Immunology and Allergy service in SBUHB

On 21st February 2024 we sent an email update regarding Immunology and Allergy service in SBUHB:

Dear Practices

The LMC has been seeking an update from the HB since practices shared that the Cardiff allergy services and immunology specialist service had been decommissioned.

The SBUHB Commissioning and Contracting Manager has shared the following with the LMC:

"We have had clarity that Cardiff service would continue to accept referrals for patients who have been seen and treated within local secondary care allergy services who continue to have significant symptomatic burden despite the interventions made and where the secondary care allergy service requests a tertiary opinion. For SBUHB residents, new referrals are being sent to West Sandwell & Birmingham NHS Trust via the Prior Approval route as an interim arrangement whilst alternative commissioning options are being explored. I would advise that any referrals are submitted via SBU IPFR team at: Planning.Office@wales.nhs.uk. This would also support in quantifying the ongoing demand for this service requirement toward establishing a sustainable resolution.

As notice was provided to cease activity to all South Wales Health Boards, a task and finish group lead by Powys THB are collectively exploring a joint commissioning route via bordering English Trusts to support with the demand for Welsh patients. Primarily, ongoing discussions are taking place between North Bristol and Powys THB for this commissioning approach but appreciate that due to the specialist nature of the service we are faced with limitations.

I aim to continue with further internal conversations to explore the viability of a potential local SBU resolution, but note that this will take time to plan, design and implement but will ensure the primary care colleagues are updated as soon as possible with any developments."

A commissioned service would be in the LMCs opinion the most robust and safe approach. As soon as we have more information we will distribute.

Many thanks

Nimish

The LMC have been continuing to seek updates on the commissioning of a local adult allergy service.

There have been no substantial developments. Can we therefore ask that you utilise the attached partially pre-populated form to submit via IPFR. This form will only require patient details and your electronic signature.

If there are further developments the LMC  will update practices.

Allergy for GP_NEW_PRIOR APPROVAL - V2.1 July 25 PRE-POPULATED FORM.docx

Download DOCX • 47KB

Phlebotomy Update 27/1/26

We recently posted about the phlebotomy waiting times and have been actively engaging with the Health Board to improve this situation. The issue was discussed at the SBUHB Board meeting on 26/1/26 and the paper is attached below.

MLMC have been informed by SBUHB that the current waiting time (median) is now (as of 27/1/26) 13.5 days actual days (not working days) and this is down from ~22 days in December. There remains significant variation across sites with the best areas (Gorseinon and Port Talbot) averaging a 5 day wait whereas Singleton remains at >20 days.

Rather than running at 100% capacity the service is now holding back specific capacity in some areas for shorter notice release for urgent appointments and the extended hours trial, allowing for patients working 9-5 to access the service, is looking to be extended.

Another issue which has been acknowledged is patients having to travel to secondary care sites to access phlebotomy services and consideration is being given into increasing community phlebotomy provision.

A national benchmarking exercise is being completed by SBUHB and this will inform a new operating model, acknowledging that there are challenges with the current booking system.

SBUHB is keen to work with the LMC to design a sustainable, future-proofed, 3-5 year model for the phlebotomy service, noting that recent data from 2 years ago indicated that approximately 12K blood tests were taking place in practices and not being claimed for. It should also be noted that the Welsh Government have an agenda to transform the phlebotomy service illustrating that it is a national area of concern.

Please continue to datix related issues and contact us regarding your concerns about this important patient safety issue. 

Phlebotomy Paper Jan Board 2026.docx

Download DOCX • 244KB

Information for GPs working in Out of Hours regarding General Medical Practice Indemnity (GMPI) cover

The Scheme for General Medical Practice Indemnity (GMPI) is a discretionary state-backed scheme that covers clinical negligence claims for incidents occurring on or after 1 April 2019.

The indemnity coverage differs significantly depending on how the GP is engaged:

1. Out of hours services (OOH) provided via contractual arrangements between a Health Board and an independent provider/sub-contractor, are captured by the scheme for GMPI. This includes any locum or agency staff who are engaged via such independent provider/sub-contractor. However, all locum doctors who are engaged by an independent provider sub-contractor (other than those doing locum work solely in their own GP practice) are required to join the All Wales Locum Register, to have access to the scheme for GMPI

2. Any employees, locum, agency or bank workers who are directly engaged by a Health Board are captured by standard NHS indemnity arrangements. (this is not GMPI) 

So you need to be quite clear as to your employment status and if it qualifies for section one then you are covered under the GMPI and need to be on the whole Wales register but don't have to document every Out Of Hours shift.

So for peace of mind individuals should get clarity about their contractual status with the health board and then contact their indemnity provider to see if they are covered.

The other burning question is all the guidance talks about Out Of Hours services and again clarification would need to be gained from GMPI regarding NHS111 which operates in hours.

Dr Nimish Shah