Your Livi Population hub

After every consultation, medical notes recorded by the Livi GP will be visible in the practice patient record. Thus, new patients will need to have had at least one practice consultation first (physical or virtual) so they have active consultation notes in the EMR in order for a Livi GP to treat them.

To help your practice team get to know more about Livi and when to refer patients, please find answers to some frequently asked questions below.

Q: What is Livi? Livi is a video GP service that lets patients see a GP the same day – even on weekends. Livi's registered NHS GPs can offer medical advice, prescriptions and referrals by video. It’s available free on the NHS to patients of participating practices including this one. Patients simply download the Livi app on their mobile or tablet and sign up.

Q: When should I recommend Livi to patients? If patients don’t need a physical examination, always consider Livi. GPs can offer medical advice, prescriptions and referrals by video for a wide range of symptoms. They also regularly see patients who:

• Can’t make it into the surgery. For example due to time, work, or accessibility issues

• Are anxious and want to speak to a GP quickly

• Are busy parents who have difficulty attending surgery or are anxious

• Are unable to get an appointment for days, or even weeks

• Prefer to see a GP by video rather than face-to-face

Livi is available to everyone but is especially useful for some patient groups:

• Busy mums

• Time-poor workers

• People with disabilities or accessibility issues

• Patients with more complex conditions

• The elderly

• Patients with social anxiety

Patients with the following symptoms may require immediate assessment and local procedures should be followed:

• Chest pain or signs of a heart attack

• Signs of a stroke

• Severe difficulty breathing

• Severe injuries or heavy bleeding

• Ongoing seizures

• Sudden or rapid swelling of the eyes, lips, mouth or tongue

• Signs of sepsis

• Severe abdominal pain

• Thoughts of self harm or feeling suicidal

• Back pain with any of the following new symptoms: bowel or bladder disturbance; weakness in both legs; numbness to buttocks, saddle area or both legs.

• Routine face-to-face appointments: The Livi GP will advise the patient to contact their practice to organise an appointment.

• Urgent face-to-face appointments: The Livi GP will signpost the patient to attend their local WIC/UCC/A&E or contact your surgery directly.

• Fit notes: The Livi GP will create and save the fit note into the patient record before tasking to ‘tasks from Livi’ if they are unable to send it to the patient digitally.

• 2ww referrals: The Livi GP will complete the 2ww proforma and save this in the patient record. The Livi admin team will then process the referral via E-RS before sending the appointment information to the patients Livi inbox within the app. The Livi admin team will also send a task to 'tasks from Livi' which will include the booking reference number (UBRN) to confirm that the referral has been processed.

• Blood tests and other diagnostics: The Livi GP will put details of the investigations required in the medical notes and task details of the test required under ‘Tasks from Livi’. In most instances, our clinicians do not have access to ICE, so investigations will need to be added to ICE via practice staff.

• Routine referrals: Referrals are processed via E-RS/email by the Livi admin team as per local pathways. Once processed, the appointment information or next steps will be sent to the patients Livi inbox within the app. If Livi does not have an appropriate pathway or the pathway is not accessible to Livi, a task will be sent to 'tasks from Livi' and the referral must be processed by practice staff.

• Prescriptions: The Livi GP will issue an EPS prescription and send this to the patients nominated pharmacy. If the patient does not have a nominated pharmacy or prefers to collect their prescription from elsewhere, the GP will issue an EPS prescription that can be collected from any pharmacy. The GP will also send a confirmation message to the patient's Livi inbox within the app.

Please be aware that Livi GPs will generally not request: CT’s, MRI’s or X-rays as the patient will likely need a face-to-face review first.

For a list of conditions Livi GPs can treat please visit livi.co.uk/medical-advice/all-conditions. The Livi GP will only offer help for one health concern per appointment (unless there are clinical safety concerns). Livi can treat children from age 1+. However, if the patient booked is under 16 (ages 1-15) they would need to be in attendance with the legal guardian/parent.

Our clinicians are prohibited from prescribing certain medications, which include, but are not limited to:

• Antipsychotic medication (newly initiated, with limited exceptions such as prochlorperazine for nausea, vomiting, vertigo)

• Nicotine replacement therapy

• Anticoagulants (newly initiated)

• DMARDS (for example methotrexate, azathioprine)

• Sodium valproate

• All immunosuppressants and immune-modulating drugs

• Cytotoxic drugs

• Botox & fillers

• Schedule 1 and 2 controlled drugs (e.g. morphine, methadone, oxycodone)

• Certain schedule 3 and 4 controlled drugs (e.g. gabapentin, pregabalin, zopiclone, diazepam)

• Drugs needing initiation via a specialist

• Drugs restricted on the local formulary

• Patient leaflet: here
• Practice poster: here
• Livi logo for use on websites, online or email: here