A Yuletide Ode to Noble Healers
In winter’s chill, as frosts adorn the dale,
We raise our hearts to those who guide the way,
Through trials vast, your strength will never pale,
You heal with care and light each weary day.
The year has passed with burdens sorely borne,
Yet still, you stand, unwavering and true,
Through every dawn, through every patient’s mourn,
The spirit of your calling shines anew.
From all at Doncaster LMC, our cheer,
We thank you for the work you’ve always done,
Through starlit nights and days both bright and drear,
You’ve served with grace till each new hope begun.
So, may this Christmas bring you peace and rest,
For you, dear GPs, are Doncaster’s best.
Sharp collections for patients
Sharpsmart Ltd
By phone: 01388 348 007
By email: Doncaster@sharpsmart.co.uk
By post: Unit 1, Enterprise City, Meadowfield Avenue, Spennymoor, DL16 6JF
IMPORTANT UPDATE: TIER 3 WEIGHT MANAGEMENT SERVICE CAPACITY & RIGHT TO CHOOSE
The Doncaster Tier 3 Weight Management Service is unable to meet the demand for injectable weight loss medications. Waiting times for Tier 3 weight management are already considerable – over 18 months for new referrals. The commissioned service is only for patients who are considering bariatric surgery, and it currently does not have the prescribing capacity to provide the injectable weight loss medications that NICE has approved.
For these reasons the Service is not accepting referrals for patients requesting GLP-1 therapy for weight loss. Adult referrals meeting the criteria below should continue to be referred as normal.
We are aware that practices have been contacted by other providers offering Tier 3 Weight Management Services through Right to Choose. Where Right to Choose applies to a provider, patients can be referred to these services, provided they meet the current Doncaster commissioning criteria:
Referral Criteria for Doncaster adult patients
The following acceptance and exclusion criteria apply to patients registered with a general practice in Doncaster.
The Service is available to individuals who:
- Have a BMI over 35 with another health condition that can be improved with weight loss, such as Type 2 Diabetes, sleep apnoea or high blood pressure
- Have a BMI over 40 with no other health conditions
- Are over 18 years old
- Patient is considering bariatric surgery
The following conditions exclude patients from participation program:
- Pregnancy or Breastfeeding
- Uncontrolled Health Conditions: Including uncontrolled hypertension, heart conditions, or any medical condition preventing increased activity levels.
- Severe Mental Health Conditions: Patients with severe, unstable mental health conditions beyond primary care expertise, active eating disorders (e.g., binge eating Severe Mental Health Conditions: Patients with severe, unstable mental health conditions beyond primary care expertise, active eating disorders (e.g., binge eating disorder), recent suicide attempts (within the past year), or mental health concerns that would prevent engagement in a behavioural change program.
For patients who meet these eligibility requirements, if a referrer deems a referral clinically appropriate, referrals to providers offering a Tier 3 Weight Management Service can be made via the Right to Choose framework. We remind practices that the providers currently offering services under Right to Choose are offering a digital only model. When considering whether a referral is appropriate, please ensure that patients understand the commitment required for participation and are able to engage with the digital only programme.
If a patient does not meet these eligibility requirements then they can not be referred under Right to Choose.
The ICB is also working with the local Service on an appropriate recovery plan to reduce waiting times for patients, implement prescribing locally and consider the future development of the service. Further updates will follow.
National Breastfeeding Helpline
The National Breastfeeding Helpline provides free evidence-based non-judgemental, friendly breastfeeding support for all. The service can be accessed via the phone, messenger or webchat. It has been running for a number of years but it has recently had government funding to make the helpline 24/7.
NBH will continue to run 24/7 throughout the festive season.
The breastfeeding network also run a Drugs in Breastmilk Service (DiBM) which provides information for mothers, families and healthcare professionals on the relative risks of medications taken by breastfeeding mothers. Health professionals regularly use this service so you may have already used it
If you require any further information please contact :
Karen Mosley
North Outreach & Development Officer
Email: karen.mosley@breastfeedingnetwork.org.uk
Mobile: 07494 161067
Audiology Update
This message follows-up on the information given on 7th October, sent by Dr Mallaband, Acting Executive Medical Director at Doncaster and Bassetlaw Teaching Hospitals (DBTH), regarding temporary changes to both Children’s and Adult Audiology services provided by the Trust.
DBTH are temporarily limiting some diagnostic activities and hearing aid services for both adults and children as part of a broader improvement plan. In consultation with partners, this decision was not taken lightly and a huge amount of work has already taken place in the short period since to help meet the goal of standing services back up in the new year. The Trust are triaging all new referrals and for urgent cases seeking mutual aid across other providers, so please could we ask that you continue to refer in the usual way. We have attached a draft (nearly finalised) version of DBTH proposed triage/prioritisation criteria.
Certain essential services such as hearing aid repairs, tinnitus clinics, and certain diagnostic tests like Auditory Brainstem Response have continued to be provided as normal.
As you would expect, the postponement of planned appointments or lengthening of waits for patients already on a waiting list is a big concern to patients and their families.
The Trust apologises in advance for any patient contacting GP practices directly for something that is outside your control and from this. Options are being urgently explored and we will let you know if there are any changes to the process.
As per the previous email, if you are concerned about the patient’s condition after seeing or speaking to them, please liaise directly with the Audiology service for escalation and to discuss appropriate next steps.
- Adult Audiology: 01302644950and hearing.rehab@nhs.net
- Children’s Audiology: 01302642763and childrens.audiology@nhs.net
If you want to discuss concerns relating to this process or other impacts from the temporary limitations then you can email syicb-doncaster.primarycare@nhs.net at the ICB and we will collate and escalate any concerns.
Please also find below details of how the service is prioritising new referrals and the existing waiting list at this difficult time which the ICB and DBTH thought would be helpful to share with General Practice.
AUDIOLOGY CLINICAL PRIORITISATION: ADULTS
NEW REFERRALS
Accept:
Urgent – Terminal illness (End of Life care) / Visual Impairment.
Routine – all other referrals
Priority 1 (P1) – Timeframe within 2 weeks
- Hearing assessment in cases of confirmed or strongly suspected bacterial meningitis or sepsis
- Jaundice near or above the exchange line
- Hearing assessment in adults about to undertake chemotherapy or for monitoring following administration of ototoxic drugs
- Patient with hearing aids that are new to area, where the patient’s hearing aids are documented to be lost or broken beyond use
- Other indication noted in the referral that the triaging clinician determines as urgent based on their clinical judgement of the referral information (e.g. Rampton Hospital caseload with significant hearing loss.)
Priority 2 (P2) – Timeframe within 4 weeks
- New hearing assessment of an adult with significant visual impairment
- Significant bilateral hearing loss identified at previous appointment elsewhere, defined as average of 40dB or greater in the better hearing ear
- Previous test results suggest SNHL that needs to be confirmed before a management decision can be made
- Patients with memory issues or processing issues e.g. learning difficulties and dementia
REVIEW / REPAIRS
P1
Both aids broken / lost – unable to work
Both aids broken / lost – unable to hear (moderate or worse hearing loss)
Both aids broken / lost – distressing tinnitus
Both aids broken / lost – dementia / sight loss
Both aids broken / lost – Terminal illness
One aid broken/ lost – other ear unaided (profound)
REVIEW / REPAIRS
P2
One aid broken / lost – unable to work
One aid broken / lost – distressing tinnitus
One aid broken / lost – dementia / sight loss
AUDIOLOGY CLINICAL PRIORITISATION: CHILDREN
NEW REFERRALS
Priority 1 (P1) – Timeframe within 2 weeks
- Hearing assessment in cases of confirmed or strongly suspected bacterial meningitis, sepsis or congenital CMV
- Hearing assessment following head injury
- Jaundice near or above the exchange line
- Hearing assessment in children about to undertake chemotherapy or for monitoring following administration of ototoxic drugs
- Diagnosis of Permanent Childhood Hearing Impairment (PCHI) requiring intervention
- Tinnitus/hyperacusis whereby the patient is reported to be at risk of self-harm due to distress
- Patient with hearing aids that are new to area, where the patient’s hearing aids are documented to be lost or broken beyond use
- Other indication noted in the referral that the triaging clinician determines as urgent based on their clinical judgement of the referral information
Priority 2 (P2) – Timeframe within 4 weeks
- New hearing assessment of a child with significant visual impairment
- Significant bilateral hearing loss identified at previous appointment elsewhere, defined as average of 40dB or greater in the better hearing ear
- Previous test results suggest SNHL that needs to be confirmed before a management decision can be made
- Review of a child where no results were obtained at a previous appointment, or where limited results were obtained which suggest a possible hearing loss
- New referral of a child who has not had a new-born hearing screen – this could be because the hearing screen was missed, declined or they were not born in England.
REVIEW / REPAIRS
P1
Both aids broken / lost – unable to hear (moderate or worse hearing loss)
Both aids broken / lost – distressing tinnitus
Both aids broken / lost – sight loss
Both aids broken / lost – Terminal illness / syndrome
One aid broken/ lost – other ear unaided (profound)
REVIEW / REPAIRS
P2
One aid broken / lost – distressing tinnitus
One aid broken / lost – sight loss
Huntington’s Disease Webinar
As Huntington’s disease is a relatively rare condition many GPs may not have come across a family where there is Huntington’s before, so when they do it can present many challenges. As Huntington’s disease is progressive, patients’ needs change over time and can be complex due to not only the impact of physical symptoms but those of a cognitive and psychiatric nature. As it is a genetic condition family members may also approach their GP with questions about testing to see if they carry the gene or about having children.
To try to support GPs in providing good care the Huntington’s Disease Association is organising a short lunchtime webinar at 1pm on 24 January 2025. It is free to attend and a certificate of attendance will be available.
Huntington’s disease – a webinar for GPs
Speakers will be:
Dr Nayana Lahiri, Consultant Clinical Geneticist, St Georges University Hospital, will take us through how to support Huntington’s disease family members around questions of genetic testing and having children.
Dr Marianne Novak, Consultant Neurologist, St Georges University Hospital, will talk us through supporting your Huntington’s disease patient to manage their symptoms.
The link for more information and to register is below:
https://www.hda.org.uk/events/supporting-people-in-huntingtons-disease-families-a-webinar-for-gps/
Switchboard
Switchboard is the national LGBTQIA+ support line. For 50 years, their volunteers, who all identify as LGBTQIA+, have been available to discuss anything related to sexuality and gender identity; whether it’s sexual health, relationships or just the way someone is feeling. Switchboard’s support line is completely free, and available on the phone, via chat or email. 10am-10pm every single day.
Phone: 0800 0119 100 Chat: www.switchboard.lgbt Email: hello@switchboard.lgbt
LMC Buying Group
Doncaster LMC is been a member of the LMC Buying Groups Federation. This means that practices can access the discounts the Buying Group has negotiated on a wide range of products and services. If you’re not sure what the Buying Group is all about then this short video explains what they do: https://www.youtube.com/watch?v=FekMwFI5ILg.
By registering with the Buying Group: www.lmcbuyinggroups.co.uk/members/, you can view all the suppliers’ pricing, contact details and request quotes. The Buying Group also offers any member practice a free cost analysis which demonstrates how much money your practice could save just by swapping to buying group suppliers. Tel: 0115 979 6910 Email: info@lmcbuyinggroups.co.uk Website: www.lmcbuyinggroups.co.uk
