COVID-19 Primary Care bulletin

12 June 2020

COVID-19: today's round-up for primary care

Dear colleagues,

The deadline for GP practices to sign up to the 2020/21 Network Contract Directed Enhanced Service (DES) passed on 31 May, and we are very pleased to report that 98 per cent of practices have chosen to participate in Primary Care Networks (PCN) this year. They have formed 1,250 PCNs – the same number as last year. PCNs have been at the forefront of the general practice response to COVID-19: for example by providing resilience where staff have been absent, enabling collaborative arrangements for COVID assessment hubs, and enabling a cross GP and community services multi-disciplinary team approach to supporting care homes.

Expanding the workforce is the top priority for PCNs this year. It is critical to relieving the workforce pressures felt by many in general practice, enabling primary care to be sustainable into the future. And it is necessary to deliver improvements in patient access to general practice, and support better care. Colleagues up and down the country are already experiencing the benefits of clinical pharmacists and social prescribing link workers in general practice: this year, the number of reimbursable roles has expanded to 10 (with at least a further two roles to follow in 2021/22). The DES reimburses 100% of actual salary costs plus employer on-costs (up to the maximum levels set out in the scheme). Support for staff recruitment and deployment is available from CCGs and other community services partners; the PCN development funding for 2020/21 will enable support for staff induction and retention.

We know that recruiting will have been difficult over recent weeks and understand that PCNs will have got off to a slower start this year than ideal. We want to encourage you to take steps now to make sure the investment offered to primary care for additional workforce is used this year.

Supporting remote monitoring using pulse oximetry

Yesterday we published guidance setting out principles to support the remote monitoring, using pulse oximetry, of patients with confirmed or possible COVID-19 in the community, focused on primary care.

There is now clear evidence that patients most at risk of poor outcomes are best identified by oxygen levels. The use of oximetry to monitor and identify ‘silent hypoxia’ and rapid patient deterioration at home is recommended for this group.

The principles we have set out will inform the work already ongoing in many practices and community teams using oximetry to support remote monitoring, and support these services being expanded to a wider cohort as needed.

Nikki and Ed

Dentistry

Resources for dental practices

As dental practices begin to open to see patients, we have produced a poster for practices to use in their entrances. These are now available to download on Public Health England’s Campaign Resource Centre.

The Oral Health Foundation have also created a poster on what patients can expect when attending dental practices for treatment which you may find useful.

Community pharmacy

Electronic repeat dispensing

Community pharmacies are likely to be experiencing an increase in electronic repeat dispensing (eRD), and patients whose prescriptions are moving to eRD may need advice and support on how to use the service as they adjust to the new arrangements. GP practices have been advised by NHS England and NHS Improvement to discuss the changes with local community pharmacies.   

On 4 June, NHS England and NHS Improvement wrote to community pharmacists and GPs to say the requirement for patients to consent to receiving their regular medication via eRD had been temporarily suspended until 30 June 2020. Any patient who is already receiving or who has agreed to receive electronic prescriptions may now begin to receive the regular medication in this way, subject to the practice confirming that the service is both clinically and practically appropriate for the patient. Practices may also seek consent and pharmacy nomination from patients who are suitable but currently receiving paper prescriptions.

Additional information

Minimising the spread of infection

Earlier this week NHS England and NHS Improvement sent a letter to organisations across the NHS, including community pharmacies, GP practices and PCNs and dental and optometry providers, to ask them to take actions to minimise the spread of infections in the NHS while maintaining patient access to services.

The key actions for community pharmacies are:

1. To prepare for potential staff absence, providers should review their existing business continuity plans and take actions as required. This includes ensuring that arrangements are in place to maintain patient access to services.
2. Providers should inform their commissioner as soon as they consider that delivery of the full contracted service may be compromised by staff absence due to Test and Trace. The commissioner will work with the contractor to put business continuity arrangements in place and to maintain access to services for patients.

Ongoing and consistent implementation of national infection prevention and control guidance, including in staff areas, will be paramount in reducing healthcare associated infections. This includes all staff adhering to social distancing (2 metres) wherever possible.

NHS Volunteer Responders ready to help health and care frontline staff

Health and care staff working in frontline services can now get help with essential tasks such as shopping and collecting prescriptions from NHS Volunteer Responders. Access to this service will help staff working at the forefront of the COVID-19 pandemic so that they can continue to support those most in need at this time.

Anyone working in frontline services can ask for help from NHS Volunteer Responders by calling 0808 196 3646 (8am to 8pm). When requesting support, staff will need to provide an email address, which should ideally be their work email address. It’s quick and easy to request support.

New support package to help manage patients with long-term conditions

UCLPartners has launched a new package of digital resources and practical support to help primary care teams to continue providing proactive care to patients with long-term conditions during and post COVID-19. The support on offer can help stratify care for patients according to level of risk, using new models of care that are virtual by default, mobilise the wider workforce, draw on digital innovation and support patient self-management. The support package focusses on the management of asthma and COPD, with resources for the management of type 2 diabetes and cardiovascular disease being added soon. Dr Matt Kearney, GP and Programme Director for Primary Care Innovation at UCLPartners, explains more about the support package in a new blog.

Collecting your examples of innovation

We are collating examples of new and innovative ways of working in general practice and community pharmacy, so that we can ensure beneficial changes are captured and, where appropriate, sustained. We would like to learn from you, and the communities you care for, about the innovations that have emerged in response to COVID-19, and understand which of these should be kept and protected in the months and years to come. Submit your examples by Thursday 25 June at ipsos.uk/COVIDinnovation. Please contact the team if you have any questions.

Self Care Forum Coronavirus Innovations Award

Every year the Self Care Forum invites submission of examples of good practice and innovation during Self Care Week - this year they will be celebrating good self care practice for coronavirus initiatives. Winners will be given a £500 bursary and highlighted as a true innovator at a time when we need to find inspirational ways to support and protect people against one of the deadliest viruses this country has faced in decades. If you have implemented an inititive that has made a difference to individuals and the local community then get in touch. This invitation is open to everyone and the closing date for admissions is 31 July 2020. Find out more and submit.

Dates for your diary 

Wednesday 17 June, 1.30-2pm - Digitally Excluded Communities - how to support your patients with getting online

Thursday 18 June, 5-6pm – GP webinar with Nikki and Ed

Nikki and Ed's link of the day

Prof Donna Kinnair on racism in the NHS: ‘In every community, BAME patients suffer the most’