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​News and Updates

​We send out news and updates relevant to GPs via the Dorset CCG's weekly email bulletin, but you can also find the information issued here.

We have also started sending a regular e-bulletin with a supporting video to GP practices directly. If you don't receive these and would like to be added to our distribution list please email communications@dchft.nhs.uk​


DCH Clinical Haematology Paper/Email Referrals

Firstly I would just like to say thank you for your help and understanding regarding our capacity issues (we appreciate the acknowledgement in many of your letters).

Again while working through our pathway we have noted that we still receive, weekly, between 10-20 paper/email referral letters to the Haematology Service which is outside of the agreed referral process for the Trust and also causes delays for the patients (especially if the letter is posted) and extra work for yourselves as the referrals are returned to you by central referrals for you to resubmit electronically.​

What we ask of you:

  • When referring a patient please send through agreed routes not as a paper referral.
  • When using advice and guidance use ERS to make the referral once you have seen the response from the consultant advising you to refer.
  • Please note a paper referral will not get a patient see quicker, if anything it has the potential to delay them getting seen.

 

Please be assured that the Team are continuing to do everything they can to reduce the waiting times and get patients into the system quicker.

Denise Adcock
Cancer Lead Manager
Service Manager – Integrated and Holistic Care Cancer, Haematology, Respiratory and End of Life
01305 254285
Denise.Adcock@dchft.nhs.uk


DCH Rheumatology Service on E-referrals

As of Friday 30 August 2019 the following services are no longer available on E-referrals as they have been unpublished:

Rheumatology Service – Blandford – Dorset County Hospital, including the service for Non Dorset Referrals 

Rheumatology Service – Bridport – Dorset County Hospital, including the service for Non Dorset Referrals 

Rheumatology Service – Yeatman – Dorset County Hospital, including the service for Non Dorset Referrals 

These services have been unpublished as there is no longer a relevant outpatient clinic running at the community hospital locations.

Please continue to refer all non-red flag patients for Rheumatology via the MSK triage pathway.

Sabrina Ghataura
Business Manager
Patient Access and Performance Directorate
Sabrina.ghataura@dchft.nhs.uk


Specimen Transportation to DCH

In August during a hot spell, we monitored the temperature within the specimen bags, from 2 of the outlying surgeries. It is snapshot but I believe we would have seen similar traces for most surgeries during that week, with the interior of the bags reaching temperatures between 28°C and 30°C.

Unlike the transportation of pharmaceuticals, there are no guidelines or scientific papers / literature establishing criteria /ranges for sample transportation. Fresh samples will start at 30°C - 37°C and then cool to the ambient temperature of the surroundings, which varies unless climate controlled.

Microbiology specimens not transported in preservative during periods of elevated temperature have the potential of the integrity being significantly altered giving false results, especially if combined with time delay.

Histopathology specimens are usually transported in fixative and therefore the integrity is maintained, however if not , during periods of elevated temperature have the potential of the integrity being significantly altered giving false results.

The integrity of Blood Science specimens maybe significantly altered in extremes of temperature especially if combined with time delay.

Specific instructions are given for cold agglutinins and andrology specimens which need to be kept at body temperature as for critical specimens which require transportation on ice. Details of which can be found on the Trust Website:

http://www.dchft.nhs.uk/gps/pathology-services/Pages/default.aspx

It is important that users are mindful of the effects of heat on samples, when interpreting results, of specimens collected, stored and transported in hot weather. 

The following interventions maybe considered to minimise the effect on specimens:

  • Improved storage conditions at the requestor site, refrigeration and controlled ambient temperature as appropriate to specimen type.
  • Encouragement of centrifugation at requestor site (GP practices/community hospitals) in order to stabilise samples with gel separators.
  • Lean pre-analytical processing and centrifugation at laboratory reception
  • Ensure stabilisation of samples that require to be left overnight for analysis next day
  • Temperature controlled holds in transport vans
  • Improvements in sample transport – transport time and frequency of pick up
  • Procurement of  new insulated pathology medical bags, which in addition to compliance with packing instruction P650, maintain temperature for up to  6 hours by the requestor.


The most of the above is out of the control of Pathology; and we are regularly auditing and reviewing our processes to reduce risk to the sample integrity and factors which impact on the quality accuracy of the results.

The sample transportation provided by the Trust Transport department is commissioned by the CCG and the responsibility for the integrity of the samples until they reach the laboratory lies with the requestor. As does the responsibility for the safe transportation under the packing instruction P650 and the provision of transportation bags, unless stated otherwise in a service level agreement or contract.

I will be doing a similar snapshot audit in the autumn and also in the winter to get a feel for the norm and extremes.

Please can you share with your staff and ask them to be mindful of specimen storage and transportation conditions, especially when interpreting results, when experiencing extremes in weather conditions.

Sharon Wood
Pathology Quality Manager
Dorset County Hospital
Sharon.wood@dchft.nhs.uk


Dorset County Hospital Gynaecology E-referrals Change

As of Friday 9 August 2019 the following service is no longer available on E-referrals as it has been unpublished:

Gynaecology General - Bridport - Dorset County Hospital 

This service has been unpublished as there are currently no appointments available for General Gynaecology patients at Bridport Community Hospital. This will be reviewed in three months and an update provided.

The following services are still available to refer to via E-referrals for General Gynaecology:

Gynaecology General - Dorset County Hospital 

Gynaecology General – Weymouth - Dorset County Hospital 

Sabrina Ghataura
Business Manager
Patient Access and Performance Directorate
Dorset County Hospital
Sabrina.ghataura@dchft.nhs.uk


DCH Private Patient Services

For information in case it is useful for your patients, Greenwood Private Patient Service at Dorset County Hospital is adding three new services for people wishing to use their private health care insurance or self-fund their treatment. These are 4D baby scans, varicose vein removal and a Sports Cardiology Clinic led by Dr Edwards, Consultant Cardiologist. Patients should contact our private patient team on 01305 254138 for more information.​

Claire Rowlands
Private Patient Office
01305 254138
claire.rowlands@dchft.nhs.uk


DCH E-Referrals Update

As of Tuesday 30 July 2019 the following service will no longer be available on E-referrals as it has been unpublished:

Complex Leg Ulcer – Dorset County Hospital

This service has been unpublished as there is no longer a relevant outpatient clinic running at Dorset County Hospital

The following service is still available to refer to via E-referrals:

Leg Ulcer  – Weymouth Community Hospital

Sabrina Ghataura
Business Manager
Patient Access and Performance Directorate
Dorset County Hospital
Sabrina.ghataura@dchft.nhs.uk

​ 

E-referral Changes

As of Friday 28 June 2019 the following services will no longer be available on E-referrals as they have been unpublished:

Gynaecology General Service – Lyme Regis

Orthopaedic Paediatric (excludes Spinal) – Weymouth

Elderly Care - Yeatman

These services have been unpublished as there is no longer a consultant running a clinic for this service at these locations. Alternative locations are available on ERS for all of these services.

Sabrina Ghataura
Business Manager
Patient Access and Performance Directorate
Sabrina.ghataura@dchft.nhs.uk​ 


Reminder - Alerting DCH Stroke Team to Fast Track TIAs

(as of 1 April 2019)

Following the decision to remove fax machines from GP surgeries, Dorset County Hospital's Stroke Team has enabled and tested a generic email address for surgeries to use to alert the team to fast track TIAs.

There is essentially no change in the internal DCH process apart from using email rather than fax. Surgeries may wish to request 'read receipt' messages to provide assurance that the email has been received by the Stroke Team. The email address is: stroke@dchft.nhs.uk

The email address is already monitored throughout the day, as is (currently) the incoming fax, so there will be absolutely no change in service level.

Tom Smith
Service Manager Integrated & Holistic Care
Dorset County Hospital
tom.smith@dchft.nhs.uk

Diabetic Medicine Service – Bridport Community Hospital

As of Tuesday 11 June 2019 the following service has been published on E-referrals: Diabetic Medicine Service – Bridport Community Hospital.

Sabrina Ghataura
Business Manager
Patient Access and Performance Directorate
Sabrina.ghataura@dchft.nhs.uk​ 


Respiratory Medicine Service – Blandford Community Hospital

As of Friday 7 June 2019 the following service will no longer be available on E-referrals as it has been unpublished: Respiratory Medicine Service – Blandford Community Hospital.

This service has been unpublished as there is no longer a respiratory consultant running a clinic at this location. The following services are still available to refer to via E-referrals:

Respiratory Medicine Service – Bridport Community Hospital

Respiratory Medicine Service – Dorset County Hospital

Respiratory Medicine Service – Weymouth Community Hospital​

Sabrina Ghataura
Business Manager
Patient Access and Performance Directorate
Sabrina.ghataura@dchft.nhs.uk​ 


Diagnostic Imaging eRequesting

In line with Dorset County Hospital's strategic direction to move to a digital, paperless environment all requests for X-Ray, CT, MRI and Ultrasound must be placed on ICE from Monday 3 June 2019.

We will not be accepting faxes or paper requests from GPs. The only exceptions (where paper requests will be accepted) are where the examination is not currently available on the ICE pages (breast imaging, interventional radiology, obstetric ultrasound, theatre imaging and dental) or where the referrer is  external  to the Trust and not an ICE user.

If you are a referrer and have any questions about requesting Diagnostic Imaging examinations on ICE please contact Kate Lewins (Radiology IT Systems). If you do not have access to ICE please contact Louise Godber (ICE Systems Manager).

We would like to resolve any issues you have using ICE for requesting before the 3 June!​

Kate Lewins
Diagnostic Imaging IT Systems/Senior Radiographer
01305 255221
kate.lewins@dchft.nhs.uk


DCH Pathology User Survey

As a frequent user of our pathology service, your feedback is invaluable to help us evaluate areas requiring improvement. It should take no more than 10 minutes to complete. Please complete by 24 May 2019. 

Click here https://www.surveymonkey.com/r/Y2CHB6Y to access the survey.

Thank you in advance.​

Dr Annemarie Yeates
Quality Lead
Microbiology
01305 254521
annemarie.yeates@dchft.nhs.uk


Urgent Ophthalmology Referrals E-mail Address

This email address is for requesting urgent casualty appointments at the Ophthalmology Department at Dorset County Hospital: REITriage@dchft.nhs.uk

Referral letters and optometrist reports can be e-mailed to this address and will be received by the triage team in the Eye Department.​

Sally Barnes
Ophthalmology Secretary Team Leader
Dorset County Hospital
01305 255245
sally.barnes@dchft.nhs.uk


Alerting DCH Stroke Team to Fast Track TIAs from 1 April 2019

Following the decision to remove fax machines from GP surgeries, Dorset County Hospital's Stroke Team has enabled and tested a generic email address for surgeries to use to alert the team to fast track TIAs.

There is essentially no change in the internal DCH process apart from using email rather than fax. Surgeries may wish to request 'read receipt' messages to provide assurance that the email has been received by the Stroke Team. The email address is: stroke@dchft.nhs.uk

The email address is already monitored throughout the day, as is (currently) the incoming fax, so there will be absolutely no change in service level.​

Tom Smith
Service Manager Integrated & Holistic Care
tom.smith@dchft.nhs.uk


Change of Service Offered by Microbiology Department

We wish to inform you that the microbiology department will continue to be able to offer a testing service for bacterial vaginosis, but this test will not be covered by the laboratory's compliance with BS EN ISO 15189:2012 (Medical laboratories – requirements for quality and competence).​

This is a new laboratory standard which replaces the previous CPA accreditation standards, and demands some additional quality assurance measures. Unless stated, all other tests in our repertoire meet the requirements of BS EN ISO 15189:2012. Unfortunately there is no external quality assessment scheme available for the bacterial vaginosis methodology that we use, therefore it does not meet the new standard.

The new standard has prompted us to review our test repertoire, and I would like to take this opportunity to seek users' opinions as to whether testing for bacterial vaginosis is a useful test outside of the GUM clinic setting?

As you may be aware, the wet microscopy which DCH lab performs on HVS/ LVS samples, to look for evidence of bacterial vaginosis, can give both false positives and false negatives and must be interpreted in the overall clinical context, including features such as appearance and pH of discharge. At present we include a comment in the result report to inform you if the microscopy is suggestive of BV, but generally do not issue negative reports when it shows no features, due to the limited sensitivity. I would be very grateful for any feedback regarding whether you find this test valuable or not. If so we may explore a more robust testing methodology.

Please send your comments to Victoria.Potts@dchft.nhs.uk. Please also refer to https://www.gov.uk/government/publications/abnormal-vaginal-discharge-management-and-laboratory-diagnosis

In the meantime, we will continue to report this result where appropriate but clinicians need to be aware that is not compliant with the requirements of BS EN ISO 15189:2012.

Dr Catherine Jeppesen
Consultant in Microbiology
Catherine.jeppesen@dchft.nhs.uk
01305 254346​


Ophthalmology Out of Hours Service Changes

The ophthalmology out of hours on-call service is changing as of 3 December 2018. There will be 2 phases:

1st phase – Week day (Monday – Thursday) out of hours will be transferred to (Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust) RBCH from 3 December 2018

·2nd phase – All out of hours will be transferred to RBCH from 5 January 2019

Any patients that are referred to DCH Emergency Department will continue to be triaged in the usual way, but if their condition is deemed urgent and needs Ophthalmology Consultant input the patient will be transferred to RBCH.  Where possible please can you ensure patients are referred as early on in the day as is possible. 

All rapid access referrals will continue to be dealt with in the usual way - this pathway will not change.  ​

Catherine Abery-Williams
Deputy Divisional Manager
Family and Surgical Services Division
01305 254711
catherine.abery-williams@dchft.nhs.uk


Microbiology Updates

Filling of Boric acid Urine Tubes
Due to the toxicity of boric acid to some bacteria, urine tubes MUST be adequately filled. Monovettes containing boric acid will no longer be accepted if they are significantly underfilled (i.e. more than 2cm below the fill line) and where boric acid universals are still being used, they must be filled to the line. Any samples that will not achieve this fill level should be submitted in a non-boric acid (yellow topped) Monovette tube, or a plain universal.

Sample Labelling
As of 1 January 2019 Microbiology will be following the same labelling requirements as blood sciences. If samples are not labelled appropriately they will be rejected. The requirements are:

All request forms and sample labels MUST have at least the following three points of reference, which are identical on both the form and sample label

1.            Patient's full name or unique coded identifier (where this applies)

2.            Patient's date of birth

3.            Hospital or NHS number (with the exception of anonymized patients)

Unrepeatable samples that are unlabelled or mislabelled will be processed at the discretion of the Microbiology consultant.  Usually the requesting clinician will be asked to attend the department to confirm the identification on the sample.

Sample Bags
Pathology has moved to a new bag system, as you may have noticed. The instructions on how to use them come with each bag, but we have noticed that people are not following these. Please note, the form should be stuck to the sample bag, and NOT put into the bag with the sample.​

Paul Davies
Pathology Services Manager and Head of Microbiology
01305 254344
paul.davies@dchft.nhs.uk