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Primary Care Bulletin - this week's round-up
22 July 2021
Dear colleagues,
We may be on the cusp of the school summer holidays, but planning is well underway for the autumn both in terms of the booster COVID-19 vaccine and the annual flu vaccination programme.
The expanded flu vaccination programme will continue this year as part of our wider winter planning when we are likely to see both influenza and COVID-19 in circulation. This means that alongside the usual eligible groups, all 50-64 year olds will again be offered flu vaccination. For the first time the programme is also being expanded into secondary schools up to Year 11.
The tripartite annual flu letter contains all the details on eligible groups. A briefing document about the schools flu vaccination programme is also available.
Further details will follow shortly for both general practice and community pharmacy.
Self-isolation
The government has confirmed that Public Health England is updating its guidance to enable essential frontline staff to return to work following a negative PCR if they have been asked to isolate due to potential contact with COVID-19. This applies to all contractor groups in primary care. Further details can be found in this letter and on the Public Health England website.
A discussion will need to take place between the relevant worker and their employer about whether it would be appropriate to make use of these provisions based on the facts of the individual case.
Risk assessment as per the published guidance should be carried out by the senior clinical leadership in that provider (e.g. a practice). We recommend that the risk assessment takes into account the considerations in the letter and any other recommendations or instructions from local public health teams.
Please notify your local commissioner of the outcome of the process unless they inform you this is not required and assume that the DPH must formally authorise each individual’s return to work, unless notified of an alternative sign off process.
This bulletin also contains further information from the Department of Health and Social Care for the clinically extremely vulnerable patients. See below for more details.
Nikki and Ed
Dr Nikki Kanani
GP and Medical Director for Primary Care,
Deputy SRO, COVID-19 Vaccination Deployment Programme
NHS England and NHS Improvement
Ed Waller
Director for Primary Care, NHS England and NHS Improvement
COVID-19 updates
Clinically extremely vulnerable patients
Responding to the Government’s further easing of covid related restrictions on Monday 19 July, the DHSC have updated the guidance to those who are clinically extremely vulnerable. In the coming days, we expect that DHSC will provide some additional information about advising vulnerable patients who are immunosuppressed and who may not respond as well to the COVID-19 vaccine as others. Evidence is still emerging on relative risk and clinicians will be informed if this results in any changes to the advice for patients.
This letter outlines our continuing expectations across primary care in relation to access, infection prevention and control, and continuing contractual/regulatory arrangements. It also confirms that a number of the standard operating procedures (SOPs) that have been in place since March 2020 will be withdrawn.
Pharmacy-led Phase 3 local vaccination services Designation FAQs
Further to the Phase 3 webinar held on Thursday 15 July for general practice and community pharmacy, we have published a set of frequently asked questions (FAQs) for community pharmacy to support those considering expressions of interest to take part in the potential COVID-19 booster programme from the autumn. A set of FAQs for general practices will be published very soon.
Transition to new Covid test kits for pharmacies
NHS Test and Trace are moving to new COVID-19 test kits over the coming weeks. Innova COVID19 Test kits which are nose and throat tests will be replaced with Orient Gene tests from week commencing 26 July for a short period of time.
Orient Gene Kits are a rapid nose-only test for COVID-19 for use at home and are different to the Innova tests which are nose and throat tests.
From the 2 August, Orient Gene kits will be replaced by Acon Flex Flow kits which are also nose-only tests.
As we transition between products Pharmacies should continue to work through existing stock levels and are reminded that people collecting for themselves should only be provided with one box of test kits.
Please continue to report test collections every week using the NHSBSA’s Manage your Service (MYS) portal. We thank you for your continued support in delivering this service.
GP and Pharmacy PPE Engagement Panels
The Department of Health and Social Care (DHSC) is recruiting panel members for GP and Pharmacy personal protective equipment (PPE) engagement panels to gather feedback on the quality and quantity of PPE provided to meet service needs.
The purpose of the panels is to provide end-user customers the opportunity to discuss their (COVID) PPE provision experiences, in order to improve the service of the DHSC PPE cell. The meeting will take place for one hour on a monthly basis.
If you would like to express an interest in joining, please email NonAcutePPECustomerDemand@dhsc.gov.uk with your name, role and panel preference.
Working safely during COVID-19: guidance from Step 4 (Community pharmacy and optometrists)
A new update to the guidance relating to those providing services in retail spaces and those providing close contact services was published yesterday. This is particularly relevant to community pharmacies and optometrists who will often have both healthcare and retail spaces within their premises. There are a number of priority recommendations, key amongst which is to undertake a risk assessment so that contractors can identify the actions they need to take to ensure that their staff and patients/customers are protected and able to access services. The full guidance, including a list of the priority recommendations, is available for you to review and action as appropriate to your premises.
Patient queries about vaccination records
A service is being established to support people in England with specific queries about their COVID-19 vaccination records. This service is expected to go live in August and NHS Digital will provide more information when available.
In the meantime, you can find answers and support for common data queries on the NHS Digital website.
Letter to help people without an NHS number access the COVID-19 vaccine and register with a GP
An NHS England and NHS Improvement letter tells people without an NHS number, including migrants, how to get the COVID-19 vaccine and if they wish to, how register at a GP practice. Circulated via the Home Office and local housing, homeless and migrant teams; it explains that COVID-19 vaccines are safe and available to every adult living in the UK, free of charge without any immigration checks. The letter also stresses that people do not need to have a GP or an NHS number to get the COVID-19 vaccine and what people need to do in these circumstances. Information is also available on how to record these vaccinations. If you are unable to access Future NHS platform, please email england.vaccination-equalities@nhs.net for a copy of the letter.
General practice
Reminder to submit your workforce data
The new National Workforce Reporting Service (NWRS) went live earlier this month, and is now accessible via your Strategic Data Collections Service (SDCS) account. Please ensure you have access to this or find out how to register. Information and helpful videos on how to complete your workforce data through the NWRS is also available. The next practice data extraction will take place on 31 July, so please do ensure you complete your data submission before this date.
General Practice Data for Planning and Research programme
On 8 June, a pause to the data collection was announced until 1 September 2021, to allow time for NHS Digital to speak with GPs, patients, health charities and others, and strengthen the plan. A letter from NHS Digital was sent to general practice on Tuesday this week, confirming that, while NHS Digital will continue to develop the infrastructure and engagement for the programme, they are not setting a specific start date for the collection of data. This means that the 1 September date no longer stands.
In addition to the letter, NHS Digital is issuing a press release and notifying a range of national and local stakeholders to help ensure that people are aware of the change of approach.
Information on applying for visa sponsorship now available
Information about applying for a visa sponsorship licence is now available on the GP Workforce Scheme Delivery Hub.
This includes the slide pack used by the Home Office for the GP visa sponsorship webinar we hosted in June, along with some questions and answers that were raised at the webinar. Both contain useful information for people who were not able to attend.
Gaining the right to be a UK visa sponsoring practice has many advantages and could form an important part of your general practice workforce planning. One in three newly qualified GPs this year will be international medical graduates and numbers will increase in years to come. These candidates have spent three years training in England as part of the HEE programme and have excellent language skills and knowledge about the NHS.
Pharmacy
Contractual Terms of Service
In response to the pandemic, a number of contractual dispensations were put in place to support contractors to maintain core services and meet the needs of their patients in 2020/21. For clarity, pharmacy contractors are reminded that all contractual Terms of Service will need to be completed in 2021/2 included the following:
- The Community Pharmacy Assurance Framework screening questionnaire will need to be completed via the NHS BSA MYS portal by 24 July 2021.
- Updating of practice leaflets where and when required
- The NHSE&I determined national clinical audit, details of this audit for this year are still to be announced, and the contractor chosen clinical audit.
- The Community Pharmacy Patient Questionnaire (CPPQ) for 2021/2
- The annual complaints return for 2021/2
- The health campaigns still to be announced for 2021/2
Further details on the contractual Terms of Service can be found online.
In addition, contractors are advised that routine provider assurance post payment verification sampling will resume, as will the requirement to return NMS quarterly returns to the NHS Business Services Authority for quarter 2 onwards.
Dentistry
Primary care
Medical Associate Professions (MAPs) Core Capabilities Framework consultation is open
In 2015 Health Education England commenced work to establish the Medical Associate Professions (MAPs). This professional group includes Physician Associates, Anaesthesia Associates, Surgical Care Practitioners and Advanced Critical Care Practitioners.
This year, a Core Capabilities Framework is being developed, which identifies and describes skills and knowledge MAPs need to deliver safe, high quality care.
A project steering group commenced earlier this year, and the framework is now seeking feedback and engagement more widely.
We invite you to participate in the framework online consultation (open until 4pm Friday 13 August). We also encourage you to share this with your professional networks.
New ‘equivalence’ scheme for non-ARRS PCN clinical pharmacists
A process to recognise the knowledge, skills, training and experience of clinical pharmacists working in general practice outside Additional Roles Reimbursement Scheme (ARRS) roles has been established. The Centre for Pharmacy Postgraduate Education (CPPE) has published guidance on behalf of NHS England and NHS Improvement and Health Education England.
There are a large number of clinical pharmacists working in general practice who haven’t been eligible to undertake the Primary Care Pharmacy Education Pathway (PCPEP), but who, through other post-registration programmes and experience, may have the necessary skills to undertake structured medication reviews (SMRs). This will help enable as many patients as possible to access an SMR in primary care. Separate guidance already exists for those who are exempt from the PCPEP.
Record patient safety events to our new national ‘Learn from patient safety events’ service and support safer NHS care
Primary care staff and organisations are encouraged to create an account and start recording patient safety events directly onto the new national Learn from patient safety events (LFPSE) service.
Recording patient safety events to a central system provides vital insight to make care safer across the NHS. The new system also supports safety at a local level by giving organisations access to analysis and oversight of the incidents reported by their individual practice or group. For further information, visit our dedicated LFPSE primary care webpage.
The previous NRLS GP e-forms for recording incidents are no longer in use and now redirect to the new service.
Responding to formal complaints
We would like to remind all providers that the handling of formal complaints should be a matter of business as usual. Whilst there was a previous pause period, the 2009 Complaints Regulations have applied throughout. Complaints should be handled and managed as usual irrespective of whether the complaint has been made directly to you as a provider or whether the complainant chose to complain to NHS England as the commissioner (as the Regulations permit them so to do).
We are aware of reports of growing levels frustration among some patients and carers which are being reflected in a number of ways including increased levels of complaints. Good complaint handling can help us mitigate these pressures and prevent further escalations and we would be very grateful if you could co-operate as best as you can, recognising the circumstances you are working in as well.
Support for the Deterioration Tool Survey in Care Homes
The National Patient Safety Team’s Managing Deterioration Safety Improvement Programme, working with the Academic Health Science Networks and Patient Safety Collaboratives, has recently circulated a Deterioration Tool Survey on the Care Homes Capacity Tracker.
This survey will help the team to understand the following:
- Numbers of care homes that are already using tools to spot when their residents are becoming unwell.
- Which types of tools are being used in relation to deterioration and personalised care and support planning, and how often they are used.
- Where more support is needed.
You can find more information about different types of deterioration and structured communication tools (including free videos and e-learning resources) on the Care homes AHSN Network page.
Please encourage your local care homes to complete the Deterioration Tools Survey to tell us where more help is needed and what type of free support we can provide.
BestMSK Health Collaborative High Impact Strategy now available
BestMSK Health Collaborative have published new guidance now available on FutureNHS, High Impact Restoration Strategy, designed to be adapted to meet your local systems.
The guidance includes core recommendations and supporting documents to help shape delivery and improvements of the BestMSK Health Collaborative programme at ICS and place level.
The programme is working on further developing the strategy, pathways and metrics reflecting population health approach and welcome any feedback, please submit comments to england.mskimprovementprogramme@nhs.net.
More documents and tools to support implementation work are available on the BestMSK Health Collaborative regional area on the Futures site. Contact england.mskimprovementprogramme@nhs.net to be given access on behalf of your region.
Key dates
Upcoming events and webinars
Tuesday 27 July, 9am - 11am. Welcome to General Practice webinar for GP trainees and newly qualified GPs
Link of the day
Royal College of General Practitioners: Women at the heart of general practice online exhibition
