Mycophenolate has been added to the list of approved DMARD drugs in the ABUHB Near Patient LES. Ina addition there has been clarification regarding patients who may be on 2 or more DMARD Drugs simultaneously.

"In the event that a patient is prescribed more than one Near Patient Testing drug practices must seek authorisation from the Deputy Medical Director in advance of claiming multiple reimbursement. Where authorisation has been granted practices can then claimfor each drug individually; they must clearly demonstrate the additional workload requiredfor each drug e.g. completely different tests at different frequencies. This must be clearly recorded within the patient record. The Primary Care Team will notify NWSSP as to each approval so that payments can be processed accordingly."

An updated version of the BMA guidance ‘Focus on Subject access requests for insurance purposes’ was circulated to LMCs recently. The guidance includes updated advice for practices on responding to SARs for insurance purposes, following further dialogue between the GPC’s IT Subcommittee, BMA’s Ethics department and the Information Commissioner’s Office. There is also advice on responding to SARs from third parties for non-insurance purposes, for example a solicitor acting on behalf of a client.


The COPD primary care audit is a key element of the overall national COPD audit programme which is administered by The Healthcare Quality Improvement Partnership (HQIP). The COPD National Primary Care Audit will allow, for the first time, data to be collected which will allow integrated assessment of the quality of services, at the level of the individual patient, across the whole of the treatment and outcome pathway.

Due to ongoing IT software issues in England, sufficient data is not able to be collected to enable GP practices in England to participate. These IT issues however do not affect Wales. As a result, HQIP has agreed to provide funding to enable the COPD primary care audit to proceed in Wales which I am sure you will agree reflects very well for Wales. You will be contacted shortly by your Local Health Board to ask you to participate in this important audit and we encourage you to agree to the automatic collection of data.

Practices who agree to participate will be able to download their own individual practice reports later this year (Dec 2015) and a national report containing aggregated information will be published in early Spring 2016. Additional options for providing information back to practises to support patient care are also being considered.

The Audit is supported by BMA & Gwent LMC

The attached link gives more details on the audit


The LMC wrote to ABUHB with concerns that a review was needed with regard to recent anticoagulation developments, which include Nice AF Guidance, the recent transmission locally of TTR and the green light approval for use of Rivaroxaban in primary care in Gwent.

In response, LMC and ABUHB have set up a task and finish group to work for consideration of the service approach needed to tackle various aspects of anticoagulation. This will include consideration of the current anticoagulation ES, in addition the slow loading of warfarin, introduction of NOACs and the funding of any initiatives. This is going to be a priority to be completed as soon as possible.

The issue of TTR read-coding has been raised and a solution is being sought.


Family doctors in Wales are under massive - and mounting - strain. For years, GPs have been saying they’re weighed down by excess patient demand, increased paperwork and declining investment. It’s been described as an “industrial hazard”.

A quarter of GP’s are due to retire in the next five years and others are leaving the profession early due to high levels of stress. Others no longer want the responsibility of running a surgery as an independent contractor.

"In Wales we see about 19 million GP appointments a year and every year that’s increased by three quarters of a million so in ten years we’ve had a 40% increase in consultations." Credit: ITV Cymru Wales

– Dr Debbie Waters, Chair of the Local Medical Committee for the Aneurin Bevan University Health Board


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