alliance - research into pancreatic diseases

EUROPAC is working closely on a national level with all Cancer Alliances in order to raise the profile of our research into pancreatic diseases and further increase the number of participants registered with us, (currently standing at approx. 2200+).

As you will be aware, the survival rate for those developing pancreatic cancer rises when diagnosed through G.P. referral and it is for this reason that I am keen to further expand our work within the primary care sector.

EUROPAC is open to receiving referrals from families with a history of pancreatic cancer and pancreatitis and, as nominated contact for Northern, Humber Coast and Vale, West Yorkshire & Harrogate and South Yorkshire & Bassetlaw Cancer Alliances, you can request referral forms directly from me at; liam.royle@rlbuht.nhs.uk or, alternatively, call me directly on 0151 794 0718.

For further information about the EUROPAC Research Programme please see www.europactrial.com

UPDATES FROM WIDER STAKEHOLDERS

Clinical and Professional Assembly

The South Yorkshire MHLDA Provider Collaborative are seeking motivated forward-thinking individuals to join a new Clinical and Care Professional Assembly to contribute to the work of the South Yorkshire Mental Health Learning Disability & Autism (MHLDA) Provider Collaborative. This assembly will be key to working together with our teams, and the people we serve, to improve services and develop solutions that are sustainable and make a difference.

The Collaborative brings together four MHLDA trusts to work at scale to benefit the population of South Yorkshire. We are ambitious and want to significantly improve our MHLDA offer to the local population and for the South Yorkshire Mental Health Learning Disability and Autism community to be well regarded as a great place to work.

We know that increased collaboration of clinical and care professionals across organisations offers patients and people with lived experience an improved experience of health and care services; and the evidence suggests that strong leadership leads to better health outcomes.

Please follow the link for further details in the Clinical and Professional Assembly recruitment pack.

New study for people living with type 2 diabetes

People aged 18 to 75 living with type 2 diabetes are being invited to join a new study seeking to identify if early nerve damage in adults with their condition can be reversed by managing risk intensively.

The study is called the OCEANIC (One-stop Screening and Intensified Care) study and is being run by Sheffield Teaching Hospitals NHS Foundation Trust.

Patients joining the study will be asked to attend a screening visit to check if they have early nerve damage of the feet. This will be undertaken using non-invasive point of care devices (e.g. DPNCheck and SUDOSCAN) and to check their eligibility to enter the trial.

Further details can be found at: https://www.isrctn.com/ISRCTN14584801

Eligible volunteers will be randomly assigned to either:

The 1:1 intensive risk factor intervention or
Standard/usual GP care.

The intensive arm treatment approach will require more nursing (provision of greater diabetes education), doctor support (optimising risk factors more effectively together with use of continuous glucose monitoring and smart weighing scales) and lifestyle modification where necessary (diet and exercise programmes).

Anyone interested in finding out about the study should contact Dr M. Shaan Goonoo on 0114 2712568 or email: m.goonoo@nhs.net.

Bringing health services to Barnsley high street

A partnership with local organisations will transform some parts of the Alhambra Shopping Centre in Barnsley into a health and wellbeing hub for the community.  

Barnsley Council has revealed its plans to create a health and wellbeing hub within the Alhambra Shopping Centre, in collaboration with Barnsley Hospital, Barnsley Premier Leisure (BPL), South West Yorkshire Partnership NHS Foundation Trust (SWYFT), South Yorkshire Mayoral Combined Authority (SYMCA), The Alhambra Shopping Centre and The Glass Works. This follows the announcement in September 2023 that Barnsley Council had purchased the leasehold of the shopping centre. 

Montagu Hospital expansion of Community Diagnostic Centre services

Senior colleagues from Doncaster and Bassetlaw Teaching Hospitals (DBTH) joined construction specialists, IHP Vinci, to officially commence the next phase of development for the Community Diagnostic Centre (CDC) at Montagu Hospital.

The ground breaking ceremony marked the commencement of a 13-month programme to expand CDC services within the Mexborough site. This includes the construction of a purpose-built unit equipped with a CT and MRI scanner.

It is anticipated that works will be complete by March 2025, with the service opening to patients at that time.