GPN Resources

Restrictive physical interventions and the clinical holding of children and young people – Guidance for nursing staff 2019

RCN Restrictive physical interventions and the clinical holding of children and young people: Guidance for nursing staff (pdf)

• The guidance applies to all children and young people receiving health care interventions.
• For children being nursed under the Mental Health Act 1983 (as amended 2007), to ensure all patients receive high quality and safe care, there is specific statutory guidance on different forms of restrictive intervention (and considerations for their use) detailed in the Mental Health Act: Code of Practice (Chapter 26) (2015).
• For young people aged over 16 years of age nurses need to be aware of their professional obligations relating to the Mental Capacity Act (2005)
• The physical restriction or barriers which prevent a child leaving, harming themselves, or causing serious damage to property are also included in the term restrictive physical intervention.
• Clinical holding has been distinguished from restrictive physical intervention by the degree of force used, the intention of the hold and the agreement of the child (Bray et al., 2014), but should still be considered a restrictive physical intervention
• Clinical holding without a child’s consent should only be considered when there is no alternative and an emergency or urgent intervention needs to be performed in a safe and controlled manner.
• Targeted training provision should provide nurses with relevant understanding of restrictive physical intervention and clinical holding – nurses working in areas such as emergency care departments, special schools, walk-in centres and GP practices should receive training in using restrictive physical interventions as well as clinical holding for procedures; nurses working with children and young people in all other clinical areas should receive, as a minimum, training in clinical holding for clinical procedures and de-escalation techniques.

Tissue Viability Nurse: Referral Contact Details
There is a single point of access for referrals to all of our Wandsworth services:
Phone: 0333 300 2350 (lines are manned Monday to Friday from 8am to 8pm and Saturday, Sunday and Bank Holidays from 8am to 5pm)
Email: clcht.wandsworthspa@nhs.net

New Sexual Health Clinic Opens in Roehampton
On 11^th July 2019, a new nurse led sexual health clinic opened at Danebury Avenue Surgery in Roehampton. The clinic is open for routine contraception and sexual health services every Thursday between 9am and 5pm. This clinic is by appointment only and patients can book by calling 0333 300 2100 (lines open from 8am to 8pm Monday to Friday) or by visiting: https://shswl.nhs.uk/contact

RCN indemnity cover extension for nurses providing travel vaccination.
In April, a new state-backed indemnity scheme for general practice (GP) staff was introduced in England. The Clinical Negligence Scheme for General Practice (CNSGP) is operated by NHS Resolution. It automatically provides cover to nursing staff working in NHS GP services. It includes self-employed workers and covers all clinical negligence claims that arise from an act (or omission to act) on the part of someone providing a GP service that is NHS-funded in England. In Wales, a similar scheme, General Medical Practice Indemnity (GMPI), was introduced at the same time. Both schemes include travel vaccinations given in GP surgeries except for where vaccinations are paid for by the patient.

The RCN is now extending its indemnity scheme to cover this gap. This means both employed and self-employed RCN members who are providing any paid-for travel vaccinations from GP practices not included in CNSGP in England and GMPI in Wales will be covered by the RCN indemnity scheme.

See here: https://www.rcn.org.uk/news-and-events/news/uk-rcn-extends-indemnity-scheme-to-protect-members-providing-paid-for-travel-vaccinations-090719

Further details of the RCN scheme are available here: https://www.rcn.org.uk/get-help/indemnity-scheme

Travel Health update blog from JC RE: Indemnity Insurance
http://janechiodini.blogspot.com/2019/05/indemnity-in-general-practice-again.html?m=1

PGDs
Message from Nick Bevon:

We direct all GP Practices and community Pharmacies ( Flu) to the London website. Although the people who create the PGDs are generally the same ( NHSE London Region for national use) each NHSE Regional has to authorize the PGDs. For example if you look at Men B PGD page 4 on the London site and the South West site the governance signatories are different. In addition there are differences in what London or other regions may commission and therefore there is a risk of using the wrong PGD.

The links to the London PGDs normally go direct to the GP Practices and I also send the link to practices in Wandsworth and all other London CCG Chief Pharmacists.

My advice is that only the London link should be used which has the sign of by the London team who hold the contracts for London GP Practices.

Link is here: https://www.england.nhs.uk/london/our-work/immunis-team/

RCN New Guidance Publications

The Role of Nursing Associates in Vaccination and Immunisation. Position statement (April 2019)
007 565
The RCN recognises that nursing teams are key to the safe and effective administration of large numbers of vaccinations to those who need them. The overriding principle is: health care professionals involved in the prescribing or administration of vaccines must be suitably competent and have the knowledge as well as the skills to ensure patient safety, and public trust in immunisation is maintained. In some clinical areas, it is likely that NAs will be involved in the delivery of the national immunisation programme.

Health Care Support Workers Administering Inactivated Influenza, Shingles and Pneumococcal Vaccines for Adults and Live Attenuated Influenza Vaccine (LAIV) for Children
RCN guidance  007 441
The RCN recognises that nursing teams are key to the safe and effective administration of large numbers of vaccinations to those who need them. This guidance has been developed as a resource and framework for health care support workers who undertake vaccinations as part of their role.

They can be downloaded from: www.rcn.org.uk/publications

Hayfever Season Resources
Hay fever v2.pptx
Hay Fever Self care PIL final with logos April 2019.pdf
prescribed otc antihist Auto Report.zip

South West London Wound Care Management of Products Formulary January 2019
The electronic documents are on the SWL website:
https://www.swlmcg.nhs.uk/Clinical/Pages/Wound-Care.aspx

GPN Leads Forum Presentation
Click here to download Allison Ferdinand’s presentation: Practice Nurse Leads LLMC forum 21.3..2019 presentation by Allison Ferdinand
Should you wish to get in touch with her, you can email her here: Allison.ferdinand@nhs.net

Nursing & Midwifery Mentor Resources
You can find supporting information for supervisors and assessors (mentors) on the Kingston & St George’s website here: http://www.healthcare.ac.uk/courses/nursing-midwifery-mentor-resources/

Primary Care Nursing Framework
Very useful document describing how different roles with Nursing Teams in GP Practices are supported/ funding attached for training etc.
Primary Care Nursing Framework (.docx)

Travel Health Consultation Resources
Click here to download the resource list (.docx)

NDPP – ICS Health Wellbeing Introduction – Slides
These slides are from the presentation on ‘Healthier You: The National Diabetes Prevention Programme’ by Elliot Rogers, Senior Service Coordinator, ICS Health & Wellbeing delivered at the January Practice Nurse Wandle Forum.
NDPP – ICS Health Wellbeing Introduction (.pptx)

Please find below an excellent resource for any registered nurse or GP performing an LD health check:
https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/health-check-toolkit.aspx

Advanced Clinical Procedures Toolkit
The toolkit aims to benchmark this level of practice and its application to specific roles across clinical practice, leadership and management, education and research.

The toolkit provides general information about the ACP role as well as specific information aimed at the following groups of people: practitioners, educators, employers, commissioners, those planning the workforce across systems and patients/service users.

This toolkit will be updated and supplemented with further information as it gets developed. You can give feedback on this toolkit for future developments.

https://www.e-lfh.org.uk/programmes/advanced-clinical-practice-toolkit/

For Patients
Tools and resources to help yourself and others to feel better: https://www.good-thinking.uk/
Contains information for those seeking help with stress, anxiety, poor sleep, or feeling sad or low. It also contains information apps available for free to Londoners.

PHE Immunisation Webinars
This is a FREE training resource for immunisers working in primary care in London. Click the link below to see all upcoming webinars.
https://bhcic.co.uk/events/categories/primary-care-immunisation-update-webinar-series/

Diabetes Teaching Session Presentations
Insulin refresher slides 2017_final_full version.pptx
Prescribing in Diabetes_May 2018.pptx

Changes to gluten-free prescriptions

The Department of Health and Social Care (DHSC) has placed restrictions on the prescribing of GF food. Several products, except bread and mixes, will no longer be available. This guidance comes into effect on Tuesday 4th December 2018 and the December 2018 Drug Tariff has been amended to reflect this change. Consequently, community pharmacies cannot dispense an NHS prescription for GF products (other than bread and mixes) on or after 4th December 2018.

Recommendations for practices:

• Inform patients currently receiving GF foods (other than bread and mixes) that from 4/12/18 these foods will no longer be available on prescription. A list of allowed products can be downloaded here: GF products available from 04-12-2018.
• an EMIS search tool has been included in this email to identify which patients fall under this category
  • a template text message has been created for practices to send to relevant patients to inform them of this change. Download this here should you wish to use it: GF text message template
  • Encourage patients to follow a strict gluten free diet.
• Continue to provide annual reviews and monitoring in line with NICE’s recommendations.
• Advise patients to take supplements such as calcium or vitamin D if their dietary intake is insufficient alongside other over-the-counter vitamin or mineral supplements.
• Remind patients of the wide range of GF foods available to buy and of non-gluten containing carbohydrates such as potatoes and rice as alternatives

Please do not hesitate to contact your practice support pharmacist for more information.

Sepsis: Guidance for GPs
Click here to download Sepsis: Guidance for GPS (.pdf)
“THINK SEPSIS” is a Heath Education England programme aimed at improving the diagnosis and management of those with sepsis.

We are developing a ‘train the trainer’ franchise package on sepsis with the RCGP and electronic copies of the slide set and lecturer notes will be hosted on the RCGP sepsis toolkit and referenced from our eLfH sepsis webpage.  The learning materials that are available on this website support the early identification and management of sepsis. This website has a film and a wide range of learning materials for primary care, secondary care and paediatrics.

For more information on HEE’s work on sepsis please visit our website.

If you have any questions please contact Mohamed Sadakat at: Mohamed.sadak@hee.nhs.uk
Website: https://hee.nhs.uk/our-work/sepsis-awareness

HIV Education update by Helen Webb, HIV Specialist Nurse – The Courtyard Clinic, St. George’s Hospital
Click here to down the presentation slides from the forum.

Update on Influenza Vaccine in London
NHSE has issued a letter on maximising use of aTIV influenza vaccine in London during winter 2018/19:

GP practices and community pharmacy providers should offer the adjuvanted trivalent vaccine (aTIV) for all 65s and over. Based on available evidence, the aTIV vaccine is more effective and highly cost effective in this age group compared with the non-adjuvanted (TIV) vaccines. Quadrivalent vaccine (QIV) is advised to be the best option for the 18-65s at risk group.

A large number of GP practices in London do not have enough aTIV for their over 65s practice populations.

NHSE (London) public health commissioning team advise the following steps to be taken to ensure that the over 65s population are adequately protected this winter:

• If your practice has not ordered aTIV for your over 65s population, the patients can be referred to community pharmacies where aTIV is available.
• If the community pharmacy does not have aTIV, the over 65 year old patient should be informed and can be offered QIV.
• If your practice has low stock of aTIV, the over 75s should be prioritised and those over 65s at clinical risk before offering to the rest of your over 65s cohort.

Community pharmacies vaccinating patients with Influenza vaccine must notify the patient’s GP Practice using the form as outlined in the Service specification: Community pharmacy seasonal influenza vaccination advanced service.

IMMUNISATIONS UPDATE
To be cascaded out to all staff involved in immunisation
NHS England London Region has published an Addendum to the IM Influenza PGD v06.00 on its website. This can be accessed at http://www.england.nhs.uk/london/immunis-team/

The Addendum is:
• NHSE PHE IM Influenza PGD v06.00 Addendum

Practices should ensure that any registered healthcare professional who is due to administer vaccinations under this PGD should be made aware of this Addendum.

False Widow Bite Information
Click below to download the advice for schools from PHE, which may be useful if doctors and nurses are asked about these bites.
False widow spider advice for schools

Sexual Health Services Location Changes – Please Note
The new location for the sexual health service is 160 Falcon Road, London SW11 2LN. It is less than 5 minutes’ walk from the main entrance of Clapham Junction station.

Please note that the service will continue to run from Bedford Hill till 17 November and the Falcon Road site opens on 19 November. The phone number for the Single Point of Access will remain the same i.e. 0333 300 2100 after the move to the new premises.

Compression Hosiery Presentation
Anatomy & Physiology Doppler Assessment & WHY? by Jane Webster, Regional Clinical Advisor

Huntleigh Vascular Range 12PP Brochure

Wound Care / Compression therapy / Chronic Oedema and lymphoma / Care Home and HCA training
https://lohmann-rauscher.co.uk/education/elearning – eLearning accredited by the RCN

Sexual Health Updates
https://wandsworthproviders.wordpress.com/ – this is a link to Free webinar updates and training dates hosted by Sexwise and the FPA.

Poster from the Independent Medicines and Medical Devices Safety Review
The Independent Medicines and Medical Devices Safety Review (IMMDS) is investigating 3 medical interventions where patients have reported problems and suffered serious harm. These are pelvic mesh implants, Primodos and hormonal pregnancy tests, and sodium valproate (Epilim or Depakote). Full details can be found on their website.

The Review wants to make sure any individual or family affected by these three interventions is aware of its work and can make contact or provide evidence.

They are therefore asking Clinical Commissioning Groups (CCGs) to distribute a poster to GP practices and community pharmacies so that it can be displayed prominently for members of the public to see, and if possible to feature it on the CCG website. The poster is available in two forms: print-sized version or e-version.

Asthma Event (13th Sept) Resources

• Link to the asthma toolkit
• Link to the primary and community care toolkit
  
• Asthma Event Resources (.zip) containing:
  > 48 hour review leaflet
  > AAA event Presentation
  > Annual Report 1718 Case Studies 1-6
  > Healthy London Sept 18 updated
  > pPAAP
  > SWL asthma event 13 Sept CK GH slides

GPN 10PP – National Programme Update July 2018 (.pptx)

PHE Updated Guidance on use of Tetanus Specific Immunogloblin for management of Tetanus prone wounds 2018 (.pdf)