Vasectomy referrals for diabetic patients

Further to our communication in November 2021, we write to remind you that a HbA1C result must be provided at the time of the referral for diabetic patients being referred for a vasectomy.

From 1/12/21, Solent NHS Trust’s vasectomy service implemented the following:

• GPs must include an up to date (within 3 months of referral) HbA1C result. Failure to provide this will mean the referral will not be accepted and you will need to submit a new referral.
• All referrals of patients with HbA1C >69 mmol/mol will be rejected and patients will be asked to return to their GP for optimisation of their diabetic control before being referred back for a vasectomy.
• If, in the future, self-referrals are accepted, any diabetic patient who self refers will be asked to see their GP for review of their diabetic control and only be accepted following a GP referral which satisfies the above criteria.

Please see  document attached for further details.   (24 KB)

Rapid Investigation service update

All of the team at the Wessex Rapid Investigation Service would like to thank you for your continued support since June 2020.

Please see attached refreshed document referral proforma, (29 KB) an informative pdf FAQ sheet (160 KB) and a pdf newsletter (317 KB) with some of our outcomes from the first full operational year.

The RIS is always keen to receive feedback from our service users.  If you would like to do so please email This email address is being protected from spambots. You need JavaScript enabled to view it.

Following our last Fitter’s forum, we discussed the need for   document guidance for other practice staff on how to remove IUCDs (73 KB)  as they do not need a LARC fitter to do standard IUCD removals. We hope this will also prevent inappropriate referrals across practices.

Thankfully Solent NHS Trust contraception specialists were able to quickly respond and share this useful information with us. Please see attached which can be shared with your practices or others as guidance on how they can attempt to remove non-complex coils themselves or where to refer for complex coils.

document One Minute Guide IUC removal Feb 22 (73 KB)

pdf Top Tips for IUC Removal from FSRH (98 KB)

Portsmouth Young Parent Care Pathway

'Partners in Portsmouth have come together to develop this resource for professionals to use as a reminder for them about the services and pathways available to signpost or refer to for young people in Portsmouth who think they could be at risk of being pregnant or know they are pregnant.

Please note that for some services 'timing' is really important, for example if the unprotected sex is within 5 days (120 hours) then the person at risk of being pregnant can be signposted to free emergency contraception.

Colposcopy Services at PHU are now available via eRS/RAS

From Monday 3^rd January, PHU moved to Referral Assessment Service (RAS) via eRS for Colposcopy referrals.  This means that your referral can be submitted as normal via eRS and the speciality will triage to determine the most appropriate clinical pathway and schedule an appointment if required. 

During this transition period paper referrals have still been accepted but please be advised that from 1^st March 2022 paper referrals will no longer be accepted or processed and you will be redirected to resubmit your referral via eRS.

For any e-Referral service queries contact This email address is being protected from spambots. You need JavaScript enabled to view it. or 023 9268 1713/5/6/7

If you have any queries about this change, please contact us via This email address is being protected from spambots. You need JavaScript enabled to view it.

Targeted Lung Health Check (TLHC) programme in Portsmouth

In September 2021, Portsmouth was selected to be in the Phase 3 expansion of the Targeted Lung Health Check screening programme.

The programme, which is planned to start in April 2022, is aimed at smokers and ex-smokers aged 55 to 75 who will be invited for a Lung Health Check (LHC) and where required, a low dose CT scan.

The primary aim is to reduce mortality from lung cancer. Currently Portsmouth early diagnosis rate is 38% (Stage 1 or 2). In line with the NHS Long Term Plan 2028 target, the TLHC programme is aiming for a 75% early diagnosis rate with a target population of 24,000.

Health and Care Portsmouth, which includes NHS Portsmouth Clinical Commissioning Group CCG, Portsmouth Primary Care, Portsmouth Hospitals University NHS Trust (PHU) and Portsmouth City Council Wellbeing Service, are working in partnership to deliver this programme.

Further information and support resources for the programme will be shared with you in the next few months. If you require additional information please contact Denise Perry This email address is being protected from spambots. You need JavaScript enabled to view it.

The programme is expected to become a national rollout in 2024. 

Targeted Lung Health Check (TLHC) programme in Portsmouth

In September 2021, Portsmouth was selected to be in the Phase 3 expansion of the Targeted Lung Health Check screening programme.

The programme, which is planned to start in April 2022, is aimed at smokers and ex-smokers aged 55 to 75 who will be invited for a Lung Health Check (LHC) and where required, a low dose CT scan.

The primary aim is to reduce mortality from lung cancer. Currently Portsmouth early diagnosis rate is 38% (Stage 1 or 2). In line with the NHS Long Term Plan 2028 target, the TLHC programme is aiming for a 75% early diagnosis rate with a target population of 24,000.

Health and Care Portsmouth, which includes NHS Portsmouth Clinical Commissioning Group CCG, Portsmouth Primary Care, Portsmouth Hospitals University NHS Trust (PHU) and Portsmouth City Council Wellbeing Service, are working in partnership to deliver this programme.

Further information and support resources for the programme will be shared with you in the next few months. If you require additional information please contact Denise Perry This email address is being protected from spambots. You need JavaScript enabled to view it.

The programme is expected to become a national rollout in 2024. 

Developing a Women’s Health Hub

This Women’s Health Hub Toolkit has been designed by women’s health experts as a source of inspiration and practical advice for decision makers, commissioners and providers of women’s health services to set up a Hub for the holistic delivery of women’s health services for the local population.

This short animation introduces the concept of Women’s Health Hubs, how Hubs bring core services together based on local need, what they provide to women in the local community, and how they fit into the wider healthcare picture.

Developing a Women’s Health Hub | Women's Health Hub (pcwhf.co.uk)

6 February - International Day of Zero Tolerance for Female Genital Mutilation (FGM)

• FGM is a global issue, with victims numbering in the millions every year.
• Please see embedded “One Minute Guide – Female Genital Mutilation” for information how to spot signs and indicators that a child has been cut or is a at risk

pdf 2022 01 28 Female Genital Mutilation FGM (145 KB)

Guidance for initiation of contraceptive injections

- Contraceptive injections (Depo – provera, Noristerat and Sayana press (sub cutaneous medroxyprogesterone injections)) are classed as a Long acting reversible contraceptive (LARC) and are a very effective way of providing contraception.

Please see embedded guidance for further details.

document 2022 01 28 Initiating contraceptive injections Jan 22 (29 KB)

National HIV Testing Week 2022: Campaign briefing - HIV Prevention England

From January 2022, you’ll be able to:

• Order information resources and merchandise
• Download the National HIV Testing Week 2022 social media pack. Don’t forget to share our social media assets and your local events using #HIVTestingWeek.

LARC update

Please see attached for details on:

• LARC referral options and advice available
• LARC Training pathway - updated
• Free online Contraceptive Counselling Course

document Reminder about LARC referral options and advice available comms to GPs 28 1 22 (2.03 MB)

pdf SHIP Training pathway (483 KB)

Portsmouth Hospitals NHS Trust Gastroenterology RAS

The Portsmouth Hospitals NHS Trust Gastroenterology Service will be moving from an Advice & Guidance (A&G) Service to a Referral Assessment Service (RAS) from Monday 29th November 2021

The benefits of a RAS are as follows:

• The department has the ability to change the service as part of triage – currently this task sits with primary care and happens in 50% of A&G requests
• When sending straight to test, the test date will be visible to the referrer, the patient and the outpatient booking team
• This will bring the service in line with other existing abdominal RAS specialities e.g. Upper GI

You will still be able to request advice from the department, however more than one exchange will require a new UBRN to be raised.

There will be two referral assessment services to enable 2ww and routine to be kept separate:

• Medical Gastroenterology RAS-PHU-RHU                                                             
• 2WW Medical Gastroenterology RAS (Upper GI and IDA Proforma)-PHU-RHU       

Both will remain under the GI and Liver specialty and the clinic types/linked clinical terms will be the same as the current set up.      

If you need help finding the services please call the booking centre for assistance on 02392 681713

Routine extended use of LARC is not recommended

As a result of the COVID-19 vaccination programme, the risk/benefit balance for LARC procedures has now shifted and routine extended use of LARC is not recommended. Individuals should be advised to attend for LARC removal/replacement at 3 years (Nexplanon), 5 years (Mirena), 6 years (Levosert – note the licence for Levosert has been extended to 6 years), and 10 years (10-year copper IUDs).

https://www.fsrh.org/documents/fsrh-ceu-statement-extended-use-of-long-acting-reversible/

Calling all implant fitters

Organon are hosting 3 Fitter Forums over the next three weeks:

There are three levels as follows:

• New Fitters 25th November 7pm–8.30pm
• Intermediate Fitters 7th December 7pm–8.30pm
• Experienced Fitters 8th December 7pm–8.30pm

To register, please see attached pdf invitation (2.05 MB) for details.

Vasectomy referrals update

Current guidance from the Centre for Perioperative Care (Guideline for Perioperative care for people with Diabetes Mellitus: March 2021) state that all patients referred for surgery should have their diabetes optimised prior to referral for elective surgery. All patients should have their HbA1C measured within 3 months of surgery and this should be < 69mmol/mol (8.5%).  If the HbA1C is >69mmol/mol, they should be referred for optimisation of their diabetes control prior to their elective surgery is undertaken. 

From 1/12/21, Solent NHS Trust’s vasectomy service will implement the following:

• GPs must include an up to date (within 3 months of referral) HbA1C result.
• All referrals of patients with HbA1C >69 mmol/mol will be rejected and patients will be asked to return to their GP for optimisation of their diabetic control before being referred back for a vasectomy.
• If, in the future, self-referrals are accepted, any diabetic patient who self refers will be asked to see their GP for review of their diabetic control and only be accepted following a GP referral which satisfies the above criteria.
• Men with persistent HbA1C levels persistently above 69mmol / mol, despite intervention of the GP and local diabetes service will only be accepted for a vasectomy in exceptional circumstances following discussion with clinical lead for vasectomy.

Please find attached document guidance (51 KB) for further details and a new document Vasectomy referral form (26 KB) that will be uploaded to Ardens.

NEW – Local Group Patient Education from the Community Diabetes Specialist Nurse Team

Low Carbohydrate Management of Type 2 Diabetes to Achieve Remission

Portsmouth Community Diabetes has been successful in securing some funding from NHS England for this financial year to provide a series of low carb/remission educational sessions for people with type 2 diabetes.

The 12 week programme is delivered over seven hours divided into three sessions.

Please see document attached (14 KB)  for further details.

Colorectal 2ww Pathway - FIT Testing

We have been working with the Colorectal Surgical Team at Portsmouth University Hospitals to review the 2ww pathway and also to support the delivery of the Optimal Colorectal 28 Day FDS pathway.  

As a result, the following clinical question has been raised.

Please see document attached (19 KB) for further details

READ coding of HOUSEBOUND patients on S1

The community nursing service is for housebound patients only. Please, therefore ensure that you have checked if the patient could possibly come into the surgery and if not, CODE their housebound status on their records  ( Housebound SNOMED code: 160689007)

Thank you for all your efforts, the Community Team will look for this READ code and we just need to be as efficient as possible to save on rejected referrals.

Managing Women’s Hormonal Health – 09:30 – 12:30, 29 September 2021 – online

This half-day hot topic event, held online, gives you the opportunity to learn more about the impact menopause can have and discuss approaches to manage this. It’ll take a closer look at menopause management, contraceptive options and managing menopause and mental health.
For further details document please see attached (14 KB) . To book please follow this link: Book your place now

New Patient Education group - Low Carbohydrate Management of Type 2 Diabetes to Achieve Remission

The Solent Community Diabetes Specialist team are delighted to offer your patients group education around low carb management of type 2 diabetes to achieve remission. Patients must meet the criteria outlined in the document attached flyer (14 KB) in order to refer onto the scheme. This is an exciting opportunity for the team to support those who are motivated to act on their diagnosis to achieve remission.

To refer, please use the Community Diabetes referral form, and tick the option “Type 2 Remission Group”. Updated form will be available on Ardens shortly.

If you have any questions, queries please don’t hesitate to contact the Community Diabetes Specialist Nurse team.

Heart Failure e-Referrals via Advice & Guidance

Please be aware that the current referral processes to the Portsmouth Hospital Heart Failure team is changing from a Referral Assessment Service (RAS) to Advice and Guidance (A&G) approach.

This change over is planned to happen on the 6^th Sept. 2021.

This move is aimed at improving dialogue between primary and secondary care colleagues.

• The current ‘Suspected New Heart Failure’ form is to be completed and added to the A&G request to enable triage by the clinical teams.
• Tell a clinical story and ask a question. This should include the expectation from the request – clinical advice to be enacted in primary care, accessing a specialist investigation, etc.
• Ensure all primary care management options have been exhausted before accessing consultant advice – this includes discussion with a GP within the practice where the request does not come directly from a GP – and ensure the details of this are included in the “story”.

The aim is to improve access to expert knowledge and share clinical understanding across the system, enabling two-way conversations between clinicians to support the delivery of patient management within primary care.

Webinars: Should more women be offered IUS?
Presented by: Dr Jane Davis and Dr Radhika Vohra

8th September 2021 - 7:00pm -  8:30pm

To register, please contact:

Sian Piper
+44 7971 225798
This email address is being protected from spambots. You need JavaScript enabled to view it.

Sexual Health Summer 2021 Campaign

Teenage parents are more likely to be living in poverty up to the age of 30 (for more info see Teenage pregnancy prevention framework - GOV.UK (www.gov.uk))

Any unplanned pregnancy has an impact on a young person in many ways, and any STIs undiagnosed can be unknowing passed on and cause complications if left untreated. We also know that understanding 'consent' is important in prevention of harm and to encourage access to support.

Professionals across all sectors working with young people play a really important role in supporting young people access accurate information, support and advice around relationship and sex.  

Therefore, I hope you will help us cascade information about this exciting new campaign (with an innovative new remote clinic option also included) so that wider workforces across our city are able help reduce poor outcomes so that our young people can make informed decision.

document 2021 08 12 Sexual Health Summer 2021 Campaign (74 KB)

 

National Diabetes Prevention Programme update

• There were 57 referrals in May’21 and 51 referrals in April’21 across the city. Were possible, practices are encouraged to continue to refer (and bulk refer) patients to the programme to support uptake
• Updated e-leaflets for patients and healthcare professionals are now available on the system ( pdf Patient's leaflet (754 KB) & pdf Professional's leaflet (918 KB) ) 
• Case studies: 7 from HIOW http://www.stopdiabetes.co.uk/case-studies
• Links to a BSL video to support promotion of ‘Healthier You’ BSL pilot (date tbc):

Youtube BSL sessions for the Healthier You NHS Diabetes Prevention Programme are now available - YouTube and on Stop Diabetes website https://stopdiabetes.co.uk/programme-overview

Sexual Health - NEW! Video C-Clinics for Young People

We are piloting online pop up video C-Clinics for young people aged under 18 living in Hampshire, Portsmouth, Southampton and Isle of Wight.

This is an online video drop-in service to talk to a sexual health team member and aims to support young people with:

• Condoms and Get it On Condom Cards
• Contraception information and advice, including how to get emergency contraception
• Support with prevention of and testing for Chlamydia and other sexuality transmitted infections (STIs)

This clinic is staffed by specialist health promotion practitioners is not to be used for clinical advice or diagnosis.

For more information on the Video C-Clinics, including running times and how young people can access, please visit www.letstalkaboutit.nhs.uk/video-c-clinic

Poster:  pdf 2021 06 16 Solent NHS Video C Clinic Poster (280 KB)

Please be advised that HIV Prevention England are running a webinar on Shigella.   document “Shigella trends in England: Free webinar 1-2pm Tuesday 29 June 2021” (15 KB)

The intention is to raise awareness amongst health professionals including SRH services but also, importantly, in Emergency Departments and Primary Care etc.  

Please see document attached information (15 KB) for further information.  To register please follow this link  https://bit.ly/hpeshigella

Guidance: Shigella (Shigella: guidance, data and analysis - GOV.UK (www.gov.uk)

Closure of the Practice Plus Group (PPG) Dermatology Service

We notified practices in early May that the dermatology service delivered by Practice Plus Group would stop accepting new referrals, following discussion between the CCG, PHU and PPG around the future of dermatology services. Patients who have already been referred and were waiting to be seen will receive their appointment. We can now confirm that all these patients have been seen and either referred to PHU for ongoing care or written to explaining their treatment at St Mary’s Treatment Centre is now completed.

Portsmouth Hospitals University Trust Dermatology service is now providing a digital first service which will be further enhanced with the delivery of dermatoscopes to practices in the coming month. 

Audiology Referrals for Hearing Aid Fitting 

We have been made aware that a number of recent audiology referrals have had to be rejected due to impacted ear wax.

To help us manage this, please could we ask practices to advise patients, at the point of referral, that they will not be able to have their hearing aid fitted unless their ears are clear of wax.  Please provide patients with an advice, how they can managed this themselves. (Recommendation to a patient is to purchase olive oil ear drops or sodium bicarbonate 5% ear drops. If symptoms persist, consider ear irrigation using an electronic irrigator providing that there are no contraindications.) Please see attached   document “Removal of Ear Wax Pathway” (60 KB)  for further details.

Also attached is a pdf patient information leaflet (354 KB) , which you might want to give the patient to support these discussions. The leaflet was co-produced with Portsmouth Hospitals but applies to all audiology services within our patch.

We will also be asking the provider to make contact with the patient, ahead of their appointment, to ensure they have followed this advice.

Thank you for your continued support.

Access to Fast Access Chest Pain Clinic following Cardiology A&G

You will be aware of the functionality within eRS that enables the consultant responding to A&G requests to convert the request into a referral. We encourage the Trust to use this feature wherever possible however if following A&G to cardiology it is felt referral to the Fast Access Chest Pain Clinic is required, there is additional information the department requires to enable them to safely triage and assess the patient - potentially virtually - which will would not be available to them from the initial A&G request.

You will therefore receive a message back from Cardiology asking you to refer to the service using the proforma available on Ardens, as the most effective option for providing all of this relevant information. Please be assured that if referral into other cardiology clinics is indicated, the service will continue to convert these for you.

Please see attached the latest version of the spreadsheet Solent Directory of Services (DOS) (64 KB) , which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Bladder & Bowel Service

• Level 1 clinics to be re-instated where it is deemed necessary for a face-to-face appointment.
• Level 2 clinics will continue to be completed over the telephone.

NHS Diabetes Prevention Programme we will be hosting  document two virtual events (15 KB) during Type 2 Diabetes Prevention Week next week. Please see attached for further information.

1. For healthcare professionals: Preventing Type 2 diabetes in 2021 and beyond – a virtual event for healthcare professionals

When: Monday 10 May 2021, 5 – 6.30pm
Click here to register for the event.

 2. For patients: A tweet chat featuring Professor Partha Kar.

When: Thursday 13 May 2021, 5 – 6pm
Where: @NHSDiabetesProg on Twitter

 

Portsmouth Hospitals NHS Trust Ophthalmology Department - Use of general enquiries mailbox 

It has come to our attention that a general enquiries mail box held by the Ophthalmology Department at Portsmouth Hospitals NHS Trust is being used by practices to ask for patients appointments to be expedited.

This email address is not encrypted so should not be used for sharing patient identifiable information.

The department is continuing to work through their backlog, ensuring that patients with the greatest clinical need are seen as quickly as possible. The Clinical Director has asked that if your patient is experiencing a significant worsening of symptoms that may change the urgency, please notify the relevant subspecialty via letter. Medication queries for patients already known to the service can also be sent to the consultant directly by letter.

Patients with significant vision deterioration will need reassessment. If acute/urgent this should be done via eye casualty.  If gradual, reassessment can be done by the optician.

We appreciate the pressure primary care are under to manage patients expectations around long waits for treatment and we continue to work with the department to support them in their recovery. Thank you for your cooperation.

 

Cessation of the Practice Plus Group (PPG) Dermatology Service

With immediate effect the dermatology service delivered by Practice Plus Group has ceased accepting referrals. Patients who have already been referred and are waiting to be seen will receive their appointment.

Portsmouth Hospitals University Trust Dermatology service is now providing a digital first service which will be further enhanced with the delivery of dermatoscopes to practices in the coming month. A large proportion of the patients referred to Practice Plus Group previously ended up being onward referred to secondary care, creating an additional step for the patient which will now be much more streamlined.

 

Please see attached the latest version of the spreadsheet Solent Directory of Services (DOS) (65 KB) , which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Dental

• Routine appointments and walk-in slots (on the day appointments) will be reinstated for the nurse clinics in line with original model of patient care before Covid 19.

Sexual Health

• Outreach services is being reinstated
• Community delivery is being reinstated

(for further details please see attached)

A&G for Upper GI via the General Surgery and Upper GI RAS

As you know, Upper GI moved over to a Referral Assessment Service (RAS) on e-RS at the end of March.

Since this move the Gastroenterology team have had an increased amount of Advice and Guidance requests submitted to them which are addressed to Upper GI.

Advice can still be asked of the Upper GI team, via the General Surgery and Upper GI RAS. GPs need to send for a triage rather than advice please.

We would appreciate, if you could please share this information with all GPs and secretaries. Thank you.

NHS Diabetes Prevention Programme Webinar by Ingeus (provider of ‘Healthier You’): Wednesday 12^th May 1-1.45 pm

Please see attached document poster (4.33 MB) for details and event registration.

 

To gain access to the free licences for the online Cambridge Diabetes Education Programme (CDEP), you can sign up by following the instructions in the attached flyer and by using the REGISTRATION KEY CODE: HIOWCDEP  

The study programme has 5 levels and is therefore suitable for variety of staff (HCAs, receptionists, students, psychologists, care workers, practice nurses, GPs, paramedics, diabetes link nurses, diabetes podiatrists / midwives / pharmacists……..)

The latest topic on Insulin Safety Week aims to raise awareness of insulin safety among healthcare staff and runs from the 17th - 23rd May 2021.

For further information on how to register please see attached.

pdf CDEP registration info (462 KB)

pdf CDEP flyer - HIOW (530 KB)

 

Pulse oximetry for people with darker skin

There have been some reports on the accuracy of pulse oximeters for people with darker skin. Medicines and Healthcare products Regulatory Agency (MHRA) guidance published on 26 March notes that it is possible that patients with lighter skin may have small differences in the result reported when compared to those with darker skin (along with other well-known factors), however, they are not aware of any incidents where skin colour has had an adverse effect on the use of pulse oximeters when providing effective clinical care.  

Existing guidance on COVID Oximetry @home and COVID virtual wards takes this potential factor into account by recommending recording of baseline readings and monitoring trends, as well as using clinical judgement to remain vigilant for other signs of deterioration. Therefore, it remains important that everyone who could benefit has access and support to use pulse oximetry effectively at home to identify silent hypoxia. Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. with any queries about remote monitoring using pulse oximetry.

COVID-19 has fundamentally changed the way health & social care services are delivered at a time where self-care has also revealed itself as the critical answer to tackling the pandemic. Self-care praxis remains largely understudied, and in particular how the attitudes of health & social care staff may have changed with respect to embedding good health-seeking self-care behaviours in the clients they serve in the new setting.

Imperial College London Self-Care Academic Unit (SCARU) is conducting a qualitative research study to explore this further. Please take a moment to review the Participant Information Sheet of this study which also has ethical approvals in place

Webinar on Blood Pressure @home: Steps to success -  on Tuesday 20^th April at 2.30pm – 4.30pm.

Dr Shahed Ahmad, National Clinical Director for Cardiovascular Disease Prevention will be chairing the ‘Blood Pressure @home: Steps to success’ webinar which will walk-through the practicalities of the Blood Pressure @home Standard Operating Procedure, followed by examples of how GPs and local areas have targeted specific vulnerable patient cohorts. 

Who is this aimed at:

This session is aimed at GP practice and Primary Care Network business managers and clinical directors, and Clinical Commissioning Group cardiovascular disease prevention colleagues or similar roles. 

Find out more and register here: https://www.events.england.nhs.uk/events/blood-pressure-home-steps-to-success-webinar

Webinar on CVD Proactive Care Frameworks – Primary Care – on Thursday 22^nd April at 10-11am

UCL Partners and the British Heart Foundation invite you to join a webinar to learn more about practical tools and resources helping primary care teams proactively support patients to manage high risk conditions including hypertension and cholesterol.

Who is this aimed at:

The webinar is aimed at Health Care Professionals working within Primary Care Teams: Health Care Assistants, GPs, Practice Nurses, Clinical Pharmacists, Paramedic Practitioners etc

About the Frameworks

• Workforce education and training: The tools provide protocols, guidance, videos and virtual training sessions to upskill the breadth of primary care team members to proactively support patients.
• Digital resources: There are a selection of clinically appraised digital resources to support patient activation and self-management in the home setting.
• Search and risk stratification: The tools can be used with EMIS (and SystmOne to follow), to help stratify patients into those at low, medium and high risk.

View the CVD tools here    Register for the webinar here: Register for the webinar

The webinar will be chaired by Helen Williams, Consultant Pharmacist and National Specialty Adviser for CVD Prevention, and will be providing information about how the tools can be used to help you support patients.  Questions about the webinar? Name: Sian Martin . Email: This email address is being protected from spambots. You need JavaScript enabled to view it..

Please see attached the latest version of   spreadsheet the Solent Directory of Services (DOS (62 KB) ), which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Bladder & Bowel Service

Level 2 patient care will be reinstated using a combination of remote consultations and out-patient clinics (where necessary).

Level 1 (product assessment and delivery) capacity will improve as a redeployed member of staff returns. This will focus on remote consultations but also include face to face domiciliary visits. Waiting lists for new patients have grown due to re-deployment of staff. Patients on the caseload awaiting review face significant waits of over 52 weeks.

Community Nursing Portsmouth (Nightingale and Seacole)

Seacole and Nightingale to be aligned with the five Primary Care Networks (PCN’s) creating 5 teams: Brunel, Island City, Portsdown, Portsmouth South and Portsmouth North.

These five teams will continue to support and work together as part of a city-wide approach. The alignment will provide continuity and improved care to patients within the community. Providing a wider range of services to patients and allow the Locality team to integrate with the wider Portsmouth Health and Care system.  By working collaboratively, the Community Localities will work alongside the PCN network in order to deliver national service specifications including, enhanced health in Care Homes , supporting prevention of  and  early discharge from hospital, structured medication reviews and anticipatory care planning for End of Life patients.

SALT Adults & Community

A staged return to full BAU service provision  has commenced with remote consultations, face to face assessments and treatments including outpatient appointments and domiciliary visits where necessary, in-reach into care & nursing homes and with full PPE compliance. Staged return will enable utilisation of priority scoring (both NPs and follow-ups) and long waiters.

1 April 2021 Service change - Adult Routine Audiology Services for patients over 55 year old

The Routine Audiology service is changing, from 1 April 2021, all new patients over 55 years of age with routine presbycusis (gradual symmetrical hearing loss, thought to be age related) must be referred to St Mary’s Surgical Centre (Practice Plus Group) only and referrals will no longer be accepted by Portsmouth Hospital University Trust (PHU).

PHU will continue to treat existing routine patients (referred up until 31st March 2021). Once these patients require a new hearing assessment, Audiology at PHU will refer to St Mary’s Surgical Centre and will inform Practices of this referral. All Complex Audiology patients should continue to be referred to PHU for assessment and treatment. Please note any patients requiring audiology treatment under 55yrs are considered Complex by definition and should be referred to PHU only.

Please see the attached pathway and referral forms for additional information. If you have any questions/queries please email  This email address is being protected from spambots. You need JavaScript enabled to view it.

pdf 2021 03 29 Audiology Pathway over 55 years Final 16 3 2021 with a new logo (627 KB)

pdf 2021 03 29 Managing Ear Wax A5 leaflet 20 1165 Sept 2020 (354 KB)

document PCCG213b Complex Audiology Adult Referral Form PHT QA final 30 3 2021 (61 KB)

document PCCG477 Practice Plus Group Adult Routine Audiology referral form OVER 55 years old final 30 3 2021 (34 KB)

Please see attached the latest version of the spreadsheet Solent Directory of Services (DOS (61 KB) ), which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Dental

As of 1/4/2021, the plan to reinstate domiciliary care for prioritised/most vulnerable patients unable to access dental care within a surgery setting.

Cessation of Consultant Connect contract

We are writing to inform you that from 13^th April 2021, the contract with Consultant Connect will cease. From this date, urgent advice to avoid an admission can be accessed via alternative routes detailed in the document attached document (14 KB) .

Please note, this is for urgent advice to avoid an admission only.

For non-urgent advice when all primary care management options have been exhausted, please continue to use the advice and guidance function within eRS.

Once the contract with Consultant Connect ends, the recordings of the discussion stored in the cloud will no longer be accessible. Therefore, if you are planning to review recordings to update the patient notes, please ensure you do this before the contract expires.

We are writing to make you aware that the Portsmouth Communication Support Service for Stroke patients run by the Stroke Association will be closing on 31 May 2021. The service will continue to support you up until that date as needed.

These decisions are never easy but the number of people using the service has been low and we have other services in the city that pick up several of the elements offered by the Portsmouth Communication Support Service.

The Stoke Association will continue to provide support to people and carers affected by stroke, via the Portsmouth Stroke Recovery Service: https://www.stroke.org.uk/finding-support/support-services/portsmouth-stroke-recovery-service

You can also access support through:

• HIVE Portsmouth, which can help you find relevant services and support https://hiveportsmouth.org.uk/covid-19. They also offer a directory that details different groups and organisations and what they can help with - https://hiveportsmouth.org.uk/hive-directory. You can also contact HIVE Portsmouth via their helpline on 023 9261 6709, available 9:00am to 4:30pm Monday to Friday.
• Different Strokes (Portsmouth) a group of younger, and younger minded, stroke survivors and carers http://www.different-strokes-portsmouth.org.uk/

If you have any questions concerning this, please do not hesitate to contact me This email address is being protected from spambots. You need JavaScript enabled to view it.

Referrals to Andrology via ICE

Please see below for the most up to date referral processes to Andrology to prevent any treatment delays. Thank you.

• All ICE requests need to be set to ‘REQ’ on the system please (not as ‘POS’ (postponed))
• After a request has been made on ICE, please can the patients be directed to telephone the laboratory on 023 9228 6799 to book an appointment
• Currently, patients are being booked in a 2 to 3-week turnaround from when they phone. This represents about the minimum waiting time due to the need to meet abstention times
• Due to the need to ensure samples are tested within an hour, Andrology are now only offering an on-site service
• Those patients with an overseas NHS number – one that begins with ‘7’ – need to be referred to the overseas team at QAH to clarify if a fee is due to be paid before an appointment can be made. It may be helpful to highlight to the patient, at the point of requesting that the test may be chargeable, as it will help prevent awkward conversations when this is mentioned to patients when they phone to make an appointment.
• The laboratory is not able to provide patients with their results over the phone. Patients will be directed back to the requesting GP to obtain results.

If you require any other information, please contact Hedley Glencross, Lead Biomedical Scientist

on 03292 286737 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

GOS18 Referrals for Cataracts and Optegra/SpaMedica (or other private cataract provider)

You may begin receiving GOS18 referrals for cataracts where the optometrist has indicated that the patients wants to go to Optegra/SpaMedica or other private cataract provider. This is usually based on the expectation that these providers can see patients very quickly, even in the current climate. 

We would just like to remind you that these providers do not hold local contracts with the CCGs, which means we have no relationship with the provider and no oversight of their quality or governance processes.  In addition, we have no agreement on the management of complications or emergency support whereas with commissioned services, we have agreements between providers and we are able to monitor instances of adverse events.

Naturally, we do support GPs to have a conversation with a patient who wishes to exercise their right to choose an alternative provider but this must be done through ERS.  In most cases, the Optometrist does not have access to ERS or the full medical history of the patient.  We are finding that a number of providers professing short waits do not accept all patients and published waits do not translate to treatment times.  

As part of the CCGs restoration and recovery work, we are commissioning additional capacity from local providers where we have existing contractual relationships to bring down waiting times in a fair and equitable way.

Locally we commission cataract surgery from our main Acute Trusts and Practice Plus Group.

We have asked the LOC to communicate with local optometrists and ask that they do not to make a provider recommendation on the GOS18 forms.  They can of course inform patients of their right to choose but putting a provider on the GOS18 may raise patient expectations, which cannot be fulfilled, and it cannot currently be a fully informed choice.

We anticipate the LOC’s continued support and trust this is helpful in understanding why we ask everybody to refer via the locally commissioned pathways.  

Please see attached the latest version of the spreadsheet Solent Directory of Services (DOS) (60 KB) , which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Specialist Palliative Care Team

The service is reinstating the Early Palliative Care clinic by providing Face-to-Face appointments where appropriate.  The service will also continue to offer patient choice of digital (virtual) consultations where appropriate and accessible.

Sexual Health

Vasectomy services assessments to re-start w/c 15 March’21

Allergy Advice & Guidance for Covid Vaccination

Following some feedback from the allergy service at University Hospitals Southampton, we have jointly developed a form for GPs to fill in when requesting advice for managing patients with anaphylaxis or who had an allergic reaction to the first dose of their covid vaccination.

This request for allergy A&G form will enable the team to make an informed decision and feedback promptly to the requesting GP around whether their patient is safe to vaccinate and which is the safest place to carry out the vaccine. The requesting GP will then be required to act on the advice. 

The document form (131 KB) is available on Ardens and will need to be attached as an advice and guidance request to UHS via eRS, using the new service details 7974034 Allergy-COVID Vaccine Concern – (Advice & Guidance)-Southampton-UHSFT-RHM

A pathway for managing patients who have allergic reactions to the first dose is included with the form to support GP decision making. More detailed information can be found in the green book: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/955548/Greenbook_chapter_14a_v6.pdf

Please use this information before considering asking the allergy service for advice as it is very straightforward to follow and is being continually updated as new information becomes available. Thank you.

Vasectomy Services re-start (Solent NHS Trust’s)  

Please be advised of the below:

Assessments

• Assessment will be re-starting w/c 15th March.  All clients that had their appointments cancelled have been re-booked. Solent are now booking in new referrals that are on the waiting list.  Any additional new referrals are going into appointments (but will then have their procedure in order of when the referral was made)

Procedures – in house

• ST. Marys Hospital – Fridays will re-start 19th March, Wednesdays will re-start 7th April, and Tuesdays will re-start in May
• Royal South Hants – possibly Thurs and Mon re-starting w/c 15th April – still tbc
• Crown Heights – possibly re-starting w/c 15th March – still tbc

Procedures – sub-contractors

• Dates vary when these can re-start (between end of March and beginning of May) Solent still to awaiting  further confirmation from a few sub-contractors

GPs can refer into Solent Sexual Health Vasectomy Services and they are committed to offer a choice of site to clients to avoid delays for men as much as possible.

NDPP 24 month eligible bloods timeframe for all referrals has been extended until March 2022 (extended from March 2021).

The 24-month bloods eligibility criteria extension does not change normal practice and there continues to be a requirement that all patients with NHD receive their annual review. Thank you. 

document Updated referral form (44 KB) will be uploaded to Ardens. 

British Sign Language (BSL) pilot programme, on Saturday 27^th March 2021 at 10.00am.

Content will mirror the usual remote NDPP programme but with a BSL interpreter present at each session alongside the educator to deliver the session content and help engage with the group. There are 14 spaces in total, 11 spaces remain available.

• Please share this opportunity with primary care colleagues – suitable patients include 1) those who are deaf or indicate BSL as their preferred language AND 2) at risk of developing type 2 diabetes indicated by eligible NDH blood test or previous GDM (usual eligibility criteria apply).
• Patients can be referred:  1) GP route or 2) Self-referral until 31.3.21 https://riskscore.diabetes.org.uk/start   

Endometriosis South Coast is an inclusive charity set up to help people along the South Coast who are going through the diagnosis stages of endometriosis or have been diagnosed with the condition.

Please see attached a pdf poster (3.47 MB) and pdf leaflet (1.21 MB) for sharing.

 

Adult Routine Audiology Services for patients over 55 year old

The Routine Audiology service is changing, from 1 April 2021, all new patients over 55 years of age with routine presbycusis (gradual symmetrical hearing loss, thought to be age related) must be referred to St Mary’s Surgical Centre (Practice Plus Group) only and referrals will no longer be accepted by Portsmouth Hospital University Trust (PHU).

PHU will continue to treat existing routine patients (referred up until 31st March 2021). Once these patients require a new hearing assessment, Audiology at PHU will refer to St Mary’s Treatment Centre and will inform Practices of this referral. All Complex Audiology patients should continue to be referred to PHU for assessment and treatment. Please note any patients requiring audiology treatment under 55yrs are considered Complex by definition and should be referred to PHU only.

Please see the attached pdf draft pathway (624 KB) for additional information. If you have any questions/queries please email This email address is being protected from spambots. You need JavaScript enabled to view it.

Please see attached the latest version of the spreadsheet   (60 KB) spreadsheet Solent Directory of Services (DOS) (60 KB) spreadsheet   (60 KB) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Community Physiotherapy Team

Community physio will be prioritising patients assessed as risk of hospital admission / hospital re-admission / ED attendance.

Non-urgent treatment (such as long-term strength and balance training or outdoor mobility work will not be provided).

Routine referrals received after 4/1/20 will be rejected and will not be held on a waiting list.  Patients and their families will be given advice on how to re-refer themselves to our service from June 2021 if they have, non-essential rehabilitation needs 

Home Oxygen Service

Continuation of ‘step down’ Home Oxygen Service to Support PHU, allowing early discharge of COVID-19 patients at PHU.

Spinnaker Ward (St. Mary’s Hospital)

Bed capacity on Spinnaker ward will be restored to 16 beds plus 1 winter escalation surge bed.  Covid attributable surge beds will be closed with immediate effect.

Sexwise, the Sexual Reproductive Health information website funded by PHE, now has advice to women on extended use of LARC.

This  is in response to fewer face to face contraception appointments being available in many areas.

There is also a specific Sexwise page about getting SRH help during covid-19.

The FSRH guidance for women who need to access contraception, abortion and other sexual and reproductive healthcare during the third wave of the COVID-19 pandemic has also been updated and can be accessed on FSRH updates advice guide for women seeking contraception and abortion during COVID-19 - Faculty of Sexual and Reproductive Healthcare:

FAQ page. https://letstalkaboutit.nhs.uk/c19faq

Shielding advice for patients with chronic liver disease

Portsmouth Hospitals University Trust has alerted us to some national advice for patients with chronic liver disease that they have asked us to share with you:

https://www.bsg.org.uk/covid-19-advice/defining-patient-groups-that-should-be-considered-for-shielding-highly-vulnerable-categories/

This information also informs the Covid vaccination schedule as these patients will be in Group 4 as extremely clinically vulnerable and therefore, currently eligible for the first dose of Covid vaccine.

Please see attached the latest version of the   spreadsheet Solent Directory of Services (DOS) (60 KB)  which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Home Oxygen Service

Team will supply oxygen to patients that had an early discharge from PHU with C-19.  Appropriate patients for this pathway will be identified by PHU Respiratory team and then referred to the CO@H virtual ward and Solent Home Oxygen service. If required patients may also be referred to PRRT as per the usual discharge planning pathways under the PCAT (Discharge Hub).

Children’s Community Nursing Team

Long term complex children and those requiring nursing interventions on the CCN caseload or referred from PHT will be assessed on a case by case basis and considered for either a home visit, clinic appointment or remote consultation.  Portsmouth and South East Hampshire service will be offering an 8am-8pm service Monday to Friday and have extended their operational hours to 10am-8pm at weekends to support hospital avoidance.

Sexual Health

The service will be launching an online portal that allows patients to register for their 'own' account.  Patients will be able to update their own details, triage their sexual health needs (book/cancel and alter appointments), order condoms and STI kits by post and receive copies of their results.  The portal will be linked to their Inform patient record used by the Trust.  Future developments to the portal will also allow treatment by post, self-taken histories, image sharing and two way text messaging.

CAMHS East

To manage demand and capacity within the CAMHS service the following interim changes to the operational model have been implemented:

• The Single Point of Access /CRISIS /Liaison and Extended Teams have been amalgamated to provide cross cover.
• Appointments prioritised and allocated based on risk based assessment (for cases that need allocating to a caseload and cannot go on a waiting list e.g. eating disorders)
• Children and Young people will be diverted from the Drop-in into SPA. Self- referrals are taken via this route for young people age 13-18
• Options for urgent cases to be completed face to face
• Managing Emotions group (MEG) to be videoed and sent out weekly for CYP and parents with follow up calls offer.
• DBT group to continuation
• Eating Disorders offer and groups to continue by Zoom which addresses management of CYP and families.
• CAMHS Liaison offer available from 9-5 Monday to Friday. On call to be offered 9-5 on Saturdays.
• Existing caseloads would continue to be managed via telephone, video consultation and face to face.
• CAMHS LD – To continue to offer assessments and follow up appointments to manage the increased demand and complexity of cases presenting
• LAC will continue to offer initial assessments and follow- ups to manage the demands and prevent the risk of placement breakdown.
• Continue to prescribe to Children and Young people
• Continue to initiate medication to children and young people who require antipsychotic mediation or medication for anxiety or depression.
• Continue to triage Neuro-developmental referrals to identify any mental health crisis that need to be escalated. Children and Young people will be placed on the waiting list if no concerns identified and families informed of the wait and that they can contact the SPA duty if they have concerns about their child’s well-being.

  pdf NHS Diabetes Prevention Programme February 2021 Update (82 KB)

• Extension to eligibility criteria from 1.2.21: women with a past diagnosis of Gestational Diabetes Mellitus (GDM) and normoglycaemia. Women with GDM and Non-Diabetic Hyperglycaemia have been able to access the programme from the outset.
• Key Touchpoints: 6-8-week post-natal review, yearly glycaemic check for non-diabetic women with a history of GDM and systematic searches of clinical systems.
• Patients can be referred into the programme using the same referral process, using the   document updated referral form (37 KB)  on clinical systems. Referral includes glycaemic test results (normoglycaemia or NDH).

• Eligibility timeframe is consistent with NDH eligibility (expanded from 12 months to 24 months until 1st April 2021 due to the pandemic).

• NDPP continues to be delivered remotely over the telephone or group video conference or via a digital pathway with an online platform. It is available during the day, evening and weekend, in English, Hindi or Urdu and with no waiting list. 
• Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. NDPP Programme Manager if you have any queries. 

Conversion of A&G to a referral by a Provider – clarification on processes

As of 29^th January, referrers will be able to authorise conversion of A&G to a referral by a provider, when the A&G request is initiated.

Please note: If referrers provide authorisation, they must ensure the patient is happy to be referred to that provider and that adequate clinical information is provided.

Process for Routine Referrals

• GP submits A&G and provides authorisation for referral (in case referral is required and only if patient agrees)
• Provider assesses A&G and either provides advice back to GP or converts the A&G into a routine referral.
• If A&G is converted into a routine referral by the Provider, the Provider is responsible for booking the appointment for the patient, contacting the patient and sending all relevant paperwork to the patient. GP practice only has to remove the A&G from the A&G worklist and update patient record accordingly.

• Provider is also able to convert the A&G into a routine referral and to request an upgrade to this referral. This means that patient will remain on the routine pathway but will be seen within a 2 weeks period. This is not a true 2ww referral. In this case Provider is still responsible for booking the appointment and contacting the patient.
• If, after reviewing the A&G, Provider feels patient should be referred on the 2ww pathway, Provider will respond to A&G and ask GP to submit 2ww referral on e-RS. (2ww pathway can be only initiated by a GP). In this instance the GP will be responsible for initiating the 2ww referral, booking the appointment and contacting the patient with relevant paperwork.

Process for 2ww Referrals

• PHUT 2ww services do not have the option to ask for A&G, they are appointment only services
• If a referral to 2ww speciality is required; as per the Cancer Operational and Access policy, this will have to be initiated and submitted on e-RS by a GP. GP is required to book the appointment and contact patients with all relevant paperwork as per current process.

PHUT Gynaecology runs two ‘see and treat’ hysteroscopy clinics – 2ww Post-menopausal Bleeding and a Menstrual Disorders Hysteroscopy clinic.

We have received feedback from the PHUT that some patients are turning up to their appointments to these clinics unaware and unprepared for the treatment, which is resulting in patients refusing treatment and appointments having to be cancelled and rescheduled.

PHUT would like to ask for your help to ensure patients are fully prepared for this one-stop service. When referring a patient could you please confirm with patients that they understand and agree to an outpatient investigation / treatment at first visit.

To enable patients to receive treatment on the day, could you please advise them to take Ibuprofen 400mg/Paracetamol 1gr an hour before clinic and provide them with a pdf patient leaflet (1.51 MB)  for more information about their appointment.  This leaflet will be uploaded onto Ardens and is linked directly into the referral form for easy access. (both attached for information)

• Referrals to the Menstrual Disorders clinic can be made by filling in a referral form called document “Gynaecology Referral to Direct Listing Outpatient Hysteroscopy clinic” (1.41 MB)  available on Ardens and submitting it on e-RS.

Please submit referral on e-RS to:

Speciality: Gynaecology

Clinic type: Menstrual Disorders

Service name: Gynaecology Menstrual Disorders and Hysteroscopy-Portsmouth Hospitals NHS Trust-Queen Alexandra-RHU

• Referrals to the 2ww Post-menopausal Bleeding are to be submitted on the 2ww Gynaecology referral form. A link to the patients leaflet has been added to the 2ww Gynae referral form for an easy access and printing.

spreadsheet Solent Service changes - update (59 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

Sexual Health:

Vasectomy assessments and procedures will be ceased from 01/02/21 (due to redeploying staff in to Covid vaccination centres).  Assessments & procedures carried out by Solent will be stopped however GP sub-contractors will carry out any planned procedures whilst able to and will also see any patients already assessed by Solent prior to the beginning of February.

document AcuuRx template:  Diabetes UK – T2DM new diagnosis. (212 KB)

A new template text message has been included on the AccuRx platform, which signposts people newly diagnosed with type 2 diabetes to the advice and support Diabetes UK offers.

www.diabetes.org.uk/type-2-diabetes.

The page offers a range of information, including about the ways type 2 diabetes can be managed, nutritional advice and ways to access emotional support.

Type 2 diabetes diagnosis can be very overwhelming and getting the right information and support early can have a big impact on how the condition is managed long-term, so if possible, we would encourage your practice to utilise this resource please. Thank you.

Convert A&G to referral functionality in eRS

The option for A&G requests to be converted to a referral by the Provider is now available within eRS.

New tick boxes will be displayed under the question:

“Do you authorise the provider to convert this advice request into a referral if appropriate?”.

The tick box options are:

“Yes – I will ensure adequate clinical information is supplied”

“No – I only require advice at this time”

If the “YES” box is not ticked, but the outcome of the advice and guidance is that the patient needs to be seen, it will remain the responsibility of the referring clinician to convert the request into a referral.

If referrers provide authorisation, they must ensure the patient is happy to be referred to that provider and that adequate clinical information is provided.

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

spreadsheet Solent Master DOS1 28012021 (56 KB)

Cataract Referral Pathway – reminder

We have been made aware that Optegra Eye HealthCare are approaching local GPs and community optometrists advising them that they can refer patients directly to Optegra for cataract surgery. Locally, we already have established referral pathways in place which allow for informed choice discussions to take place, ahead of referral to commissioned services via eRS. Optegra are indicating that they will accept direct referrals by email, fax or paper, which is against the terms of the NHS standard contract and will not be supported by the CCGs. Our position is being communicated to them via local contracting teams with support from the LOC.

A reminder that Advice and Guidance as the initial route into paediatrics is for the Paediatric Team only and not for all specialties offering a paediatric service i.e. ENT, Dermatology, Orthopaedics and Ophthalmology.

PHUT list the Paediatric Department on eRS under Children’s & Adolescent A&G Service.

If you are seeking a surgical or department opinion please search by the individual department, then the relevant clinic type.  E.g. Orthopaedics + Hips for clicky hips or ENT + Ear for glue ear.

Other Children & Adolescent departments offering service specific A&G when required:

• Epilepsy
• Endocrinology
• Gastro
• General Medicine
• Cardiology
• Dermatology
• Diabetic Medicine
• General Surgery
• Haematology
• Rapid Access Clinic
• Renal
• Rheumatology
• Urological Surgery
• ENT, Ophthalmology and Orthopaedic and other surgeries need to be search by the relevant surgical specialty and then the appropriate clinic type

Completion of Cremation form 4

During the last few months Portchester Crematorium has noticed an increase in the Cremation Form 4 being completed incorrectly, thus causing an unnecessary increase in the workload of crematorium staff and Medical Referees.

As you are aware without the proper information being provided on the form there could be a delay in the funeral proceedings. In particular we are finding Q9 being either filled incorrectly or in some cases being left blank or N/A being inserted – this is not acceptable by The Ministry of Justice

“ If the body of the deceased was not seen by you, or was seen by another medical practitioner known to you, you should answer Q8 N/A and report the observations of such other medical practitioner at Q9 noting their full name and GMC number “

As stated before if the deceased was NOT seen by any doctor in the 28 days before death AND NOT seen by any doctor after death then a conversation/referral must be made to the coroner.

A video consultation with the patient can classify as being seen in the 28 days prior to death BUT under no circumstances should a video be used to view the deceased’s body.

If in doubt the staff and Medical Referees at Portchester can be contacted via 01329 822533

Dr David G. Atchison, Medical Referee, Portchester Crematorium

COVID-19 and diabetes: Update for primary care in response to the ongoing coronavirus pandemic.

Significant knowledge and clinical expertise has been gained from the first wave, especially with regard to the consequences of COVID-19 and its treatment on people with or at risk of diabetes. This embedded documents provides an important update and recommendations for practice, with links to relevant resources.

pdf PCDS COVID statement 22 Jan FINAL (002) (324 KB)

pdf COVID 19 Dexamethasone and Hyperglycaemia Guidance v1 (264 KB)

Delegation of Insulin Administration | Diabetes UK

To enable community teams to manage the increasing demand for this service, suitably trained health and care workers (HCWs), including health and care support workers and healthcare assistants, could administer insulin to those adults whose diabetes is stable.

The links to documents (above & below) provide a voluntary framework for teaching and training HCWs to administer insulin to adults who are unable to do this themselves. They also ensure patient safety and cover areas such as access to medicines ensuring care is delivered at the right time in the right place by clinicians with the right skills.

• Final letter of delegation of insulin administration
• Sample document for the delegation of insulin administration
• Checklist for health and care workers who are delegated responsibility to administer insulin to adults
• Competency framework and workbook for blood glucose monitoring and subcutaneous insulin administration 
• Frequently asked questions

Solent Service changes - update

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

spreadsheet Solent Master DOS1 21012021 (56 KB)

Type 1 diabetes and disordered eating (T1DE)

Wessex ComPASSION Pilot project team has launched a short series of publicly accessible podcasts about Type 1 diabetes and disordered eating (T1DE).

‘The T1DE Podcast’  helps share and spread awareness and understanding about the combination of conditions: T1 diabetes and disordered eating (T1DE).

A short series of podcasts is planned where patients, families, friends and health care professionals can hear what members of the ComPASSION pilot project have learned and experienced diagnosing and treating people with both conditions in Dorset and Portsmouth.

Episode one ‘What is T1DE?” is available to download now. Subscribe to the podcast via this link https://thet1depodcast.podbean.com/ so you don’t miss the next episode.

Update Solent MSK Service Delivery Portsmouth CCG

The Solent MSK Service has currently changed back to a predominately telephone/video consultation service and only seeing patients Face to Face if there is an identified urgent clinical need.

We have had to make the decision due to large amounts of MSK staff being redeployed to both acute and community settings to support the Covid pandemic workforce that we are running an Urgent MSK Service only.

This means we will still accept Consultant, GP and self-referrals but we will prioritise them clinically which means if triaged as routine they will have an extended wait from our usual waiting times.

Our established First Contact Physiotherapy Services are still being delivered as before but we are reviewing if patients can be managed effectively with telephone/video consultation rather than a Face to Face appointment.

Our Specialist MSK Services will continue but again if clinically routine there will be a delay in their care.

Hydrotherapy remains open to urgent referrals only and is supporting PHU inpatients.

We are confident that all referrals we have within the MSK Service and those we will continue to receive we are managing effectively and mitigating the clinical risk as much as we are able to do.

We hope once this severe and unprecedented demand on the NHS recedes  we will be able to restore the MSK Service delivery as before.

Solent Service changes - update

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

spreadsheet Master DOS1 - 15.1.2021 (53 KB)

Referrals for routine X-ray and Ultrasound – Reminder

Given the challenges providers are facing currently with an increase in COVID patients and staff isolating, it is likely that increased waiting times for routine diagnostics may be seen, and also some changes to the locations where certain tests are offered (whether referred into PHU services or PPG services). It is also likely there will be a delay between the diagnostic test and the next step in the patient pathway i.e. procedure or consultation.

We are therefore asking referrers  to consider when requesting an XR and USS whether the outcome of the test will change the management plan and also whether the patient is ready, willing and able to attend an appointment.

We appreciate this is probably usual practice for most referrers but given the current circumstances, we wanted to send a gentle reminder so that wherever possible we can avoid missed appointments and duplication of tests further down the line.

Changes to ICE for Ultrasound requests

In addition to this, to support referrers and improve the user experience of ICE, PHU are in the process of creating a drop down list of clinical scenarios that meet the agreed referral criteria when requesting ultrasound. This will go live for Pelvis, Urinary tract, and Testes first on 18^th January 2021. If there is not a suitable option in the drop down list, there is the option to add more information in a free text box, however we anticipate this will limit the amount of written input required from the referrer in most cases.

Work is ongoing to determine whether this can be rolled out to other ultrasound request options. Should you have any concerns or suggestions that might help further improve the process of requesting appropriate direct access diagnostic test then please feed these back via This email address is being protected from spambots. You need JavaScript enabled to view it.

MyDesmond – online programme

The current Covid restrictions unfortunately continue to prevent the running of face to face DESMOND group education. The Diabetes team are able to offer MYDesmond online instead. In order for patients to register, they need an email account, so where possible, could you please ensure patients email address is recorded on System1. Thank you.

Please continue to refer ALL newly diagnosed patients for DESMOND as the team will maintain a waiting list and register those pts who do not have an email account for face to face group education when we can resume. The team will also re – email and offer all of those patients registered for MYDesmond online an opportunity to attend face to face either as a follow up to,  or if they struggled to complete/ declined MYDesmond online.

The team is also planning to undertake an audit of all pts referred.

Please continue to utilise Diabetes UK resources for newly diagnosed Type 2 patients to support the above.

Thank you.

Community Diabetes Nurse Specialist team

Consultant Connect Service Reminder

Please continue to use the service to get Urgent advice from a range of specialties. With hospitals under increasing pressure a call could result in patients avoiding a same day hospital admission. Current average call connection times are as follows:

• Cardiology – 1min 12sec
• Cardiology – Heart Failure Only – 33sec
• Gastroenterology – 1min 08sec
• General Surgery – 20sec
• Gynaecology – 26sec
• Hepatology – 54sec
• Medicine for Older People – 1min 29sec
• Respiratory Medicine – 1min
• Palliative Care – 25sec

Due to the added pressure within the hospital the consultant may not be able to take your call on the first occasion but please do call back as the clinical teams are keen to support your decision on same day admission avoidance. If you have any questions please contact your Consultant Connect representative Joanne (This email address is being protected from spambots. You need JavaScript enabled to view it.).”

Diabetes UK free virtual diabetes related education events

Please find attached a covering letter for people with diabetes and a corresponding list of online/virtual events held Jan-March’21. 

Couple of the later sessions are particularly aimed at people from South Asian communities.

All sessions are free to attend and led by healthcare professionals from across the region.

For more information or to book go to Virtual Events in the South East | Diabetes UK or email This email address is being protected from spambots. You need JavaScript enabled to view it.

pdf Covering letter for virtual series of events (216 KB)

document Virtual Events in the South East Jan - Mar 2021 (22 KB)

Solent - decision to suspend some non-urgent services

We are writing to make you aware that we have had to make the difficult decision to suspend some non-urgent community services. This is in response to the considerable pressure on QA Hospital and our own community inpatient services and PRRT at this critical point in the Covid-19 pandemic.

As the impact of the second wave surpasses that of the first, as in the rest of the NHS, we are all experiencing high levels of staff sickness, self-isolation and demand for services. In response to extreme pressures at QA we have opened additional beds at Jubilee House and have imminent plans to increase the PRRT caseload by 20 patients and open a further 5 beds at Spinnaker Ward. In order to do this safely we need additional staff and we are asking staff from our specialist teams to be redeployed. We know that this will have an impact on waiting lists for these services in the future, but at this point our highest priority has to be doing all we can to support our local services to cope with the clinical demand from Covid-19.

Please see embedded documents for the current list of service changes.

pdf Message to Referrers from Dr Jonathan Lake and Suzannah Rosenberg 210108 FINAL (121 KB)

document MHS Covid response Jan 2021 (157 KB)

spreadsheet Solent Master DOS1 - 8.1.2021 (52 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Pulmonary Rehabilitation - The service will be running only two cohorts of remote pulmonary rehabilitation due to staff redeployment to support inpatient capacity.
• SALT Adult - The service has now reduced to seeing Priority 1 triaged patients only.

Diabetes UK are providing free, online Peer Support Groups.

They start next week and are open to anyone living with type 2 diabetes in the South East. Patients can take part in either a 10am or 7pm session, where topics such as Food, Treatment and Emotional Health will be discussed.    Patients can sign up by following the below links.

10AM: https://tinyurl.com/yxnc7t3e

7PM: https://tinyurl.com/y2q8fvrb

For more info, please contact:   Caroline Walker <This email address is being protected from spambots. You need JavaScript enabled to view it.>

UHS Pathology update

UHS has suffered a breakdown with an equipment which is used to run the blood borne viruses and sexually transmitted infections tests.  This is being dealt with by the supplier but is taking longer than expected, samples were sent to another centre which is also now having issues.  There are engineers on site and the necessary work should be completed and tested today.

Arrangement has been made to use another provider as a temporary measure, but turnaround times for the following tests are likely to be delayed. It is anticipated the current backlog should be cleared within 7 days.

Blood borne viruses viral loads:

• HIV
• Hepatitis C
• Hepatitis B

Sexually transmitted Infections

• CT/NG

Please accept our apologies for the delay and the impact on your patients and sexual health services.

Dermatology Update

As part of the ongoing transformation of Dermatology we are pleased to present to you an updated process for accessing Dermatology services to be in place from 4^th January 2021.

The revised dermatology will be put in place to support the Covid-19 response and to allow primary care to access consultant dermatological opinion in a sustainable way.

A&G has been readily available from Dermatology and we have received very positive feedback about the use of photos. Attaching photographs has allowed the dermatology service to triage advice and guidance or referrals quickly and effectively. As a result the new pathway requires referrers to continue to attach photos to A&G requests and referrals.

In early 2021 we plan to provide all practice sites with equipment to take a dermoscopic image on a mobile phone, in the meantime please continue to submit the best quality images you can using your phone as you do at present.

To help with the change in process we have attached a number of documents:

• The   document updated pathway (75 KB) with guidance on what is needed for either a referral or advice and guidance request
• A   document minimum dataset for lesion referral and rash referral (42 KB)  into dermatology via Advice and Guidance.
• document Guide on how to import photo into S1 (73 KB)
• Guidance from PHU Dermatology team and the British Association of Dermatology guidance on the best way to take a photograph pdf 2020 12 30 DermPhotoGuide (1.61 MB) document 2020 12 30 Guide to Photographing Rashes and Lesions (751 KB)

In addition Dr Zaid Hirmiz has created three videos:

1. A ‘how to’ video for take photos and upload them to A&G requests (April 2020): https://www.youtube.com/watch?v=geJoSRdMRjo&feature=youtu.be.
2. A updated guide on how use A&G within Dermatology to get the best reply: https://youtube.com/video/wIMe473-gwA

3. A guide on how to best use the eRS system to refer a patient into dermatology:https://www.youtube.com/watch?v=SpYMaLhdBRc

We would like to thank you for your support with this change.

Mapping of Consultant Connect and SDEC

Sometimes it is unclear which service to contact when wishing to discuss a patient who needs additional clinical input from the acute specialist service. In order to support those discussions please see embedded summary of the 3 key levels of input for various specialties depending on the urgency that the situation needs (based on a traffic light system)

Green - Advice and Guidance

• To be used in a non-urgent situation, when a GP has exhausted all available primary care management options and wants to seek advice from secondary care on next steps. Available for all specialities.

Amber – Same Day Emergency Care

• To be used for an urgent situation but is NOT an emergency. Available for specialties indicated.

Red – Consultant Connect

• To be used only for an emergency situation about a patient who you would otherwise admit. Available for specialties indicated

Updated advice on supporting people with a learning disability around COVID-19

As we gain further information and experience of COVID-19 we have changed our understanding of the needs of people with a learning disability and how best to support them. The following guidance is intended to support the key issues being experienced currently.

Also attached are two leaflets for further information and sharing.

• As of 23rd November 2020 a weekly testing is now available to carers working in other people’s homes (A testing service for homecare workers in England - GOV.UK (www.gov.uk)

pdf 2020 12 14 Updated advice on supporting people with a learning disability around COVID 17 11 2020 V2 (331 KB)

pdf 2020 12 14 Supporting people with a learning disability around COVID 19 leaflet (6.93 MB)

pdf 2020 12 14 COVID 19 and people with learning disabilities (2) leaflet (1.25 MB)

Advice & Guidance - Reminder

Specialities within Portsmouth Hospitals University Trust are continuing to report huge variability in the quality of how the eRS Advice and Guidance (A&G) tool is being used. There are an increasing number of requests without all the relevant information being included and as a result a number of practices have had their requests for advice returned.

As advice and guidance is a key enabler to our system’s recovery and restoration plans, it is now more important than ever that we ensure A&G is being used in a way that provides maximum benefit to primary care clinicians, secondary care clinicians and most importantly our mutual patients. 

The number of requests for advice from non-GP referrers is increasing, and we would ask practices to ensure there is clear guidance available to all your referring staff on how and when A&G can be used appropriately and safely.

To support our GP and non-GP referring colleagues, we will be holding a number of virtual education sessions around effective use of the service and we would encourage you to support your staff to attend these sessions. Details to follow.

In the meantime, please could you share the following guidance on how to use the service appropriately with anyone who has access to A&G within your practice:

• Referrers must have followed the common conditions pathways before accessing A&G. These are all available via Ardens for multiple specialties.
• Use the text box to include all the relevant information rather than attaching lots of individual documents.
• Tell a clinical story and ask a question. This should include the expectation from the request – clinical advice to be enacted in primary care, accessing a specialist investigation, etc.
• Ensure all primary care management options have been exhausted before accessing consultant advice – this includes discussion with a GP within the practice where the request does not come directly from a GP – and ensure the details of this are included in the “story”.

Any concerns regarding the quality and timeliness of A&G responses, could you raise it via Quasar please. Thank you.

Wessex Rapid Diagnostic Service Launch

As part of the wider roll out of the Rapid Diagnostics service, this will now be opened to your practices from 10am on Monday the 14^th of December.

Please find below links to an information pack for practices and an instruction sheet for making referrals (also available on Ardens)

Please note that there are specific mandatory filter tests which need to be completed with results prior to referral to ensure patients are going down the right pathway, first time. 

We appreciate that in these particularly challenging times there are issues being experienced with turnaround times for some tests; however, we have found this does save time overall for the patient. We are keeping this under review as the pandemic impact further unfolds.

Recognising that everyone in general practice is under even greater pressure than normal with increasing amounts of information being sent in multiple formats, we are keen not to add to that burden. As such, we would welcome any queries direct (contact details below), can respond to individual requests for support or information. 

In addition, would like to invite you to attend future regular ‘Drop In’ MS Teams sessions with our service ( listed below).

This regular session can be accessed by any nurse, practice manager, commissioner or GP from across the Cancer Alliance footprint. We can provide a brief presentation on what we are and what we do, and then give time for questions and queries. There is also an LMC Video here about the service which can be accessed for further information.

Service email: This email address is being protected from spambots. You need JavaScript enabled to view it.    Service telephone number: 0300 1231385

Drop in Sessions are available on the following dates, with sessions hosted on Microsoft Teams through this link Click here to join the meeting:

Dec, Friday 18th, 10.30-11.00am

Dec, Tuesday 22nd, 11.30-12.00pm

Jan, Tuesday 5th, 12.00-12.30pm

Jan, Friday 8th, 10.30-11.00am

Jan, Thursday 14th, 11.30-12.00pm 

document PCCG706 Referring to Wessex Rapid Diagnostic Service Portsmouth (136 KB)

document PCCG705a Rapid Diagnostic Service RDS Referral Form v10 4 (21 KB)

pdf PCCG707 Wessex Rapid Diagnostic Service FAQs for GPs (687 KB)

pdf PCCG708a Wessex Rapid Diagnostic Service Patient Leaflet (440 KB)

Solent NHS Trust Pulmonary Rehab Service- temporary suspension of Face to Face Service provision

While we are in the Covid 19 pandemic, Solent NHS Trust have taken the decision to cease face to face Pulmonary Rehab to protect the high risk group of respiratory patients. To enable the service to continue the Solent team have developed a comprehensive virtual pulmonary rehab package to support the patients on the waiting list.

Please note: If you make a referral for pulmonary rehab during this time the Solent NHS Trust will only be able to accept referrals for Virtual Pulmonary Rehabilitation. All patients referred to the virtual service will receive a comprehensive triage assessment to help them understand the benefits of attending the virtual rehab offer, and provide help with any IT issues and accessibility.

The decision to reinstate the Face to Face service will be reviewed on a monthly basis. Once it is deemed safe to recommence the Face to Face Pulmonary Rehabilitation, the Solent team will prioritise the patients on the current waiting list before accepting new referrals.

  document Updated referral form (165 KB) attached for your information.

Respiratory Consultant Connect – changes to operating hours

Please be advised that to make the rota more robust, the operating hours for Respiratory access via Consultant Connect have been revised and the service is now available from 8am – 5pm, Mon – Fri.

National Diabetes Prevention Programme – new resources

1.   pdf Handbook (3.64 MB) for communicating with black and south Asian communities about Type 2 diabetes: useful insight into the barriers and drivers for engaging this population. The next NDPP Hindi/Urdu session is taking place in Portsmouth on 18/01/2021 at 12:00. 
2. Updated e-leaflets ( reflecting remote delivery) for both pdf patients (741 KB) and pdf health care professional (215 KB)

 

Consultant Connect – Emergency Medicine line ceasing

During the first wave of Covid a consultant connect line was established for emergency medicine within Queen Alexandra Hospital. This was supported by consultants who were shielding at home. These consultants have now returned to work and are also now covering evenings and weekends due to current levels of activity. Following discussions between PHUT, CCG clinical leads and urgent care leads, all parties were in agreement that consultants taking these calls whilst on duty is not clinically safe. As such a decision has been taken to cease the provision of an emergency medicine consultant connect line with immediate effect.

As you will be aware there remain other routes to obtain additional support when discussing a patient including the CAS and GP admission line, together with consultant connect lines for specialties.

Colorectal Service as Practice Plus Group – pathway reminder

The colorectal service offered at St Mary’s is limited to anorectal disorders, and only patients with a negative FIT and normal faecal calprotectin result can be accepted.

Please refer positive results to QAH, where they will be reviewed by gastroenterology/colorectal teams and  investigated by agreed common pathways.

Update re Audiology referrals to PHU and Practice Plus Group

A number of recent audiology referrals to Practice Plus Group (formally Care UK) have had to be rejected due to impacted ear wax.

Removal of ear wax was suspended,  this has now been reinstated under full PPE including face visor procedures.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/910885/COVID-19_Infection_prevention_and_control_guidance_FINAL_PDF_20082020.pdf

It would be really helpful if practices could encourage patients to use pharmacy over the counter treatments prior to their appointment with either Practice Plus of PHU. Also could we please request that practices assess the patient where appropriate and address any issues first, before referring to Audiology Services, in accordance with Nice guidance (2018) especially where over the counter treatments have been unsuccessful and the wax needs to be removed to facilitate examination of the ear. 

spreadsheet Consultant Connect - links to directories - Portsmouth (12 KB)

Please be reminded that Consultant Connect is available to all GPs, should you required an urgent advice from a range of specialties.

In recent weeks, the service expanded to include Palliative Care, to help queries from primary care, particularly focusing on decisions to admit a patient to hospital/hospice or continue/escalate treatment in primary care.

Since the launch Consultant Connect, GPs have enjoyed a 71% call connection rate. The average connection time is 56 seconds and the average call time is 04 minutes 46 seconds.

To see the current list of specialties available, please refer to your service directory which also includes your practice’s unique dial in number.

Please find attached a useful document to support   pdf communications with Black and South Asian communities regarding type 2 diabetes. (3.16 MB)

PARM Diabetes launch webinar is taking place on the 30th November at 6:30 to showcase the tool to HCP’s  who may not yet had the chance to see it.

PARM is a population health management tool which can help to make best use of clinical skill sets across the  type 2 diabetes mellitus (T2DM) caseload and to organise  patient information without any data leaving NHS premises. The tool is provided at no cost to the NHS.

The speakers include:

• Paddy English – Diabetes Consultant in Plymouth
• Nicola Lant – Diabetes Lead Commissioner in NHS Devon CCG
• Emma Broome – Diabetes Specialist Nurse – NHS Kernow CCG
• Mark Oliver – Key Account Manager, Lilly

If you wish to register, please follow the link to the registration form.

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&referrer=&eventid=2711315&sessionid=1&key=D9E84A5C405FD0C764A2FC7463B97F1E&regTag=1638491&sourcepage=register

Continuous Glucose Monitors now available on the NHS for all pregnant women with Type 1 diabetes

Type 1 diabetes increases the risk of adverse outcomes in pregnancy but research has shown that use of a continuous glucose monitor (CGM) throughout pregnancy can help reduce the risks to mother and baby that are associated with Type 1 diabetes and pregnancy.

A CGM consists of a small device that sticks to the skin, which measures glucose levels continuously throughout the day and night. It is connected by Bluetooth to a reading device and shows trends in glucose levels over time. it can alert a patient if their glucose goes too high or too low – the information collected by the CGM is also shared with their maternity and diabetes care team.

By March 2021, all joint maternity and diabetes services are required to identify and offer all women with Type 1 diabetes CGM as part of their care.

Access training resources on how to use CGM at https://abcd.care/dtn/CGM and https://abcd.care/dtn-uk-top-tips.

Please see attached a comms pack to help you share the information about this new offer with your colleagues  and patients. If you have any questions about Flash please email This email address is being protected from spambots. You need JavaScript enabled to view it..

pdf CGM Comms pack 13 11 20 (439 KB)

pdf CGM patient infographic (222 KB)

document CVD prevention guidance for Primary Care (1.21 MB)

Please see embedded documents for details around CVDPREVENT and 2 guidance documents for CVD during the COVID-19 pandemic.

The resources provide practical and pragmatic guidance, examples of good practice, case studies and links to additional resources to support primary care teams in delivering CVD prevention.   

pdf 1. CVD during the COVID 19 pandemic guidance for primary care interactive pdf October 2020 (1.32 MB)

pdf 2. CVD during the COVID 19 pandemic guidance for primary care October 2020 (682 KB)

 

 

Fast Access Chest Pain Clinic - QAH

Portsmouth Hospitals University Trust would like confirm that patients with suspected or confirmed angina are still able to access the Fast Access Chest Pain Clinic during the COVID-19 pandemic including during this second lockdown phase.

Over the past few months the service has seen an increase in the acuity of the patients referred to the service from primary care.

To enable the service to remain as safe and efficient as possible, GPs are reminded of the importance of completing the most up to date clinic pro forma  with all of the requested essential information to allow remote consultations to be offered where possible.

The department appreciates the challenges faced by practitioners in primary care with collecting all of this information if they are assessing patients remotely and are happy to be contacted directly with any queries on 02392 286734 Ext 6734.

Up to date referral forms can be accessed via Ardens.

Routine cardiology services also remain available and GPs are asked to access these services via the usual advice and guidance route for patients not suitable for the Fast Access Chest Pain Clinic.

PHU Pathology Department update

The Pathology laboratories at PHU are now running a near normal service for routine patient appointments, which are offered within 2-3 weeks of the submitted request.

The department would like to remind practices that samples for analysis need to be arranged via the service and not sent in generic pots which they are unable to process. The PHU service supply the correct pots for patients to return.

 

 

spreadsheet Solent Service Master DOS - 2.11.2020 (51 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities:

Health Visiting Service:

Health Visiting Service will continue to deliver virtual 'Bright Beginning' Clinics due to C-19 and until it is safe to consider face to face appointments (Portsmouth and Southampton).

The Mental Health Assessment Centre:

The Mental Health Assessment Centre was relocated from the Turner Centre to St Mary's Hospital.  MHLT have now returned to QAH as demand for the service has increased. MHLT continue to triage referral’s and undertake these remotely wherever possible. In the event that the patient needs to be transported somewhere for assessment, but do not require physical assessment at QAH, they will be transported to St Marys and the face to face assessment will be undertaken by CRHT.  

Children’s Continence Service Portsmouth

The service will be open to receive new referrals from 28th October 2020.

In order to ensure that the referral process remains effective, could you please ensure that clients have received initial advice and support regarding their continence issue prior to making referrals.

The service will continue to use remote technology such as WhatsApp and Visionable and telephone calls to enable them to offer virtual support. Where appropriate, children will be seen within the clinic setting, all whilst following government guidance.

To help to keep everyone safe, could you advise patients that only one parent will be able to accompany their child, and parents and children over 12 will be asked to wear a mask in the clinic. Thank you.

For any further queries, please contact the service directly on: 030012303797

 

Haematology RAS

As of Monday 2nd Nov’20 Haematology service will be changing to RAS for Haematology on e-RS.

This means that your referral can be submitted as normal and the Haematology service will decide on the most appropriate clinical pathway and schedule an appointment if required. 

For any e-Referral service queries contact This email address is being protected from spambots. You need JavaScript enabled to view it. or 023 9268 1712.

 

 

document Neurology Referral Process Update for New referrals and Advice and Guidance (14 KB)

Please see attached document for detailed guidance on how to submit A&G to the Neurology service, new referrals triage, and links to NICE guidance.

Please note:

Advice & Guidance

For patients currently under Neurology:

• A&G to be sent via A&G portal of e-RS (stating the name of a consultant patient is under, to expedite the process).

For new patients currently not under Neurology

• A&G to be sent via Referral portal of e-RS

New Referrals 

All new referrals for appointment request to be sent via current method on e-RS. All new referrals will be triaged

 

 

Endoscopy Pathway - Reminder

Endoscopy Pathway - Reminder

Changes to  endoscopy  access  were implemented during the summer to help  manage  capacity across the system

Since implementation, Practice Plus Group (PPG) has continued to receive urgent OGD referrals that should be being sent to PHU. To support GPs while the pathways were embedded, PPG have been forwarding these to PHU rather than returning them to primary care for the correct pathway to be followed. 

Given this pathway has now been live for a number of months, we have agreed with Practice Plus Group that from Monday 26^th October they can return referrals that do not meet their criteria to practices, asking them to follow the correct pathway. This change will bring the service in line with usual provider practice for managing referrals that do not meet their criteria.

A reminder of the pathway changes are as follows:

image Endoscopy pathway changes (99 KB)

 

 

Self-referrals referral route into NDPP

To support GP practices during the Covid-19 pandemic and to ensure sufficient number of people are accessing the programme, there are now 2 ways of patients being accepted into the National Diabetes Prevention programme:

1. GP Referrals: GPs to continue to refer as before – patients with NDH coding (Hba1c venous bloods taken up to 24 months ago).
2. Self-referrals: Until the end of March’21, the public can use an online tool diabetes.org.uk to calculate their risk of developing Type 2 diabetes.  If risk score is moderate or high, they can refer themselves to local Healthier You NHS Diabetes Prevention Programme for support remotely or online.

FAQ document attached for further information.  pdf Healthier You - Self referral FAQ (679 KB)

For both routes, GP Practices will continue to be informed when patients start the programme.

NDPP is currently being delivered remotely using Zoom technology with availability at various times to suit everyone, or via a digital pathway with an online platform.

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. NDPP Programme Manager if you have any queries.

Palliative Care now available via Consultant Connect

As of Monday 19th October 2020 GPs will be able to access Consultant Connect for urgent palliative care advice.

Continuing the 24hr service provided for the last 20 years; out of hours and weekend cover will be provided by Consultants or senior Specialty Doctors working in the Solent NHS Trust and Rowans Hospice Specialist Palliative Care and Hospice teams.

In hours, please consider whether a patient is already known to your locality Community Specialist Palliative Care team; to contact that team please select the Specialist Palliative Care option.

For patients unknown to community services and seeking advice, hospice admission, Living Well Centre information or Hospice@Home involvement please use the Rowans Hospice option.

For Urgent referrals (admission/support/symptom control) we would encourage calling us first via Consultant Connect, this should lead to a faster response for the patient and less typing for you.

Fingertips demonstration – getting the most out of PHE Fingertips: Tuesday 17 November 14:00-15:00

PHE’s Fingertips is a freely available platform that allows you to gain insight by exploring and visualising a range of indicators related to population health.  Fingertips has over 1500 indicators and can help you to understand how your area compares to national, regional and demographic benchmarks.  

To join the live demonstration of PHE's Fingertips platform, please see embedded document for links and further details.

document Fingertips demonstration webinar on Tue 17.11.20 (13 KB)

 

spreadsheet Solent Service Master DOS1 - 16.10.2020 (51 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities

Adult Mental Health inpatients

From 10/10/20 - Orchards refurbishment to take place - during this time, acute beds will be on Oakdene Ward with additional capacity on the west wing at Maples.

SALT

Referrals to community SLT voice care pathways can continue to be received in the absence of an endoscopic evaluation during the C-19 pandemic.  Applicable to Adults with Voice disorders (Dysphonia) in Portsmouth City, South East Hampshire and Fareham and Gosport

Mental Health Assessment Centre

The Mental Health Assessment Centre is being relocated from the Turner Centre to St Mary's Hospital.  MHLT have now returned to QAH as demand for the service has increased. MHLT will continue to triage referral’s and undertake these remotely wherever possible. In the event that the patient needs to be transported somewhere for assessment, but do not require physical assessment at QAH, they will be transported to St Marys and the face to face assessment will be undertaken by CRHT. 

document PCCG657a Solent Sexual Heath Referral form Jul 2020 (24 KB)

Please be reminded that all referrals to sexual health have been combined into one form. This form is accessible on Ardens comms template. Due to the Covid-19 pandemic, initial contact with the patient will be by telephone. Please supply preferred telephone number.

The embedded form covers referrals to:

• Psychosexual Counselling Service (brief psychological-based sex therapy interventions to help address sexual problems experienced by individuals and couples over 16 years of age.)
• Outreach Nursing service (at risk clients who are unable to attend clinics with a view to facilitating their eventual attendance at clinic.)
• Sexual Health Promotion Team (Provide 1:1 support/motivational interviewing for individuals engaged in risky sexual behaviours and therefore at increased risk of unplanned pregnancy, sexual exploitation or sexually transmitted infections including blood borne viruses. Clients must be prepared to engage with a behaviour change programme.)
• Complex GUM or Sexual and Reproductive Health (For insertion / removal of difficult coils, difficult / deep implant removals, ultrasound for complex contraception, not responding to STI treatment, persistent symptoms, syphilis diagnosis.)
• HIV Services (new HIV diagnosis or transfer of HIV Care into area, HIV care queries)
• Sexual Assault Referral Centre (non-urgent referrals (outside the forensic window))

Further guidance on sexual health referrals also attached.

document PCCG681 Solent Sexual Health Service Info for GPs Jul 2020 (60 KB)

Updated Acute GI pathway

Please see below updated pathways and referral form which has been amended at PHUT`s request.

To summarise, the changes are as follows:

• Amended the Faecal Calprotectin threshold to reflect new  guidance
• GPs are now able to order Faecal Calprotectin test again
•  tTG test added to Iron Deficiency referral form

Please note, that the ordering of  FIT test is now mandatory for all symptomatic patients that present with suspected colorectal cancers to support appropriate referral via 2ww LGI pathway. 

Requesting bloods in anticipation of colonic investigations avoids delays in investigation prep and patient diagnosis.

This approach fits with both the recent guidance around how to manage elective services in response to COVID-19, and our ongoing transformation programme which aims to reduce face to face outpatient appointments in line with the NHS Long Term Plan.

document 2020 10 14 Acute GI referral pathway phase 2 Updated 091020 (105 KB)

document 2020 10 14 Faecal Calprotectin IBS IBD Pathway Updated August 2020 (98 KB)

document 2020 10 14 Portsmouth Iron Deficiency Clinic Referral Form updated 071020 (47 KB)

We will be working closely with primary and secondary care colleagues to support the implementation of these amendments, but if you have any queries, please contact us via This email address is being protected from spambots. You need JavaScript enabled to view it.

NDPP webinar recording

For those, who weren’t able to join the NDPP webinar, please find a recording of the webinar here: https://www.youtube.com/watch?v=bncEFBobuOg

Embedded is the full set of slides used in the webinar for your information. document NDPP What makes a good referral (6.73 MB)

NDPP - bulk referrals - funding available

Practices are being offered a small amount of funding to boost referrals to NDPP (National Diabetes Prevention Programme).

Funding of £170 per practice is being offered for conducting searches for eligible patients in SystmOne, contacting patients via Mjog to obtain consent for referrals, and sending a bulk referral to NDPP.

Please see embedded document for supporting information.   

document NDPP (24m) SystmOne Bulk Referral 091020 Portsmouth v 2 (196 KB)

Could you please confirm, if your practice will / or will not be able to take part in this exercise by emailing to This email address is being protected from spambots. You need JavaScript enabled to view it.

Patient Portal Go Live

On 13th October the Ultrasound department at Portsmouth Hospitals University Trust will be rolling out Patient Portal for all their appointments.  This allows patients to receive their ultrasound scan appointment letters  digitally, straight to their  mobile phone.  Most patient’s mobile numbers are on PHUT PAS system already, but if possible, could you include patient’s mobile number on the ICE request. 

WHAT HAPPENS IF PATIENTS STILL PREFER POSTAL APPOINTMEMTS?

If the link that is sent to the phone is not accessed within 24h, then a postal letter is automatically sent. Patients can also let our reception teams know if they prefer postal appointment letters so they can update your communication preferences

WHAT IF PATIENTS DON’T OWN A SMARTPHONE

Patient will still receive a text with a link to their appointment letter. They can copy this link to a desktop web browser to access the digital appointment letter. If the digital letter is not accessed within 24h, the postal letter is automatically sent.  Patients can also let the reception team know, if they prefer postal appointment letters, so the team can update their communication preferences

Patient leaflet attached for further information and sharing. Patient Portal Digital Letters Poster for Community

CARE UK - Changes to company name and brand identity 

As of October’20, Care UK Health Care, corporately, became Practice Plus Group. In line with the company name and brand identity change, updated referral forms will be available on Ardens.

Locally the name ‘St Mary’s NHS Treatment Centre’ remains but at a service level, St Mary’s NHS Treatment Centre, St Mary’s Urgent Treatment Centre (UTC) and Havant NHS Diagnostic Centre will be known as;

1. Practice Plus Group Surgical Centre - St Mary’s, Portsmouth
2. Practice Plus Group Urgent Treatment Centre - St Mary’s, Portsmouth
3. Practice Plus Group Diagnostics, Havant document DIAGNOSTIC IMAGING REFERRAL Ultrasound 01 10 2020 (37 KB) ;  document DIAGNOSTIC IMAGING REFERRAL Xray 01 10 2020 (26 KB) ;  document Echo Referral 01 10 2020 (35 KB)

Patient Portal Go Live

On 13th October the Ultrasound department at Portsmouth Hospitals University Trust will be rolling out Patient Portal for all their appointments. 

This allows patients to receive their ultrasound scan appointment letters  digitally, straight to their  mobile phone.  If the link that is sent to the phone is not accessed within 24 hours, then a postal letter is automatically sent.

Patients can also let the reception team know, if they prefer postal appointment letters, so the team can update their communication preferences

Patient leaflet attached for further information and sharing. 

document Patient Portal Digital Letters Poster for Community (623 KB)

Diabetic Eye Screening

To encourage attendance of diabetic eye screening appointments, it would be helpful if you could please display the below message on your practice website or a Facebook page. If you could also like and share this Facebook page https://www.facebook.com/desphiow/ it would extremely helpful to promote the page and get the message to our patients. Thank you.

Message text:

The National Diabetic Eye Screening Team have recently issued guidance to restart screening for all in a phased approach. Our Restoration Plan has been agreed with the local NHS England and NHS Improvement Commissioners and we are very pleased and eager to start screening once again.

We will invite people to screening appointments in the following order:

• Invite over next few weeks and months – those who are pregnant, under digital surveillance, newly diagnosed, had background retinopathy at last appointment (R1M0) or Did Not Attend their last appointment.
• Next Year – Those who at their last appointment had no retinopathy or maculopathy (R0M0) are at much lower risk of developing diabetic retinopathy.

Should you notice any severe changes to your sight in the meantime, please telephone your local Hospital Eye Department or A&E.

The Bookings Team will be in touch to rearrange all other appointments once screening resumes. Thank you for your patience.

If you have any questions please do not hesitate to contact us This email address is being protected from spambots. You need JavaScript enabled to view it.

Further supporting info and posters attached.

image PPE and Cleaning Poster v1 (193 KB)

image DES coronavirus information insert June 2020 final (246 KB)

image HIoW Covid Entrance Instruction Poster v1 (274 KB)

image Clean Clinic Room Poster v1 (171 KB)

image 7 Changes to Appointments Poster HIoW v1 (307 KB)

document Primary care briefing NHS 111 Firstv3 (732 KB)

Please see attached embedded briefing presentation on NHS 11 First.

Key points to note:

• Service fully operational from Monday 28th September
• Has been tested since end of June
• Portsmouth an early implementer but requirement for service to be in place nationally by 1st December
• Key focus is to encourage patients to contact 111 ahead of deciding to go to ED. If they need ED a timed slot is available but most cases are assessed by CAS and provided with alternative disposition
• Introduced to manage demand and maintain safe distancing at ED
• From Mon 28th walk-in patients with non-emergency needs will be asked to contact 111 via iPad terminals provided at QAH ED main entrance
• Information enclosed &  available to share with patients

pdf DPP referral webinar poster 29 September (135 KB)

Lunchtime NDPP Webinar hosted by Diabetes UK: 29th September 12.15-13.30 for primary care referrers and those interested to know more about the remote delivery of the NHS Diabetes Prevention Programme.

Please see imbedded poster and link to webpage to register attendance and access the recording.

https://www.diabetes.org.uk/professionals/conferences/all-events/webinar-nhs-prevention-programme

If you have any questions in the meantime, please contact This email address is being protected from spambots. You need JavaScript enabled to view it.

pdf Delivering diabetes foot care during covid 19 restrictions- 24.9.20 (140 KB)

Appropriate care, education and timely referral are essential for people with diabetes foot disease during lockdown and will continue to be afterwards. Please see attached article for further information and helpful links that can be shared with patients.

Simple steps to prevent foot problems and tips for everyday

foot care: https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/taking-care-of-your-feet

How to check their feet thoroughly

https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/serious-foot-problem

Test for sensation

https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/touch-the-toes

Low carbs approach in the management of diabetes

• Following the success of the Low Carb course held in Bournemouth last year, David Cavan is running a new live online version that will take place on Saturday November 28th.
• The course is designed as an introduction to the low carb approach to managing type 2 diabetes for all professionals involved in diabetes care.   In addition to David Cavan the  co-facilitators will include Gayle Gerry (practice nurse) and Tara Kelly (dietitian), who both have extensive experience and expertise in lifestyle management of type 2 diabetes. 
• Using Zoom, the course  will retain the interactive elements by breaking into small groups for case discussions

Further info at www.drdavidcavan.com/for-professionals or via This email address is being protected from spambots. You need JavaScript enabled to view it.

Patients informational video

This 11 min patient centered video explains how Type 2 Diabetes and obesity can be significantly improved with a low carb diet and physical activity, and also how COVID-19 relates to Type 2 Diabetes.

https://vimeo.com/429751553

Please share it with your patient if possible.

document Diabetes UK Peer Support Group - 24.9.20 (51 KB)

An on-line Peer Support group for people with Type 1 Diabetes is starting on October 6th. It will take place on Zoom at 7.00pm for an hour, for 6 weeks and it will be facilitated by Caroline Walker from the team who also has type 1.

To find out more or to take part contact Caroline on:

This email address is being protected from spambots. You need JavaScript enabled to view it.

document Consultation on Local Commissioned Services Document - 24.9.20 (53 KB)

The Council would like to consult with existing provider organisations and request feedback on the current service specifications and processes.  The feedback would inform updated specifications and any required changes to the current processes prior to the tender being published.

We ask that your responses are returned at the earliest opportunity and no later than 5pm on Friday 9th October 2020.  Responses can be submitted either via the correspondence function on In-Tend or as correspondence within PharmOutcomes.

document Fitter forum invite Portsmouth 30th Sept and 14th October - 24.9.20 (35 KB)

Virtual Implant Fitter Forum (for existing fitters)

• Wednesday 30th September 2020 – 2.30pm
• Wednesday 14th October – 2.30pm

These meetings are non-promotional meeting, held for the education and support of Nexplanon fitters inserting and removing implants.

To reserve a place for any of the above sessions, please email, This email address is being protected from spambots. You need JavaScript enabled to view it. the date you would like to attend.

All attendees will receive a Certificate of Attendance which can be included as evidence in their CPD portfolio of one hours LARC training .

Revised National Diabetes Prevention Programme Clinical Reporting on SystmOne

document NDPP (24m) SystmOne User Guide 170920 Portsmouth (103 KB)

The revised Clinical Report identifies patients who may be suitable for referral to NDPP using criteria revised September 2020. The new criteria differ from previous versions in that HbA1c and FPG measurements within the last 24 months are used instead of 12 months previously.

The new report is intended as a temporary solution only - for use until April 2021.

The medical records of patients identified by the report should be checked individually before a referral is made. In particular a patient should not be referred if pregnant - the report does not check for this. There may be other reasons why the clinician will decide not to refer. For example the patient may be too frail or unable to complete or benefit from the programme.

For further information please see embedded document.

spreadsheet Consultant Connect - links to directories - Portsmouth 18.9.20 (12 KB)

We have been made aware that the links and dial in numbers in the previous version of this spreadsheet were broken.

Please accept our apologies and refer to this version instead to see your individual practice dial in number and list of services available to you.

Cambridge Diabetes Education programme

This is just a brief reminder, that we still have FREE licences available for you to register for the online Cambridge Diabetes Education Programme (CDEP).

To gain access to the free licences, you can sign up by following the instructions in the attached flyer and by using the REGISTRATION KEY CODE: HIOWCDEP  

pdf CDEP registration info (462 KB)  ,  pdf CDEP flyer - HIOW (530 KB)

The study programme has 5 levels and is therefore suitable for variety of staff (HCAs, receptionists, students, psychologists, care workers, practice nurses, GPs, paramedics, diabetes link nurses, diabetes podiatrists / midwives / pharmacists……..)

The latest three CDEP's topics explore the latest physical activity guidelines to support healthcare staff empower people at risk of or living with diabetes reap the benefits of being active.

https://mailchi.mp/ccce50f289f1/physical-activity-and-diabetes?e=b839a17831

Consultant Connect – please outcome your calls

To help us determine whether the service being delivered by Consultant Connect is having an impact on avoiding admissions, we would encourage you to record your outcomes after using the service. Additional benefits of leaving an outcome allows you to easily track, and keep a record of, the patient pathway.

If you have called using your dial in number please wait for the consultant to hang up and then stay on the line for a few seconds. You will hear an automated menu of outcome options.  Select the relevant option from the automated menu and hang up.

If you have used the app, finish your call and hang up, a menu with outcome options will appear on the screen, select an outcome from the menu by tapping on it.

As a reminder, the outcomes options are:

1. Referral via Advice and Guidance made
2. Diagnostics Requested
3. Admission Avoided
4. Admission Made
5. Managed in Primary Care

  spreadsheet Solent Service Master DOS -11.9.2020 (51 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities. 

Community Diabetes Team

• Reinstating diabetes service to virtual and physical support for Practice Nurses and Community Nursing as well as the patient education programme DESMOND

Dental

• Resuming dental services for urgent and priority routine care patients at Eastney services and Havant Health Centre
• Restarting Intravenous Sedation for urgent care patients / prioritised patients

Heart Failure and SLT

• Resuming clinics for ASP Heart Failure and Speech & Language Therapy Teams in St Mary’s Health Campus

Home Oxygen

• Fully reinstating the Home Oxygen Team, the Abulatory Oxygen Clinic at St Mary's Hospital to allow face to face assessments and the review of green RAG reviewed patients for all types of oxygen therapy.

MSK

• Reinstating limited face to face appointments

Sexual Health

• Reinstating face to face consultations for the following criteria:
  • Insertion and removal of LARC including implants and coils
  • Provision of routine contraception
  • Treatment for skin conditions including warts, herpes
  • Treatment of STI’s that cannot be managed remotely
  • Provision of vaccinations for all patient groups eligible in sexual health
  • Complex contraception including scan clinics
  • HIV care for routine blood monitoring
  • PreP – to attend face to face when U&Es and urine tests are required

document Solent Sexual Health Service Info for GPs Jul 2020 (60 KB)

Please see attached update guidance on Solent sexual health services:

• GUM and HIV
• Contraception – including emergency contraception (tablets and intrauterine devices )
• Psychosexual counselling
• Vasectomy
• Unplanned pregnancy
• Sexual Assault Referral Centre (Treetops)
• Sexual health promotion
• Outreach

Further details of the services provided can be found on the website https://www.letstalkaboutit.nhs.uk/professionals/

document Diabetes in the Primary Care Network Structure - final Sept 2020 (423 KB)

Please see imbedded document “Diabetes in the Primary Care Network Structure” for information.

There are 5 key priorities which include:

• early referral and intensive treatment for people newly diagnosed with diabetes, 
• addressing long-term disease burden in addition to HbA1c,
• targeting special populations,
• the development of a Diabetes Support Team within the PCN, with appropriate HCP diabetes education
• upskilling to support and ensure high-quality diabetes care. 

document Ingeus NDPP Webinar presentation - Portsmouth (9.26 MB)

Please see embedded presentation from the NDPP Portsmouth Webinar detailing information about the current service provision and the service model.

Please be aware, that the Diabetes Prevention Programme continues to be delivered during COVID-19. Referral form can be accessed on Ardens

Blood Tests at QAH – reminder

We have been made aware that a number of patients are arriving at QAH for a Blood Test without their Request Form,

Please note, that Trust phlebotomy staff are unable to print blood test request forms so patients should be provided with the request from and be advised that they will need to take it with them when attending for their blood test otherwise they will not be able to be seen.

document Updated Ovarian Cancer 2ww pathway (98 KB)

A new 2ww Ovarian Cancer pathway has been developed. It aims to  reduce the time from diagnosis to treatment, and negate the need for patients to attend the hospital for a face to face first 2ww outpatient appointment, and in most cases will allow the patients to go direct to test.

As a result and with immediate effect GPs are asked to submit their referral in the normal manner along with mandatory screening bloods at point of referral, this will help the consultants to prioritise referrals to the most appropriate “Direct to Test” pathway. The tests can be requested at the time of referral, rather than delaying referral until results are received. Where there are capacity constraints in community based Phlebotomy services there is the facility to book the blood tests directly at PHU by calling 023 92 286759  in order to avoid any delays in the pathway.

For more details please see attached updated pathway and more detailed communications.  document Ovarian Cancer 2ww pathway final - 2.9.2020 (82 KB)

spreadsheet Solent Service Master DOS1 - 1.9.2020 (47 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Dental Services - New referrals will be screened via a virtual appointment to ensure they are sent to the right place for the right treatment. Should a referral not be appropriate, the patient will be referred back to the existing referral setting.

document Changes to the Endoscopy Pathway 27.8.2020 (14 KB)

In line with the changes to the endoscopy pathway we advised of earlier this month, the following Care UK clinics will no longer be directly bookable via eRS until further notice:

• Colonoscopy Pre assessment-St Marys Treatment Centre-NTPAD
• Female only-Flexible Sigmoidoscopy- St Marys Treatment Centre-NTPAD
• Male-Flexible Sigmoidoscopy-(Exclusions apply)- St Marys Treatment Centre-NTPAD

The clinics are still available, but slots will be booked following clinical review as per the advice and guidance pathway. A reminder of the pathway changes can be found in the imbedded document.

Consultant Connect Survey

After recent survey feedback we have increased the ring time across all specialties to 45 seconds which will give general practitioners a better chance of getting in touch with a consultant for urgent advice. If you have any other feedback which you would like us to take action on then please fill in the survey which was circulated in your previous update and attached again here for ease. (click here).

Thank you.

Consultant Connect - update

Available specialties (Mon - Fri; 8am - 6pm unless otherwise stated):

1. Cardiology
2. Heart Failure (Mon-Fri; 9am-5pm, Sat; 9am-12pm)
3. Emergency Medicine (Mon-Fri; 8am-10pm)
4. Gastroenterology
5. General Surgery
6. Gynaecology (Mon-Fri; 8am-5pm)
7. Hepatology
8. Medicine for Older People (Mon-Sun; 8am-midnight)
9. Respiratory Medicine (Mon-Fri; 8am-8pm)

Please note the service is for urgent advice when it might impact on the decision to admit a patient or continue/escalate treatment in primary care.

Please continue to use eRS Advice and Guidance for the majority of queries except those where it will likely influence the decision as to whether to admit.

All of the specialties available to you can be found in your service directory and via the Consultant Connect App, which can be downloaded for free from the App Store or Google Play

Consultant Connect - GP Survey

We would greatly appreciate it, if you could fill in our quick GP survey (click here) about your experience of using the Consultant Connect urgent advice service. Any feedback that you provide will be used to develop and enhance the service provided to you.

If you have any questions or require further information, please do not hesitate to contact This email address is being protected from spambots. You need JavaScript enabled to view it.  Tel. 07539976620

PHUT – Integral telephone system upgrade

An essential work is being done on the PHUT telephone exchange on Saturday 22nd August 2020 from 3am until 7am.

There will only be a limited number of lines coming into switchboard and no direct contact with departments/wards.

The Trust is setting up a separate Incident Control Centre (ICC) to manage this planned incident. As the whole internal phone system is being upgraded, no internal communications will be available (mobile phones and radios will be used to mitigate as much as possible). It is expected that switchboard will take the incoming calls and pass any urgent information onto the ICC, who will then cascade out to the relevant department.

 

The PHUT switchboard number is 02392 286000

Phlebotomy Capacity at PHUT for Patients with Suspected Cancer or on the Cancer Pathway

 If your practice is unable to see suspected cancer patients within an appropriate timescale PHUT currently has capacity for phlebotomy tests on the QAH site which you can direct appropriate patients to.

 Patients can directly book by phoning 023 92 286759 and more information can be sourced via https://www.porthosp.nhs.uk/patients_and_visitors/blood-testing.htm

 Please ensure you are only directing suspected cancer or known cancer patients.  Please ensure this message is circulated to all practice GPs and booking staff. 

pdf PHUT Acute Admissions Policy April 2020 (355 KB)

This policy outlines the guiding principles for the appropriate admission of acute patients to the correct clinical team. It also clarifies the admitting team for diagnoses that may create division of opinion between specialties.

This is a PHUT internal document and is being shared for information only.

spreadsheet Solent Service Master DOS1 - 10.8.20 (49 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Sexual Health – new referrals are now being accepted and evening clinics are being introduced across the service (Thursday evenings in Portsmouth )
• Recovery of Sexual Health Promotion service - reinstating community work and supporting at risk groups (1:1 and group) for young people, BAME, LGBT and other vulnerable clients
• Vasectomy Service – new referrals now being accepted

pdf NDPP Webinar leaflet 9. 9.2020 1pm (137 KB)

Are you involved with referring patients to the Diabetes Prevention Programme? Please join this webinar on the 9th September 2020 at 1-1.30pm for the programme update.

To be discussed:

• Who Ingeus are
• How is the programme being delivered during COVID-19
• How to refer into the service
• Portsmouth data including referrals, completed Initial assessments and attendance.
• Q and A

This Webinar is relevant to practice managers, GPs and anyone else responsible for referring into the NDPP.

Please save the embedded meeting invitation in to your calendar and share it with your colleagues. Thank you.

Join Microsoft Teams Meeting

Learn more about Teams | Meeting options

document Endoscopy update (88 KB)

For the past few weeks our local providers have been working together to look at how we can make the best use of our limited endoscopy capacity during the COVID pandemic and as a result and following discussion with PCN leads, the following pathway changes will be implemented with immediate effect:

Colonoscopy - access route - Advice & Guidance - PHUT

Flexible sigmoidoscopy - access route - Advice & Guidance - PHUT

OGD referrals that are chronic uncomplicated relapsing reflux (having failed PPI use) - Access route - Direct Access – ISTC (with recognition that there is reduced capacity due to covid-19 and therefore possible long waits )

OGD referrals that are: urgent or require an opinion or cannot wait for the ISTC planned date or are not simple chronic relapsing PPI resistant reflux  -  access route - Advice & Guidance - PHUT

Please see updated referral form and full update for more details:  document Care UK - Day Surgery Referral ENDOSCOPY amended 29 7 2020 (199 KB)

pdf Appointment of Dr Jim Hogan to Portsmouth Hospitals University Trust as Associate Medical Director (Primary Care) (184 KB)

Please see attached letter to all PSEH GPs re the appointment of Dr Jim Hogan to Portsmouth Hospitals University Trust as Associate Medical Director (Primary Care)

Consultant Connect - urgent queries only (admission avoidance)

The Consultant Connect service is intended for the provision of  timely telephone advice for urgent queries from primary care, especially when it might impact on the decision to admit a patient or continue/escalate treatment in primary care. 

Please continue to use eRS Advice and Guidance for the majority of queries except those where it may influence the decision to admit a patient.

To see the full list of specialties available, please refer to your service directory. If you have any queries then please contact This email address is being protected from spambots. You need JavaScript enabled to view it.

Consultant Connect - Please stay on the line!

We are seeing in the data that GPs are sometimes hanging up the call before being connected to a consultant or before the clinical rota has been exhausted. For all of the specialties there are rotas with multiple consultants available to speak with, if the first consultant on the rota is not available then your call will be redirected to the next consultant on the rota.

The consultants are answering the calls alongside their clinical duties so on some occasions, the rota may be exhausted before you are able to speak with a consultant. If you are not successful with your first call then please do try calling back a few minutes later.

Please note that the current average connection time is 50 seconds and the average connection rate in the past four weeks is 74%.

document Dermatology pathway 16 July 2020 (77 KB)

The following approach has been discussed and agreed:

• To reinstate the eRS booking pathway for 2WW referrals with immediate effect. This is for Melanomas, high risk cancer and SCC where the clinical suspicion is high .  i.e NOT for all skin lesions. 
• To encourage GPs to continue to use Advice & Guidance (with photo attachment where possible) for queries about the management of dermatological conditions and  lesions (AKs, Bowens, BCCs)   
• From the 1stof August, the on call dermatologist for the week will be in responsible for reviewing A&Gs requests but this platform  WILL NOT be checked on a daily basis so 2ww referrals MUST NOT go through this A&G route. 
• The Teledermatology service will remain suspended until further notice.

When making routine referrals, GPs are asked to write the referral text in the "reason for referral box" (rather than to attach a letter). This makes it much easier for triage, avoids duplication , also makes the process easier for the GP.

Full update:  document Dermatology PHT comms (14 KB)

Link to a guide:  pdf DermPhotoGuide (1.61 MB)

Link to a photo guide:  document Photographing Lesion and Rashes patient guide v3 (250 KB)

Consultant Connect Update

With an immediate effect, the gastro and hepatology rotas will now provide backup to each other on Consultant Connect, so that if the whole rota is exhausted in one speciality, it will automatically start calling the other.

This is following feedback from GP’s that they have experienced difficulties in getting through to hepatology.

We hope this will improve the experience, please continue to share your feedback on the service with us by emailing This email address is being protected from spambots. You need JavaScript enabled to view it.

document Hovertravel safe travel charter (15 KB)

The Wessex Cancer Trust is launching a safe travel charter with Hovertravel and a specially designed lanyard, which is free to support cancer patients to build their confidence in accessing treatment. This is being offered to Island patients and then to patients accessing cancer treatments anywhere.

pdf Hovertravel WCT charter July 2020 (322 KB)  &  image Lanyard (2.45 MB)

pdf NHS Diabetes Advice helpline FAQs and materials (186 KB)

NHS England and NHS Improvement have recently launched a new Diabetes Advice helpline to support people living with insulin-treated diabetes during the COVID-19 pandemic. The helpline offers clinical advice for people who cannot access their usual care teams due to local service disruption. 

Please find attached a one page FAQ for local healthcare professionals along with promotional text that local GP practices and diabetes specialist teams can share with potential helpline users; including a template letter/email, text and twitter content. 

 

spreadsheet Solent Service Master DOS1 - 16.7.20 (45 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Child protection medical service
• CAMHS
• Health Visiting service
• MSK services
• Podiatry
• School Nursing service
• Special Dental Care service

spreadsheet Solent Service Master DOS1 - 10.7.2020 (43 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

 Since this information was last circulated, there have been changes to the following services / facilities.

• From 13/07/20 – the plan is to reinstate Dental GA Services at multiple acute sites across Hampshire and the Isle of Wight, with a gradual increase in provision as anaesthetic services become more available at Hampshire Hospital Foundation Trust (HHFT) with sessions at North Hampshire Hospital Basingstoke and Royal Hampshire County Hospital, Winchester, Portsmouth Hospital Trust (PHT) with adult Special Care sessions at Queen Alexandra Hospital, University Hospitals Southampton (UHS) at the General and St Mary’s on the Isle of Wight.

document Consultant Connect Speciality Details & update (16 KB)

Just to remind you that Consultant Connect is still available for urgent advice to support admission avoidance. Specialities covers attached.

Last week Consultant Connect enjoyed a record high call volume since launching in April. 43 calls were placed, out of which 36 were answered resulting in an 84% connection rate, consequently 4 out of the 8 specialities available achieved a 100% connection rate. In addition to this, 28 of the outcomes recorded from these calls resulted in admissions avoided, this is a great example of how Consultant Connect can be utilised as an admission avoidance tool for clinicians.

If you need urgent advice and guidance, we encourage you to access this through the free Consultant Connect App which can be downloaded from the App Store or Google Play. Alternatively, you can call your surgery's Dial-In Number. Your Dial-In Number can be found in your new Service Directory which  was recently emailed to you by Consultant Connect.

If you did not receive your Service Directory or do not know your Dial-In Number, please contact This email address is being protected from spambots. You need JavaScript enabled to view it. 

 

document Cessation of MAR test letter June 2020 (82 KB)

Removal of anti-sperm antibody test

The Andrology service has been advised to remove the anti-sperm antibody or MAR test from the fertility sample testing repertoire. Due to unequivocal positive results being rare and the clinical relevance of the test being doubtful. The attached letter has been sent to service users. 

Andrology service update 

The Andrology service at PHT was suspended at the end of March due to COVID-19 and patients were not being allowed to visit the site. The service was then resumed mid-May. At the moment the service is working through the backlog of referrals, new referrals are being allocated appointments for the beginning of September. Once the backlog is cleared the service is aiming for a 5/6 week turnaround for patients.

In the meantime if you have patients whose partners are nearing the 35 year old threshold can you please ask the patient, once you have made the referral, to phone the clinic who will try their best to accommodate the patient as a matter of urgency.  The telephone number for urgent cases only is 02392 286081. 

spreadsheet Solent Service Master DOS1 (42 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Community Neurological Service
• Diabetes Community Nursing service
• Dental Care

document Consultant Connect - new speciality 19.6.20 (52 KB)

From Monday 22nd June 2020 Cardiology will be available to access via Consultant Connect. A full list of the specialities now available and their access times is attached. A summary as follows:

• Cardiology
• Heart Failure
• Emergency medicine
• Gastroenterology
• Hepatology
• Medicine for Older People
• Respiratory Medicine
• General Surgery

Please see embedded document for further details.

spreadsheet Solent Service Master DOS1 - 19.6.20 (43 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Bladder & Bowel Service
• Havant Health Centre & QA - Dental Respiratory Response team / St. Mary’s
• Pulmonary Rehab team
• SALT Community
• School Nursing

FSRH guide to restoration of Sexual Reproductive Health services during Covid-19. June 2020 

Please see embedded document for details.

NHS Diabetes Prevention Programme Remote Delivery Overview Updated Jun20

Please find attached an updated referral form and remote delivery update.

• Referrals: patients can be referred into the programme using the same referral process, using the updated form.
• Service delivery: patients will be offered a remote service (group sessions) by zoom technology, or a digital pathway via an online platform.
• Temporary change to blood test eligibility criteria: patients can be referred with Non-Diabetic Hyperglycaemia (NDH) ie HbA1c of 42-47mmol/mol (6.0%-6.4%), or; Fasting Plasma Glucose (FPG) of 5.5-6.9mmol/l, recorded within the last 24 months until 1st April 2021, at which point the plan to revert to within 12 month eligibility.

Solent Service Master DOS1 - 12.6.20

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line. Since this information was last circulated, there have been changes to the following services / facilities.

Sexual Health

• Recommencing initial assessment of Psychosexual services via phone and video consultation - during June 20. No new referrals to be accepted during C-19.
• Planned vasectomies for clients already on the waiting list are being re-instated from 22.06.20.
• Starting to bring back some face to face  appointments for warts/skin conditions / LARC / vaccinations - during June 20.

document Changes to Colorectal 2ww referral pathways to support COVID 19 (127 KB)

GPs are asked to order a FIT test for all symptomatic patients that present with suspected colorectal cancers to support appropriate risk stratification of your referral via 2ww LGI pathway.

Please see embedded document for further details, updated referral form and a new pathway.

document Hepatology guidance (349 KB)

Portsmouth Hospitals NHS Trust has produced some algorithms/guidance to support GP decision making when managing the following:

• Abnormal liver function
• Raised serum ferritin
• Gall bladder polyps
• Positive Hep B
• Positive Hep C

The guidance will be available on Ardens and the department have requested this guidance is checked before a request for A&G is made. This is in addition to the Fatty Liver Pathway/Guidance which is already available on Ardens.

document Consultant Connect - new speciality 11.6.20 (52 KB)

As of Friday 12th June 2020 general surgery will be available to access via Consultant Connect.

A full list of the specialities now available and their access times is attached. A summary as follows:

• Cardiology – heart failure only
• Emergency medicine
• Gastroenterology
• Hepatology
• Medicine for Older People
• Respiratory Medicine
• General Surgery

Please see embedded document for further details.

document Message re Sexual and reproductive support for vulnerable individuals Portsmouth (21 KB)

For information about sexual health, including service provision and other relevant guidance and resources, Solent Sexual Health service updated their website  www.letstalkaboutit.nhs.uk   

For further information, please see embedded document that will help to inform conversations that may be had locally about sexual or reproductive health.

document Common Conditions Pathways for Renal Conditions (486 KB)

PHT have developed some common conditions pathways to support GP decision making in the management of patients with the following conditions:

• Chronic Kidney Disease
• Anaemia related to Chronic Kidney Disease
• Acute Kidney Injury
• Diabetics with renal involvement
• Haematuria
• Proteinuria
• Renal cysts
• Resistant hypertension

The department has a robust advice and guidance process in place to support these pathways. The pathways will be available on Ardens. Please see full update for more details.

document PHT Gastroenterology Department Update (12 KB)

Please use A&G prior to referring to gastro The A&G service is manned most days to enable a quick turnaround.

Faecal Immunochemical Testing (FIT) is now available to access in primary care for suitable patients.

If 2ww referral is required, please ensure as much information as possible is included to help the department with triaging. For example – differentiating between high and low dysphagia is very useful to the department.

Please include this information as text, rather than attachments and consider using A&G to discuss the patient ahead of referral if you are unsure.

Requesting FIT at time of 2ww referral is also encouraged.  While these will not exclude patients from the 2ww pathway, it will help gastro triage and prioritise more effectively at a time where investigation capacity is significantly reduced due to covid19.

Ophthalmology Pathways – Advice and Guidance

You will be aware that as of 1st June 2020 access to Ophthalmology Services at PHT is via Referral Assessment Service (RAS) only.

Any queries that you would have previously submitted via A&G should now be submitted via the RAS. To do this you will need to select the relevant sub-speciality on eRS and submit your query which will then be responded to by the consultant.

document Consultant Connect - reminder (52 KB)

We would like to remind you that you now have access to urgent consultant advice via the free consultant connect app. This has been set up to enable rapid discussion with a consultant to avoid emergency admissions and is delivered by PHT consultants from the following specialities:

• Cardiology – heart failure only
• Emergency medicine
• Gastroenterology
• Hepatology
• Medicine for Older People
• Respiratory Medicine

More specialties coming soon..

To access the service, download the free Consultant Connect from the  App Store and Google Play. Alternatively you can access the service by calling your surgery’s dial in number (see attached).

This service is for urgent advice to support admission avoidance only. Please continue to use the Advice and Guidance function via eRS for routine advice.

Please see embedded document for further details

spreadsheet Solent Service Master DOS 5.6.2020 (40 KB)

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Dental Services - Somerstown hub. As from 08/06/20 the plan is to start to carry out some less urgent procedures (routine dental care) for existing special care patients. 

Solent Service Master DOS 28.5.20

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line. Since this information was last circulated, there have been changes to the following services / facilities.

• From 04/06/20 -  there will be a partial recovery of the GA service at Poswillo (QA hospital).  This will allow Solent to carryout urgent dental treatment for clients assessed as requiring urgent dental treatment.  Solent will be delivering one GA session per week as part of their recovery plan

document Full Service RAS Ophthalmology comms May 20 (14 KB)

From 1st June 2020 access to all Ophthalmology Services within Portsmouth Hospitals NHS Trust will be via the RAS function on eRS.

All usual clinics remain accessible however it will not be possible to book patients directly into slots within these clinics; instead one of the following two things will happen:

• The referral will be reviewed and booked into the correct clinic by the ophthalmologist within the Trust or at Care UK if this is more suitable

OR

• The referral will be reviewed and advice will be sent back to the GP to manage without the need for an outpatient appointment. This advice will be sent back via the eRS system and is the GP’s responsibility to review and enact

For further details on clinics see embedded document.

Solent Service Master DOS

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

Since this information was last circulated, there have been changes to the following services / facilities.

• Solent Community Matrons will be piloting the use of the accuRx application to connect patients with primary care through real time video consultations. This will be a 3 month pilot starting mid May 2020

Patient Antenatal Pack

Patient antenatal pack and self-referral - A special thank you to Jooles Allison and Sam King for their hard work in putting together the information in the attached patient antenatal pack.

The pack is designed to provide the patient with information on how they can  now self-refer into maternity service in Portsmouth along with some important antenatal and postnatal information. This document is now available on PIP, and the self-referral form can be accessed through the communications template on Ardens.

Portsmouth CCG Deep Links

Consultant Connect have created a service directory for all listed practices – this is a live service and will update if/when new specialisms become available. This provides  visibility of all specialisms available in the area and the timings of these services. Please see attachment for your unique practice link.

NDPP - blood test criteria changed

Confirmatory venous blood test (FBC or Hba1c) indicating Non Diabetic Hyperglycaemia  will be temporarily increased from 12 months to 24 months.  This change will apply until 1st April 2021, at which point plan to revert to 12 month eligibility.

Diagnostics update

As of Monday 18th May,  Havant NHS  Diagnostics Centre will be reopening and starts accepting referrals for x-Ray, Ultrasound and Echo.

Please note the change in referral process during COVID-19:

• Please do not give the referral form to the patient
• Referral forms to be emailed to CARE UK and once received, CARE UK will contact patient to book an appointment.

Updated referral forms will be available on Ardens as of Monday 18th May.

DIAGNOSTIC IMAGING REFERRAL Xray updated 15 05 2020

DIAGNOSTIC IMAGING REFERRAL Ultrasound updated 15 05 2020

Care UK Echo Referral updated 15 05 20

COVID Contraception Webinar Invite 20th May

This speaker-led webinar “COVID-19 and Contraception” Online Conference, is taking place on 20th May starting at 7.30pm. To book a place please contact: This email address is being protected from spambots. You need JavaScript enabled to view it. 07469402847

Solent Service Master DOS

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services. . Since this information was last circulated, there have been changes to the following services / facilities.

COPD Pulmonary Rehab Portsmouth:

• Referrals are still being accepted and triaged but there is a change in the service model
• myCOPD digital platform is being utilised - all patients (even with Bronchiectasis and ILD who would not normally access this programme) will be screened for exercise suitability, and offered access to the application to support them 

Fast access clinic proforma updated April 2020 version 3

Please be aware the FACP Clinic referral form has been updated.

Changes to note are as follows:

• Updated referral criteria (The clinic is intended for patients with new onset stable, predictable exertional angina.)
• Referrals that fail to meet the referral criteria (not appropriate for this clinic) will be returned to the clinician or redirected to alternative cardiology outpatient services.
• COVID screening question has been added

Mental Wellbeing resources

Updated Mental Health and Wellbeing resource leaflet is now available on Ardens (on Leaflets: Psychosocial template). It includes information on the services listed below as well as details on other services available locally.

• Positive Minds
• Solent Recovery College
• Solent Mind
• PARCS
• Domestic abuse

SC administration by HCSW April 2020

Subcutaneous anticipatory medication administration at home  by Health Care Support Workers (HCSW) policy was developed specifically to support HCSW to provide subcutaneous anticipatory medication at home to patients with palliative care  needs. Please see embedded document for further details.

Consultant Connect Speciality Details

Please be advised that emergency medicine have extended their Consultant Connect hours of availability and are now available from 8 am - 10pm Monday-Friday for emergency advice to support admission avoidance.

A full list of the specialities accessible via Consultant Connect and their hours of availability is also attached.

 

document Portsmouth mental health services update (147 KB)

AMH and OPMH continue to accept new referrals. For urgent advice please call the intensive case management teams:

Adult patients; 0300 123 3921

Older adults; 0300 123 3923 

A2i referrals are being triaged in usual way usually with a remote assessment  but where required a face to face assessment can be arranged

IAPT and secondary care therapy continues with patients being given choice as to whether they start or continue with this remotely or not.

Therapists continue to take on new cases but are prioritising those with suicidal thoughts. 

Please see embedded letter from Dr Kayode Osanaiye , Clinical Director for Portsmouth Mental Health Services.

 

COAST update from Solent

From Monday 4th May, COAST service is available to all children up to 16 years old who present with one of the 6 following HRG’S (Tonsillitis has been added as an additional condition) 

• Bronchiolitis
• Gastroenteritis
• Exacerbation of Asthma
• Viral Wheeze
• Chest infection
• Tonsillitis 

The service is offered as part of the integrated Community Children’s Nursing Service and is open from 10.00 hrs- 20.00 hrs 7 days a week (the last referral must be received by 19.00hrs)

Please see embedded documents for further details.

COAST Referral Form from GP May 2020

Tonsillitis referral pathway under 5yrs

Tonsillitis referral pathway 5 11yrs

Tonsillitis referral pathway 12 17yrs

 

Paediatrics Advice and Guidance Functionality May 2020

Following discussion with GPs, from Monday 11th May Advice and Guidance will become the single method of referral into paediatrics. After this date any referrals to paediatrics which have not initially gone through advice and guidance, will be rejected with the advice to resubmit via advice and guidance.

Following your request for advice you will be asked to do one of the following:

• Continue to manage the patient in primary care with specific paediatric advice
• Send your patient for a diagnostic test
• Refer your patient to the paediatric team within the Trust for further management. The consultant will specify the exact clinic to refer the child to.

Please see embedded document for further details.

 

NEW Children and Families Hub - Now Open

You can contact the Children and Families Hub on 023 9261 6710 (8.30am - 4.30pm weekdays).

• The Hub will help schools and lead professionals meet the needs of vulnerable children and their families.
• Schools (and their Link Co-ordinators), GP's and health colleagues will be able to refer families for additional support where a child has vulnerabilities which cannot be met by the school or lead professional.

 For further details please see embedded document.

 

7 Day Cardiac Event Monitoring service

7 Day Cardiac Event Monitoring service is still being delivered from St. Mary’s Treatment Centre. The event monitor used at St Mary’s is very similar to a Holter monitor and it commonly records a continuous two lead digital recording of your patient’s ECG over a 7 day period.   

• The patient report will be sent directly to the referring GP
• The service is directly bookable via e-RS and can be found under: Portsmouth Community ECG 7 Day Cardiac Monitoring Service Care UK NTPAD
• The current waiting time is around 3 weeks

Precautions have been taken at St Mary’s NHS Treatment Centre to keep patients and staff as safe as possible during this pandemic.

 

document Implementation of FIT in primary care (12 KB)

Faecal immunochemical testing (FIT) is now available to primary care as part of the GI pathway (attached)

• Test kits will arrive at your practice over the coming days.
• The test is available via ICE
• The sampling tube should be labelled with the sticker from the patient’s ICE form.
• Please give the instructions to the patient along with the request form and sampling tube.  It is important to emphasise that patients should only ever unscrew the green end of the tube.
• Patients should bring the sampling device back to the surgery on the same day that they have taken the sample

document 200430 Acute GI referral pathway phase 2 version 4 FINAL (107 KB)

document Instructions for collecting a stool sample using the FOB Gold sampling device (479 KB)

Solent Service Master DOS

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services. .

Since this information was last circulated, there have been changes to the following services / facilities.

• CAMHS (St. James’s) - an interim pathway for the delivery of self-harm assessments has been put in place.
• COAST - Referrals will be received directly from 111 for CYP with suspected or confirmed Covid-19.
• Community Paediatric Medical Services - For new referrals a full assessment will be carried out when children are back in schools to assess functional needs and a report will follow.
• Dental - Somerstown has become a Cold Covid Emergency Dental Care site - weekend working stood up

 

Diagnostic Silver Command update 2

Returned referrals - Those referrals which have already been sent for validation to GPs can now be returned to Care UK and PHT by sending the patient’s NHS number, exam requested and original date of referral to the email addresses in the embedded document. These patients will be reinstated on the waiting list using their original referral date. We would ask referrers to review these referrals to ensure they are still required and are non-urgent. Please bear in mind that these patients may be waiting for an unspecified period of time on the waiting list.

New referrals - if they meet the current urgent CoViD criteria they will be seen as soon as possible. If the referral is in line with clinical pathways for routine referrals, but not the CoViD criteria, the referral will be added to the waiting list.

PCCG074g DIAGNOSTIC IMAGING REFERRAL Xray updated 01 05 20

PCCG240h DIAGNOSTIC IMAGING REFERRAL Ultrasound updated 01 05 20

Please note:

All Care UK x-Ray and Ultrasound Referral forms to be send to: This email address is being protected from spambots. You need JavaScript enabled to view it., once received, CARE UK will contact patient to book an appointment.  (please do not give the referral form to the patient)

 

Consultant Connect

Please note – the service cannot be accessed via switchboard. Please use the number associated to your practice or download the app. Information around how to download the app and a list of specialities that can be accessed is attached.

The service is designed to provide urgent advice to GPs to support admission avoidance. Please continue to use the A&G service via eRS for routine advice and guidance. If the outcome of the advice is to admit the patient, please follow the usual admission process.

If you would like to see additional specialties added to Consultant Connect or have any feedback on the service, please let us know.

For full update and further info please see embedded documents.

document Consultant Connect Speciality Details (12 KB)

document CC GP How to Guide and Practice Number PORTS (27 KB)

pdf GP Start Up Guide PSEH (878 KB)

Who can access Covid 19 testing

Testing is a government arrangement and details about getting tested can be found here:

 https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested#list-of-people-being-tested

 This includes details of who can access testing. This does change regularly but currently includes:

• all those working on the frontline in health and social care (with or without symptoms)
• patients in the NHS and residents in care homes (with or without symptoms)
• all other essential workers with symptoms
• anyone over 65 with symptoms
• anyone who goes into work because they cannot work from home (for example, construction workers) and has symptoms
• anyone who has symptoms and lives with someone who meets any of the above criteria

Please note testing is currently only to test if you currently have the virus and must be taken within 3 days of symptoms developing. 

Self-referrals for both drive through and home swabs can be accessed here:   https://self-referral.test-for-coronavirus.service.gov.uk/”

Solent Service Master DOS updated

Please see attached the latest version of the Solent Directory of Services (DOS) which indicates changes to current services.  This can be searched by service, location and service line.

 Since this information was last circulated, there have been changes to the following services / facilities.

• A change to sexual health PREP trials (numerous locations noted on DoS)
• Withdrawal of the BPAS termination of pregnancy service in Andover (sexual health)

Substance misuse services

• The service is providing telephone assessments and advice. 
• Group work and 1 to 1 support is also being delivered via online media, such as Zoom groups. 
• Substitute prescribing is still available, in most cases the service will be prescribing Espranor (Buprenorphine) via telephone assessments, rather than methadone. 
• For the time being planned detoxes are delayed in line with Public Health England advice.

Drug and alcohol patients can access support by calling the Recovery Hub on 023 9229 4573