Locally Commissioned Services Review

NHS Norfolk and Waveney Clinical Commissioning Group (CCG) commissions a significant number of Locally Commissioned Services (LCS) from its 105 General Practices. These LCS include services often provided in general practice but which are not part of the General Medical Services contract, such as phlebotomy, minor injuries and treatment room services.

A review has taken place and from April 2022 there will be changes to these services:

Removal of ear wax – GP practices will no longer be commissioned to remove ear wax and this decision has been made on the basis of clinical priority.

Patients should self-care where possible to manage ear wax. For patients who can’t self-care and where self-care has not worked and the patient remains symptomatic (e.g. hearing loss, earache, tinnitus, vertigo, cough suspected to be due to earwax) or where the patient has a hearing aid or needs one fitted, the CCG commissions aural micro-suction services in the community which the patient can be referred, via the GP, for treatment.

Deep Vein Thrombosis (DVT) D-Dimers – Hospital Provision

Historically, West and North Norfolk practices provided DVT assessment (D-Dimer). As this service is available from all three hospital trusts in Norfolk, it is not an appropriate use of resources to also commission the service from all Norfolk practices. Patients will continue to receive appropriate care for DVTs from their local acute hospital trust.

24-hour ECG services

Historically, only North Norfolk practices were commissioned to provide 24-hour ECGs and the test was often repeated when patients were referred to hospital. This service is available from all three acute hospital trusts in Norfolk, it is therefore not an appropriate use of resources to also commission the service from all Norfolk practices. Patients will continue to receive appropriate care for 24-hour ECGs from their local acute hospital trust.