Welcome 

Welcome to the new NHS South Yorkshire Primary Care Bulletin which we will be sending to practices monthly. We want to communicate with practices the latest developments happening within primary care from NHS South Yorkshire and the South Yorkshire Primary Care Alliance as well engaging with you on the primary care strategy.

In this month's bulletin we cover the launch of the South Yorkshire Primary Care Strategy, our first NHS South Yorkshire AGM, the new Children and Young People's Alliance Clinical Director, changes to order and supply of covid-19 testing and much more.

Please get in touch if you have any feedback on the bulletin such as what you would like to hear about or any other ideas you may have. 

Dr David Crichton Chief Medical Officer, NHS South Yorkshire  
Dr Andy Hilton, GP Carterknowle and Dore Medical Practice and Chief Executive Officer Primary Care Sheffield 

Primary Care strategy 

As you know NHS South Yorkshire picked up responsibility to commission wider primary care services back in April this year for community pharmacy, optometry and dentistry.  

Doncaster Place Director Anthony Fitzgerald and GP Andy Hilton, who Chairs the Primary Care Alliance for South Yorkshire, have been working with partners to refresh and develop our primary care strategy particularly building on the work to date to establish integrated neighbourhood teams involving NHS, Care and VCSE partners. Many of the themes with the plan were covered at the South Yorkshire primary care summit in May, which supported the development of our long-term strategy.  

In September NHS South Yorkshire approved the South Yorkshire Primary Care Strategy which could not have been developed without the significant engagement with primary care colleagues from each of our four places, as well as all primary care provider groups including optoms, dental, pharmacy and GP. We have also had input from AHPs and the workforce hub so thank you to everyone who helped with the strategy development. 

Key priority areas in the strategy are:  

1. Access 
2. Integrated neighbourhood working 
3. Workforce 

We’ve also identified a range of ‘enablers’ such as digital and data, contract transformation, research and design and estates.  

For more information you can read the Primary Care Strategy here.

NHS South Yorkshire First Annual General Meeting 

NHS South Yorkshire held its first Annual General Meeting (AGM) on Thursday 28 September which was held online. At the meeting updates were given from members of the board including Chair Pearse Butler, Chief Executive Officer, Gavin Boyle and Chief Finance Officer, Lee Outhwaite.  

At the AGM we officially launched the ‘NHS Five Year Joint Forward Plan’. This has been developed by NHS South Yorkshire, working with the region’s hospitals, Local Councils and voluntary, community and social enterprise organisations.  The plan is a forward look at what is most important for keeping people healthy and making sure everyone has equal access to health care across Barnsley, Doncaster, Rotherham and Sheffield.  

There are seven areas of focus in the plan:  

• Improving maternity services and services for children and young people. 

• Improving access to primary care (GPs, pharmacists, optometrists and dentists)  

• Improving access and transforming mental health services  

• Transforming community services  

• Recovering urgent and emergency care including developing alternatives to A&E  

• Recovering and optimising cancer, elective and diagnostic pathways  

• Improving access and redesigning specialist services for those with learning disabilities and autism.  

You can watch the meeting, view full report, summary and easy read version on our website here

Aligning the South Yorkshire Commissioning Policies and Guidance 

We have recently been getting some enquiries about the commissioning for outcomes policy and checklists. Just a reminder that they can be found on the NHS South Yorkshire website on the policies page under commissioning Policies, procedures and Guidance :: South Yorkshire ICB 

NHS South Yorkshire aligned a number of South Yorkshire commissioning policies and some of its current guidance to tackle health inequalities and ensure that all patients across each of our four places (Barnsley, Doncaster, Rotherham and Sheffield) are treated fairly and equitably.  

As you will be aware when ICB’s officially formed in July 2022 the boundaries for our South Yorkshire system changed. Bassetlaw is now part of Nottingham and Nottinghamshire ICB therefore Bassetlaw patients are not affected by these changes. Click here for Nottingham and Nottinghamshire ICB policies and procedures. 

The following changes took place across South Yorkshire from 1 April 2023.  
Gluten Free Guidance Changes 
Gluten Free (GF) provision across South Yorkshire become aligned to the 2023 Coeliac UK England recommendations.  

In Vitro Fertilisation (IVF) Policy Changes  
All of South Yorkshire now offers up to two cycles of IVF. 

Decommissioning Fitness for Surgery Policy  
It was agreed to decommission the Fitness for Surgery policies that was in place in Rotherham and Barnsley to align with the rest of South Yorkshire. 
 
The policy can be found on the NHS South Yorkshire website under commissioning Policies, procedures and Guidance :: South Yorkshire ICB 

CYP Alliance appoints new Clinical Director

The Children and Young People's (CYP) Alliance in South Yorkshire recently appointed a new Clinical Director, Alicia Sansome. Alicia is the Head of Public Health (Children and Young People) in Barnsley. Her professional background is as a Registered Nurse and Specialist Community Public Health Nurse and holds a Public Health Master’s Degree and a diploma in Leaders for European Public Health.

Alicia steps into the CYP Alliance Clinical Director role with significant experience in providing strategic professional leadership to shape and deliver public sector services within Local Authority, NHS and VCSE. She will do this role for two days a week starting in August alongside her role as the Head of Public Health (Children and Young People) in Barnsley.

Ruth Brown, CEO lead for the CYP Alliance said: “ I am delighted with Alicia’s appointment to this important leadership role. Improving health and wellbeing, and in particular reducing inequalities in outcomes has been central to Alicia’s career and she is committed to improving the life chances for children, young people and families in South Yorkshire and Bassetlaw”

All members of the Alliance warmly welcome Alicia and look forward to working with her.

COVID-19 testing - changes to order and supply 

Please see the following letter which confirms that from Sunday 1 October the ordering and supply of lateral flow devices (LFDs) will transition from UKHSA to NHS England and that LFDs for all NHS use cases (with the exception of patients eligible for COVID-19 antiviral therapies) will be ordered through and delivered to NHS trusts by NHS Supply Chain. 

It sets out changes to the reporting of tests and confirms that there are no changes to patient and staff testing use cases and LFD tests will continue to be free of charge to trusts until 31 March 2024. Click here to view this item

Changes to the Rotherham Crisis Team referral process

With immediate effect, the way referrals are received into the Rotherham Crisis Team have changed.

All crisis referrals should be directed to the Single Point of Access Team by telephone on 0800 8048999 or via secure nhs.net email Doncaster.SPA@nhs.net.

The Crisis Team is run by Rotherham Doncaster and South Humber NHS Foundation Trust (RDASH).

Modernising cancer waiting time standards and what this means for primary care 

NHS England recently announced that from 1 October, the standards measure waiting times for cancer diagnosis and treatment are being modernised and simplified. 

The NHS will move from the 10 different standards in place now to three: 

1. Faster Diagnosis Standard: a diagnosis or ruling out of cancer within 28 days of referral (set at 75%) 
2. 31-day treatment standard: commence treatment within 31 days of a decision to treat for all cancer patients (set at 96%) 
3. 62-day treatment standard: commence treatment within 62 days of being referred or consultant upgrade (set at 85%) 

The main changes being announced are: 

1. Removal of the Two Week Wait standard requiring a first appointment within two weeks  

2. Combining together the first and subsequent treatment 31-day standards to create one headline performance standard. 

3. Combining together the Urgent Suspected Cancer GP referral, Urgent Screening and Consultant Upgrade 62-day standards to create one headline performance standard for all patients. 

Please note: there is no change to the way GPs refer patients onto Urgent Suspected Cancer pathways – the only change is that the NHS will measure how well it is dealing with those referrals by looking at speed of actual diagnosis, not whether the patient has a first appointment within a fortnight. The data submitted by providers will not change, and until the language in the Cancer Waiting Times dataset is updated, expected to be in 2024/25, GPs and providers should still use the “Priority type – Two Week Wait” data item to record performance against this pathway. 
 
This follows a consultation in 2022 where these recommendations received widespread backing from cancer specialists and patients.  
 
The new standards aim to encourage innovations like straight-to-test pathways, remote image review, use of AI and one-stop-shop clinics, and to ensure that patients receive equal focus and priority regardless of their point of entry to the pathway, whether GP referral, screening, or consultant upgrade. They focus on outcomes and incentivising the completion of pathways rather than process measures.  
 
Cancer Waiting Time statistics will continue to be published monthly by NHS England, who will take this opportunity to improve the granularity of the statistics by cancer type. 
 
The target for meeting the Faster Diagnosis Target will be gradually increased, from 75% now to 80% by 2026 and trusts have been asked to now prioritise improving performance against the new over-arching 62-day standard, with an interim target of 70% by March 2024 put in place. 
 
More information is available here: NHS England » Cancer 
 
What does this mean for South Yorkshire and Bassetlaw? 
The following table gives an example of what South Yorkshire and Bassetlaw’s performance is using the old metrics and the new metrics. We have used data from June 2023 for this example. 
 
What does this mean for primary care? 
Although the national team do not want primary care to change the way they refer patients with suspected cancer, the language will have to change slightly as two week wait is dropped and the target will be 28 day FDS, against which hospital trusts will be measured and challenged. This is seen to be a much better approach as many pathways already have a straight to test entry rather than two week wait.  
 
We don't expect to see pathways in our region change directly as a consequence of this change to targets, more that they have already changed or that they may now look to change going forward. 
 
If GPs and primary care staff are communicating with patients, you should now indicate that unless an appointment has been made with them present on eRS, they will expect to hear from the hospital within a 2 week timeframe about the next steps – this could be diagnostics and/or an appointment. We recommend that as a safety net, patients should be advised to contact the practice if they haven’t heard from the hospital in 2 weeks, or if they deteriorate. 
 
For the foreseeable future, when referring patients for suspected cancer via eRS, this will still be found under 2ww. The referral templates on CTheSigns will also remain titles 2ww referral forms.  

Important Information: Teladoc myStrength Emotional Wellness and Mental Health apps  

From 31 October 2023 the Teladoc myStrength Emotional  Wellness and Mental Health  apps will no longer be available to use or download across Barnsley, Doncaster, Rotherham and Sheffield. 

Patients who currently use the app will be notified prior to 31 October that the services will no longer be available. Users will be provided with the local mental health and wellbeing support information below:  

Barnsley: https://www.barnsley.gov.uk/services/adult-social-care/help-with-your-mental-health/ 

Doncaster: https://www.donnydot.co.uk/ 

Rotherham: RotherHive – The wellbeing and mental health resource for Rotherham  

Sheffield: Local support for when you're feeling low | Sheffield Mental Health Guide, NHS Sheffield Talking Therapies, Self help | Sheffield Health and Social Care (shsc.nhs.uk) 

Emergencies: If you are concerned for your own life or someone else’s safety and in an emergency (life-threatening) situation, you should dial 999 immediately or find a way to present at your local A&E department as soon as possible. 

If you have any questions regarding the Teladoc myStrength Emotional Wellness and Mental Health apps, please contact helloworkingtogether@nhs.net  

Veteran Friendly Accredited Practices 

The RCGP are looking for more practices in South Yorkshire to become Veteran Friendly Accredited PHC practices. 

If you are interested, detailed information about the benefits of becoming accredited as Veteran Friendly can be found on the RCGP website along with the application form (which takes less than 15 minutes to complete) 

The RCGP have also recently recorded an FAQ session which may be useful Becoming a veteran friendly accredited GP practice - NHS Arden & GEM CSU (ardengemcsu.nhs.uk)  

Oliver McGowan Training 

The government has introduced a requirement for all health and social care employers to ensure their employees receive learning disability and autism training appropriate to their role. This is to ensure the workforce have the right skills and knowledge to provide safe, compassionate and informed care to autistic people and people with a learning disability. This requirement is set out in the Health and Care Act 2022.    

The Oliver McGowan Mandatory Training on Learning Disability and Autism is the standardised training that was developed for this purpose and is the government's preferred and recommended training for health and social care staff to undertake.   The Oliver McGowan Mandatory Training on Learning Disability and Autism | Health Education England (hee.nhs.uk)  

It is employers' responsibility to provide relevant training to their staff and will be monitored through CQC. 

The NHS South Yorkshire Learning Disability and Autism programme are working with health and social care organisations to build capacity and test models of delivery. If you would like to receive updates about the programme please register here or email syicb-doncaster.ommt-enquiries@nhs.net. 

South Yorkshire Primary Care Together - Helping you Survive and Thrive 

The South Yorkshire Primary Care Workforce Training Hub has various programmes and incentives starting in October 2023 to help improve retention within the South Yorkshire Primary Care Workforce. 

• GP Together – facilitated group support sessions 

• Healthcare Humanities – facilitated group support sessions using medical humanities 

• Balint – facilitated group support sessions using Balint 

• Mentoring – one to one peer mentoring provided by GP-S 

• Wellbeing – online wellbeing webinars 

• Leadership – Leadership Development Programme with evening online webinars 

• Pensions Advice – webinars from the non-commercial Money and Pensions Service 

For more information and to register, please visit our website: https://pcwth.co.uk/helping-you-survive-and-thrive/ 

General Practice Nurse and Nursing Associates Leadership for Quality Programme 2024 

Are you a registered nurse or nursing associate working in general practice?  

Are you interested in developing your leadership skills to improve quality and patient care?  

NHS England North East and Yorkshire are funding places for registered nurses or registered nursing associates to undertake a 6-month leadership course. The programme is virtual, with all sessions being delivered online. 

Time commitment: 15 x 3-hour sessions delivered online.

Some self-study will also be required.  

The course is planned to start January 2024 

Click the link for more information and to register your expression of interest: https://pcwth.co.uk/wp-content/uploads/2023/09/GPN-Quality-and-Leadership-course-2024-V1.pdf

NHS Clinical Entrepreneur Programme Now Open

Are you a nurse or a midwife in the NHS with an idea to improve patient care? Do you want to join a community of likeminded individuals and develop your skills? The NHS Clinical Entrepreneur Programme may be for you!  

The NHS Clinical Entrepreneur Programme (CEP) are now welcoming applications for cohort 8. Budding entrepreneurs can apply for this ground-breaking programme that is helping to bring innovations into the NHS to improve patient care.  

The NHS Clinical Entrepreneur Programme, delivered by Anglia Ruskin University and part of the Accelerated Access Collaborative (AAC), is the biggest entrepreneurial workforce development programme of its kind.  

The programme is free and open to all NHS staff. It provides learning, opportunities and experiences through which entrepreneurs develop the commercial skills and knowledge to accelerate their innovations that will, in turn help transform patient care. A dedicated programme on how to build a start-up or develop an intrapreneurial idea is delivered as a series of CPD accredited educational events called Pit Stops, which can be attended either in person or virtually. 

If you are problem solver, creative thinker, or innovator in the NHS? And have an idea you wish to develop and scale for patient benefit, then the NHS Clinical Entrepreneur Programme (CEP) may be for you!  The CEP is a one-year entrepreneurial workforce development programme which is open to all NHS staff.   

Applications are open until 29 October 2023, with cohort 8 starting in March 2024.  

To find out more and to apply visit the NHS Clinical Entrepreneur website www.nhscep.com/apply-now , connected on LinkedIn or Twitter/X .  

To get you application ready, join the CEP Prep webinar series. You can find the full list of events and more details on their website  www.nhscep.com   

Questions can be directed to: cep@aru.ac.uk 

NHS Community Pharmacy BP Check Service  

Did you know General Practices can refer patients for free blood pressure checks (including referral for ABPM) to community pharmacies? Referrals can be for patients already diagnosed with hypertension.  

There are 260 pharmacies signed up and 218 actively delivering the service across SY – you can use the SHAPE Atlas to see which pharmacies near your practice are providing the service and if you haven't done so already discuss with them how they could help you offer more patients clinic BP or ABPM checks.  

Access to the SHAPE atlas tool is free: SHAPE Atlas registration form  

The ICB has developed resources including a protocol for patients requiring escalation and a Top Tips guide for practices and PCNs to help you get the most out of the opportunity of working with your local pharmacies to reduce CVD risk and tackle health inequalities in your PCNs. In particular, please could we encourage you to read the protocol for patients requiring escalation. 

Please read the newsletter for further information and links to resources.

Community Pharmacist Consultation Service 

Please click here for the September edition of the CPCS Newsletter. This newsletter is distributed to all pharmacies and practices in South Yorkshire and aims to support the delivery of this service. It includes information on Preparation for Winter Pressures and The NHS Community Pharmacist Consultation Service (CPCS) self-assessment framework.