Interface Officer Simon Nichols presents an overview of this year’s activity to support practices with interface issues.
As we approach the end of the year, I thought it would be helpful to summarise a selection of key areas of work undertaken in 2024. Many of the areas we have been working on have been directed and shaped by the 750 queries you’ve sent over the last few months, whilst other areas relate to stakeholder engagement and consultation. In this end of year roundup, we discuss a small selection of reports, key areas of success, and ongoing difficulties we have supported you with. We include relevant links for your information.
Collective Action Support
One key element of collective action is declining inappropriate work requests, where it is safe to do so. To support you, we created a number of interface documents including a new workload rejection template letter, and a list of activities your practice could consider declining. Where you require your patients to be safety netted, we have supported you in doing this too. Please continue to decline inappropriate requests, where it is appropriate to do so, and make us aware of any difficulties you want support with.
Midwifery Requests
One key area of success this year was midwifery. This was as a direct support of the collective action you have taken. We reported on this in November’s LMC newsletter. In summary, GPs were frequently receiving requests from the midwifery team, to action the results of tests ordered by other professionals. After GPs declined around 40 midwifery requests within a single month, there was a concerted effort to address this and North Bank GPs are reporting that they receive far fewer requests of this nature. South Bank colleagues have not reported this as an issue but, if it is, please do notify Humberside LMCs and we would be happy to address this for you.
Podiatry
GPs on the North and South Bank reported that Podiatry services were making requests for GPs to make onward referrals, prescribe, and provide additional information to podiatry services. Again, as a result of your decline activity, Podiatry have now got a number of their own referral pathways in place, and information requests to GPs have reduced. Prescribing remains an ongoing difficulty, but PGDs are being explored as a possible solution.
MAR charts
Requests for GPs to complete MAR charts have been an interface issue for many years. Collective action brought this to the forefront of people’s minds. This year, we’ve received confirmation that for routinely prescribed drugs, MAR charts are no-longer required. Collective action led to GPs serving notice on completing MAR charts for just in case drugs. Solutions are being actively explored by provider colleagues and we are hopeful that a solution will be found in the near future.
Interface Report
At the start of 2024, Humberside LMCs released their report on the Burden of Interface Difficulties for General Practice in Humberside. The report conservatively estimated that the cost of interface difficulties, to general practice, was £4,000,000. It highlighted that interface difficulties arose from multiple providers and made recommendations for local decision makers. This document has shaped Humberside LMC’s interface strategy and interface group agendas. The report was covered by Pulse.
Radiology Incident
Early in 2024, we worked closely with GP practices, ICB colleagues, and HUTH to understand the radiology results delivery processes, why practices appeared to be receiving duplicate messages, and why some results weren’t being received by practices. As a result of this work, a patient safety incident report was written, along with guidance for general practice explaining steps they can take to ensure they are receiving and acknowledging radiology results.
Consensus Document
In 2024, Humberside LMCs co-published a Consensus on the Primary and Secondary Care Interface with North Lincolnshire and Goole Hospitals, and the ICB. The documented explained the roles and responsibilities of clinicians in primary and secondary care. Whilst to some extent this document has been superseded by collective action, it remains a valuable tool to help improve the interface between general practice and the Acute Trust.
Gender Guidance
Over the last 18 months, we’ve received queries relating to the care of transgender patients. We have escalated your concerns to the ICB, NHSE, and the issue has been debated at the national LMC Conference. Unfortunately, there remains ongoing deficits in care due to commissioning gaps and/or funding arrangements. To support you and your patients, we recently updated our guidance on providing care to transgender patients.
Tasks
We have been told that the use of Tasks by other providers has been causing patient safety concerns and were being used to inappropriately transfer work into general practice. Humberside LMCs therefore wrote Tasking guidelines for general practice and providers. The guidance recommends that Tasks are not used by general practice, but also provides clear recommendations for where practices wish to continue using them.
Day-to-day support
We have continued to support you with your day-to-day interface queries and wherever possible resolve these for you. We have produced monthly reports which are available on our website so that you can see how we are support you. We recognise that some issues can be fixed quickly, whilst resolutions for others are more protracted. Please do keep sending your difficulties through to us – email humberside.lmcgroup.nhs.net.
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