Primary Care Bulletin - today's round-up

12 March 2021

Dear colleagues,

Thank you for the key role you have played in the vaccination programme to date and your continued efforts to ensure that all eligible patients are offered a COVID-19 vaccination. We recognise the significant commitment you have made to the programme whilst also caring for your patients’ routine, urgent and COVID care.

People aged 55 to 59 (cohort 8) were sent a vaccination invite letter over the weekend, and this week more than 400,000 people who are aged 55 or an unpaid carer will be the first to get text messages from the national booking service.

We have now written to PCN-led vaccination sites about phase 2 of the COVID-19 vaccination programme. We want to support as many PCN groupings as possible to sign up to deliver vaccinations to cohorts 10 to 12 (patients aged 40-49, 30-39 and 18-29), though we need to keep balancing delivery of vaccinations to these cohorts with wider general practice led service provision, which we recognise is a priority for you too.

The COVID-19 Vaccination Programme 2020/21 Enhanced Service Specification has been updated to enable PCN groupings the option to provide COVID-19 vaccinations to these cohorts once each of these cohorts has been authorised and announced and where practices in the PCN grouping can demonstrate to their local commissioner that they meet the requirements in the annex of the enhanced service.

For now, cohort 6 remains a priority for first dose vaccinations via PCN-led sites. Please make every effort to support everyone in cohort 6 to understand the importance of their vaccination so that we can achieve good uptake in this cohort and can ensure that no one gets left behind. All those eligible in this cohort, as defined by JCVI, should be offered an opportunity to receive the vaccination. To ensure that those who are eligible come forward to receive their vaccine, the national booking service will send text messages to all those in cohort 6 with underlying health conditions encouraging them to book their vaccination via the national booking service if they are yet to receive an invitation.

As we move into phase 2 it will be important that all PCN-led sites can provide assurance that an offer for vaccination has been provided to those in cohorts 1-9 before the vaccination of cohort 10 begins.

Kiren and Ali

COVID-19 updates and guidance

Post-COVID Assessment Services

There are 67 Post-COVID Assessment Services across the country. Each region has an identified lead for post-COVID services, details of which are available on the Primary Care Future NHS site, with information on how local teams or post COVID assessment services can refer patients to the Your COVID Recovery online platform. Please contact your regional lead for further information on long COVID services and patient pathways in your area.

A set of SNOMED CT codes to support the management of long-term effects of COVID-19 are available on all major GP EPR systems. You can find more information on the Primary Care Future NHS site.

New simulation videos for COVID Oximetry @home and Virtual Ward services

In partnership with The Royal Free NHS Foundation Trust, UCLPartners have developed Stop:Start simulation videos to support trusts in setting up COVID Oximetry @home and Virtual Ward services.

The videos have been created to support multi-professional clinical staff by simulating clinical assessment and triage calls with patients onboarded to these services. The aim is to familiarise clinicians with some of the situations they will face and provide self-led training focussing on communications skills and monitoring patients safely.

Reminder to place an order of lateral flow devices

All primary care contractors are reminded that following a direct email from Primary Care Support England (PCSE), they should place their second round of orders for lateral flow devices (LFDs) on the PCSE online portal to re-supply their staff with a new box of 25 tests, which will enable them to test for another 12 weeks. More information on how to order tests can be found on the PCSE website.

Primary care contractors should carefully take notice of the following key points:

• Order your test kits separately from any other weekly orders, as any orders placed with other supplies items cannot be processed and will need to be cancelled.
• You will receive confirmation of your order. Please make sure you do not place duplicate orders, as this will delay the process.
• Please order 1 item per member of staff. The maximum order quantity on the portal is 54. If you need to order for more than 54 members of staff, please email pcse.urgentsupplies@nhs.net
• Deliveries will start on 25 March and will be delivered over the next 2-3 weeks after this date.
• Reporting of all test results via gov.uk remains imperative – whether negative, void or positive. This is a statutory notifiable disease reporting requirement.

Flowing Covid-19 Assisted Lateral Flow Device test results to GP records

Positive Assisted Lateral Flow Device (LFD) test results will shortly begin to be flowed to GP records, including historic results. Assisted refers to LFD test results being interpreted and reported on behalf of the citizen by a trained operative at a test site.

This does not apply to Unassisted LFD tests which are self-administered, interpreted and reported by the individual, such as LFD tests that primary care staff are regularly undertaking twice weekly. At this stage, negative and void Assisted LFD tests and all Unassisted tests will not be flowed to GP records.

There is no action on the GP following receipt of these LFD results and no need for GP practices to report them to PHE as a notifiable disease. GP staff can identify these results by using SNOMED Code 1322781000000102.

Depending on current national guidance and prevalence rates, individuals may be required to take a confirmatory PCR test following a positive LFD test result. This will be communicated to them separately.

COVID-19 Vaccination Programme – workspace

General practice

Update on vaccination and immunisation changes for 2021/22

We have written to practices confirming the changes to the provision of routine vaccination and immunisation in general practice from 1 April 2021. These changes were first set out in February 2020‘s Update to the GP contract agreement 2020/21-2023/24 as part of a two-year transition to the new requirements.

Update on Quality Outcomes Framework changes for 2021/22

We have written to update practices on the changes to QOF for 2021/22. To provide practice stability and to support recovery, QOF for 2021/22 will be based on the indicator set already agreed for 2020/21, with very limited changes only. An updated version of the QOF guidance has also been published providing further detailed information on the changes to QOF for 2021/22. QOF will be reinstated from 1 April 2021.

We also wish to inform practices that the Department of Health and Social Care have now published the amended QOF Statement of Financial Entitlements for 2020/21 which provides practices with further information on income protection arrangements for QOF 2020/21.

Publication of Primary Care Network Dashboard

After a period of user testing, we have launched the Primary Care Network (PCN) Dashboard on NHS ViewPoint. To access the dashboard, please either register on the Insights Platform or login in using your existing Insights Platform account and then select the NHS ViewPoint product. A user guide is available on FutureNHS to help navigate the dashboard.

The dashboard supports PCNs to understand their local population health priorities and the benefits that they are delivering for their patients. It will include indicative data on performance and achievement for the Investment and Impact Fund indicators, as well as PCN service delivery and progress with recruitment. Some indicators draw on data extracted from GP IT systems, as described in the 2020/21 Network Contract DES. Further information about these indicators, and the SNOMED codes that they draw on, can be found on NHS Digital’s website.

The dashboard is refreshed when new data sources are updated providing a consistent and current view. It’s accessible to all PCNs and generates shared and comparable views across the country.

The product will evolve based on user feedback over the coming months, and we welcome your views on how it can be improved. Please send any feedback on the product to the dashboard team using the webform or email england.viewpoint@nhs.net if you have questions about the product or struggle to gain access. If you have any questions about the data available on the dashboard, email england.gpcontracts@nhs.net.

General practice – latest updates

Primary care

New joint national plan to make pharmacy practice more inclusive launched

Pharmacy professionals across England are being urged to join in with a new Joint National Plan for Inclusive Pharmacy Practice published on The Royal Pharmaceutical Society and Association of Pharmacy Technicians UK websites to help make the most of the benefits of their diversity for improved and better healthcare provision.

Chief Pharmaceutical Officer Dr Keith Ridge, Royal Pharmaceutical Society president Sandra Gidley, and Association of Pharmacy Technicians UK president Liz Fidler, on behalf of 12 partner organisations, have written to pharmacy professionals asking them to work to deliver the plan in their healthcare setting over the next four months, with a focus on continuing to address vaccine hesitancy and reducing health inequalities more broadly.

The plan has been co-produced by an advisory group working with a wide range of partners from across national organisations in the pharmacy sector. It sets out actions for pharmacy professional leaders and their teams at all levels and in all care settings to consider, including developing their understanding of the benefits of diverse teams and culturally competent healthcare service delivery to address inequalities and ensuring the voices of colleagues from Black, Asian and Minority Ethnic backgrounds are fairly represented and equally heard in decision-making forums.

Lonely young people have an increased risk of mental health problems years later: research suggests lockdown could have a long term effect

Loneliness and social isolation increase the long-term risk of depression and anxiety in children and teenagers, a recent review of research suggests. Researchers wanted to find out more about the possible impact of COVID-19 measures on the mental health of this vulnerable group. They hope their work will raise awareness of the likely rise in mental health issues and encourage clinical services to provide targeted help and support for young people. Read more about this study.

International #SocialPrescribingDay

If you have seen the impact of social prescribing link workers (SPLWs) in your practice, International #SocialPrescribingDay on 18 March is a good opportunity to take to social media to share their stories and talk about how they have become part of the PCN team. During the pandemic SPLWs have helped to keep many people connected and engaged, and they will have an important role in supporting people and communities who need additional time and resource as they begin to recover. Banners and logos for social media and email signature are available to help you spread the word.

Public urged to act FAST if they suspect stroke

Public Health England (PHE) and NHS England and NHS Improvement, supported by the Stroke Association, have this week relaunched the Act FAST campaign. Stroke is a time-sensitive condition – any delay in getting treatment impacts a patient’s health outcomes. The campaign reminds people of the symptoms of stroke and why urgently calling 999 is vital for saving lives.

The campaign has been relaunched in response to data suggesting that some people put off seeking help for stroke during the first months of the pandemic.

Think and act FAST - the signs of stroke are:

• Face – has their face fallen on one side? Can they smile?
• Arms – can they raise both their arms and keep them there?
• Speech – is their speech slurred?
• Time – it’s time to call 999 if you see any of these signs or symptoms.

Campaign materials are available on the Campaign Resource Centre.

Dates for your diary

Tuesday 16 March, 9am – 5pm. NHS and the armed forces conference

Wednesday 17 March, 9.30am – 11am. Supporting your team to work flexibly

Wednesday 17 March, 3.30pm – 5pm. Inclusion health self-assessment tool live demonstration

Thursday 18 March, 1pm – 2pm. Learning from co-production – using better engagement to address health inequalities

Thursday 18 March, 2pm – 3.30pm. Workforce recruitment and retention in PCNs

Thursday 18 March, 8pm – 9pm. The role of the PCN/GP practice pharmacist in implementing the GP referral pathway to the Community Pharmacist Consultation Service (CPCS)

Monday 22 March, 1pm – 2pm. Public Health England: CVD Prevention Packs update

Tuesday 23 March, 10am – 11am. An Introduction to Working with People and Communities

Tuesday 23 March, 10am – 2pm- 3pm. ICSs and patient empowerment – how can we work, at place, to effectively give people better control over their own health and care?

Wednesday 24 March, 10am - 11am. Connecting with our local community to deliver the COVID vaccine programme

Wednesday 24 March, 12pm – 1pm. NHS Confed: Mental Health Practitioner

Thursday 25 March, 9.30am – 11am. Flexible working: how to ask

Thursday 25 March, 10.30am – 11.30 am. Building and developing trusted connections with communities

Link of the day

The health of people from ethnic minority groups in England