November 2025 Update

Welcome to the new practices who've joined us!

Our next webinar is scheduled for Wednesday 3 December at 1pm. We're looking at refining your SystmOne organisation preferences to reduce work and make life easier for you. We particularly recommend attending with the decision-makers in your practice so you can review and amend your setup as we go through the meeting. Sign up here - https://bit.ly/WelbyWebinar

Improving communication with patients

Following feedback from practices and ICBs, we're looking to shorten the messages we send. We're wary of doing this at the expense of clarity, leading to more calls into practices (the last thing we all want!). Here are some other steps you can take to reduce costs and improve comms...

• Review this article to check your settings, e.g. turn off access codes and allow links to last much longer than 7d - How should I configure my system for sending SMS? : Welby Innovate
• Look at how you can increase the uptake of SMS and particularly email - How do I increase the use of Email and SMS? : Welby Innovate
• We've recently recorded a video on how you can attach letters to messages in bulk and have created brief presets to aid this - https://youtu.be/dS1i2HxciMw - we haven't changed the names of any reports to suggest where to use this; we've left that up to you for now but we're planning to do this when we next overhaul and update the Recall invites (likely in readiness for the start of the next QOF year)

Recall Updates

• Monitoring changes
  • Terbinafine - now configured to monitor LFTs every 6w if on repeat (Terbinafine | Drugs | BNF | NICE)
  • Lipids - system now takes account of recent codes like "Lipid Lowering therapy not indicated" or "Max tolerated dose" or "Cholesterol test declined" and won't routinely monitor lipids in those cases
  • NSAID monitoring - as its a "consider" rather than essential monitoring category, we've created an option to turn off monitoring of this medication. Let us know if you'd like that enabling for you
  • Finasteride – now monitored every 12m for PSA
• New Questionnaire to consider sending – some of you have raised concerns about patients who’ve had their LTC review but without any lifestyle info gathering or advice. We’ve built some reports that can be used to send a one-off message with a lifestyle questionnaire – essentially the General AR questionnaire but without the requests for BP, weight, etc:

These reports are looking for patients who haven’t had diet/exercise, smoking status, and alcohol consumption recorded in the QOF year, or coded advice given about health education. They’re entirely optional to use.

Pathology Updates

• AutoReview Rules – we’re regularly adding new rules and updating existing ones to keep pace with labs, who seem to enjoy changing their codes and information. We’d recommend reviewing the rules you have active and let us know if results aren’t filing that you think should be
• BP – in September, we changed our approach with raised average BPs, to go straight to coding a hypertension diagnosis, rather than just suspected hypertension. This approach is working better and means patients will have annual monitoring and reviews, even if they don’t respond to invites to have other tests. We’ve had a few issues with updating all the elements of the system with this change. There may be a few patients appearing in reports to send letters out to where there’s been a slight delay as a result. We’ve also built some more reports to check our systems are working as they should, and to provide opportunity to audit how they’re being used in practice. We’d recommend auditing some of the patients in these reports:

As ever, please do let us know if patients aren’t getting the follow up you’d expect.

We’re also improving the way we communicate with patients about BPs and planning to introduce some new reports for sending various different messages for requesting home BPs. We’ll let you know when this is coming and provide an updated pathology planner.

• Haematinics – following feedback from several practices, we’ve decided to pause filing B12s that are in the indeterminate range (180-350 or equivalent). There are scenarios where action should be considered for these patients. We’re planning to develop pathways to manage these results in bulk. If you want to review results that have been previously AutoReviewed in this category, we’ve built a report that can be used:

• PSA filing – We’re aware that several areas have guidance like “re-refer if PSA doubles over 6m”. Due to the array of possible instructions, it’s not practicable to test all of these in our systems. Instead, we’ve built an option to record that each PSA result should be reviewed, and reminders checked when filing. You can access this protocol on the PSA template:  
• Questionnaires – we’re considering phasing out options like “I’d like to discuss this with a pharmacist” – this generally creates additional steps and work for the practice. Our plan is to move towards providing more information in the main body of the questionnaire to support a decision. The questionnaires will still say the patient can contact the practice to discuss if they’d like, but put the onus firmly on the patient for that. Our data shows that often patients say they want to discuss the medication, but then don’t respond to invites, so it feels like we’re creating additional work with little benefit. Do let us know if you have any particular views on this either way.

Prescribing Updates

• HRT questionnaire – we’ve made a number of updates to this, including adding questions re Weight loss injections and progesterone and updating the articles we direct patients to. The pathway for managing the answers remains unchanged.
• Overdue repeats protocol – we have an option to block sending questionnaires out when a patient has had a med review coded since their last birth month. The protocol will prompt staff to task for review. Let us know if you’d like that enabling for you.

Displaying BP readings

We regularly get feedback about the self-reported BP readings not appearing in the BP graph. We've raised this with TPP - they're aware and may sort it at some point. There is a development request you can vote for: 1ec30000. If 10 staff from every practice receiving this email voted, we'd soon have >1000 votes and TPP may pay attention! I have also tried to develop a visualisation that accounts for different types of BP codes and displays them all. It's available and you're welcome to try it, but feedback so far hasn't exactly been glowing! As ever, open to suggestions!

In general, we're trying to group major updates together, particularly those that affect how staff use the system. This means there are fewer updates each month, but we're starting to plan larger, focused updates. Our next update will be to the Prescribing module in late January. As well as simplifying how reports will work and providing a Prescribing Planner, like we have for Recall and Pathology, we’re also looking at some new features. We’re particularly interested in developing pathways to review newly initiated medication without the need for appointments, e.g. SSRIs and Asthma medication.

Finally, one of our plans for 2026 is to launch a new module for Safeguarding. It will be based on resources we’ve been developing and using for many years. It won’t be as big as the other modules but we know what a significant area of work this can be and we want to help get it right. Watch this space for more details!