Dear Enfield GPs,
What is the LMC and what do we do?
The Local Medical Committee (LMC) works on your behalf to represent the interest of all GPs in Enfield. We are here for partners, salaried GPs, locums and those working in non-traditional GP roles. If you have a difficult work-related issue then our GP support team may be able to help – they can be contacted at [email protected]. This is the first of a regular newsletter to keep you updated on our work.
Primary/secondary care interface – how to reduce un-resourced work from secondary care
We know that many of you are frustrated when asked to carry out tasks on behalf of secondary care and that this is escalating. LMC members attend interface meetings at all the local hospitals, where we are working hard to reduce this. The primary/secondary care interface consensus document will be published later this month, and we will be in touch again with a link and to explain how you can best take advantage of it.
In the meantime, remember the overriding principle is that everyone involved in patient care should do their own work. Consultants should not ask you to carry out blood tests or imaging on their behalf, even if it is more convenient for the patient – blood forms from any hospital in NCL can now be taken to any phlebotomy site in NCL via Swiftqueue. You should not be asked to chase the results of tests requested in secondary care, provide a fit note after surgery, carry out tests with an unreasonable timescale (e.g. daily renal function after discharge), or refer onwards for a patient whose care needs to be transferred or who is moving from paediatric to adult care. Any referral which is either related to the reason why they are seeing the patient, or is urgent, should be done directly.
If these principles are to become established, we need your help. Whenever you are asked to do one of the things mentioned above, please pass it back to the requesting clinician, rather than doing it yourself. You can do this via the GP liaison teams who are contactable on the email addresses below, and you might also want to cc your email to the department (where the email is given on the letter) and to the clinician in question, using the global address list option in nhs.net. We are keen to find out how much of this is going on, so please copy the email to [email protected]. This template letter covers most of the inappropriate transfers of work outlined earlier.
You might want to think about training some of your senior admin staff to return this work to secondary care without it ever coming to a GP.
- NMH – [email protected]
- UCLH – [email protected]
- RFH – [email protected]
- Whittington – [email protected]
If you are having any persistent problems with primary/secondary care interface issues, then we would like to hear about them and you can contact us on [email protected].
Direct referral from opticians to ophthalmology
After much work by the LMC and the ICB, systems are in place for opticians to refer directly to ophthalmology rather than asking the GP to do it. This depends on opticians having an nhs.net email address – currently around two-thirds have one and this number is growing. If you are asked to do such a referral from an optician, please can you do it for now, so that patient care is not delayed as the system beds in. However, we would like to know the volume of such requests so please email us on [email protected] with the name of the optician and the reason for the referral. We can then check that opticians who are able to refer directly are in fact doing so and find out where the gaps are.
Roaccutane
The MHRA created new guidelines for prescribing Roaccutane to under 18-year-olds last year. This requires 2 independent prescribers to agree that the prescription is in the patient’s best interest (due to the risks of depression and non-reversible sexual dysfunction). It has come to our attention that Enfield dermatologists (particularly privately) have been requesting GPs to act as the 2nd independent prescriber. It is our opinion that GPs should not consider themselves independent prescribers in this instance as they are unable to prescribe the medication – these requests should be returned to the dermatologist.
Consider joining the LMC
If you’d like to get involved and effect change locally, consider joining the LMC – we have three vacancies and would be keen to hear from GPs in all types of roles and in all stages of their career from newly qualified onwards. Please email [email protected] for more information and to arrange an informal chat.
Your current LMC members are:
- Dr Catherine Aimiuwu
- Dr Rachel Osijo
- Dr Chitra Sankaran
- Dr Hetul Shah
- Dr Catherine Steven
- Dr Pippa Vincent (Chair)
- Dr Adhavan Sugumar (Vice Chair)
- Dr Howard Daitz
- Ms Tara Sarkar-Practice Manager Representative
- Ms Julie Crouch Practice Nurse Representative
Yours faithfully,
Dr Pippa Vincent
Enfield LMC Chair