ENHT: GP Update 88

East and North Hertfordshire NHS Trust sent this bulletin at 05-04-2024 09:00 AM BST

A white banner with blue writing that says GP Update

A picture of Justin Daniels, medical director

Edition 88
5 April 2024

Dear colleague,

It has been really exciting to start seeing the fruits of our partnership with the Virginia Mason Institute as we begin embedding our ENH Production system across the Trust.

Last week the Trust held our first Rapid Improvement Process Workshop, looking at reducing the time taken to recruit and get people “day 1 ready” for work at the Trust. Teams across the Trust took part in the workshop representing all the different systems that can affect the recruitment journey.

The ENH Production system is about gradual sustainable improvement rather than any large, sweeping changes, but we can already see how this can benefit us across all areas of the Trust. We will be involving GPs in projects whenever possible and will let you know when there are opportunities for you to get involved.

Network issues

As many of you are aware the Trust experienced some network issues on the 28 March, affecting several different systems including those between the Trust and GPs. I would like to apologise for any inconvenience this might have caused and thank you for your patience while the issue was resolved. As per our last email on Thursday the system has been thoroughly tested and confirmed to be secure and stable. If you are still experiencing any issues, please let us know us via Gpliaison.enh-tr@nhs.net

Kind regards,

Dr Justin Daniels

Medical Director

justin.daniels@nhs.net

GP Update – contents

Trust news

Temporary closure of Bedford Renal Unit (updated message)
Diabetic Eye Screening Programme (DESP) – new lead provider (repeat message)

GP engagement

Grand Round – GPs welcome
Consultant and GP liaison committee – 19 March
Looking for general information about your patient seen at the Trust?
GPs and Professionals pages

Consultant starters and leavers

Service update/information

Radiology
- iRefer Clinical Decision Support (CDS) - affecting SystmOne
- iRefer contacts - urgent technical issues or feedback
- iRefer supporting videos
- Webpage for GPs and health professionals
- Wait times

Key documents

Key contacts

Trust news

Temporary closure of Bedford Renal Unit (updated message)

As you are aware we have had to temporarily close Bedford Renal Unit until further notice, as we investigate a potential issue with the haemodialysis water. Work has been undertaken to ascertain the cause of the issue and we expect to be able to reopen the unit from 15 April, following thorough testing.

We continue to closely monitor our patients and are pleased to confirm that all patients have continued to receive dialysis, with no cancellations.

A 24-hour help line to provide advice and support has been in operation since the temporary closure and patients can call to discuss any concerns via 07393 142969. Staff monitor the support line 24 hours a day from Monday to Saturday. Patients have also received weekly letters to update them on progress to reopen the unit.

Investigations will continue into actual and potential harm caused to patients due to this incident and full details will be shared with patients and families.

Learning will be shared across the Trust’s renal units, and more widely in the NHS.

Diabetic Eye Screening Programme (DESP) – new lead provider (repeat message)

From 1 April 2024 Hertfordshire Community NHS Trust (HCT) will be the lead provider for the Diabetic Eye Screening Programme (DESP) across Hertfordshire and West Essex (HWE).

HCT already runs the DESP for West Hertfordshire and they will be working with the Trust who will provide clinical leadership and deliver screening at several locations. This will enable HCT to deliver a single, efficient, effective, and standardised service across the whole of HWE.

New contact details for the service come into effect from 1 April 2024

Telephone number: 01442 285854

Email: hct.hwedesp@nhs.uk

For further details about the Diabetic Eye Screening Programme move to HCT, please visit the HCT website

GP engagement

Grand Round

Grand Round takes place in the Lister Education Centre at the Lister Hospital and provides a platform for discussion of clinical and non-clinical topics. All sessions take place 1pm-2pm.

Face-to-face attendance is welcomed but, if you would like to join remotely via Microsoft Teams, please email the team and they will send you a link.

Each session will be sponsored, and our sponsors will provide lunch and refreshments, available from 12.30pm.

The Grand Round Summer programme is now available on our GPs and Professionals webpage.

Consultant and GP Liaison Committee – 19 March

The March committee meeting took place on Tuesday and the following issues were discussed:

Maternity postnatal contraception service
Emergency department discussion – challenges and pathways other than ED
Enhanced Commissioning Framework (ECF) – Pharmacy
Reducing bureaucracy – assessment tool

The new dates and invites for the committee went out in December. If you have not yet received an invite, please email our GP Liaison team.

All meetings take place on MS Teams from 12.30pm-2pm.

28 May

29 July

24 September

26 November

Invite request

If you do not already have an invite and would like to attend, please email our GP Liaison team.

What is the consultant and GP liaison committee?

WhatsApp group

Click here on a mobile device to join the consultant and GP liaison committee WhatsApp group

Looking for general information about your patient seen at the Trust

Shared Care Record and Share for Care give GP surgeries access to general Trust patient information such as upcoming appointments, inpatient and ED discharges summaries, radiology and endoscopy reports, encounters (visits) and pathology.

Hertfordshire and West Essex GP surgeries

Please visit the ICS website for more information about the Shared Care Record including user guides, instructions on how to open the Shared Care Record

Bedfordshire, Luton and Milton Keynes (BLMK) Share for Care

If you would like any more information about Share for Care, please visit the BLMK Health Care Partnership webpage

GPs and Professionals webpage

Please make use of the dedicated GP section of the Trust’s website containing supporting documents and information for GP surgeries. We are working with the specialities to provide more information but please do contact us is there is something you would like to see included by emailing the GP Liaison team.

Consultant starters/leavers

Consultant starters/leavers – February

Starters

Dr Emily-Jane Musgrave, consultant paediatrician
Dr Samina Sheraz, consultant dermatologist (locum)

Leavers

No consultant leavers in March

Service updates/information

Radiology

iRefer Clinical Decision Support (CDS) - affecting SystmOne

We have received reports that iRefer CDS is affecting SystmOne. We would like to reassure you that we are aware of the reports and that the relevant teams, both internally and externally, are working to understand and resolve the issue.

In the meantime, please continue to report any issues or feedback:

For urgent iRefer technical issues

ICE Order Communications Systems Team
01438 284798
9am-5pm, Monday – Friday

To provide feedback on iRefer

Please use the feedback button in iRefer located on the left-hand side of the system, as shown below.

iRefer Supporting videos

6-minute iRefer demonstration video
3-minute iRefer training video - Free text indication when reason for imaging not found through search
2-minute iRefer training video - Reason for indication does not appear on CDS hint list
6-minute iRefer training video with scenarios (no sound)
Scenario 1 - requesting an US Abdomen for Acute Abdomen
Scenario 2 – requesting an X-ray Lumbar Spine for Chronic Lumbar Back Pain (LBP)
Scenario 3 – Requesting an X-ray Chest for a Cough (custom)

Further information about iRefer CDS is available from the Royal College of Radiologists.

P lease visit our radiology page on the GPs and Professionals webpage for more information about iRefer including FAQs

Wait times

	Request to attend (days)			Attend to report (days)
Week ending 24.03.24	2WW	Urgent	Routine	2WW	Urgent	Routine
CT	13	Contrast:81 Non-contrast:111	Contrast:94 Non-contrast:126	8	32	44
DEXA	N/A	141	217	N/A	Same Day	Same Day
MRI	14	181	191	7	15	18
US	11	108	121	Same Day	Same Day	Same Day
X-Ray	N/A	27	31	12	20	37

Radiology colleagues will be provided with the data and can also advise patients of these waits.

Scanner downtime

Wed 27/03 MR2 Engineer 0900-1100 (2 hours downtime)

Sat 30/03 CT Engineer 0900-1400 (5 hours downtime)

Supporting information: Request to attend - 2WW

XR – walk in service at the patient’s convenience therefore data produced N/A
DEXA – not performed as a first line investigation for cancer therefore data produced N/A

Key documents

Please click on the link below (in blue and underlined) to access the related documents

British Medical Ultrasound Society – justification of US requests – This document is intended to support referrers in the appropriate selection of patients for whom US would be beneficial in terms of diagnosis and or disease management
Notifying the Trust of a death in the community
Paediatric guidelines and referral pathways

Key contacts

GPs and Professionals – contacts page

To access contact details please use our key contacts page on the GPs and Professionals webpage

GP switchboard bypass number

01438 759928 (GP surgery use ONLY)
For all GP surgery staff to bypass the main switchboard queue

Alternative pathways other than ED
Speciality	Contact details	Additional information
Acute care GP referral hotline – medical patients only	07500 792616 – Monday-Friday 8.30am – 6pm 01438 759928 – out of hours (ask for medical registrar on bleep 1030)	For all patients requiring same-day general medicine assessment or ambulatory care services and same day emergency care. An urgent and emergency care coordinator will triage patients to identify the most appropriate place for them to be assessed and treated.
Acute care GP referral – general surgery patients only	01438 759928 (ask for surgical SHO on-call)
Frailty hotline	07500 092322 – Monday–Friday, 8.30am–5pm Email interfacegeriatrician.enh-tr@nhs.net	For patients 75 years and over or clinical frailty score of 5 or more – urgent medical assessment within 24–48 hours of referral for patients who have complex needs that are deteriorating, and are at high risk of admission For review in frailty hot clinic within Same Day Emergency Care area, Lister Hospital
Paediatric hotline – GP heralded patients	07500 882733 – Monday-Friday, 12pm-4pm 01438 759928 out of hours (ask for the on-call paediatric) For all URGENT CAU and ED referrals please continue to contact the on-call paediatric registrar through the GP switchboard bypass number (01438 759928). (If you are unable to get hold of the paediatric registrar, please contact the paediatric consultant via the paediatric hotline number above.)	The GP heralded service is to be used for: CAU (Children’s Ambulatory Unit) vs. outpatient appointment referral queries Referrals to rapid access clinic General advice for semi-urgent issues
Orthopaedic trauma (urgent fracture patient referrals only)	07717 301721	GP to call trauma and orthopaedic registrar on-call to discuss the patient’s care needs For acute MSK conditions needing urgent assessment (excluding urgent elective patients) email referral to virtualfracture.enh-tr@nhs.net
Urgent eye clinic	enh-tr.urgenteyereferral@nhs.net	Referrals can be made by GPs or optometrists. For East and North Hertfordshire GPs, the referral form can be found on Ardens under ‘urgent referrals’ Alternatively the urgent eye clinic referral form can be downloaded here

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Trust Headquarters
Lister Hospital, Coreys Mill Lane, Stevenage, SG1 4AB
Website | Email us | 01438 314333

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