Bromley LMC News Update

Transcription

1 LMC News Update w/c Xeroderma Pigmentation: Inherited disease which causes sun sensitivity. 208A Appraisals for Details of the 2010/11 appraisal requirements have now been sent to all practices and GPs. If you have not received your pack, please contact: Your attention is drawn to two changes: 1) All appraisals need to be done on the NHS Appraisal Toolkit. If you have any concerns about this, please contact Joe and request a support pack, in the first instance. 2) If you wish to choose your own appraiser, please make contact and agree a date BEFORE the end of September. At the beginning of October, any doctor who has not agreed a date with an appraiser will be given a choice of two appraisers and asked to arrange a date with one of them. All appraisals must then be done by the end of March B Community verruca clinics The PCT Podiatry Department has recently issued on the intranet its guidelines for the management of verrucas. It would appear that patients can self refer and that three potential treatment options are available (though not every treatment on every site) cryotherapy, acid treatment and electro-dessication. If the verrucas are asymptomatic, the patient may be sent away with appropriate advice and information only C Update on information request from Oxleas Following my earlier this week to practices, the LMC received a detailed response from Nicola Wilson, Lead Commissioner for Mental Health at the PCT (see attached documentation) and on Thursday, Londonwide LMCs representatives met with Sean Farran from NHS London to try to resolve the issues of data protection and resource. LMC will keep you updated as soon as we have more information, but in the meantime would encourage you to provide all clinically necessary information on referral but not (unless you wish to) to print summaries for patients already in the system. 208D Accessing a second opinion in Mental Health In the PCT s written control documents on the intranet is new guidance for GPs and psychiatrists for access to a second opinion. Guidance for GP s and s: How to access a second opinion in Mental Health (GUD CM003)

2 208E Chlamydia LES new higher rate of pay Details of a new Chlamydia LES launched from 1 st July should be arriving in practices soon. For the next 9 months there will be a much higher payment of 12 made up of: - 2 for handing out the kit - 10 if a urine sample is received at the lab PCT figures indicate that only 20% of kits handed out have been used. If the practice team can offer the kit to every sexually active year old, persuade them to provide a urine sample while they are at the surgery and post it off for them in the postage paid envelope provided then the conversion rate should increase. 208F NHS Health Checks LES - Have you signed up? Gillian Fiumicelli of the PCT has asked us to highlight that only 29 Practices so far have expressed an interest in participating in the NHS Health Checks LES (details of which were sent round at the beginning of June). She asks that all practices reply by Friday 16th July at the very latest expressing their interest on the response form provided. If she does not hear from you by then it will be assumed you are not interested in participating and the PCT will make alternative arrangements for the provision of Health Checks for your patients. If you have any queries please contact the Public Health Vascular team on /79 or Gillian Fiumicelli on gfiumicelli@nhs.net. 208G Reminder: Oxleas new referral pathway In March we published details of Oxleas new structure and referral pathway but there still appears to be some confusion about the changes. Attached (or by link) is the new pathway, including contact details of the Oxleas team and the response times you can expect H Sessional GPs newsletter, Summer 2010 The latest sessional GPs newsletter is now available to download from the BMA website: Computer problems supposedly true! Customer: I have a huge problem. A friend has placed a screen saver on my computer, but every time I move the mouse, it disappears. James Heathcote ( Secretary ) Jackie Peake ( Committee Liaison Executive ) Local Medical Committee, Londonwide LMCs, Bassetts House, Broadwater Gardens, Farnborough, Kent. BR6 7UA Tel: Fax: james.heathcote@bromleypct.nhs.uk jackie.peake@bromleypct.nhs.uk Disclaimer: This publication is written for health care professionals in and information may not be appropriate for use elsewhere. Editorial comments do not necessarily represent the views of the LMC committee. Londonwide LMCs is the brand name of Londonwide Local Medical Committees Limited Registered and office address: Tavistock House North, Tavistock Square, London WC1H 9HX. T /7418 F E. info@lmc.org.uk Registered in England No Londonwide Local Medical Committees Limited is registered as a Company Limited by Guarantee. Joint Chief Executives: Dr Michelle Drage and Dr Tony Stanton

3 LMC News Update Documentation No G Oxleas new referral pathway 23 March 2010 Dear Doctor Following consultation on the change programme last year, work has been on-going to finalise the details of the newly configured service. We are now in the final stages of planning and we will be implementing the new team structures with effect from Tuesday 6 th April Please find enclosed the revised referral pathway, together with information leaflets that have already been sent to the service users. Service users who, are experiencing a change in care co-ordinator have been informed both verbally and in writing. Although the change programme has focused mainly on the community services, we have Also introduced an inpatient model. The medics based within the inpatient service are as follows: Working Age Adults Dr Gunnen Ghosh, Dr Markus Bienroth, Dr Marsha Tsvetkova and Dr Clodagh Commane. Older Adults Dr Marilyn Cook and Dr Za-Za Darwiche We look forward to continuing to work together and to ensure that the new care pathways improve the care quality and efficiency for our patients. We also look forward to working in partnership to improve the interface between primary care and secondary care services. If you have any queries please contact us on Yours sincerely Iain Dimond Director of Mental Health Services Dr Hashim Reza Clinical Director

4 Referral Pathway Yes Patient Suffering Life Threatening Crisis No Accident & Emergency Green Parks House Crisis & Home Treatment Team Age Older Adults LIAISON & INTAKE TEAM Stepping Stones 38 Masons Hill BR2 9JG Tel: Multi Disciplinary Team Dr Derek Tracy - Derek.Tracy@oxleas.nhs.uk Laraine Bell - Laraine.Bell@oxleas.nhs.uk The liaison and Intake Teams will assess and decide whether the referral is for secondary mental health services, and if so, whether or not it will be allocated to the Short Term Intervention Team or Recovery Team BRIDGEWAYS COMMUNITY ASSESSMENT & THERAPY TEAM (BCATT) Bridgeways Turpington Lane BR2 8JA Tel: Dr Fai-Zaza Darwiche - Fai-Zaza.Darwiche@oxleas.nhs.uk Michael Bennett - Michael.Bennett@oxleas.nhs.uk BCATT will assess and decide whether the referral is for secondary mental health services, and if so, whether or not it will be allocated to one of the Community Mental Health Teams & Memory Clinics SIT Team Stepping Stones 38 Masons Hill BR2 9JG Tel: Vacant Caroline Shannon Caroline.Shannon@oxleas.nhs. uk Recovery Team East Tel: Dr. Morgan Haldane Morgan.Haldane@oxleas.nhs.uk Peter Maasdorp Peter.Maasdorp@oxleas.nhs.uk Recovery Team West Yeoman House Croydon Rd Penge SE20 7TS Tel: Dr. John Abraham John.Abraham@oxleas.nhs.uk Grace Korley-Quaye Grace.Korley-Quaye@oxleas.nhs.uk EIP Team Tel: Dr. Mona Salem Mona.Salem@oxleas.nhs.uk Nicola Smedley Nicola.Smedley@oxleas.nhs.uk Community Mental Health Team East Tel: Dr. Isabel Alcoreza Isabel.Alcoreza@oxleas.nhs.uk Iris Young Iris.Young@oxleas.nhs.uk Community Mental Health Team West Yeoman House Croydon Rd Penge SE20 7TS Tel: Dr. Oluwatoyin Sorinmade Oluwatoyin.Sorinmade@oxleas. nhs.uk Janki Karunanthan Janki.Karunanathan@oxleas.nhs.uk LIT Initial Referral Gateway assessing all referrals into the secondary mental health service. Referrals processed within 10 working days SIT Short Term Interventions Teams carrying out targeted, time limited clinical treatment packages, for up to one year. This team will concentrate on clients with non-psychotic symptoms. Clients with a psychosis will be allocated to the Recovery Teams or EIP. Crisis Response Same Day Response Where a Patient requires an immediate response due to the deterioration in their mental health AND there are significant risk factors. Also, when the Patients symptoms, previous history and treatment indicate that Primary Care interventions are not appropriate Urgent Response Within 5 Days Where the Patients secondary mental health is relapsing but safety issues are not immediately significant to the Patient or others. In order to prevent further deterioration an assessment WITHIN 5 working days is required to identify the appropriate treatment / management plan. In cases where the level of risk is clearly identified, the Patient may well be seen earlier Non Urgent Response Within 14 Days Patient s who have not responded to first line treatment (following the NICE guidelines) and further assessment / advice is required to establish how best their needs can be met within Secondary Mental Health Services is appropriate Out of Hours Contact Requests for Mental Health Act Assessments out of hours call Emergency Duty Team on st March 2010 For Medicines Information telephone or medicinesinfo@oxleas.nhs.uk

5 208C Oxleas information request: re: Mental Health Contract and CQUIN indicators From: Nicola Wilson, Lead Commissioner, Mental Health and Learning Disabilities The Mental Health Contract includes CQUIN indicators and is comprised of a range of Goals; 3 were set regionally (London Wide) and 3 were set locally (BBG). The debate relates to one of the regionally set CQUINs. The detail of the regional CQUIN 'to improve the physical health care of patients with mental health problems' was developed regionally with no direct input from local commissioners, and was for mandatory inclusion in the contract. CQUIN accounts for 1.5% of the mental health contract (0.6% allocated to regional indicators and 0.9% to local indicators) The detail of the regional CQUIN was available to Trusts and commissioners since January/February and whilst Oxleas and local BBG commissioners reviewed and discussed the regional CQUINs, and the potential difficulties were highlighted, it was not for local commissioners to vary the content of the regional indicator. I believe that London MH Trusts raised their concerns with region (who set the indicator), but the indicator was not changed, and was included in the final version of contract CQUIN in April. Whilst Oxleas have raised concerns with local commissioners, it has been our response that the indicator was set by region and that we would be required to monitor compliance against their specification (copy attached). I acknowledge that the PCT may not have fully communicated the content of this CQUIN to GPs and primary care, for which I apologise. I hope all parties would agree that the spirit of the target is reasonable and that it is good clinical practice to take in to account both an individuals mental and physical health care needs as part of care planning, as well as sharing information regarding medicine management etc as set out in the CQUIN rationale. I would have anticipated that in may cases much of this information would already be routinely shared and updated as part of the referral process and regular CPA reviews. The nature of the CQUIN indicator 'milestones' and recording requirements has resulted in an approach of Oxleas sending out 'batch' requests to GPs which has understandably caused some concern by GPs relating to demands on their time. Local commissioners are not in a position to be able to vary the regionally set CQUIN, but following the issues highlighted locally, and elsewhere across London, we have received notification from Sean Farran (Lead for Mental Health Commissioning, NHS London) that this is being discussed and dealt with at a regional level, between the NHSL and Londonwide LMC representatives later this week. When we receive further guidance from NHSL I will of course communicate to you all. In the meantime, I would like to request that the LMC consider agreeing to recommend to GPs that all new referrals to Oxleas include the requested key physical health and prescription / investigation information, as part of referral good practice, whilst we await further guidance from NHSL on managing this CQUIN including the data collection for the large volume of existing patients already within the services. I hope this provides some further context and background. Regards, Nicola.