This exciting programme is rolling out new ways of working across primary care, Evelina London and Variety Children’s Hospital at King’s College Hospital to look after Children and Young People. 

Since the launch of the programme in May 2016, we have delivered:

• Consultant and GP joint clinics at GP Practices bringing specialist care closer to home: 641 patients seen in the in-reach clinics since March 2016  
• Community clinics run by specialist nurses joining up care for children with asthma and epilepsy
• Home visits by multidisciplinary team joining up physical and mental health for children and families
• Emotional Resilience training to teachers in schools across the two boroughs
• Training for Personal Advisors for Looked After Children working with Local Councils.

As part of the Planned Care Programme, Lambeth, Southwark and Bromley CCGs are piloting a new telephone advice and guidance service called Consultant Connect. The service allows GPs to speak with local specialty consultants at Guy’s and St Thomas’ Trust and King’s College Hospital in real time during Monday to Friday between 9:00-17:00.  Each practice will have received its unique dial-in number to access the service.  If you are not sure what this is, please contact your CCG.

The service can be used for routine advice and guidance which GPs would usually seek via a written request or through the switchboard or bleep system. GPs will be able to use the system to seek help with the treatment of patients who may otherwise be referred for treatment.

The service has been available since Monday 16 October and will initially include the specialties below (further specialties to be added later):

• Neurology
• Gynaecology
• Cardiology
• Diabetes

The patient experience survey published by the Care Quality Commission (CQC) last month found that Guy’s and St Thomas’ is performing as well as other trusts overall. Areas where we are performing particularly well include:

•           Feeling safe in the department

•           Privacy when being examined or treated

•           Staff explaining test results in a clear way

However, areas where performance could be improved include waiting times, emotional support, and communication when leaving the department.

The full results of the survey are available on the Care Quality Commission website.

As we move towards receiving 100% of our GP referrals via e-RS, from 1 December a second tranche of services will accept referrals via e-RS only:

• Endocrinology
• Allergy (adults and paediatrics)
• Rheumatology
• Breast (non 2 week wait)
• Haematology
• Nephrology.

Over the next two months we will be promoting the use of e-RS for these services. From 1 December we will no longer accept GP referrals by email or paper for the above.

We welcome your feedback on our Directory of Services for the above areas.  Please contact Arti Trivedi (e-RS Manager) arti.trivedi@gstt.nhs.uk for issues related to e-RS only. 

All 2 week wait (2ww) referrals must now be sent via e-RS.  Please ensure that you book the appointment in agreement with the patient.  Should the patient wish to book their own appointment (this is not recommended), please explain to the patient how to make the appointment using web or national telephone appointment line (TAL). If the patient is making the appointment, the practice will need to monitor that the appointment has been made and contact the patient if this has not been done.

If there are no slots available to book on e-RS, practices should continue to use e-RS and should ‘defer to provider’ and we will process the referral as we can instantly see patients on our appointment slot issues work list.

To access 2ww services – you need to ensure you select the below:

Select Priority:                  2 Week Wait

Select Specialty:               2WW

Select Clinic Type;            select appropriate 2ww clinic type

Whilst every effort is made to ensure enough capacity is available to see all patients there are occasions when appointment slots are unavailable. In this situation please use the 'defer to provider' functionality with e-RS.  If we are unable to book an appointment via e-RS, then we will need to contact you to request a copy of the referral letter.  All patients with appointment slot issues are managed centrally and should a practice wish to email the referral at the point of deferring the patient to provider they should email it directly to gst-tr.GSTTERS@nhs.net. 

Please ensure that you email the referral letter as well as any supporting information and not just the clinical information summary to avoid any delays.

We have seen a number of patients being incorrectly referred to our “2ww colorectal/ Lower GI telephone clinic (straight to test)” service.  Please read the service criteria under the “Review Referral Criteria” especially the conditions treated and exclusions to avoid referring patients into the wrong service.   

The following patients are not suitable for the Colorectal Telephone Clinic:

• Hard of hearing
• Do not speak English
• Have learning difficulties
• Very frail and elderly
• Has specifically requested a face to face appointment
• Have no telephone.

We are still getting a large number of skin cancer screening patients booked inappropriately into our general dermatology service. For patients who do not meet the 2ww skin criteria for moles, basal cell carcinoma, skin screening etc, please refer to our Skin Cancer Screening service on e-RS.  This can be accessed via:

Specialty:          Dermatology

Clinic Type:       Basal Cell Carcinoma

We also have an alert on the general service (“For routine skin cancer screening use clinic type ‘Basal Cell Carcinoma’ to refer to the correct clinic”) which should help GPs refer to the correct service for these referrals.  Please do not refer into the general service.

Please ensure when referring the patient to a service that you select the most appropriate service for that condition,  eg under “Ophthalmology” our services are set up under specific conditions like cataracts, glaucoma etc, linked to the most appropriate clinic type(s).  The clinic type “not otherwise specified” should only be used when there is not a more appropriate clinic type available.  We only have a small number of ‘general’ appointment slots and the majority of our patients are seen in condition based clinics. 

Please ensure that you read the information on the Directory of Services (DoS) when shortlisting the services.  This will prevent you having to “defer to provider” as we have more capacity available in the other services.

For example out of an audit of 50 “defer to provider” patients for Ophthalmology over 85% were redirected to another service available on e-RS which had appointment slots for patients to book into.

Our assistive communication service supports adults and children with complex physical and/or communication disabilities. We support people who have difficulty communicating verbally, usually as a result of a neurological condition or learning disability. Examples of service users include; people who have motor neurone disease, cerebral palsy and autism.

The service has been commissioned by NHS England to provide a specialised augmentative and alternative communication service in north and south east London. The service provides electronic communication aids with voice output and wheelchair mounting.

How to refer:

If you have a patient who may benefit from an electronic communication aid, please refer to your local speech and language therapy team, (SLT) who will make an initial assessment and then contact the Assistive Communication Service. If there is no local SLT service available please refer directly to the ACS – referral forms are on the web site listed below. To discuss a potential referral or any other queries please do not hesitate to contact: gst-tr.acs-hub@nhs.net or 0203 049 7751.

Visit our website for more information.

The Rapid Access Diagnostic Clinic can now see patients aged 40 years or over if they have significant concerns about non-specific symptoms which raise suspicions but for which there is no appropriate urgent referral pathway.

Please visit the website for details about the referral criteria.

Please complete the referral form and email it to gst-tr.rapidaccessdiagnosticclinic@nhs.net or contact the team on 07393763157. The RADC team is also happy to visit practices to speak about how they may be able to help. If GP practices would like a visit, please contact the team on the telephone numbers or email address provided.

The new national clinical guidelines recommend that patients with transient ischaemic attack (TIA) are seen and managed within 24 hours of referral.

Guy’s and St Thomas' has set up a system that enables patients to be seen every weekday (Mon-Fri) by staff at Guy’s and St Thomas’ and by the Hyperacute Stroke Team at Kings' College Hospital at weekends.

How to refer:

• To discuss the case prior referring contact the TIA Mobile (07825 023845) Mon-Fri from 9am to 5pm.

• Download and use this referral form.

 Please note that the previous risk stratification tool, the ABCD2 score, is no longer used.

Evelina London phlebotomy services for children and young people have moved to a larger, purpose-build space allowing for increased capacity and reduced queues. Service have relocated from the ground floor within Evelina London Children’s Hospital to the ground floor, South Wing of St Thomas’ Hospital, next to the adult blood test centre. The new blood test centre is open for walk-in patients Monday-Friday, 8am-5.30pm.

Directions, opening hours and a map can be found on the Evelina London website.

For any issues about printer misalignment please see the attached document for advice.

For any queries or concerns about Viapath, please contact the customer service team by emailing customersupport@viapath.co.uk or phoning 020 7188 9684.

Lambeth Clinical Commissioning Network is looking to recruit a GP Clinical Lead for Sexual Health on a sessional basis in Lambeth. The successful applicant will provide clinical leadership to the development of sexual health services in Primary Care and other sectors. The successful applicant will work with commissioners and providers to support the development of safe, effective sexual health services, develop guidelines and promote the delivery of services and improved outcomes within primary care.

Please see the attached job description for information about the role. 

The South London Faculty present the South London Annual General Meeting!

This informal, social evening will commence with a drinks reception from 6.30pm followed by a three course meal.

The AGM business and talk will be held during the evening, along with a certificate ceremony for new members, new fellows and prize winners. Our guest speaker this year is Dr Zoe Williams, GP Clinical Champion for Physical Activity and Lifestyle.

The London Headache and Facial Pain Symposium is unique in its comprehensive approach to facial pain. This topic will be addressed by international experts with differing perspectives. These include the general practitioner, the pain specialist, the neurologist, the radiotherapist and the neurosurgeon.

The course will provide delegates with extensive teaching on the diagnosis, pathogenesis and treatment of facial pain and trigeminal neuralgia. On completion attendees will be equipped with the skills required to diagnose and treat patients with facial pain.

For the full programme including speakers and costs please click here.

The title of the next Schwartz centre round is is “Too close to home; the impact of terrorism on staff” and will be taking place on Friday 17 November, in the South Wing Lecture Theatre, Ground Floor, South Wing (between blocks C and D), St Thomas’ Hospital, from 1:30 – 2:30pm.

Lunch will be provided for attendees from 1pm (if you have any particular dietary requirements please email qips@gstt.nhs.uk).

This course focuses on improving the confidence, knowledge and skills of General Practitioners in assessing and diagnosing common musculoskeletal conditions in the primary care setting. This will include common traumatic injuries encountered, both acute and chronic and also common non-trauma related musculoskeletal presentations.

The session will include: normal development of bones, joints & muscles, MSK pain in children, when does normal become abnormal, common scenarios and managing grey cases.

For the full programme click here.

 This accredited RCGP course is commissioned by the South London Faculty RCGP. Run over 2 days, it will familiarise delegates with the MRCGP Clinical Skills Assessment (CSA) module, include methods of preparation and mock CSA cases conducted in small groups with role players.