13 OCTOBER 2023
A Note From the Chair - Dr Ian Lalsingh
Dear Colleagues,
Welcome to the next edition of our newsletter.
General practice continues to operate and deliver care in the most challenging of circumstances, along with the covid booster campaign, flu and shingles vaccinations.
The cuts to Federation elective care are at best a difficult decision to understand.
The complete withdrawal of funding for the vasectomy service is a prime example of the blinkered, short-term thinking behind budget cuts.
An innovative service, using a novel technique, that delivered on all fronts for doctors and patients. In keeping with all the other Federation elective care services, it met all delivery/activity targets and financial scrutiny.
The service would not exist without the input from East Antrim staff – those involved in service design, as well as delivery.
I must thank Siobhan McEntee, Conor Gorman, Carol Andrews and Sandra Roberts in particular. Indeed, without Sandra or Carols’ many hours of input and work on operating procedures etc the first vasectomy clinics in Carryduff would not have happened.
This is a bitter blow to the host practices, GPESs, NFSU staff and all who have worked hard to ensure that Federation elective care is a service that actually works, delivering excellent care to patients locally in a timely cost-effective manner. This is in stark contrast to trust outpatient services.
Vasectomy in Northern Ireland has now been essentially privatised.
The people of Northern Ireland do not deserve this kind of “leveling down” of services.
On a more positive note, I look forward to the implementation of our EA/NRC diploma course.
I am cautiously optimistic that the trust has submitted a business case for first contact physio. As always, the devil is in the detail.
The most recent Northern Federation strategy afternoon was on Thursday 5th October.
We continued to work on our values and how we live these in our day-to-day work.
Windsor Murdoch, Mike Megaw (regional head of operations for Federations) and Roger Kennedy (regional MDT project team) where in attendance. It was great to engage with them on innovative ways to implement the MDT model, given the current financial constraints, lack of workforce and no definitive timetable for rollout.
Now is the time to consider the “shallow and wide” approach versus deep and narrow.
The Federation AGM is on Wednesday 8th November.
We will be seeking nominations for 2 new Executive Directors.
For your Federation to turn your ideas or potential projects into reality, it depends on members being willing to get involved. Our EA /NRC diploma course is a great example of what we can achieve. Please feel free to join the weekly Fed ZOOM or contact me by the usual means, happy to discuss directorship or any other issue.
Federation Education
Dr Richard McClean, Dr Aine McNeill, Shauna McKinley & Janice Russell - Federation Education Team
We have the GP Trainer/Trainee Session at Inver Surgery on 18th October at 1.30pm for lunch then a session on Palliative Care from 2pm-4pm.
Our next PBL is on 29th November 2023 has a paediatric focus:
2 to 3.15 Dr Jenny Hughes: Paeds: medical approach to significant infant feeding issues: GORD, lactose intolerance, cow's milk and food allergy.
3.15 to 3.30 Dr Louise Sands. Medical Students.
3.30 to 4.30. DR Carol Smyth, Psychologist. Avoiding overmedicalising: A common sense approach to infant feeding difficulties in GP
Can we encourage any practices able to host a trainee/trainee event to let Dr McClean know.
Nicola Symth - Lead General Practice Pharmacist
The 2024 GPP Recognising Achievement Awards were held on 26/09/2023.
We are delighted to announce that Sarah Brimstone (Victoria surgery) from East Antrim won the overall award in the 'Excellence in Practice' category, designing an SOP and patient information leaflet for the reduction of Tapentadol with primary care.
The Federation saw an overall reduction in Tapentadol prescribing of 10.6% with some practices managing to reduce more than 30%. Most patients now have a noted indication for their Tapentadol in their records. This piece of work will remain on the East Antrim Action plan for next year as we aim to reduce this further. If any practice would like further information, please get in touch.
The other category winners were:
🎉 Medication Safety- South West Fed- HRT project - ensuring all women were not on unopposed oestrogen if needed
🎉Innovation in Practice- East Belfast Fed- Diabetes project-Federation approach to Diabetes reviews
🎉The Valerie Baurain award went to East Belfast
Three members of the team have raised over £3000 for Lymphoma and Leukaemia NI by running the Belfast Half Marathon.
Furthermore, on September 25th, 2023, we thanked out Pharmacists on World Pharmacy Day. This occasion served as a moment of reflection on the crucial role they play in healthcare and an opportunity to appreciate their collective accomplishments.
Federation Elective Care Services
Conor Gorman - Deputy Clinical Director for Elective Care
No doubt most of you will be aware of the recent draconian cut to funding for GPECS. It’s hard to believe that just over six months ago we completed the training of a further 8 GPs to gold standard level as vasectomists, we had finalised a training programme to allow any GP to upskill through our clinics, were progressing towards managing low risk skin cancers through our surgical service and had recently won a national award in dermatology .
During the summer months we were informed that all services would have funding cut by 50% until March 24, apart from the vasectomy service which would have no funding beyond November 2023. By the time we were informed of these cuts, they were already in place as of the start of July, despite clinics being booked 8 weeks in advance through the summer. The GPECS team were at no stage consulted or asked for input regarding the decision to cut funding, its timing or scope.
A fundamental requisite for all our services is robust clinical governance and with no guaranteed funding for vasectomy beyond November 23, it was felt that clinical governance would be compromised and thus the decision was taken to close the service. All attempts to secure additional funding for vasectomy have so far been fruitless.
We are currently waiting to hear from SPPG what their plan is for the patients still on the vasectomy waiting list. GPECS will strive to ensure that our patients are transferred in a fair and open manner. However, given the current state that secondary care waiting lists are in, I suspect that de facto there will be no ability for our patients to have timely vasectomy within the NHS in Northern Ireland. This poses an equality issue, in that only females can now access sterilisation which we know carries a greater risk. It is incredulous that the NHS has invested tens of thousands of pounds training GP’s who want to work in the NHS only to close this option to them.
Our other services [Dermatology, Gynaecology, MSK and Surgical service] will continue until March 2024 by which time we are hoping that the SPPG will have secured ongoing funding. We would encourage you to continue to refer into these services despite the longer waiting times as these are still much shorter than most of those in secondary care.
GPECS had seen over 63000 patients through our clinics, with consistently positive patient feedback. It is exasperating to witness the dismantling of innovative, successful and viable services {secondary care cost of vasectomy £1397 compared with £329 in primary care}. That GP services are being cut to prop up Red Flag and Urgent referrals may be a sad reflection of a failing Health Service lacking leadership at the highest levels.
Finally, I would like to take this opportunity to acknowledge and thank all the practice administrative staff, practice managers, nurses and GP’s who have gone above and beyond to make these services the success they are. It has only been through their commitment that these services were developed, relaunched in the midst of Covid [long before secondary care] and continue to provide high quality care as is reflected in patient feedback. Our practice staff and clinicians are the bedrock upon which we proved that Primary Care could deliver innovative care to our patients.
Northern GP Federation Support Unit (NFSU)
If you have any questions, feedback or suggestions for Causeway GP Federation please contact NFSU on info@northernfsu.co.uk.
Project Coordinator Update
Rachael Elliot - Project Coordinator
Naomi Hutchinson NFSU Project Coordinator is on maternity leave and we are delighted to let you know she has had a baby girl, Mya, who are both doing amazing. 💗
Rachael Elliott will be covering for Naomi during this time, most of you will have already met me by now and as always if you have any ideas/projects you wish to share please do not hesitate to contact me on Rachael.elliott@northernfsu.co.uk or 02896208333.
There has been a lot of project work taking place within EA Federation which is great. Thank you for liaising with us in relation to further project ideas.
Level 2 Primary Care Medical Administration Course
Naomi has worked extremely hard these past 12 months to get this project off the ground. We are delighted the funding has been approved by SPPG to cover the cost of the course fee for the students and the payment for placement.
14 of the 17 GP Practices in East Antrim is involved in the project and will be hosting 1-2 placement students from the course.
The students started the course on the 12th September at NRC and will be in class every Tuesday.
In addition to the mandatory modules throughout the year we will be introducing different learning opportunities for the students such as vision and emis training, deaf awareness, medial terminology and will be inviting guest speakers to NRC to speak to the students such as GPs, GPPs, PMs so that students have a full understanding of the general practice team. If you feel there is a subject. Topic you would like taught please let me know.
Placement date and details is TBC – NRC has confirmed they are waiting on access Nis to be cleared before these details can be finalised. I will update you as and when I know any information. This hopefully should be within the next week when we know the date & further information.
Sincere thank you to all those who have actively assisted with this to get this initiative to this stage. We will help each of the host practices to help us ensure that this is a success so that SPPG may consider funding similar initiatives in the future.
This is just one example of a project which was raised and has been taken forward.
Economies of scale, potential cost savings for GP Practices.
The Federation is committed to providing support to Practices in every way possible. Based on valuable suggestions and feedback from Practice Managers in the East Antrim area, Dr Lalsingh has agreed for FSU to explore and potentially implement an "Economies of Scale" project.
For GP practices, this concept can be applied to the procurement of various consumable items, including ink/toner, paper, shredding, postal & office essentials, and other necessary resources. The Federation will proactively engage in negotiations with the suggested suppliers, with the primary objective of securing reduced costs for each individual practice.
15/17 practices completed the survey below. By collating and analysing this data, we can tailor the economies of scale project to meet the needs of the participating practices effectively. I am currently in the process of analysing this data submitted by 15 practices and currently contacting suppliers to help determine the specific and finer aspects of the process.
I will be in contact with you as soon as possible following these investigations to see how/if we can support this.
Posters
Another project I have been working on as requested by EA Fed was developing “closure posters” for GP practices during public holidays. This includes lists of public holidays, numbers to ring in emergencies and individual posters for each date. These are currently in draft versions and is with Shauna/Janice and Carol to review before finalising and uploading the Federation website for download at anytime for practices. Final details TBC and we will inform you by email when these are available for download.
AccuRx
We are delighted to have almost all our Emis Practices joined up to the FSU contract for AccuRx. A platform to connect and communicate to patients which has a number of modules to help support Practices. Accurx | The simple way to communicate about patient care .FSU hold the contract alongside Eastern, Western and Southern Federation Support Units, those who are in the contract provides practices with a large, reduced discount than purchasing this software alone.
If you wish to have any training on any of the modules or software, please do let me know and I can organise this.
As always, we are here to support you, so please reach out if you feel the Federation can support you in any way.
Rachael
(Project Coordinator mat cover for Naomi H)
Tel: 028 9620 8333 | Mob: 07799249892
Strategy afternoon
The NFSU recently held a strategy afternoon Thursday 5th October. Thank you to the guest speakers and to Dr John Armstrong MBE for facilitating. We had a number of GPs, Pharmacists, PM, Nursing, and FSU staff who attended.
NFSU Meeting Rooms
NFSU based at Galgorm Castle has two meeting rooms which can be used individually or opened to one large room. The have video conference cameras/ TVs which can be connect to laptops. We have coffee and tea making facilities and local catering companies nearby. We welcome any practice who wishes to use these rooms which are free of charge for any training/ meetings.
The large room together can hold up to 24 people.
If you wish to see pictures or book these please contact info@northernfsu.co.uk
Job advertising
The Federation website can host any of your GP Practice jobs on our website to get the reach to the public. If you wish to post any of your live jobs on our website please send the details to info@northernfsu.co.uk
Thank you.
HR
NFSU Health and Wellbeing
🌟 We're thrilled to share the heartwarming success of our Macmillan Coffee Morning hosted by the Northern GP Federation Support Unit on September 28th, 2023! ☕️🍰
Our team came together for a fantastic cause, spreading warmth and raising an incredible £350 in support of Macmillan Cancer Support.
A big shout-out to everyone who participated and contributed to this meaningful initiative. 🌈💚 Thank you for joining us in supporting those who need it most! 🙏
The coffee morning was kindly sponsored by local businesses and suppliers. 🍰
Menopause Workshop
We are delighted to offer an online Menopause Workshop with Clare Hegarty Nutrition, that happens to coincide on World Menopause Day – Wednesday 18th October 2023.
Clare is a certified nutritionist and health coach, specialising in supporting perimenopausal and menopausal women by educating and guiding them through their menopause journey. Clare is passionate about improving women’s health and giving them the tools they need to thrive at every stage of life.
This will be a 1-hour online session which includes a 45min presentation with the opportunity for a 15-minute Q&A’s slot at the end. All topics being covered are included in the invite below.
Anyone wishing to join the Zoom workshop must register to confirm their attendance by clicking this link https://forms.office.com/e/en5q09vtiq or on the poster.
Please could you register no later than 12 noon on Monday 16th October 2023.
We looking forward to seeing you and hearing from Clare. 💜
Wear it Pink Day
In honour of October being Breast Cancer Awareness Month, let’s wear pink on Friday 20th October 2023, to show our support to those who have been affected by Breast Cancer, living with a diagnosis and whose memory we remember closely.
We are conscious that we have already fundraised in September for Macmilllan Cancer support. Therefore, this month, we want to raise awareness and show support by wearing pink.
This small gesture can start a conversation, remind someone to check in on a loved one or even make a donation.
So, ladies and gentlemen, please raid your wardrobe and don’t forget to take some pictures of yourselves and/or your team together and send them to us at hr@northernfsu.co.uk that we can use for our social media platforms.
Also, it is important to note , if you have any concerns regarding Breast Cancer, please remember early detection saves lives:
💗Know what is normal for you
💗Know what changes to look for
💗Report any changes to your GP without delay
💗Attend routine screening if you’re aged 50 to 70
💗Learn your family cancer history
For more information, please access NHS - Common Health Questions
Who does what?
There is quite a few statutory and associated bodies in the HSC landscape. Here is a brief overview of the remit of each:
GP Federations are provider organisations. There are 17 Federations across Northern Ireland (our boundaries are co-terminus with ICPs) and 4 Federations Support Units, Northern, Southern, Eastern & Western. We work on behalf of our member practices to deliver services which will improve primary care for both patients and GP practices. A group of GP practices, aimed at addressing capacity and workload issues within general practice. By coming together within a largescale, primary care organisation, it enables economies of scale, not achievable by a single practice.
SPPG Strategic Planning and Performance Group (previously Health and Social Care Board) is a statutory organisation. They commission health and social care services for the population of Northern Ireland.
Integrated Care Partnerships (ICPs) There are a total of 17 Integrated Care Partnerships (ICPs), collaborative networks of care providers, bringing together healthcare professionals (including doctors, nurses, pharmacists, social workers, and hospital specialists); the voluntary and community sectors; local council representatives; and service users and carers, to design and coordinate the delivery of local health and social care services.
NILMC - The Northern Local Medical Committee (NLMC) is the statutory representative body of general medical practitioners of all grades, principals, salaried, sessional and those in training. They are funded by voluntary levy contributions from GP practices and represent the views of our constituent members to the local integrated offices of the HSCB and through our office bearers and appointed members to the Northern Ireland General Practitioners Committee(NIGPC) and to the senior management at the HSCB and Department of Health. They also represent general practice at interface areas with the local Health Trusts and other 3rd party and non statutory organisations. They act as an advocate and offer help on all matters with General Practice. They can offer advice and guidance on items as below and while not exhaustive highlights some of their roles - Disputes/queries between General Practices and other bodies, NHS contractual regulations/GMS contract, Liaison with Trusts and workforce planning ( Presently with representation with the NHSCT/GP Partnership), Facilitation with GP Federations, Guidance around practice based issues, with signposting to relevant supportive resources. Of specific note they do not give financial nor legal advice but highlight the relevant legislation and signpost to the relevant resources that are available.
Royal College of General Practitioners (RCGP) are the professional membership body for GPs in the UK. Their purpose is to encourage, foster and maintain the highest possible standards in general medical practice.
The Northern Ireland General Practice Committee (NIGPC) is a statutory committee of the BMA, the trade union and professional association for Doctors. The BMA negotiates the national GMS contract.
Bespoke, engaging courses designed specifically for GP practice staff, delivered by expert trainers.
As all Practice Managers will be aware, the Federation have purchased a 3-year licence for each of our 73 GP Practices to have access to Practice Index Training for you & all your staff within your Practice. You should all have received a log in by this stage to access the portal. Practice Index Training - A modern approach to Primary Care training - Practice Index Training
✅ Active Signposting
✅Chaperones in General Practice
✅Complaint Management
✅Conflict
✅ Correspondence Management
✅GDPR
✅Dealing with Abusive, Aggressive and Violent Patients
✅Effective Recruitment
✅Having Difficult Conversations
✅Improving Communication (Staff and Patients)
✅Leadership in Primary Care
✅Receptionists in Primary Care
✅Understanding Medical Terminology
✅Telephone Triage for Receptionists
and 100s more exciting courses for your staff which you can see here -
If you can’t find what you are looking for? – they will create it for you!
Contact us
As always if you have any questions for the FSU, please do not hesitate to contact the Federation Support Unit on info@northernfsu.co.uk or 02896208333
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