Information about weight management services and the availability of weight-related drug treatments in Suffolk and North East Essex:

We are aware of the recent news reports, however we are not able to prescribe this in General Practice locally, this varies by area – in this area there is a new NHS weight management service expected to launch later this summer. Full details aren’t available yet and we are not yet able to refer for this, but it’s likely to include weight management programmes, medications, or surgery depending on individual assessment once you have been referred on to them. Most patients will need a BMI over 35 and other conditions to be referred and the team will assess and decide on which will be suitable for each individual. Please get back in touch with us in late summer for more information. Read more

Please note our practices will be closed on Monday 25th August for the Summer Bank Holiday.

Clinical Safety

Suffolk Primary Care’s Clinical Safety Team

Suffolk Primary Care’s (SPC) Clinical Safety Team focuses on prescribing medications in line with current guidelines and ensuring the safety of nearly 70,000 patients spread across the partnership’s seven practices. It is made up of:

  • Dr Paul Driscoll, Clinical Lead and senior partner at Haven Health
  • Helen Flatt, Business Intelligence Manager
  • Judy Layton, Clinical Safety Alerts Admin Lead
  • Maddie Sibley, Clinical Safety Admin

The team combines clinical leadership with an interest in clinical safety and prescribing, administration and computer system expertise, which supports the delivery of safe care across our partnership. By using technology and system searches, the central team is able to complete a significant number of actions on behalf of practices, both ensuring consistency in our approach and reducing the workload at each site.

The service provided by the team is split into two linked parts – clinical safety audits and clinical safety alerts.

Clinical safety audits

Our monthly clinical safety audit is based on the work of Professor Tony Avery regarding safe prescribing in primary care, particularly around high-risk medications that need monitoring or medications with potential interactions. It initially began in 2008, with its remit adjusted and amended over the years as new alerts are added.

We use the audits to highlight specific areas for focus for our clinicians, such as antibiotic prescribing, non-steroidal anti-inflammatory drugs use, inhaler prescribing and opioids.

Searches which may be carried out include a selection of high risk drug monitoring and shared care medications, such as disease modifying drugs. The team also choose several areas for focus each month, with practices asked to address them. Regular audits are subsequently carried out to monitor progress.

Clinical safety alerts

When clinical safety alerts are raised – mostly by the MHRA (Medications and Healthcare products Regulatory Agency) – they are assessed by the clinical lead before searches are carried out to identify any SPC patients who may be impacted. The team also monitor supply destruction alerts and alerts raised by other sources, such as pharmaceutical companies or our local integrated care board.

If any actions are required, they take place at two levels:

  • Central actions are carried out by the Clinical Safety Team and usually involve sending text messages or emails to patients, for example to alert them to a new risk associated with their medication, such as teratogenicity in men taking valproate.
  • Practice-level actions may involve carrying out a clinical review of the patient’s medication, blood test monitoring or risk assessments, for example with topiramate in women of child bearing age.

All of these actions are logged on a central spreadsheet.

Searches are repeated where there is a clear ongoing risk, and may also be added to the monthly clinical audit.

These monthly searches can have a significant and positive impact on the care we provide, and have recently been particularly effective in helping us to:

  • significantly reduce quinine prescribing across practices
  • significantly reduce use of Saba inhalers in asthma
  • reduce high-dose opioids greater than 120mg
  • reduce non-preferred nonsteroidal use
  • reduce patients requiring review of antidepressants
Clinical guidance

In addition to carrying out audits and managing alerts, the Clinical Safety Team also help manage new clinical guidance. This includes new asthma guidance reminding clinicians that Saba inhalers should not be used without corticosteroids and recommending a move to combined inhalers. After an initial search is carried out by the Clinical Safety Team, the guidance is incorporated into a suite of respiratory searches on the monthly audits to help us make sure our practice is in line with the new guidance.

The team has also engaged with MHRA regarding its guidance and how it is communicated to practices, as well as with OpenPrescribing regarding dosulepin use.

Insights

SPC’s Clinical Safety Team illustrates that it is possible to enhance patient safety across a group of practices by having an appropriately skilled team which incorporates clinical, data management and communication expertise. Other elements which are key to our success include:

  • Ensuring all of our practices work in similar ways and/ or use the same clinical system, in our case SystemOne.
  • Carefully designing our clinical searches.
  • Having the ability to communicate easily and effectively with our patients through well-written texts or emails using bespoke medical software, such as Accurx. This has been well-received by those in our care.
  • Developing good communication and strong links between the central team and each of our practice.
  • Using data to drive and improve performance.
Clinical safety leads’ blog:
dosulepin OpenPrescribing