MHRA: medicines with teratogenic potential
What is effective contraception and how often is pregnancy testing needed?
The MHRA has published new guidance on contraceptive methods and frequency of pregnancy testing to reduce inadvertent exposures during pregnancy in a woman taking a medicine of teratogenic potential:
The table associated with this guidance is also attached.
North West Anglia NHS Foundation Trust (NWAFT)
The management of hypothyroidism in pregnancy
There is now substantial evidence that thyroid deficiency during pregnancy can result in some problems in development in children. In the early part of pregnancy the developing baby is entirely dependent on the mother's thyroid hormone, so it is vitally important that the pregnant woman's thyroid hormone levels are adequate. Women of childbearing age should be given this information when starting Levothyroxine replacement.
Hypothyroid women on Levothyroxine (T4) treatment should have:
- The TSH levels checked before conceiving if they are about to become pregnant, and we recommend adjusting the dose of T4 if necessary. The dose will still need to be increased by 25-50mcg in the first few weeks of pregnancy.
- It is recommended that the Levothyroxine dose be adjusted (by 25-50mcg), aiming to keep TSH level between 0.4 -2.5mU/L during pregnancy.
- Thyroid function (Free T 4 and TSH) should be measured every six weeks during pregnancy, and six weeks after any change in dose.
- Remember to indicate on the pathology request form “hypothyroidism in pregnancy on Levothyroxine”. This will be helpful to Chemical Pathology who in turn can give us prompts in relation to “out-of-range” TSH levels.
- Seek advice from the Endocrinologist.
- Additionally, female patients of childbearing age should be given a patient information sheet at diagnosis of hypothyroidism. This should contain advice about pregnancy.
''Good practice recommends that pregnant women who are at risk of thyroid disorders should have thyroid tests checked at antenatal booking. These groups include women known to have or have had thyroid disease, also patients with type I diabetes, any woman with a family history of thyroid disease and any woman with symptoms suggestive of thyroid disease.'' British Thyroid Association.
Dr Samson Oyibo, On behalf of the Endocrine-Pregnancy clinic
Changes to the critical value cut-off limits for phoning results
Critical value cut-off limits: updating limits in accordance to guidance published by the Royal College of Pathologists.
Please be aware of the following changes to the critical value cut off limits.
The NWAFT Clinical Biochemistry department has reviewed the existing critical low and high cut-off values utilised in the department against that recommended by the Royal College of Pathologists’ publication, ‘The communication of critical and unexpected pathology results’ (October 2017).
Considering these guidelines and the feedback received during this consultation period, new cut-off values will be implemented on Wednesday 10 April 2019. These can be found attached. In the event of results being out-with these limits, and being of new first-time occurrence, the requesting location will be telephoned.
If you have any queries relating to this please contact the Biochemistry Department on 01733 678455 or email peh-tr.ChemImm@nhs.net
Dr Mark Lum (Consultant Chemical Pathologist) and Jamie West (Biochemistry Manager).
Webinars to help GP Practices prepare for NHS App connection
After a successful pilot across England, the NHS App has now begun its public rollout. To help digital leaders, CCGs, GPs and practice staff prepare their practices for connection to the app, a free webinar series will be running until September. For more information or to book your place, visit the NHS England website.
CCG Educational Event
Managing controlled drugs in general practice – 16 April 2019
Tuesday 16 April
1-3pm (lunch at 12.30)
As part of our refreshed membership ‘offer’ we will be holding regular CCG-led educational sessions for our members. These will be held every 4-6 weeks and will be promoted via the Training Hub website https://cptraininghub.nhs.uk/ and in our GP News bulletin. The events will have a clinical and improving quality focus and will be open to all clinicians working in our member practices.
The first of these events is being held on Tuesday 16 April from. The topic is Managing controlled drugs in general practice – taking the pain out of CDs.
Please find a flyer attached which has the details included. You can book a place via the Training Hub at https://cptraininghub.nhs.uk/event/ccg-gp-ed-managing-controlled-drugs/. We look forward to seeing you there!
NEW: Easter 2019 communications toolkit now available
Practices can now access the new ‘Easter 2019’ communication toolkit on the Healthcare professionals’ area of the CCG website HERE.
The communications toolkit provides resources to help encourage patients to be prepared for the four day bank holiday weekend and raise awareness of local service available. The toolkit includes website copy, videos and images and suggested social media activity.
If you would like any further information or guidance on how to use any of these resources within your practice please contact the CCG communications team at email@example.com
Easter opening times
Pharmacy opening times for Easter bank holidays
The pharmacy opening times on the NHS England pharmacy pages are as follows:
These details are subject to change but are correct at the time of publication.
Dental services opening times for East bank holidays
2ww Breast Referral letter
On Tuesday we circulated the attached a letter regarding 2ww Breast Referrals from Dr Oliver Stovin.
Any queries regarding the attached should be directed to:
- Jane Steward, Project and Service Improvement Manager - Planned Care Team - Cancer
Office Number – 01945 482152
Mobile Number – 07989411139
Updated corporate CCG policies
The following policies have been revised and formally ratified by the Governing Body:
A detailed briefing note to the Conflicts of Interest policy is also attached here.
These policies are now on the website and can also be accessed under the Corporate Documents on the website here.
All CCG employees (including GPs employed by the CCG) are encouraged to familiarise themselves with these three key policy documents.
Please see below the latest developments from the world of Healthcare Research and Innovation:
The R&D team are located on the 4th floor of Lockton House. If you want to get in touch about our weekly research updates, please contact Sinem White (firstname.lastname@example.org).
You can also now follow the R&D team on Twitter: https://twitter.com/CPPrimaryCareR1
Local training opportunities
Local events are now being collated on the Training Hub website, we recommend you check this link for the latest training available for practices in Cambridgeshire and Peterborough https://cptraininghub.nhs.uk/
- HOT OFF THE PRESS – Cambridgeshire and Peterborough Nurses and HCA Conference! Book early to avoid disappointment. Non-medical prescribing updates also available !!
- For GPs – Caldicott Guardian Training £145 ! FREE Suicide Mitigation workshop with MIND, Lead, Manage, Thrive and Shapes Toolkit
- Book on our FREE Active Signposting, Exceptional Customer Service and Succeeding with Difficult People. We also have workshops on Clinical Coding for £45 pp.
- Still places left for the FREE Chaperone training in Peterborough and Huntingdon. Cambridge is already fully booked!
- FREE Child and Adolescent Mental Health Practice Training in Huntingdon and East Cambridgeshire and Mental Capacity Act and Deprivation of Liberty Safeguards for HCAs
- Coming to the website soon – Safeguarding for Administrators
Population Wellbeing Portal goes live
Health Education England (HEE) has worked with Public Health England (PHE), the Academy for Public Health for London and Kent, Surrey and Sussex and the Faculty of Public Health to develop the Population Wellbeing Portal.
The Portal offers free e-learning resources, training and education in population health, wellbeing and prevention. The Portal provides a central location for free training and education resources relating to the health and wellbeing of the public including links to e-learning, toolkits, videos, webinars and various publications. Whatever your involvement with the public, these resources will support you in expanding your knowledge and skills to enable you to influence the health of the population.
The Population Wellbeing Portal brings together material from multiple sources. This includes resources from HEE, PHE, the Academy for Public Health for London and Kent, Surrey and Sussex, the Faculty of Public Health and many others. It links with All Our Health, PHE’s framework of evidence to guide healthcare professionals in preventing illness, protecting health and promoting wellbeing.
For more information about the Portal visit: https://www.e-lfh.org.uk/programmes/population-wellbeing-portal/.
Primary/Secondary Care Cancer Networking Event
- The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust
- Cambridgeshire and Peterborough Clinical Commissioning Group
- West Norfolk Clinical Commissioning Group
- Macmillan Cancer Support
- Chair Dr Suzanne Phillips
- Date: Wednesday 1st May 2019
- Time: 18:00-21:00
- Venue: Knights Hill Hotel, King’s Lynn
- Please see attached flyer for further details and how to book.
FREE Programme - School for Change Agents 2019
With so many good initiatives and best practice examples out there (…the what), sometimes the question is, the how?
How do we help teams jump on the change-wagon, how to generate the culture for change, how to light that spark, take people with you, and eventually help them take over!
The NHS Horizon’s team are running their School for Change Agents 2019 - its free!
Its great the first time and as a refresher!
For more information and to sign up follow the link : http://horizonsnhs.com/school/
The inclusion of external courses and events within GP News does not imply endorsement by NHS Cambridgeshire and Peterborough CCG or any association with their operators.
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