GPN Resources

NEW Cervical Screening PHE Initiative

Public Health England launched a national Cervical Screening Saves Lives campaign on Tuesday 5 March.  This campaign aims to encourage more women to attend cervical screening.

We need your help to support and make the most of this opportunity.  Below is a short briefing with details of the campaign.

You can download resources from the campaign resource centre and also be aware of the key messages of the campaign and champion the importance of supporting it.  All GP practices, sexual health clinics and participating pharmacy networks in England will automatically receive a tailored pack – indeed most should have received these over the past week.

The campaign will:

  • Highlight the risks of cervical cancer (2 women die of cervical cancer every day in England)
  • Highlight the preventative benefits of this often misunderstood screening test (cervical screening checks the health of the cervix – rather than it being a test for cancer)
  • Encourage women of all ages to respond to their screening invitation
  • Encourage women to consider booking an appointment if they have missed previous invitations
  • Aim to tackle issues of fear and embarrassment

The latest published data on fingertips shows that the average coverage for cervical screening in London is at 64.7% compared to the national average of 71.4%.

TCST circulates quarterly CCG and individual practice screening data highlighting uptake and coverage of cervical, breast and bowel screening to stakeholders.  If you haven’t received this or would like further information please contact england.tcstlondon@nhs.net.

Further information and statistics on the cervical screening programme can also be found in the NHS Digital report published in November 2018 and click here for the in the interactive map published in conjunction with the report.

New Government Policies Affecting Primary Care

New changes are coming to Primary Care; please familiarise yourselves as there are some interesting changes ahead!

Long term plan: https://www.longtermplan.nhs.uk/

GP practice 5 year framework: https://www.england.nhs.uk/publication/gp-contract-five-year-framework/

HPV Training Pilot Wandsworth May 2019

The NHS England Commissioners have confirmed that national role out of HPV primary implementation will be taking place in December 2019 and have asked SWL and other cytology service providing hospitals to convert a proportion of their workload to HPV primary ahead of this time. Wandsworth is going to be a PILOT site for this implementation.

There are plans for e-learning to support the HPV primary implementation.

PHE wants ALL smear takers to do e-learning module: e-learning module for cervical sample takers
– You need to read 4 units and one Quiz and the HPV primary has 5 units to complete.
– This will take 30 minutes to complete.
– This is MANDATORY.
– Nurses & GPs upon completion of the PHE e-learning, upload your certificate to CSTD: https://loncstd.england.nhs.uk/

As a back up to this e-learning and not mandatory to attend are a series of dates which St George’s are hosting. These are face-to-face training around this implementation, led by the team of CNS from Colposcopy. You can find a list of the dates HERE.

Please familiarise yourselves with these articles below about HR/HPV primary care testing – thank you.

Resources used for the pilot sites re HR/HPV primary testing you might be interested to read  and the national rollout documents:

PREVENT Training

‘The practice can confirm that healthcare workers employed by the practice are familiar with the Government’s Prevent strategy and that all GPs (partners and salaried including nurses and HCA ) have attended PREVENT training in the past 3 years.
(Ref. 10.143 page 88 Prevent Strategy, HM Gov link: https://www.gov.uk/…/file/97976/prevent-strategy-review.pdf)’

Therefore everyone is required to do some training.  The link below provides you with some e-learning which is quite quick and provides you with a certificate.

https://www.elearning.prevent.homeoffice.gov.uk

Future Updates

HCA Foundation Spirometry Course – Sept TBC

Introduction to Diabetes Course – Sept TBC

HCA Immunisation Update inc. Flu (Merton), Speaker Kirsty Armstrong – 2nd September 2019 – Time/Venue TBC

GPN Immunisation Update inc. Flu (Merton), Speaker Kirsty Armstrong – 4th September 2019 – Time/Venue TBC

Training Opportunities

Venous Leg Ulcer Management study day for PN’s, HCA’s ANP’s

The Rosalind Franklin Programme for Nurses Working in General Practice and Primary Care

Programme title: The Rosalind Franklin programme for nurses working in general practice and primary care
Award: NHS Leadership Academy Award in Senior Healthcare Leadership
Length of programme: 10 months
Time commitment: Approximately 4 – 5 hours per week
Out of office days: 11.5 days
Participant cost: FULLY FUNDED as part of NHS England General Practice Nursing Ten Point Plan

For full information, download the flyer HERE.

[Updated] Webinar Immunisations Training: Flyer

This flyer outlines upcoming Primary Care Immunisation Webinars. If you need further information about the webinars please contact the team directly at ImmsTraining@phe.gov.uk

Download the April-May 2019 flyer here

Wozzard for HEI Course Applications

See the different Wozzad links below for access to the HEI’s listed below and the bottom link in how to apply for a course.

https://www.applycpd.com/herts (University of Hertfordshire)

https://www.applycpd.com/kusgul (Kingston & St George’s University of London)

https://www.applycpd.com/bucks (Buckinghamshire New University)

https://www.applycpd.com/lsbu (London Southbank University)

https://www.applycpd.com/gre (University of Greenwich [from June 2019 onwards])

https://wozzad.zendesk.com/hc/en-us/categories/360000075398-Applying-for-a-Course

Updates

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.

Medicine Matters – Prescribing Newsletter, April 2019
This issue includes:

  • Drug safety
       – Lithium
       – Fluoroquinolones
       – Sodium valproate
       – Oxycodone
  • Updated PGD for shingles
  • Bronchiectasis and cough antibiotic prescribing
  • Drug supply issues
       – Creon
       – Labetolol
  • Interface prescribing
       – Freestyle Libre
       – Wavesense Jazz
       – Immunosuppressants
       – Wound care

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

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)

Flu Information 2018/19

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 for 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.

Sanofi Pasteur flu update slides – useful for nurses who did not manage to access a flu update this year.

Childhood Seasonal Flu Vaccination Programme Resources for Registered Practitioners

Flu Season Information:
Clinical Risk Groups – Influenza immunisation – information 2018
Flu vaccines and Suppliers 2018 – Contact sheet

Free Flu training (you just need to register to access the link):
http://www.e-lfh.org.uk/programmes/flu-immunisation/how-to-access/​

NHS England London Region has published two new and four updated Patient Group Directions (PGDs) on its website. This can be accessed at:
http://www.england.nhs.uk/london/immunis-team/

Patient Group Directions (PGDs) for Vaccines
NHS England London Region has published three updated Patient Group Directions(PGDs) on its website. This can be accessed at http://www.england.nhs.uk/london/immunis-team/

The new PGDs are:
NHSE PHE IM Influenza PGD v06.00 (.pdf)
NHSE PHE LAIV PGD v07.00 (.pdf)
NHSE PHE PPV PGD v02.00 (.pdf)
NHSE PHE Hib Men C PGD v03.00 (.pdf) – This PGD updates a previous version and details of the amendments are on page two of the document.

Practices should ensure that any registered healthcare professional who is due to administer vaccinations under these PGDs should sign this and be properly authorised.

Green Book (Department of Health)
https://www.gov.uk/government/publications/influenza-the-green-book-chapter-19

The national influenza immunisation programme letter and plan 2018/19:
https://www.gov.uk/government/publications/national-flu-immunisation-programme-plan

Return to Practice

If you would like to provide a practice placement, want to engage in recruiting nurses for RtP, or have additional queries about the programme, local HEE office leads would like to hear from you. For enquiries in South London, contact info.sl@hee.nhs.uk

Information on Return to Practice is available on the Come Back to Nursing website and for AHP’s and healthcare scientists on the HEE website.

HEI’s in London delivering nursing Return to Practice courses are:
Kingston University, London
Buckinghamshire New University
City University, London
London University of Greenwich
University of Hertfordshire
University of West London (for GP RtP)

Useful Links

Core Copetencies for PNs (pdf)
http://www.rcgp.org.uk/membership/practice-teams-nurses-and-managers/~/media/Files/Membership/GPF/RCGP-GPF-Nurse-Competencies.ashx

RCN Guidance for Mentors of Nursing and Midwifery Students (pdf)
Click here to download

Nurse Prescribers
If you are a prescriber and need a BNF you can order it via the www.pharpress.com/bnf69 or order via charlotte.mason@rpharms.com

Useful link for ear care protocols:
http://earcarecentre.com/professionals/protocols/

Free online COPD training:
Free online learning to Respiratory Clinicians for the GOLD 2017 guidelines. There are 10 modules available that you can claim credit and a certificate for on completion. You can sign in for free if you are a Respiratory Clinician (Sign up as RN).
http://education.goldcopd.org

Hep B:
Hepatitis B resources can be found by going the Public Health England section of the gov.uk site and then going to Health Protection A-Z/ Infectious Diseases/ Hepatitis B.
Direct link:
https://www.gov.uk/government/collections/hepatitis-b-guidance-data-and-analysis
Direct link to dried blood spot testing for infants: https://www.gov.uk/guidance/hepatitis-b-dried-blood-spot-dbs-testing-for-infants

Primary Care Online Cancer Education Tool
This NG12 online educational tool for health care professionals in primary care has been developed to aid primary care in referring patients for suspected cancer including symptom criteria, direct access diagnostics and straight to test, safety netting, patient information and links to external educational resources.
The tool includes quizzes and case studies to aid learning.
http://ng12panlondonapproach.org/login/index.php
or via the Healthy London Partnership Website
https://www.healthylondon.org/our-work/cancer/suspected-cancer-referrals/