Dear Nigel This is very helpful. Thank you Lesley Lesley Williams Assistant Director Primary Care Strategy Londonwide LMCs and Londonwide Enterprise Ltd Tel: 020 7387 2034 ext *221 Direct Dial: 020 3818 6221 Mobile: 07768 109690 Email: [email protected]<mailto:[email protected]> Web: www.lmc.org.uk<http://www.lmc.org.uk/> Twitter: @LondonwideLMCs
From: DE KARE-SILVER, Nigel (GLADSTONE MEDICAL CENTRE) <[email protected]> Sent: 05 December 2022 06:51 To: Lesley Williams <[email protected]> Cc: DE KARE-SILVER, Nigel (GLADSTONE MEDICAL CENTRE) <[email protected]> Subject: RE: ACTION PLS: Clinical review needed of NWL LES specs by Thursday 15/12/22 Hi It is very difficult to go through all the detail and conditions My view is that al;l the snomed coding should be inclusive In consultations it is more important the clinician codes the problem rather than is forced to fret to find the right template or the right code. The principle I believe is the system should support the clinician and not the clinician support the system Similarly each document is massively long and it is impossible to digest all the details LTBI ignores east European countries we have a high prevalence of latent tb from east Europe and the list discriminates again testing here Ring pessary should be sufficient to cover cost of 3 consultations – assessment and recommendations / procedure / post fitting check + 6 monthly replacement AF remuneration for screening feels very low DMARD The document is too long However points above apply. It is not clear if payment is number of phlebotomies per year or patient has been reviewed in most recent quarter. Payment appears to be for phlebotomy and review alone and ignores admin cost by clinician prescriber or admin to check path result are up to date in eligible population This in itself is 10 minutes MH should have remuneration and targets subject to adjustments according to community services ie Westminster 75% more funding than Brenet We need a support tool We have 9KP for diabetes we need 27KP for mental health Systems need updating Payment should not be predicate don all data achieved Data collection codes should be inclusive Phlebotomy remuneration is insulting I understand hospital remuneration was set at £50 - £150??? Wound care remuneration is insulting This can take 30 – 45 minutes in some cases and multiple times per week and month – ECG home visit – will need supply of IT equipment that can take softwares – not all devices can do this and accept manufacturers downloads Home visit – we send for safety HCAs and Nurses out in pairs need higher remuneration When out it takes best part of 1 hour per patient which means increased numbers stacking up in practice for back fill Remuneration needs ot be set at a higher level The equipment is provided but often needs maintenance which is expensive either higher remuneration or maintenance charges need to be paid centrally ABPM remuneration needs to be set higher 20 minute appointment to fix and instruct patient on how to handle equipment Single next day appointment to dismantle and load software GP review – 5 – 10 minutes Best wishes Nigel From: Lesley Williams via Nwl_cd <[email protected]<mailto:[email protected]>> Sent: 02 December 2022 15:15 To: [email protected]<mailto:[email protected]> Cc: ILLIAMS, Lesley (NHS NORTH WEST LONDON CCG) <[email protected]<mailto:[email protected]>> Subject: [Nwl_cd] FW: ACTION PLS: Clinical review needed of NWL LES specs by Thursday 15/12/22 This message originated from outside of NHSmail. Please do not click links or open attachments unless you recognise the sender and know the content is safe. Dear all Please could we have your views on the clinical aspects of these draft specs. by close of play Thursday 15 December. We are still awaiting full financial information, therefore we would be grateful for feedback on the clinical aspects only at this stage please. 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