Ignoring the poorer Braun sutures, the list of claimable Johnson & Johnson Ethicon absorbable sutures as ungone an unexplained and unwarranted change.

All coated vicryl, monocryl and PDS II has been removed from the list and a large number of expensive vicryl plus sutures added. There was no advance warning of this. A list of the additions are:

The November issue of the MPS Casebook described a case of death following cardiac arrest during intralesional corticosteroid injection under local anaesthesia. The claim against the dermatologist included the allegation of failure to inform the patient of the risk of death from anaphylaxis from the anaesthetic but expert opinion was that the main issue was the delay in administration of adrenaline from the inadequate availability of emergency equipment. Do you know where the adrenaline is in your surgery and do you have  the algorithm in your head or on the wall?

New guidance has been released on the timing of corticosteroid injections and any of the Covid vaccinations. The concern is that the patient may not mount such a good immune response and the benefits and risks are discussed in the guidance.

The MDU will be presenting this new guidance during the next ASPC webinar at 7.30pm on the 10th of February 2021. Members will be contacted with the Zoom meeting details. Details of membership of the ASPC is on https://www.aspc-uk.net/join/

November 2018

Project Vantage at Johnson & Johnson has led to a change in product code in some of the sutures on the 2012 list of sutures which are reimbursable under Personal Administration on the NHS GP Tariff. Only 4 sutures are affected but practices may wish to note the conversion codes as retailers, electronic GP record systems and the NHS Prescription Service update their records. 

Update Jan 2019: The retailers are selling the sutures on the new code but EMIS WEB and SYSTEM 1 are prescribing on the old codes, which NHS Prescriptions are recognising reimbursement claims for. The GPC are working on the issue.

Update Apr 2019: Please see the letter from NHS England. 

Many GPs do not understand the new State-funded Clinical Negligence Scheme for General Pratice (CNSGP) despite it coming into operation on 1 Apr 2019.

Effectively

a) Indemnity for all NHS activity, when provided by any organisation which provides primary medical services, is covered by the CNSGP. NHS activity, when provided by private companies which do not also provide primary medical services, is NOT covered by CNSGP.

b) Indemnity any fee-paying non-NHS activity, which used to be covered by the medical defence organisations under the standard GP subscriptions (up to a certain gross income) will no longer be covered unless private practice indemnity is bought.

c) Professional services (letter writing, support for GMC hearings etc) should be purchased from the medical defence organisations and you shall need to declare if you are carrying any form of minor (or intermediate) surgical activity as the fee will be adjusted to reflect this.

More information is available at https://www.england.nhs.uk/gp/investment/indemnity/.