Portsmouth Hospitals NHS Trust Gastroenterology RAS

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

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

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

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.

Colorectal 2ww Pathway - FIT Testing

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

Low Carbohydrate Management of Type 2 Diabetes to Achieve Remission

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.

READ coding of HOUSEBOUND patients on S1

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

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

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-referral via Advice & Guidance

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 6th 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?

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

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

National Diabetes Prevention Programme update

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

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)

Closure of the Practice Plus Group (PPG) Dermatology Service

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. 

“Shigella trends in England: Free webinar 1-2pm Tuesday 29 June 2021”

Please be advised that HIV Prevention England are running a webinar on Shigella.   documentShigella 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)

Audiology Referrals for Hearing Aid Fitting

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

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.

Solent - Changes to services 17.5.2021

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.

Diabetes Type 2 Prevention - two virtual events

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

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

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.

 

Solent - Changes to services 7.5.2021

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

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 12th May 1-1.45 pm

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

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

 

Insulin Safety Week 17th - 23rd May 2021 - free licences for the online Cambridge Diabetes Education Programme (CDEP)

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

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 20th April at 2.30pm – 4.30pm.

Webinar on Blood Pressure @home: Steps to success -  on Tuesday 20th 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 22nd April at 10-11am

Webinar on CVD Proactive Care Frameworks – Primary Care – on Thursday 22nd 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..

Solent Service changes - update 12.4.2021

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.

Information

This site has been created on behalf of Hampshire and Isle of Wight general practice. It aims to provide a single place to access all the COVID-19 information and guidance needed to ensure safe, effective care for patients whilst ensuring the safety and wellbeing of staff and the resilience of practices.

Contact us

Hampshire, Southampton and Isle of Wight Clinical Commissioning Group

Commissioning House, Fort Southwick, James Callaghan Drive, Fareham, Hampshire, PO17 6AR

Email: hsiccg.communications@nhs.net