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.