19 November 2020

Action: Read and use the referral guidelines and clinical documents in the management of patients and referral to primary care.

The NHS in North West London came together to develop a range of referral guidelines and clinical documents to help the management of patients in primary care.  The guidance covers investigations to consider for specific symptoms and conditions as well as referral thresholds for specialist care. These thresholds have been agreed for adoption by NW London GP and consultant leads across all NW London CCGs and hospital trusts.

These guidelines have been developed through the NW London outpatient transformation programme and further guidelines will be added as this work progresses.  Areas covered include:

The guidelines can be accessed through the North West London CCG website.

Feedback on the new guidelines or any aspects of the NW London outpatient transformation programme would be most welcome.

Please get in touch by emailing nwlccgs.outpatient@nhs.net

Action: Note the two correction’s on last week’s article – 1) the codes going to UTCs are DX05 and DX06 (not DX07 are previously written) 2) Legislation says that GP practices should be reserving one appointment per 500 patients every day for 111 to refer into (not one appointment per 5,000 patients as stated in last week’s bulletin)

The overall number of direct bookings for the DX05 and DX06 codes currently going to Urgent Treatment Centres (UTCs) and extended GP hubs is relatively low and we would not expect more than a few referrals a week and perhaps less than one a day.

When a practice receives a referral it is given a two or six hour timeframe to look at the referral. The timeframe is decided according to the pathway assessment. This does not mean the GP needs to see the patient within two or six hours, but that they must look at the Post Event Message (PEMs) and see what the patient has contacted NHS 111, the questions asked and answers given and the outcome of the assessment.

Based on this and knowledge of the patient, the GP can then decide if a face to face or telephone appointment is needed or if they should be referred to another clinician within the practice or elsewhere.  The patient should be informed of the outcome of the decision made by the GP/clinician within the DX code time frame. This can be done by an administration member of staff.

As a reminder, Covid legislation is still in effect and this means GP practices should be reserving one appointment per 500 patients every day for 111 to refer into. To note that once the new 111 contract is awarded, the DX05 and DX06 codes will be triaged by a clinician in 111 which means that referrals to GPs will be more robust and time frames are more appropriate.

Action: Read the attached letter, which summarises what CIE is and how it will be rolled out at your GP practice

A new system to be introduced to all GP practices in NW London over the next few months will give GPs and other nominated staff real-time access to a patient’s hospital data such as:

• results of scans and tests, including for coronavirus
• letters and discharge summaries
• past and future appointments.

The Care Information Exchange will be rolled out on a CCG by CCG basis starting with GP practices in Central London CCG. Each GP practice will need to sign the interoperability service specification for the Care Information Exchange on the data controller console, complete the GP practice assurance criteria online form, and nominate a member of staff as the main point of contact for the programme team.

The system will be set up remotely and practice staff will be given access. There are a range of materials to support its use, which are available on the NW London learning hub.

The Care Information Exchange project team are NHS staff employed by Imperial College Healthcare NHS Trust working on behalf of all NW London health and social care organisations. They can also provide support to practice teams with advice on communication to staff and patients if needed.

The intention is to give GP practices across NW London the benefit of the Care Information Exchange in a way that creates very little extra work for practice staff.

If you would like more information, you can contact the programme manager, Felicia Opoku at imperial.cie.project@nhs.net

Action: Share the Help us Help you messaging with patients, included in press release here

This winter, the NHS in North West London is reminding residents of the range of healthcare services available to help them.

With coronavirus restrictions continuing to impact our day to day lives, we are aware that this winter will be unlike any other. Although coronavirus has changed how some NHS services are delivered, we want our local residents to know that no matter what your concern may be, our NHS services are still available for your use. Our services are safe to use and we are here to help.

Patient information about what services are available and how to access them is included in the press release attached.

Action: NWL CCGs thank GP colleagues for feeding back on the radiology and ultrasound referral process. See their update and response to feedback in the letter attached

GP colleagues have recently fed back issues with the local radiology and ultrasound referral requests process. A response to this feedback is included in the attached letter.

Action: Read the key messages from the NHS and primary care in NW London here

This week we would like to flag the upcoming NWL webinar  for primary care staff on the COVID Vaccine - Wednesday 25 November 2020 (1-2pm)

Please click the link below to submit questions in advance for the speakers so they can tailor their presentation to your needs:

https://www.menti.com/me15a3nher

Please join the meeting by clicking here