May 2025 Update

Welcome to the new practices that have joined us and apologies in advance for a long email! There are many changes and developments to bring to your attention.

General Updates

• Speeding up SystmOne
  • We’ve had some helpful conversations with TPP about what we can do to decrease the impact of our systems on the speed of S1. They identified the high volume of patient status alerts our systems use. We’re keen to continue using status alerts where appropriate due to their significant advantages in displaying information, such as the ability to trigger actions or the ability to see why they’re appearing. However, we have identified a few hundred alerts that can be displayed in views instead, with minimal loss in functionality. We’re also using this as an opportunity to move alerts and views into new folders/headings beginning with “WI” rather than “IHS”
  • Action to take at a practice level – go to view maintenance and deactivate all views that start with “WI” or “IHS” – this has a very significant impact on speed of patient retrieval
  • We’re looking for other ways to speed things up, including reducing some localisations and changing the default setup for new practices. A few practices may have noticed a change on the Recall Overview, with some information moving from the home screen to the Manage Recall page. If you still want all the info on the main page, let us know.

• Usability / User Instructions – we’ve started to add information into our protocols / pop-ups that make it clearer what each option does.

Recall Updates

• Select Tests for Monitoring - We’ve moved obs and samples into a separate page and added weight as an option, we’ve also made it clearer what’s included in MGUS monitoring

• Changes to Monitoring
  • AKI – if a patient has had AKI in the last 3 years, they’ll have annual UE/ACR, even if they don’t have a CKD diagnosis or abnormal results - Scenario: Management of acute kidney injury | Management | Acute kidney injury | CKS | NICE
  • ALT/LFT was previously included with the monitoring of conditions that require annual lipids, e.g. hypertension. We’ve moved this to a separate alert to make it clearer that ALT/LFT is included to support the actioning of lipids and make the system more accurate in working out when this is needed, e.g. won’t include if patient is severely frail
  • We’ve been conducting an annual review of the conditions and medications we monitor. The NICE guidance for Rheumatoid Arthritis monitoring in primary care suggests that we should conduct annual monitoring (https://cks.nice.org.uk/topics/rheumatoid-arthritis/management/confirmed-ra/). We are therefore considering removing the option to opt out of this monitoring. These patients still wouldn’t be included in the QOF only invites (unless they had other comorbidities), but it would mean that those who do attend would have RA monitoring included. A lot of practices have opted out of this monitoring so we welcome your views!

• In making these developments and changes, a few issues have come to light to make you aware of:
  • MGUS monitoring set to 4 months wasn’t properly configured when it was added. It’s been sorted now and there’s a report you can use to review any patients that may be affected in Welby Innovate Recall / Monitored Frequency / *** REVIEW: MGUS monitoring configured to 4 monthly & due monitoring
  • Sulfasalazine monitoring may not have been picked up for some patients who have been on the medication for more than a year. To review these patients, see the reports at the top of the folder Monitored Medication Shared Care.
  • DOAC frequent monitoring – the system was configured to deliberately trigger invites when the UE was due, rather than if just LFT or FBC were due for DOAC monitoring. We’ve realised that meant that sometimes patients weren’t having those bloods when due so we’ve changed the setup so they always show as due when needed, but the invite is still linked to the UE being due.
  • We really appreciate you letting us know if things aren’t quite right so we can investigate and resolve.

• Asthma Control Questionnaires - Couple of new localisation options to consider…
  • If you would like your questionnaires to be processed by clinicians rather than admin staff, let us know. We have an option that makes the protocol for processing them reflect that and work a bit differently if it’s a non-clinician processing the questionnaire
  • If patients haven’t had a phone / face-to-face Asthma review in the last 2 years, patients can be excluded from the full ACQ process

 Prescribing Updates

• New prompt available to move review dates on / add issue numbers, when a med review is coded – let us know if you would like this enabling.

• *** Coming Soon *** - GLP1 warnings / messages – this will flag if a patient is prescribed a GLP1 with any kind of contraindication. It will include preset messages that can be sent to patients / providers. We’d hoped to have this ready sooner but, like many developments, it’s a proverbial can of worms and we want to get it right. If you want to look at the reports we’ve built so far to highlight categories that we think need review, go to Welby Innovate Prescribing / GLP1

Pathology Updates

• Auto-reviewing rules - There are some new rules we’ve published. Its worth reviewing the list of what’s available and turning on what you’d like activating. Also, if you’re using the Pathology module but aren’t yet up and running with HbA1c, we can configure the rule to only file results where no action is required, i.e. it doesn’t rely on you running reports to action outcomes. Let us know if you’d like that enabling.

• Where our system generates letters to send (CKD diagnoses and BP diagnoses / further tests), we’ve created some new reports that let you split them into patients who can be sent a letter via comms annex and those who can’t. This way you can manually send them electronically rather than having to post them all.

• BP Pathway - We’re going to change how we manage new diagnoses of hypertension for patients who need follow up tests to rule out other conditions. Currently we code Suspected Hypertension and then only code the diagnosis once the other tests have been carried out. However, we realise some patients then never have the other tests and their diagnosis is never coded as a result. We will soon change this to code the Hypertension diagnosis at the point when average readings confirm raised blood pressure.

• UE filing – our systems won’t file any eGFR that’s dropped by >10% in the last 18m. Clicking on this status alert  will display that info and the option to see further info. Clicking “further info” will display what, if anything, our systems would be doing those results, e.g. confirming a diagnosis, or suggesting new medication.

In other news…

• Thank you to all the practices using our helpdesk to submit requests. If you search for “Welby Support” in the search features box, you’ll get the relevant options:

• We're looking for registered clinicians who have a passion for evidence-based medicine, and can contribute a few hours a week (reimbursed of course) to join our Clinical Governance Committee (https://www.welbyinnovate.co.uk/clinical-governance-committee/) We normally meet weekly on a Thursday morning. Let me know if you’re interested.

• I’ve talked about Webpost on a few webinars recently and several of you have expressed an interest. It’s a service that many of us use, where letters can be sent electronically in bulk to them for printing and subsequent mailing on your behalf. I’ve attached info with their latest prices. If you’d like to know more or get up and running with them, let me know (declaration of interest – I get a small commission if you sign up!). 

• If you’re interested in adopting additional modules, please be aware there may be a wait until we’re able to get you up and running – we’re growing our team and resources, but need to make sure we provide adequate support and don’t rush setup