and this is where the problems start
we have about 3500 patients with RA plus another 500 ish with psoriatic
arthritis
about 200 are on anti-TNF and about 2500 will be on methotrexate
from an unknown number of GP practices - we have patients from Carlisle
to Middlesbrough to Berwick
information about flu jabs is sent specifically out to the patient's GP
when they start anti-TNF and is on the monitoring advice sheets which
are also sent to the GP when the patient starts a new DMARD (even if we
monitor them)
but of course these don't get integrated with the records and as our
audit demonstrates this doesn't seem to make any difference at all to
the rate at which patients get flu jabs
the clinical nurse specialist has tried contacting people at 3 local
pcts and has found it difficult to find out who she should be
discussing this with
sounds as though the pharmaceutical advisor might be a good person to
start with
an alternative would be to immunise them ourselves I suppose
Lesley
On 7 Oct 2005, at 07:28, Fay Wilson wrote:
> Flu jabs are an enhanced service under the new contract and these
> patients may be covered by the original DES category for those
> immunosuppressed by disease or treatment. Almost all practices have a
> DES contract for flu so all you need to do is let them know the
> patient qualifies. If the practice doesn't provide the flu DES the PCT
> is supposed to commission it from someone else (not many of these)..
> If you are the practice nurse, you'd know if your practice was doing
> flu jabs and would just do it I guess. if there is an anxiety the PCT
> may disallow it you could check with the PCTs medical or
> pharmaceutical adviser that they agree patients taking methotrexate
> are immunosuppressed for the purposes of flu vaccination.
> Fay
>
> ----- Original Message ----- From: "Lesley Kay" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, October 07, 2005 3:49 AM
> Subject: Re: Flu Jabs for those not needing them??
>
>
>> I don't understand why it's an enhanced service though - probably
>> just me not understanding the rules - but I thought they came under
>> the heading of those immunosuppressed by their treatment or their
>> condition
>> Lesley
>>
>> On 7 Oct 2005, at 00:13, Fay Wilson wrote:
>>
>>> Contact their GP to find out whether there is a local enhanced
>>> service for
>>> it as you wouldn't expect them to do it otherwise & do they know a
>>> private
>>> provider to whom you can refer the patient?. They may be so charmed
>>> by your
>>> sensitive approach that they offer to do it anyway.
>>>
>>> Alternatively why don't you sort out a PGD with your PCT and do it
>>> yourself,
>>> you lazy so and so, expecting us poor hard-working GPs to do it for
>>> you?
>>> Now get along with you.
>>>
>>> Love and kisses
>>> Fay
>>>
>>>
>>> ----- Original Message ----- From: "Jeff Green"
>>> <[log in to unmask]>
>>> To: <[log in to unmask]>
>>> Sent: Thursday, October 06, 2005 11:39 PM
>>> Subject: Re: Flu Jabs for those not needing them??
>>>
>>>
>>>> Lesley et al,
>>>> So what does the team think - should I recommend to anyone
>>>> presenting a methotrexate script that they see their GP about
>>>> having a flu
>>>> jab - or should I search the PMR system and contact their GP
>>>> directly?
>>>> Jeff
>>>>
>>>>> can I just put a plug in for RA patients? We recommend that all
>>>>> patients on anti-TNF therapy / steroids / methotrexate have annual
>>>>> flu
>>>>> jabs. We did an audit last year and found that people only had them
>>>>> according to their other risk factors - asthma, diabetes etc, and
>>>>> these
>>>>> recommendations didn't seem to have made any difference. What do
>>>>> people
>>>>> do in other places and how would you suggest we improved things
>>>>> locally?
>>>>> Lesley
>>>>
>>>>
>>>>
>>>> ----------------------------------------
>>>> I am using the free version of SPAMfighter for private users.
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>>>> Paying users do not have this message in their emails.
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>>>>
>>>>
>>>>
>>>>
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>>>> 30/09/2005
>>>>
>>>>
>>>
>>>
>>>
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>>>
>>>
>> Lesley Kay Consultant Rheumatologist and Honorary Senior Lecturer
>> Freeman Hospital
>> Newcastle upon Tyne
>> NE7 7DN
>> 0191 233 6161 x 37867 (Carole)
>>
>>
>>
>>
>> --
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>> Checked by AVG Anti-Virus.
>> Version: 7.0.344 / Virus Database: 267.11.9/116 - Release Date:
>> 30/09/2005
>
>
>
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> Checked by AVG Anti-Virus.
> Version: 7.0.344 / Virus Database: 267.11.9/116 - Release Date:
> 30/09/2005
>
>
Lesley Kay
Consultant Rheumatologist and Honorary Senior Lecturer
Freeman Hospital
Newcastle upon Tyne
NE7 7DN
0191 233 6161 x 37867 (Carole)
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