14 January 2021

Dear colleagues,

Today, community pharmacies joined the list of sites who are delivering the COVID-19 vaccine. Boots, Superdrug and several independent pharmacies will be the first of hundreds of community pharmacies to offer vaccinations protecting against COVID-19. Around 200 community pharmacy sites are due to come online by the end of the month as more vaccine supplies come on stream.

We are very grateful for all the sites working alongside vaccination centres and hospital hubs who are able to deliver the large volumes of vaccinations needed to vaccinate as many people as possible at speed. The standard operating procedure for the COVID-19 local vaccination services deployment in community settings has been updated today with the latest guidance.

Updates on vaccinations of care home staff and residents

With the increased rate and spread of infections we must prevent further COVID-19 mortality and ensure the protection of care home staff and residents. For every 20 vaccinations in this cohort, one death is prevented. Amazing progress has already been made but we need to do more. In recognition of the time and resource needed to deliver the vaccination in care homes, we are providing more financial support so we can protect these most vulnerable of patients and move swiftly on to the next cohort. This letter contains further details and an update on the next stages.

Change in legislation to allow any GMC registered doctor to administer the COVID-vaccine in primary care settings

The Government has announced that doctors who offer their support in delivering the Enhanced Service (ES) Specification COVID vaccination programme in primary care settings will be exempt from the requirement to be included on the England Medical Performers List. The Regulations, which come into force today (14 January), remove previous barriers and mean that any GMC registered doctor will be able to administer the vaccine and any ancillary vaccine services under the ES Specification in a primary care setting. We welcome this change in legislation which will support the rapid roll out of the vaccine, allowing more doctors to administer more COVID vaccines.

The change in legislation supports providers in the delivery of the COVID vaccination programme whilst retaining appropriate safeguards for patients. Providers are therefore reminded of their existing obligations to ensure staff have the qualifications, competence, skills and experience to deliver safe care under the Health and Social Care Act 2008.

Providers will need to assure themselves that all staff fulfil the competency and training requirements set out in the National Protocol for Covid-19 mRNA BNT162b2 (Pfizer/BioNtech). Under the Protocol, the service provider/contractor is responsible for ensuring that persons are trained and competent to safely deliver the activity they are employed to provide.

Any provider/contractor administering COVID-19 mRNA Vaccine BNT162b2 under this protocol must work strictly within the terms of this protocol and contractual arrangements with commissioners for the delivery of the national COVID-19 vaccination programme

Please note this exemption is limited to medical practitioners providing care in accordance with the ES Specification for COVID vaccinations only.

Kiren and Ali

COVID-19 updates and guidance

Access to National Workforce Supply Routes for PCN Groupings delivering the COVID-19 vaccine

We have published guidance for PCN Groupings regarding access to and onboarding of additional workforce and volunteer supply from the National Workforce Supply Routes. PCN groupings can access clinical and non-clinical workers and volunteers from organisations such as St. John Ambulance, NHS Volunteer Responders (delivered by Royal Voluntary Service) and NHS Professionals via local engagement and arrangements with Lead Employers in order to support the vaccination programme.

Long COVID services

There are 69 Long COVID assessment services across the country, taking referrals from GPs for people experiencing long COVID symptoms. Details of leads for post-COVID services in each region are available on the Primary Care Future NHS site, along with information on referring patients to the Your COVID Recovery online platform. Please contact your regional lead for further information on long COVID patient pathways in your area.

To best equip clinicians to help patients with post-COVID syndrome, the Royal College of General Practitioners (RCGP) have produced tips on the management of long-term effects of Covid-19 and Health Education England (HEE) have set-up e-learning modules on Covid-19 recovery and rehabilitation.

Pulse oximetry guidance update

The guidance for pulse oximetry to detect early deterioration of patients with COVID-19 in primary and community care settings has been updated, alongside a small update to the remote monitoring COVID-19 diary which is now also available in easy read format. Following research in wave 1 of COVID-19, pulse oximeters where highlighted as a tool for patients most at risk of poor outcomes from COVID-19. It is used to identify oxygen levels and warn the patient to the risk of ‘silent hypoxia’ and rapid deterioration at home. CCGs can continue to request pulse oximeters by emailing england.home@nhs.net.

Establishing COVID Virtual Wards

All local areas are advised to pursue immediate national roll out of a COVID ‘virtual ward’ model as an option for earlier safe and supported discharge. The COVID Virtual Ward standard operating procedure and letter to commissioners and providers has been published and designed for moderate risk patients requiring more support, for example, people requiring regular monitoring, dexamethasone and/or potentially home oxygen. Practical guidance is available including a national learning network and implementation support from local Academic Health Science Networks (AHSNs). ​

Later flow test orders

Organisations are reminded that where they haven’t yet done so, lateral flow kits can be ordered for patient-facing staff. One box of kits should be ordered for each member of staff. For example if there are 10 patient-facing members of staff delivering NHS services within an organisation, the order should be for only 10 boxes of test kits – as one box contains 25 tests and it is enough for a member of staff to test for 12 weeks. To place an order, contractors should log onto the portal and complete their order as soon as possible, and by COP Sunday 17 January to start to receive deliveries from the following week.

Deliveries are scheduled to be completed by 19 January for all organisations which placed an order before the initial deadline of 30 December. We will look to arrange deliveries for all subsequent orders as soon as possible after they have been placed.

A reminder that reporting results (positive, negative or void) is a statutory requirement. Staff should report the results of their tests as soon as possible on the NHS Digital platform.

Supporting doctors throughout the second COVID-19 wave

The Chief Medical Officers, NHS England and NHS Improvement, The General Medical Council and The Academy of Medical Royal Colleges have written a letter to doctors on working through the second wave.

Monitoring the COVID-19 vaccination programme

PHE’s vaccine surveillance strategy explains how the COVID-19 vaccination programme will be monitored to evaluate its impact on health and to support vaccine policy recommendations.

COVID-19 Vaccination Programme – workspace

General practice

Reminder of PCR swab testing service in general practice

In November, NHS Test and Trace rolled out a new service making COVID-19 PCR swab testing capability available to all general practices in England on a voluntary, opt in basis. Since then, over 3,300 practices have registered to use the service with over 185,000 test kits ordered.

If GP practices have not signed up to the service yet, they can still do so via ordering test kits page, using the unique organisation number (UON) that NHS Test and Trace sent directly to practices on 4 November. If practices are unsure of their UON they can search for it on the lookup page or phone 119.

Although complementary to current testing routes, these tests can be offered to patients who present with COVID-19 symptoms in general practice settings, to streamline patient care and increase access to testing for patients who would otherwise be unlikely to get a test via the primary testing routes. For example, due to barriers around language, disability or digital inclusion. Practices can use their discretion to offer the swabs where they deem it to be clinically appropriate.

These tests are also be available for symptomatic GPs, practice staff and their symptomatic household members to support General Practice settings to remain operational.

More information, including how it works can be found on the gov.uk page. Dr Mike Holmes, General Practitioner in Yorkshire and Clinical Advisor for GP testing in NHS Test and Trace, has also written a blog to talk about his perspective of the new service and to thank his colleagues.

General practice – latest updates

Dates for your diary

January webinars on working with people and communities in PCNs
Our webinar series for colleagues working in primary care networks continues this month, helping PCNs to provide inclusive services for people and communities from the most marginalised groups, who experience the greatest health inequalities. They include:

• Tuesday 19 January, 4pm - 5.30pm. ‘Inclusion health self-assessment tool for PCNs’
• Tuesday 26 January, 12pm - 1pm. ‘A masterclass on surveys’
• Thursday 28 January, 10.30am - 11.30am. ‘Building and developing trusted connections with communities’
• Thursday 28 January, 4pm - 5pm. ‘Connecting with Inclusion Health Communities’

Wednesday 20 January, 1.30pm – 2.30pm. Social prescribing link workers webinar: digital inequalities and inclusion during COVID-19

Thursday 21 January 2021, 11am-12pm. NHS Reset: Ensuring a greener future for respiratory care. The NHS Confederation’s webinar in partnership with the Primary Care Respiratory Society will explore how we can make respiratory care greener and kinder to the environment whilst still focusing on the complete patient journey from prevention of disease and diagnosis, through to routine chronic care including the acute situation with a #NoWasteNoHarm approach.

Link of the day

Promoting the role of the nursing workforce in primary care

Vaccination deployment queries