2 February 2021

Dear colleagues,

Yesterday we confirmed that the NHS has now offered the COVID-19 vaccine to every eligible care home resident across England. Local vaccination sites and community pharmacies have helped to contribute over 8 million first vaccine doses in England. This is a huge milestone and we’d like to thank all the staff that have made this possible.

Movement of vaccines

Moving the Oxford/AstraZeneca vaccine between locations across a single primary care network (PCN) grouping is encouraged if it will help minimise inequalities, maximise access and ensure timely vaccine usage. Moving vaccine within a PCN grouping is perfectly legal but the vaccine MUST be moved safely. The vaccines are not the same as flu vaccines and the Standard Operating Procedures (SOP) need to be adhered to. More information is also available in our letter of 7 January 2021. 

Oxford/AstraZeneca has to be moved at 2-8 degrees in a validated cool box, as set out in the SOPs. Local NHS pharmacists are there to help and if they are unsure, will contact regional colleagues for support. See the latest position statement for the vaccination of care home residents using the AstraZeneca vaccine.

Pfizer/BioNTech is sensitive to movement and its movement is never encouraged. Movement of vaccine between PCN groupings and/or other providers is different and governed by the policy on mutual aid. This is discouraged unless absolutely necessary.

COVID-19 vaccination - national call/recall letters to Clinically Extremely Vulnerable people

From Wednesday (3 February), people aged 18 and over in the clinically extremely vulnerable (CEV) cohort (as identified through the Shielded Patient List) will start to receive letters from the national call/recall service inviting them to book their COVID-19 vaccine at a vaccination centre or community pharmacy. The letters make it clear that people have a choice of where to get vaccinated and can choose to wait for their GP services to contact them directly, if they haven’t already, or book into a vaccination centre or community pharmacy. A copy of the letter and a PCN letter template is available in the latest letters pack on FutureNHS.

Kiren and Ned

COVID-19 updates and guidance

Easy read letter template for people with learning disability and autistic people receiving the COVID-19 vaccination

We have developed an easy read COVID-19 Immunisation letter template for use by local vaccination services. In the short term it is recommended that communication and invitations for autistic people and those with a learning disability in an at risk group should be invited via local vaccination service as the primary route in order to ensure that appropriate reasonable adjustments can be facilitated.

Please ensure all autistic people or those with a learning disability are invited for their vaccination when eligible, in line with the government guidelines on cohort prioritisation set by JCVI. We are currently working with the National Booking Service to broaden choice of vaccination service for people with a learning disability and autistic people and further updates will be shared in due course.   

Healthcare worker vaccine uptake

Many primary care contractors will have been contacted by their CCGs or regional teams in the last few days to ask about the proportion of their front-line staff who have been given a first dose of a COVID-19 vaccine. We are very grateful for your help in providing this information, which will be important in making sure that primary care staff across the country are able to access the vaccine.

The Green Book – updates

Immunisation Against Infectious Diseases (The Green Book) is updated on a regular basis, specifically the chapter on COVID-19.

Recent changes include an emphasis that patients who are taking anticoagulants should be offered vaccination in most cases.

There is also further clarification on which children aged 12-16 years on the clinically extremely vulnerable (CEV) shielding list could be called. In brief: ‘vaccination may be considered for children with severe neuro-disabilities who tend to get recurrent respiratory tract infections and who frequently spend time in specialised residential care settings for children with complex needs.’

Confirmation has been added that the Oxford/AstraZeneca vaccine is to be authorised to those over 18 and the Pfizer/BioNTech vaccine to those over 16 years of age. Any vaccination for a patient aged less than 16 will require the authorisation of a prescriber, almost always a doctor. The Patient Group Direction or National Protocol cannot be used.

There are changes to the guidance for patients due to start immunosuppressive treatment – for example, if prior to cancer they have had therapy or a solid organ transplant they could be offered a vaccine prior to starting treatment, if clinically recommended. This includes potentially having the second dose at 3 or 4 weeks after the first.

Antimicrobials (azithromycin and doxycycline) not beneficial in the management of COVID-19 positive patients

A CAS alert has been issued by the MHRA advising that azithromycin and doxycycline should not be used in the management of confirmed or suspected COVID-19 infection within primary care, unless there are additional indications for which its use remains appropriate. General practices are asked to ensure that the local primary care team is aware.

A National Institute for Health Research supported PRINCIPLE trial found a lack of beneficial effect in patients aged over 50 who are treated with either azithromycin or doxycycline at home in the early stages of COVID-19, unless there is an additional licensed indication.

Azithromycin or doxycycline may otherwise continue to be prescribed within the licensed indications, within NICE and other associated guidelines.

Vaccine information – resources in community languages

We have produced videos of clinicians recording messages in some of the most commonly spoken languages to help ensure messages about the importance of getting a COVID-19 vaccine are clear for all.

Public Health England has also shared printable leaflets on COVID-19 vaccine information in various community languages. Download from the Campaign Resource Centre and share through your channels.

COVID-19 Vaccination Programme – workspace

General practice

Access to mental health care for students

Current government advice is that many students who returned home for Christmas will receive online teaching from home this term. All practices who register university students are asked to be alert to the needs of patients who may now be living a long distance from the practice, and ensuring remote support is available for them, including for their mental health needs.

All practices are also asked to be alert to the needs of students who may require face-to-face support, away from their university registered practice and support access via temporary registrations where needed. Students should be signposted to self-refer to NHS psychological therapies services (IAPT) where appropriate. If a formal referral to a Mental Health Trust is required, we have reminded Trusts that referrals should be accepted even when the patient is not registered with a nearby GP.

Finally, practices are reminded that every area now has an all age 24/7 open access urgent mental health helpline for those that need support in a crisis.

General practice – latest updates

Dentistry

Dentists who work in secure settings – pension scheme information

NHS dentists who currently hold or previously held NHS Standard Contracts or Personal Dental Services Contracts, or who worked under such contracts, to deliver Dental Services in the secure and detained estate, including prisons, immigration removal centres and secure children’s homes, may have been informed that they are not eligible to be part of the NHS Pension Scheme, which is incorrect.

If you believe you have been wrongly omitted from the NHS Pension Scheme whilst delivering Dental Services in these settings, please complete this form and submit to nhsbsa.retrospectivemembership@nhs.net who will calculate the arrears of employee contributions. Completing and submitting the form does not legally commit you to claiming retrospective NHS Pension Scheme membership, you will only make that decision once you know the arrears of employee contributions due.

Primary care

Locum pharmacy technicians urged to get COVID-19 vaccination

Locum pharmacy technicians working on the frontline across primary care are encouraged to ensure they take up the COVID-19 vaccine as soon as it is offered to them.

Chief Pharmaceutical Officer for England Keith Ridge, along with the other Chief Professional Officers has written to colleagues highlighting the importance of getting vaccinated to protect themselves, so they can be there for others.

An NHS number or GP registration is not required to receive a vaccination, nor for booking in for one. Hospital hubs, pharmacy and GP-led Local Vaccination Services are all offering COVID-19 vaccinations to eligible frontline health and social care staff.

Find my NHS number

A new service is now live to help find your NHS number. This service is for anyone living in England who has forgotten or does not know their NHS number. You can also use this service on behalf of someone else where the name, date of birth and registered home postcode is known. You can opt for the number to be sent to you by text, email or letter.

Roadmap for paramedics wanting to work in primary care  

Health Education England has developed a new pathway to help paramedics advance their careers. The ‘roadmap to practice’ outlines the skills and attributes needed to help paramedics become first contact practitioners (FCPs) or advanced practitioners (APs).

FCPs and APs come from several allied health professions, they are highly skilled in their own area of expertise and are trained to consider a person’s total health needs, working with a multi-profession team. This is to the benefit of both care and outcome for patients through improved critical thinking, decision-making and better teamwork.

The new roadmap provides a clear educational pathway for paramedics who wish to work in primary care, as well as setting out the supervision and governance needed and giving training guidance for supervisors.

Social prescribing link worker – recruitment support (extension)

Last August, 340 primary care networks responded to an offer of short term funded support for the costs of recruiting additional social prescribing link workers. This was in recognition of the role that link workers are playing in the primary care pandemic response.

The deadline for the recruitment to be completed was originally 31 January 2021, but this has been extended to 26 March 2021. If you have not yet confirmed your recruitment or submitted the agreement form which was sent to you it is not too late, but please confirm your intentions and submit the form to england.linkworkerrecruitment@nhs.net no later than 26 March 2021 to ensure that funding is not lost.

Blog: Nothing about us, without us

Prerana Issar, NHS Chief People Officer, discusses hosting the first ever national disability staff network leads summit in her new blog. 

Dates for your diary

Thursday 4 February, 10am – 11.45am. Supporting our working carers in the NHS

Thursday 4 February, 2.30pm – 3.30pm. Provider collaboration at scale: what is it, what are the opportunities and how do we get there?

Tuesday 9 February, 4pm – 5.50pm. New Inclusion Health Audit Tool – webinar for primary care networks

Link of the day

How collaboration pushed forward the Nottingham West care home vaccination programme