We are planning four free evening masterclasses, open to all GPs and practice staff in Bexley, Bromley and Greenwich throughout 2012.

The dates are as follows:

1 February, 25 April, 4 July and 3 October.

There will be more details regarding the February Masterclass in the January 2012 edition of Fusion.

If there are any particular topics you would like us to cover, please email: GPfeedback@oxleas.nhs.uk

Copies of all presentations from previous GP Masterclasses can be located here.

If you have any feedback, comments, suggestions or questions regarding Fusion or any Oxleas services, please email GPfeedback@oxleas.nhs.uk and we will either respond by email or arrange to visit your practice if you have a specific need.

  

Bexley Community Health Services' senior management team has now visited one third of Bexley practices. The visits include providing practice based activity reports and, to date, the meetings have been positive.

Main concerns raised relate to the rise in demand for district nursing services and, through these meetings, GPs have agreed to support service development proposals to our commissioners.  

All district nursing teams and virtual wards are now joining the monthly integrated care planning meetings with every GP practice in Bexley. 

All GP referrals to the district nursing service are now received by the central booking desk. All referrals are responded to within four hours.

All qualified nurses will be trained to improve end of life care by December 2011 and an application to implement the Liverpool Care Pathway across Oxleas has been submitted. In quarter 3, community health services will be reviewing the care of 20 patients who die within the directorates, to provide a baseline for audit following implementation.  

Ten patients from Barnard Medical Practice who have a history of hospital admissions following a UTI are being included in a prevention pilot project. Other practices have expressed an interest in reviewing the findings of this pilot with a view to replicating interventions.  

There are currently over 700 care plans with Bexley schools, in general covering:

• epilepsy
• allergy/anaphylaxis
• ADHD
• diabetes
• sickle cell
• severe asthma

The school health advisors are piloting a booklet within all schools in Bexley. The aim of this is to provide safer care for the child by making information for teachers more accessible and reducing the time taken for each yearly review. 

Currently 47 COPD patients are using Telehealth and a further two are awaiting installation. Each month, on average, the team receive 900 recordings. In September, 28 telephone follow ups and 18 home visits were carried out. Further refinements to the clinical thresholds are planned in order to reduce the number of false positives and to continue to improve the timeliness of the nurses' consultation with the patient.

As a result of increased false positives for temperature readings, Oxleas has introduced tympanic temperature measurements. It is anticipated that this will reduce the alerts significantly. 

A second wound audit for all patients who currently use pressure relieving equipment has been completed. In quarter 3, Oxleas will begin replacing the products used to improve patient care.

A flowchart process has been produced by Tissue Viability Nurse Vikki Rawlins, to ensure that patients who require pressure relieving equipment are placed on the correct mattress and cushion following a waterlow risk assessment. View the flowchart here.

On 3 October 2011, a service improvement affecting inpatient services for people with dementia and older people with other mental illnesses was implemented. Following a consistent fall in occupancy rates, the change involved reducing the overall number of beds for older people across Bexley, Bromley and Greenwich and improving the quality of care on the remaining wards.

 

A specialist dementia centre has been established in the Woodlands mental health unit on the Queen Mary's Hospital site and people from Bexley, Bromley and Greenwich requiring admission for the assessment or treatment of complex dementia will be admitted there.

 

Older people with functional mental health problems or an uncertain diagnosis will be admitted to either Scadbury Ward in Green Parks House (Bromley) or Shepherdleas Ward in Oxleas House (Greenwich) depending on where they live in Bexley.

 

Older people with dementia will be admitted to Leyton Ward (for women) or Camden Ward (for men) in the Woodlands Unit (Bexley).

 

These changes may mean that some carers and families of the patients admitted to Queen Mary's may find the journey to visit more difficult and we are extending the voluntary driver scheme to help ease this. Family and carers are asked to discuss this with ward staff. Voluntary drivers are also assisting with taking people for home visits with the occupational therapist, as well as taking people to outpatient appointments in South London Healthcare NHS Trust.

 

We aim to provide high quality specialist inpatient care, including a full programme of treatments and activities and to return people to the care of community services as soon as possible.

 

All referrals for older people mental health services in Bexley (including memory services) should continue to be made to the Upton Centre, 14 Upton Road, Bexleyheath, DA6 8LQ. To speak to a member of staff about an urgent referral or for advice on patient management telephone 0208 301 7930 or 7900.

 

The changes have been planned with a stakeholder reference group involving local GPs, voluntary groups, LINks and service user/carer governors. A review of the changes will take place in April 2012 and comments can be sent to Estelle Frost, Director of Older Peoples Mental Health Services, Bexleyheath Centre, 4 Emerton Close, Bexleyheath, DA8 8DX or email estelle.frost@oxleas.nhs.uk

 

Following the launch of the National Dementia Strategy in 2009, a review of the capacity of the Memory Service showed that there was a need to increase capacity to enable more people to receive an early diagnosis.

 

With the new staff in place, GPs were invited to attend an event to launch the new service on 7 September 2011.

 

13 GPs attended the evening event, which included presentations on the development of the service to date; a case study demonstrating joint working with the Alzheimer's Society; the proposal to develop a shared care protocol with GPs and the Advanced Dementia Care at Home Project.

 

Commissioner colleagues from the Business Support Unit also attended, and there was time for discussion and questions at the end of the evening.

 

We have improved our referral form based on your comments and the new version will be available in the revamped GP section of our website which launches next month.

 

Oxleas clinicians will be attending the GP Mental Health Education event on 24 November at the Danson Boat House, and will be presenting information on the Memory Service, as well as other mental health problems affecting older people.

 

For further information please contact Anne Waterworth, Service Manager for Community Mental Health Services, Bexleyheath Centre, 4 Emerton Close, Bexleyheath, DA8 8DX or email anne.waterworth@oxleas.nhs.uk

 

A Big Health Check Up event was held in Bexley earlier this year to gather views from people with learning disabilities about NHS services. One of the issues raised was that people were not given enough information about health conditions and procedures in easy-to-read and accessible ways. To overcome this problem, there are resources on Oxleas' website which can be printed out. They include accessible guides to cervical screening, hospital stays and ultrasound scans. They can be found here.

 

There is also guidance on health checks for GPs available as well as accessible appointment letters and easy read health check information here.

Following the integration of Bexley and Greenwich Community Health Services, we are undertaking a programme of work across Oxleas to change how we deliver care. We are doing this to ensure we:

• offer the services that patients and their GPs want
• offer care in or close to people's homes
• make it as easy as possible for people to use our services
• integrate physical and mental health services where possible
• use our resources effectively.