18 September 2020

Dear colleagues,

Thank you for everything you have been doing to keep services running and accessible to patients through the pandemic whilst keeping staff and patients safe - it is recognised and appreciated.

We have produced a communications toolkit to help communicate to patients what services are available and how best to access them.

Updated Contract DES Specification 

NHS England and NHS Improvement has published an updated Network Contract DES Specification and Network Contract DES Guidance. The changes cover areas such as the introduction of the Investment and Impact Fund, the introduction of nursing associate and trainee nursing associate roles to the Additional Roles Reimbursement Scheme, and flexibility – by exception – for the clinical lead role for care homes to be a non-GP. The full summary of changes is set out in the covering letter.

Primary Care Networks (PCNs) who wish to continue to provide the DES and have no changes to any of their sign up information (as set out in section 4.3.2 of the DES) do not need to take any action, as they will be auto-enrolled into the new DES. If a practice does not accept the revised terms and wishes to opt out, they must notify the commissioner by 17 October 2020. This information is set out in the covering letter.

In addition, guidance has been published for the Investment and Impact Fund and for Structured Medication Reviews (SMR).

Nikki and Ed

COVID-19 guidance

Update on PHE’s Acute Shortages Guidance

The Public Health England (PHE) Acute Shortages Guidance was introduced on 17 April 2020 as a result of an acute shortage of personal protective equipment (PPE). Given our improved supply, this guidance has now been withdrawn by PHE. Should similar guidance be required in the future, it would be re-issued based on the best available scientific evidence at that time.

Technical specifications for Personal Protective Equipment (PPE)

The Health and Safety Executive and the Medicines and Healthcare Products Regulatory Agency have updated the technical specifications for PPE and Medical Devices during COVID-19 including FAQs, available here.

These specifications are also used in the central procurement process for PPE but local providers should also check any donations or locally procured PPE against these specifications alongside other established checks they undertake.  

Where there are significant concerns about a product’s CE mark and/or evidence to support its use, you should  approach the relevant regulator for a review of the product’s available data/information as outlined in the FAQs.

General practice

Urgent action: Smartcard renewal issue affecting EPS prescribers

Due to a recent smartcard renewal issue, some Electronic Prescription Service (EPS) prescribers need to self-renew their smartcards urgently.

Prescribers who renewed their smartcard or were issued with a new one between 2-4 September 2020 must self-renew their smartcard before issuing any further EPS prescriptions. Smartcards that are not renewed by 4 October 2020 will expire. For further support with this, please contact your local Registration Authority.

Practices may be contacted by pharmacies unable to dispense affected prescriptions and should cancel the original EPS prescription and issue a replacement.

For action: Workforce data collection reminder 

Understanding the current workforce is essential for planning and will support the future development of primary care. It is also a requirement as part of the GP Contract and Network DES that practices and PCNs submit regular workforce information.

The next reporting deadline is 30 September 2020; you will need to check that you have updated your records on National Workforce Reporting System (NWRS). For practices, this should include any locums or subcontracted capacity. For PCNs, this should include all staff funded through the Additional Roles Reimbursement Scheme (ARRS), whether employed by the PCN or by another body (e.g. social prescribing link workers are often employed in the voluntary sector).

From October 2020, the practice reporting requirement will be changing from quarterly to monthly with the next extraction on 31 October. It would be beneficial for practices to update workforce information as changes occur, to keep the records up to date. More information on how to register and use the NWRS is here.

Advice & Guidance: guide for general practice

Advice & Guidance (A&G) services provide GPs with continued access to specialist advice on investigations, interventions and potential referrals. This helps manage non-urgent patients in the most appropriate setting. A short guide is now available which sets out practical advice for general practice teams to get the most from A&G services, including:

• how A&G can support the safe and effective delivery of care alongside COVID-19 activity;
• where general practice teams can learn more about making an A&G request; and
• how general practice can support system partners in implementing A&G services in their area.

Further information is available on the Elective Care Community of Practice. Please email ECDC-manager@future.nhs.uk for access to this platform. Support is also available on the Advice and Guidance toolkit for the NHS e-Referral Service (e-RS).

Delivering the early diagnosis of cancer PCN specification: getting started and learning from others – briefing

The ambitions of the NHS Long Term Plan could mean 55,000 more people a year survive their cancer for at least five years after their diagnosis by 2028 through early diagnosis. Primary care – and primary care networks (PCNs) – will be vital in this drive. Ahead of the early diagnosis specification’s ‘relaunch’ and the new Snomed codes for safety netting being introduced on 1 October 2020, this briefing produced by the NHS Confederation’s PCN Network and Cancer Research UK looks at what the requirements are, the challenges PCNs face and provides a wealth of practical advice, top tips and a case study.

Community pharmacy

Planning ahead for winter in community pharmacy

As we plan ahead for winter, community pharmacy must remain vigilant and safe regarding COVID-19 and maintain its focus on infection control and prevention. In order to be prepared, we encourage all pharmacies to sign up for the national PPE portal, if not done so already, as an important emergency supply route. Pharmacies will need to do this via their original invitation email.

This winter pharmacies will need to take part in two health campaigns – the public facing campaign to encourage people to get vaccinated against flu begins in early October.

The national flu campaign resources will be delivered to all pharmacies in early October. Please register here to download any additional resources.

Dentistry

Sign up: NHS dentistry and oral health bulletin

This October, we are launching a new NHS dentistry and oral health bulletin, which will include a roundup of all the latest news and important resources for anyone working in NHS dental services. We will still share important content in this bulletin. Sign up here.

Flu reminders and updates

Flu vaccination services and registration with the Care Quality Commission

The Care Quality Commission (CQC) is aware that providers are thinking about and planning the ways in which they will deliver flu vaccinations for winter 2020/21, potentially in different ways than usual as a result of the COVID-19 pandemic. CQC has provided new guidance to help providers understand whether they need to make any change to their current registration if they are delivering a flu vaccination service.

Flu vaccination funding for community pharmacy 

NHS England and NHS Improvement, the Department of Health and Social Care and the Pharmaceutical Services Negotiating Committee have agreed the funding for the Community Pharmacy Seasonal Influenza Vaccination Advanced Service in 2020/2021.

The fee per vaccination remains at £9.58, and for this year only:

• £0.50 per vaccination will be paid from CPCF funds
• up to £1m of medicines margin can be retained for vaccinations administered above the number of a normal year. This is in addition to the allowed £800m medicines margin under the Community Pharmacy Contractual Framework.

NHS England and NHS Improvement is also making additional funding available which will need to be pre-authorised by NHS England and NHS Improvement regional teams to support venue hire and cold storage costs for contractors who are planning off-site vaccinations. Further details are available on the NHS Business Services Authority website as part of the Drug Tariff.

Flu vaccinations advised for all primary care staff

In order to protect colleagues from seasonal flu and ongoing COVID-19 risks, we are asking employers to ensure that all their staff, including locums, are vaccinated.

The national flu immunisation programme letter of 5 August 2020 outlined how people eligible for free flu vaccination will be offered this through local NHS arrangements, meeting their responsibility to protect their staff and patients and support the resilience of the health and care system. It is particularly important to ensure that staff who could be at higher risk, such as Black and Ethnic Minority employees, are adequately protected this winter. Download this communications toolkit for more information.

Primary care

Blog: Wellbeing and the primary care workforce

Mike Holmes is a general practitioner at Haxby Group in Yorkshire and the Vice Chair (Membership) at the Royal College of General Practitioners. In his new blog, he talks about how our workforce has been at the heart of the response to COVID-19, working hard in new and rapidly changing circumstances – but he is worried about wellbeing, and how it’s important that everyone is aware of the support available, including the free #LookingAfterYouToo coaching support.

NHS Low Calorie Diet Pilot starts in 10 areas

Thousands of people will be able to access NHS soup and shake weight-loss plans to tackle type 2 diabetes as part of a pilot trialling the NHS Low Calorie Diet Programme.

5,000 patients in 10 areas will benefit from a year-long programme of support which includes ‘total diet replacement products’, such as shakes and soups, for three months, followed by a healthy food re-introduction phase alongside ongoing support to maintain weight loss and increase exercise levels.

There is no ask on local teams outside of the 10 pilot areas, who should continue to offer usual care. The Programme is based on clinical trials; one of which showed almost half of those who went on the diet achieved remission of their Type 2 diabetes after one year. This pilot tests evidence from the original trials in ‘real world’ implementation.

Click here for more information and the list of pilot sites.

New Personalised Care Training Hub is now open

The new Personalised Care Institute is a virtual training hub for all health and care staff to access the very latest in personalised care training and development.

It offers a wide-range of flexible, evidence-based and accredited courses from a variety of providers and will support staff to gain the knowledge and confidence to provide Personalised Care to their patients. For more details, visit our website, view our animation and join in the conversation on Twitter via @Pers_Care_Inst.

Dates for your diary

Monday 21 September, 7pm - 8pm. TweetChat: Power to the people – Coproducing MSK. Join @WeAreARMA and the MSK LEG members for a TweetChat about all things MSK coproduction #MSKCoPro.

Tuesday 22 September, 10am - 11am. The primary care hot hub - the West London experience.

Wednesday 23 - Friday 25 September. Clinical Pharmacy Congress 2020.

Thursday 24 September, 12:30pm - 1:30pm. Delivering the early diagnosis of cancer PCN specification: getting started and learning from others.

Wednesday 30 September, 12pm - 1:30pm. Musculoskeletal (MSK) First Contact Physiotherapists: webinar and Q&A session. 

Wednesday 30 September, 4pm - 5pm. Digital Primary Care - Flu Campaign 2020.

Wednesday 30 September, 10am - 12pm. New PCN health and wellbeing coaches webinar.

Thursday 1 October, 11am - 12pm. NHS Volunteer Responder programme - webinar.

Thursday 8 October, 12pm - 1:30pm. New PCN care coordinators webinar.

Nikki and Ed's link of the week

Video: Never to Forget - A musical tribute to health and care workers who have died of COVID-19