Sep 27

Interface Update September 2023

Humberside LMCs Interface Service

Thank you for your continued engagement with our interface workstream. Telling us about your interface difficulties enables us to address them on your behalf and support you. This month, we provide updates on:

  • Maternity Services
  • Cardiology
  • Jack Brignall PET-CT
  • Onward Referrals
  • Breast Screening Service
  • Ophthalmology
  • X-ray results

The time it takes to respond to interface queries has increased marginally. However, on average it still only takes around three days for us to respond. This increase is partially due to annual leave over the summer, the large volume of queries we’ve receive (and are very happy to receive), and the ongoing work involved in resolving some interface queries.

The statistics illustrating how long it takes to respond and resolve queries, as well as which organisations and departments are the subject of your queries, are available here.

Monthly Update – September 2023

September saw the launch of our Humberside LMCs survey which included specific questions on Interface. Thanks to everyone who took the time to respond; the information you provided will be used to tackle the issues that are important to you. The survey is now closed and we’ll soon be reporting on the findings.

Throughout August, we received an additional 20 interface queries. We are proactively working with colleagues to resolve any issues and improve the interface between GP practices and other healthcare organisations. Some examples of new queries, updated queries, and resolved queries are listed below.

New interface issues

  • Maternity Services – We have received queries regarding maternity services at HUTH asking GPs to undertake tests that should be undertaken by the Trust. They have also asked GPs to prescribe red drugs. These are being investigated with our HUTH contracting colleagues.
  • Cardiology – Queries relating to community cardiology reports, and secondary care cardiology results, have been raised with us. These issues relate to commissioning gaps, service provision, and difficulties accessing some services. We are also investigating whether reports can be simplified, and the way result are provided by HUTH following outpatient appointment. Whilst we are investigating these queries, we can confirm that community echocardiograms are available for:
  • New onset atrial fibrillation (with recent ECG attached) where there is a suspicion of significant structural heart disease.
  • New murmur deemed to be clinically significant (with or without symptoms).
  • Screening echocardiogram for first degree relatives of index cases with bicuspid aortic valve in whom family screening has been recommended.

24 hour tape referrals are accepted for palpitations and syncope (12 lead ECG attached). Where heart failure is suspected and BNP>1000 refer to QED clinic.

  • Jack Brignall PET-CT – GPs are being asked to prescribe sedatives. This is inappropriate an inappropriate work request and potentially unsafe. We recommend declining this request and redirecting the patient to their service unless you feel that it is clinically appropriate. The patient information leaflet given to patients also indicates that patients will be able to drive straight after their investigation. We are in conversation with the department about both of these issues.

 Updates and resolved interface issues

  • Onward Referrals – South Bank practices have brought our attention to requests to make onward referrals by Secondary Care. We have resolved the specific incidents reported to us, and we are supporting Place and Secondary Care to implement longer-term system solutions. In the meantime, regardless of whether you are a North Bank or South Bank Practice, please report any inappropriate requests to make onward referrals to Humberside LMCs and we would be happy to look into them on your behalf.
  • Breast Screening Service – Over the last few months, I have reported that GP practices ware being asked to provide patient information to the Breast Screening Service. This activity is unfunded and practices lack the resources to undertake the work. Consequently, the screening services do not always obtain information in line with the national service specification. The Cancer Alliance and NHSE spoke at Humberside LMCs committee meeting in September. As an interim solution for South Bank Practices, NHSE have identified personnel support to help extract the required data. If you would like to access this support, please get in touch with Humberside LMCs and we can direct you to the appropriate person once this system is in place. We have asked NHSE to make similar services available to North Bank practices, and NHSE are looking into this. In the longer-term, Humberside LMCs believe that a solution that does not involve general practice, or adequately funds general practice, is required. We are investigating how to make this change.
  • Ophthalmology – North Bank practices reported that ophthalmology in Goole had been sending patient documentation without important information, including dates, to practices. Administrative time was being used chasing information. We are grateful to our secondary care colleagues who very quickly resolved this issue. This should save time for both North and South Bank GP practices.
  • X-ray results – A North Bank GP practices reported that X-ray results received from NLAG were being sent to the same GP, regardless of who requested the test. This meant that GPs were being asked to undertake wholly avoidable administrative work. We are grateful to NLAG IT colleagues who have sent communications out instructing their system users to select the appropriate GP to return results to. An IT solution should be introduced in the coming months that will prevent this from happening. In the meantime, please continue to report these incidents to Humberside LMCs.

If you would like more information about any of the topics discussed in this update, or would like to raise any of your interface issues, please e-mail  the Humberside LMCs inbox humberside.lmcgroup@nhs.net.

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