“Commissioning for the Community”
Hunts Area Office California Road Huntingdon PE29 1BN
Telephone: 01480 354362 Fax 01480 354369
Chair‟s Report – Andrew Wright .............................................................................................2
Update from meetings – Richard Smith ..................................................................................2
Update on Community Sustainable Health Services Project - Paula Newton & Gill Scott ......3
Cardiology Update - Dr Malav Bhimpuria................................................................................3
Diabetes Update - Arun Aggarwal, Clinical Lead ....................................................................4
ENT & Audiology Update - John Richmond, Clinical Lead......................................................5
Gynaecology Update - Rita Aggarwal, Clinical Lead ..............................................................6
Respiratory Medicine and Follow Ups Update - David Roberts, Clinical Lead ........................6
Mental Health Update - Emma Tiffin, Clinical Lead ................................................................6
Patient Involvement Update - Alan Morris...............................................................................9
Neurology Update - Abby Richardson - Clinical Lead .............................................................9
LINK (LOCAL INVOLVEMENT NETWORK) – Nick Roberts ................................................ 10
Physiotherapy – Sarah Saul ................................................................................................. 10
Practice Manager Update - Moira Cernik .............................................................................. 11
COMMUNICATION ............................................................................................................... 11
Future PBC Practice Afternoons ........................................................................................... 11
Hunts Area Office Update - Liz Sargeant .............................................................................. 12
Website Updates – Leanne Hurren ....................................................................................... 12
Newsletter ............................................................................................................................. 13
Dr Andrew Wright (Chair) Dr David Roberts (Vice-Chair) Mrs Moira Cernik
Mr Alan Morris Dr Paula Newton Dr Richard Smith Mrs Gill Scott
N E W S L E T T E R - SEPTEMBER 2 0 0 9
Chair’s Report – Andrew Wright
As you are probably aware Gene Dunbar has been away from work with a long term illness. I would like to wish him
well in his recovery and treatment. I would like to thank Mustafa Malik for all his work in covering over the past 3
months in Gene‟s absence. I would also like to welcome Liz Sargeant, who will be covering Gene‟s role over the
next few months into the New Year.
I wrote to Practiced in July regarding concerns about the reimbursement of Alan Morris, as the HuntsComm
Independent Lay Representative. I am pleased to be able to report that following meetings with senior member of
NHS Cambridgeshire, agreement has been reached with the PCT for Alan‟s reimbursement to continue. The PCT
have acknowledged that HuntsComm is an independent entity and, as such, not a sub-group of the PCT. It has been
agreed that HuntsComm have a right to spend its Management Allowance in a way that is sees fit. The annual
Accountability Agreement between the PCT and HuntsComm will ensure that the PCT is able to satisfy itself that
appropriate use has been made of tax payer‟s money. HuntsComm have agreed that there will be clear and
transparent processes for the appointment of Committee members. Each committee member will have a job
description setting out the requirements and expectations of their job, and there will be a regular review of the
performance of each committee member. The HuntsComm constitution will continue to be reviewed on an annual
basis, with appropriate input from NHS Cambridgeshire.
Gill Scott‟s 3 year term on HuntsComm comes to an end this year. There will therefore be a process for the
appointment of a new nurse representative on HuntsComm. This will be communicated in due course.
The PCT finally sent the PBC budgets for 2009/10 to Practices in mid August. HuntsComm have reservations about
the pace of change of budgets towards fair share and the PCT‟s deviation from national guidance on budget setting
and have expressed this to the PCT. We have also asked the PCT to ensure that there is sufficient support available
for those Practices whose budgets have been significantly reduced.
The Refresh of Hinchingbrooke Option 2 is now complete. HuntsComm will continue to be closely involved in the
Programme of projects that is set up as a result of this review and there will be further information for practices in the
The process of choosing a provider to run an Operational Franchise at Hinchingbrooke Hospital has started and is
being run by the Strategic Health Authority. I am representing HuntsComm at the Stakeholders Meetings , and I
would welcome any feedback from Practices to help inform the Strategic Health Authority in the process.
NHS Cambridgeshire are in the process of reviewing their Five Year Strategy, in light of the in evitable financial
difficulties in the coming years. This will be a difficult time for the whole Health Economy and no doubt we will be
hearing more about this in due course. Richard Smith attended some of the initial meetings over the summer, these
meetings are summarised below.
I would like to thank all those who have contributed to the newsletter and all those at the Hunts Area Office for
putting it together. It is always difficult to balance the amount of information that is provided, but hope that the current
format will give sufficient information and allow you to choose areas of interest from the contents page.
Update from meetings – Richard Smith
Practice Based Commissioning Making it Happen:
On the 4 June I attended a seminar about practice based commissioning to try to get some new ideas about how to
take Practice based commissioning forward in Hunts. HuntsComm got a mention in a talk from Nick Goodwin from
the Kings Fund as an example of how things can work as a large consortium. The main messages seem to be that
practice based commissioning is here to stay whichever party is in government. We need to be proactive to move
things forward and to make savings, you have to decommission services as you develop the new ones.
In June and July I represented HuntsComm at the Storm Scenario Simulation.
We had a day and a half of meetings involving wide ranging groups of people involved in healthcare locally,
including PCT, PEC primary care, acute providers, private providers and patient representatives. We were tasked
with thinking about how the local health economy could be affected by the economic downturn. The general feeling
is that health budgets are likely to have smaller increases over the next spending review while the government claws
back the money it has pumped into the economy, which could amount to as much as 15% reduction in real terms
over 3-5 years. This at a time when the wider economy may well be growing again. There was a feeling that all
areas of healthcare may need to make savings including primary care and of course our role as practice based
commissioners makes us critical to the whole process.
This was a simulation, but it was felt by some that general practices would have to pool together in federated models
to pool resources and make economies of scale, and we may need to take on real budgets, with all the risks that
entails, to allow us to really make savings.
Interesting food for thought for the future!
Update on Community Sustainable Health Services Project - Paula Newton & Gill Scott
Paula and Gill continue to strive to keep abreast of developments in the community. The main focus over the
summer months has been the future of Hinchingbrooke Hospital. After many months of meetings with secondary
care colleagues and Cambridge Community services, we are hoping to invest in a community geriatrician as part of
the £2.2 million investment. This model of care is working well in Cambridge providing high quality care in the
community for vulnerable elderly patients, reducing unnecessary admissions and lengths of stay, and supporting
community based teams in primary care. We are liaising on this and the other evolving projects with Mustafa
Malik who is working with our Hunts office colleagues during Gene Dunbar's absence.
During the summer Gill has collated relevant information on the HuntsComm website about the work going into
equity of standards and delivery which apply to End of Life care for all patients in Cambridgeshire. With the help
of Leanne in the Hunts office, she has added web links to help you access the latest news, local hospice information,
including their admission forms. All three local hospices (St Johns at Moggerhanger, Arthur Rank in Cambridge and
Thorpe Hall at Peterborough) require pre-admission information - they need you to phone them - together with
relevant faxed medical letters so that they can make informed decisions about patients' needs.
One important aspect of End of Life care which affects all patients who are put on the Liverpool Care of the Dying
Pathway (LCP) is the need for a team strategy. The multi-disciplinary approach you use at your Gold
Standard/Vulnerable Patient/Palliative Care meetings in your practices is the ideal forum to begin this process. This
should include discussions between the relevant GP and the patients' families. Gill and her specialist nursing
colleagues will be giving all GPs the information they need for this. District Nursing teams in Huntingdon and St
Neots have all had training on the use of the LCP.
Gill attends the monthly meetings as the HuntsComm representative on your behalf and is keen to have your input
on the above. Our aim is to help you get hold of the right information at the right time. Please go to the website and
check it out. If you have any suggestions, amendments or queries please contact Gill on email@example.com or
Paula on firstname.lastname@example.org."
Cardiology Update - Dr Malav Bhimpuria
Work on the cardiology front has continued apace in the last couple of months and I shall highlight some of the
significant developments so far and also outline some areas where I shall now concentrate on in the future.
Clinical Governance Afternoon:
I very much hope everyone enjoyed the afternoon which we put together at Wood Green Animal Shelter in June,
which focused on cardiology and stroke matters. It was really heart-warming to see such a huge turnout and a real
privilege to have such distinguished speakers, who provided a useful, informative (and, at times, amusing!) set of
presentations. If anyone has any suggestions for future afternoons on cardiology and stroke themes then please let
This field of work has been quite engrossing of late but ultimately rewarding. The Cambridgeshire Heart and Stroke
Network launched the BNP pilot on 17 August 2009 for patients with suspected heart failure. To reiterate, the
funding for the pilot is from the “network” hence will not affect individual practice‟s budgets but we hope to use the
pilot to establish reference values and cut offs so we can in the future use BNP more productively as a rule-out test
for heart failure. This should then ultimately cut down on the number of echocardiograms.
I have received a lot of feedback on this so far (some of it even positive!) and do welcome further comments to
improve the service delivery.
NHS Health Checks:
I have been campaigning for a stronger role for primary care in the proposed new NHS health checks which the
Government is introducing. My philosophy behind this is that a strong voice for primary care, with our unique
knowledge of the patients, their families and our excellent data bases is the BEST way to deliver this service.
I have represented HuntsComm at various meetings and put forward this philosophy and highlighted several flaws in
the current proposals.
I shall attend a national conference on this next month and shall of course represent HuntsComm views at the bi-
monthly LIT and Steering Group Meetings.
I hope to mention more on this in the next newsletter.
My bedtime reading of late has been the “Edinburgh Heart Manual”. Although not on a par with a Danielle Steele
novel (not that I would know!), I have been reading this with a view to helping change the current cardiac rehab
pathway, in order to make it more accessible and cost-effective. This is more of a long-term goal after the NHS
Papworth in Practice Newsletter:
Some of you may have had the great pleasure of reading the latest edition of this newsletter with a riveting article by
yours truly. Dr Clarke had asked me to make the first contribution to this new column, which I hope will also be
another useful source of information for everyone.
Diabetes Update - Arun Aggarwal, Clinical Lead
The summer period has meant a relatively low level of activity and developments. Readers are reminded to look
back at the June Newsletter for the very many developments that had taken place in the spring. Specific items to
note now include:
Professional development, - please make sure you are on target for reaching 8 hours educational time
before April 2010.
Consultant Meetings – very few practices have formally arranged their multidisciplinary team meeting with
either Dr Mathews or Dr Krishnan. Please contact 01480 442841 or 442882 to arrange a date. The
quarterly meetings with the DSNs will be subject to some pressure following Inge Heisig‟s move to the
hospital and a current recruitment for a replacement DSN. Nevertheless, please do try to arrange a meeting
– you will find it very helpful for the more challenging new QOF HbA1 targets as well as educationally.
EASIPOD – I hope that you are using the templates and able to report on your progress as well as
proactively dealing with this area in potentially fertile diabetic patients.
DESMOND education in type 2 – please use your templates to record your referrals and subsequent
attendances or non-attendance or refusal. Some practices are also actively recruiting patients into the large
research trial of DESMOND education. Please keep up the good work.
Patient held records and self management plans – the diabetes handbook is nearly at the printers and you
should all have supplies before Christmas. Diabetes Manager software from Julian Brown has continued to
evolve over recent months and now has a one step Cambridgeshire upload facility which recognises that in
Cambridgeshire we have been using some different codes for many years. This should solve some of the
problems that practices were noting where they had good performance but this was not showing on
Diabetes Manager. Any practice that is still running into problems should be able to solve them by a new
manual method which should only take seconds to minutes to do for any particular category of data. Details
are available on request from Julian Brown or Arun Aggarwal.
Blood pressure management – we hope that practices have had a chance to study the appendix to the LES
which was released a little late but is very detailed indeed. The key issues are to explore concordance first,
then to up titrate existing drugs and only then to add additional drugs. (See HuntsComm website or Cambs
The joint prescribing group for Cambridgeshire are exploring the proper place for gliptins as well as the future
approach to exenatide. In the meantime they remain red listed. We will let you know as soon as there is any
There was a very good turn out for the meeting on Saturday 19 September. We might try and run another
development day in the Spring.
Joint Working with Other Networks:
The Cambridgeshire Networks have reviewed their working arrangements. For the foreseeable future we envisage
County wide meetings 3 times a year rotating to each locality (Cambridge, Hunts, Fens) with additional meetings 3
times a year for each locality separately. This should allow local issues to be dealt with as well as larger issues to
be dealt with equitably. Please let me know if you have concerns that need raising at any network meeting.
We are exploring IT linkages to have proper integrated care and some sharing of records across hospital,
community nurses and practices. Watch this space! We are exploring Systm1 based links, but also considering
EMIS Web based links.
Skills Update Questionnaire:
Every practice should have received this questionnaire from Roisin Wright in the last 6 weeks. It would be very
helpful if these could be filled in and returned as soon as possible. Please note that these are not just targeted at
the GP and Practice Nurse lead for diabetes in your teams but also for all other clinicians who may have to do some
hands on work with diabetic patients. Please let Roisin have them back as soon as possible so that we can get on
with analysing them and developing appropriate training programmes.
ENT & Audiology Update - John Richmond, Clinical Lead
Due to sickness absence, holidays over the summer months and changing priorities due to the flu pandemic things
have been fairly static within these specialities and there are not really any new developments to report since the last
A planning meeting was attended by Wendy Raper, Ian Sweetnam, Tanya Davies and I in early June. There were
still unresolved issues discussed regarding an ENT nurse and things have not moved further forward.
I was hopeful that some progress would be made with the possibility of developing a community audiology service. A
recent article in Practical Commissioning magazine reported the benefits and potential low costs of running such a
service. It would require a practice to build a business case around this and so far there has not been any business
case likely to be approved. Dr Sweetnam was looking at this as a potential option but for the reasons mentioned
above and other reasons this hasn‟t moved forward.
Community ENT clinics do continue to be hosted at Godmanchester and these are well utilised and from a personal
point of view I was very impressed with the speed with which a patient was able to be slotted into the clinic at short
notice when required. I would encourage practices to utilise this clinic as a first port of call rather than referring to the
hospital for any services that are suitable for a community ENT assessment (if unsure please check on the
HuntsComm website or email Ian who will be happy to give advice.)
There are other clinical areas that would be ideally suited to a community clinic. For instance provision of tinnitus
services is generally lacking and there was a recent document from the Department of Health „Provision of Services
for Adults with Tinnitus-A Good Practice guide‟ detailing what could and should be offered. Currently those patients
with severe problems are referred into secondary care whilst those with moderate problems are mostly just given
basic advice. Perhaps a GPSI might be interested in developing such a service? If anyone wishes to have a read of
the document please let me know and I can email it to you.
I am not sure that things will move forward anymore between now and next year due to staff changes and also more
pressing priorities now we are all concerned with the probable next wave of the flu pandemic, but at least we do
have a reasonable level of community ENT provision with patients having a choice of where they go for their
Gynaecology Update - Rita Aggarwal, Clinical Lead
The midwife-led baby unit is opened and successful.
PSI training continues at Eaton Socon, Spinney and now at Acorn. The clinics are going well, and any feedback is
welcome. We are still debating the best way to triage gynae referrals, as referral rates vary from practice to practice,
and the numbers are still high. Choose and book changes may help with this, or we may target high referring
surgeries or even set up a virtual clinic. Ideas from GPs would be welcome.
In process - any problems let us know.
Meetings are now being split up into separate obs and gynae to encourage better attendance from hospital
consultants and better communication.
Respiratory Medicine and Follow Ups Update - David Roberts, Clinical Lead
For a full update on respiratory matters, I recommend that you come to the HuntsComm Closure afternoon at Wood
Green Animal Shelter on Wednesday 30th September, 1.30-5.00pm.
The agenda will include a review of service provision at Hinchingbrooke and in the community, an update on what
we believe will feature in the National Strategy for COPD (due out this autumn, and akin to the National Service
Frameworks that we became used to a few years ago). There will be an update on the pulmonary rehabilitation
service and plans to develop this further, a talk and debate about spirometry interpretation and what additional
services we might like to see in the community to improve interpretation.
There will also be an update on planning for a local enhanced service for COPD next year - this will be preceded by
an audit this autumn as part of the PACE3 programme, which will help us develop the LES.
We would hope that you will encourage all your available GPs to come to this session (we believe that all GPs
should be able to manage COPD appropriately, although the benefits from having a lead GP who can develop a
higher level of expertise, and hopefully direct the practice's overall care for patients is recognised). Please also
encourage all Practice Nurses and Health Care Assistants who are involved in spirometry or respiratory care to
attend to what I believe will be a very useful session.
Mental Health Update - Emma Tiffin, Clinical Lead
ADULT MENTAL HEALTH:
Primary Care Psychological Health Service (PCMHS)/IAPT (Increasing Access to Psychological Therapies)
Please can all practices continue to refer all ROUTINE primary and secondary care mental health referrals
to their Gateway Worker which will speed up the rate at which referrals are screened. As per my recent
email, all urgent referrals (urgent = need actioning in less than 5 working days) go to the Duty Worker.
Please email Denise.Bowyer@cpft.nhs.uk (Manager of Hunts Intake and Treatment team) or
James.Clarke@cpft.nhs.uk ( Primary Care Psychological Health Clinical Lead for Hunts) if you have any
queries or problems, or if a practice visit would be helpful.
The primary care psychological health pathway has been developing referral criteria which will be distributed
in the near future.
The Gateway Worker role has been reviewed and the plan is to recruit 2 full time Gateway Workers to
replace the existing 5 part time staff, which we hope will increase efficiency, and release some Gateway
Worker time for developing the service including practice education and training. The existing Gateway
Worker structure/support will continue until the new Gateway Workers are in post.
There will be some increase in the capacity of the service when LIW/HIW workers finish their training at the
end of June and August respectively. The initial plan is to reduce waiting times for treatment but please
email Denise.Bowyer@cpft.nhs.uk if you have other ideas, and I shall be sending a short GP satisfaction
questionnaire to all practices in the near future which I would be grateful if you could complete, this will have
space for comments/ideas.
Due to unfortunate circumstances Hunts MIND are currently unable to accept referrals. The service will be
up and running as soon as possible.
Ruth Dube, Perinatal CPN has retired and Beverley Pearson is currently acting up to cover the perinatal
work. Beverley receives her clinical supervision from Ruth who is working 1day/week for 3 months to provide
this. Please refer perinatal mental health patients to your Gateway Worker rather than directly to Beverley.
In July a business case for psychological therapy input for patients with diabetes was submitted to
HuntsComm. This would involve the addition of 1 high intensity and 1 low intensity worker to the diabetic
team. Although the business case was essentially supported by HuntsComm, issues came up around
medicines management and admissions data that apparently need to be resolved before the business case
can move forward. I am attempting to clarify from the PCT exactly what is required before more work is put
into this project.
A PBC savings application for funding to extend the Books on Prescription scheme to all 9 Hunts libraries
will be submitted in September. This scheme allows patients to access recommended self help books from
their local library free of charge. Each library will have 1 set of the most popular 26 books on conditions
such as depression, anxiety, OCD etc. Please email Jacqueline.Wieczorek@cambridgeshire.gov.uk or
Emma.Tiffin@nhs.net for more info.
Secondary care mental health service
The adult mental health service restructured its medical staffing in august as communicated by email in
early July. The consultants now lead the following teams: Dr Dell‟Erba – Acute Care (Home Treatment
team and Acer Ward), Dr Thirza Pieters – Intake and Treatment, and Dr Emilio Fernandez – Rehab and
Recovery. The impact of the restructure is being monitored and feedback is welcome. Please contact
Neil.Winstone@cpft.nhs.uk if you have any queries or concerns
Depot antipsychotic administration
There has been a long history of issues around some Hunts practices being asked to take over the
administration of depot antipsychotics by secondary care. There has never been any specific funding for
this service (nationally or locally) and both Cambridge and Fens practices have traditionally given depots
We are currently investigating the issues involved and best way forward. The focus is likely to be on
patient choice and offering training for practices as required. I will keep you all updated.
OLDER PEOPLES MENTAL HEALTH
Older Peoples Intermediate Care Team(MHICT) – commenced 9/2/09
Key components of the team:
Crisis intervention - assessment within 4-24 hours depending on time of referral. Contact will be made within
4 hours of receipt of referral.
Team provides intensive support focussing on reducing avoidable hospital admissions and facilitating a
speedier discharge from hospital in partnership with CMHTs.
Time limited service of up to 6 weeks depending on clinical need, operates daily 9am-5pm including
weekends and bank holidays.
Refurbishment of Alan Conway Court, Doddington Hospital has commenced for the relocation of the team
from Peterborough. Full contact details for the new base will be circulated soon but at present to continue to
fax new crisis referrals via 01733 318113 or telephone 01733316700 or mobile 07785522005 weekends
/ bank holidays 9am-5pm only. Electronic referrals will be discussed in the near future.
For further information, comments or feedback – please email Nobbie.Joy@cpft.nhs.uk (or tel 01733
316700) or Emma.Tiffin@nhs.net
Please remember that all routine referrals (CMHT, memory clinic, outpatients) should continue to be sent to
OPMHS, Newtown Centre or to the Older People Gateway Worker for St Ives practices.
Older Peoples Primary Care Mental Health Service (OPPCMHS) pilot
Following the successful launch of the pilot in July, the OPPCMHS is being extended to all 5 St Ives
practices who will be offered similar services to The Spinney and Cromwell Place surgeries.
The team has received over 50 referrals since January 2009 and feedback from the 2 original pilot surgeries
above has been very positive.
The Building Confidence Group is up and running at St Ives clinic, offering older people an opportunity to
reduce anxiety and increase/develop their coping skills.
A new Graduate (Low Intensity Worker), Susan Hill, will start work this month and Elaine Withers has been
appointed as Team Secretary. Jim Leadbetter and Julie Hare continue to work as Gateway Worker and
Clinical Psychologist (High Intensity Worker) respectively.
There will be an interim report produced in October which will summarise progress of the pilot to date. The
report will be discussed with HuntsComm with a view to a phased roll out of the service across
Huntingdonshire. Some recurrent funding for the OPPCMHS has been identified from the PCT budget for
Year 2 and OPMH has been highlighted as a priority in the Cambridgeshire PCT strategic plan. We are
hoping to identify cost savings which will provide further funding for the roll out of the service across Hunts,
however we are all aware of the current financial and political climate which may well mean that this is a
Many thanks again to all practices that filled in the questionnaire regarding alcohol services. The feedback
has been used to shape the service specification which was discussed with HuntsComm in July and
circulated to all GPs by email. The majority of comments requested more support in primary care including
for patient self help. Further comments can be made to Claire.Warner@cambridgeshirepct.nhs.uk (tel 01223
A copy of the service specification is available on line @ http://www.cambridgeshirepct.nhs.uk
Feedback always welcome – please email John.Ellis@cambridgeshire.nhs.uk
CAMH - for more information please contact email@example.com
CPFT developed 5 new CAMHS out patient /community service pathways as part of its recent service
improvements. These are now being implemented:
Tier 2 (behaviour services, primary care mental health worker service)
The aim is to bring about the following improvements:
More consistent, thorough screening of referrals
Facilitating informed choice for children and carers following assessment including whether to
engage with service
More efficient treatment allocation, minimising waiting times between assessment and start of
Partnership model of treatment/therapy empowering children and carers to make decisions.
Emphasis on moving through service rather than becoming dependant on service which will include
regular multidisciplinary reviews and timely updating of care plans
Although this is not strictly speaking my remit, I have developed a prototype annual review LD template for EMIS
practices (could be used to build template on alternative practice systems) at Priory Fields which we are happy to
share and it has been approved by the PCT for the DES. Please email me if you would like a copy
MENTAL HEALTH SECTION ON HUNTSCOMM WEBSITE (nww.huntscomm.nhs.uk)
Feedback/comments welcome, please email Emma.Tiffin@nhs.net
Patient Involvement Update - Alan Morris
“LOCAL PRACTICE BASED COMMISSIONING GROUP STRIKES RICH VEIN”
COPY FOR NAPP NEWSLETTER - JULY 09
“HuntsComm” the local practice based commissioning group was established in 2006 to represent some 22 GP
practices, comprising 96 GP‟s and a mixed population of approx 170,000 patients.
At its heart was the intent to reflect wherever possible best practice and patient needs within its commissioning
decisions. The Board consists of 4 GP‟s (one as Chair) a Practice Manager, Nurse Representative and most
importantly from my standpoint an independent Lay Member with full voting rights.
Huntingdonshire (most famous for Cromwell) has always had a reputation for active patient involvement (we prefer
to call it influence). Some 3 years on we now have around 70% penetration on patient participation groups active
within practices, together with specialist groups such as diabetes, and an Acorn Support Group for those with life
threatening conditions. Patient power is alive and kicking.
However, we have now gone a step further in the formation of a Huntingdonshire Patient Congress (HPG) which
encompasses every practice and every locality within our patch.
For us that means the market towns of St Neots, St Ives, Huntingdon and Ramsey, (that‟s the one in the Fens). We
launched this to an enthusiastic audience on the 3 July 2009 at our local DGH Hinchingbrooke, a much valued
facility within our population. Our keynote speaker was HuntsComm Vice Chair Dr David Roberts, who laid out the
vision which was well received. Draft terms of reference were tabled and accepted together with the appointment of
a Lay Chair and Vice Chair. Most importantly HPG will have a seat at the HuntsComm Board to ensure effective
communication in its role as a critical friend to HuntsComm and as a conduit to practice based patient groups.
I was able to announce that the Board had commissioned a substantial number of sessions of the “expert patient
programme” which assists those patients with long term chronic conditions and enables them to manage them more
effectively in a way that minimises their reliance on both primary and secondary care support. Coincidentally we
were early implementers of this programme nationally and therefore recognise the results it can produce. This in
itself opens the gates to greater efficiencies, additional savings and the opportunity for greater investment in local
It would be wrong not to record my thanks to NHS Cambs and its Head of Patient Engagement Susan Last and
Gene Dunbar our PCT Business Manager, who both contributed to our success.
Finally, to my colleagues on the Board of HuntsComm who have provided unstinting support to me personally and to
the whole project which is now enshrined in our strategic plan.
Neurology Update - Abby Richardson - Clinical Lead
Sadly, Dr Ingunn Bjornson has decided to stop providing the headache clinics as of Christmas. The clinics have
been very successful, but her life is becoming too busy so she has decided to reduce her commitments. It will still
be possible to refer patients to her Cambridge clinic, which is available via Choose and Book. I‟m sure you will
agree that the patients have appreciated the excellent service provided in the clinic, and we wish Dr Bjornson well in
The loss of the headache clinic may well have an impact on the general neurology clinics but Hinchingbrooke was
already planning some expansion of the clinic team with a view to regular sessions from an additional consultant
hopefully. Unfortunately this process is painfully slow and plans are still in a very early stage.
The Parkinson‟s Nurse Team, Jacqueline Young and Liz Terry continue their hard work developing the community
services. They have been concerned about whether they are aware of all of our Parkinson‟s patients in and around
Huntingdon, particularly those who may have been diagnosed for some time or receive their outpatient care
elsewhere, other than Hinchingbrooke or Addenbrookes. We would appreciate your help in making sure their
caseload is up-to-date so that all our Parkinson‟s patients can receive the community services available. Shortly we
will be sending an email and I hope you will be able to spare a little time in your practice for what should hopefully be
just a simple search of the clinical system.
Dr Sian Thompson is fully aware that the general limitation of appointment slots causes problems when trying to
make urgent appointments for patients. She can be contacted on her mobile, via switchboard, to discuss the case
and will endeavour to see them, either squeezed into a clinic at Hinchingbroooke or arrange to review them at
As always if you are having any problems with the neurology service or any ideas about how it could be improved
then please contact me at firstname.lastname@example.org.
LINK (LOCAL INVOLVEMENT NETWORK) – Nick Roberts
Throughout the NHS and social services, increased efforts are being made to engage with the public. The type of
services, the location of such services and the experience of patients in using these services all helps to shape the
direction and scope of service provision.
Cambridgeshire NHS at all levels has been active in engaging with the public and this is now supported by the
Cambridgeshire LINK (Local Involvement Network) which acts as a focus for the public on a wide range of health
and social care issues.
HuntsComm has for some time recognised the importance of engaging with the public/patients covered by the 22
surgeries which make up the group. A member of LINK attends the group meetings and reports back to the PCT
and CCS groups within the LINK organisation. As a further step in the widening of public engagement and with the
active support of HuntsComm (staff and financial) a Patients Congress (believed to be one of the first in the country)
has been established and just had its second meeting.
It is hoped that at least two patients from each surgery attend the meetings which at this stage are planned to be
held every other month and a draft constitution is under review.
The main objectives of the patient congress can be summarised as follows:
To support HuntsComm in the provision of services across the area.
To work with established surgery patient groups and to support surgeries whose patient groups are not yet
To invite guest speakers to the meeting to increase members understanding of the way in which services
To ensure the equitable provision of services provided by GPs and support staff with special reference to the
increased provision of services in the community.
We hope all surgeries through their patient group notice boards or surgery newsletters will support the Patient
Congress and will do their best to ensure that their patients are represented at the meeting.
Physiotherapy – Sarah Saul
The Musculoskeletal physiotherapy service has been working in recent months with Leanne Hurren your PBC
Project Support Officer and Dr Lasman to update and add to the information on your website.
You will find sections on Physio Direct and the Core service, the ESP service, the urogynae service and also
exercise and advice leaflets for your patients.
There is a document on GP management of Musculoskeletal Conditions written by Jill Gamlin Clinical Lead and our
service pathway diagrams to demonstrate what our service offers
If you have any comments to make regarding this part of your site or any feedback about what would be also helpful
to you to aid in the management of your patients then please get in touch via Leanne.
The Musculoskeletal physiotherapy service is provided by Cambridgeshire Community Services, operates county
wide and is co-managed by Sarah Saul and Steve Wilson.
Sarah Saul: Mobile: 07983705203 Base: 01480 416091 Email: email@example.com
Practice Manager Update - Moira Cernik
The Expert Patients Programme continues to progress however due to problems with securing a venue that is
available for the same day for six consecutive weeks has been problematic. So the pilot the recruitment pilot has
been delayed until January. It is important that this is undertaken so that supply and demand can be managed, and
patients are not disappointed. EPP have appointed a project manager to run the remaining courses so practices will
be supported and the courses will take place with the minimum of delay.
The IQ Budget pilot I have been carrying out at Priory Fields, has now come to an end. The results were, from the
one month snapshot we took, that discharge letters being received by the Practice was the biggest issue, and the
only reported savings made were £306; which was a private referral incorrectly charged. So this is actually good
news because from what we could ascertain the coding was good and by running the queries that Sarah Fry has
recommended, high cost and NHS numbers should actually resolve the potential anomalies.
I am still pursuing training for practice staff to run concurrently on the PBC closure afternoons, but I will update you
on this when I have further information.
If anyone has any concerns or would like to raise any issues with me please contact me by email.
As a reminder all HuntsComm committee members can be contacted to discuss or raise specific issues; so that we
can respond please email using the following addresses:
Dr Andrew Wright Chairman firstname.lastname@example.org
Dr David Roberts Vice-Chair email@example.com
Dr Paula Newton firstname.lastname@example.org
Dr Richard Smith Richard.email@example.com
Gill Scott firstname.lastname@example.org
Alan Morris email@example.com
Moira Cernik firstname.lastname@example.org
Future PBC Practice Afternoons
HUNTSCOMM PBC CLINICAL AFTERNOON MEETING DATES
The following is a list of PBC Clinical afternoon events and In House Training dates for your diary. HuntsDoc
coverage is available from 1 – 6 pm for those practices who have requested this via the Hunts Area Office. Dates
and venues for events after September ‟09 will be circulated as soon as possible.
Wednesday 30 September PBC Event – COPD
Wednesday 14 October Practice In House Training
Tuesday 10 November PBC Event – (TBC)
Hunts Area Office Update - Liz Sargeant
My name is Liz Sargeant, I am standing in for Gene Dunbar on an interim basis as Consultant – Clinical Redesign
and Service Improvement. I have only been in post for one week but intend to come out and meet with the practices
when the mid year reviews take place during October/November. I look forward to meeting you all and welcome any
communication with you.
For those practices that have opted to do Audit1a, a template has been sent out, including all the data to be audited.
Deadline for this work has been extended to Friday 2 October. We are currently finalising the list of topics for
directed audits for those practices that have picked Audit 2.
We will be working with our Primary Care colleagues to hold joint PACE/PMS mid year reviews with all practices.
Jan Tuckwood has started contacting practices to book these visits, starting in October.
PACE2 – Achievement Payments
PACE 2 project evaluations have been reviewed and achievement payments have been calculated. Practices
should receive their PACE2 money with their next remittance at the end of September / beginning of October.
NHS Cambridgeshire wants to commission countywide Dermatology services that are equitable, safe, NICE
compliant, sustainable both clinically and financially, as well as affordable against budget compared with clusters of
PCTs elsewhere in England.
As part of this process, NHS Cambridgeshire is holding a Clinical Engagement Forum on the afternoon of 6
October at Hinchingbrooke Health Centre. This event is the first stage of that process whereby NHS
Cambridgeshire will work with patients, the public and health care professionals to review and, where necessary,
redesign services to achieve these principles.
There will be presentations from Hinchingbrooke, CHUFT and GPwSIs across Huntingdonshire and Cambridge, as
well representation from clinicians from EC&F.
Although the event is now closed to other attendees, NHS Cambridgeshire will keep you up to date on the outcomes
of the day and what next steps NHS Cambridgeshire plan to take as part of the redesign process.
Website Updates – Leanne Hurren
The public facing website has been well received – thank you to all those who commented on it!
There have been lots of updates since the last newsletter and there is now an extended Physio section. A range of
Physio Direct patient leaflets will soon be available to download and print. As Gill mentioned earlier there is a new
End of Life section with referral information and forms for the local hospices. I am currently working on a PACE
section for the website which will include further information about the various audits as it becomes available.
Please remember to review your practice details online to ensure that we have up-to-date contact details.
If you wish to submit documents to the HuntsComm website, or feedback any general queries and/or
comments, please do so via the following contacts:
Project Support Hunts Area Office
PA to Gene Dunbar / CPCT-PBC Hunts Area Office
Principal Pharmacy Technician
The Newsletter is produced on a quarterly basis (June, September, December, and March) with “newsflash” type
reports as required. We would welcome contributions from practices.