16 February 2021

Dear colleagues,

Over the weekend we sent local vaccination services a letter which provided clarification on the position on vaccinating children and young people on the Clinically Extremely Vulnerable (CEV) list and confirmed the arrangements around vaccinating the next two cohorts (5 and 6). We are asking PCN sites to focus their efforts on inviting cohort 6, while cohort 5 (those aged 65-69) will be receiving an invitation from the national booking service to attend a vaccination centre or community pharmacy setting.

The letter also includes details on delivering vaccinations in residential settings, such as care homes for people with learning disabilities or mental health problems, or hostel/hotel accommodation for the homeless, where it would not be possible for these patients to attend vaccination sites. From 15 February onwards, a PCN grouping or community pharmacy contractor, will be able to claim an additional supplement of £10 for each vaccination administered to eligible residents and staff in these settings, on top of the £12.58 Item of Service fee. 

Additional cohort of patients identified at increased risk from COVID-19

Today the Government announced a new predictive risk model to identify adults who may be at increased risk from Covid-19. The research, led by the University of Oxford following a commission from the Chief Medical Officer, combines a number of characteristics such as age, sex, ethnicity, body mass index (BMI) and clinical conditions to estimate the risk of serious outcomes from COVID-19.

Patients will be informed by letter sent centrally by the NHS and DHSC over the next few days. A letter has been sent to GPs which sets out the implication that this has for these patients, including how they should be prioritised for vaccination and noting that they will be added to the Shielded Patient List as a precaution. High risk flags are expected to appear against these patients on GP IT systems in the next few days, using the standard high risk coding.

Kiren and Ned

COVID-19 updates and guidance

Vaccinating non-NHS frontline healthcare workers 

The independent healthcare sector is included in the immediate requirement to vaccinate frontline healthcare workers. All healthcare professions seeing and treating patients are eligible, such as independent physiotherapists, podiatrists and midwives, and healthcare workers at larger organisations.

A list of allied health professions and the recent letter to the system outlines the identification of eligible workers and responsibilities within local systems for enabling and supporting them to be vaccinated.

 Nationally recruited clinical and volunteer roles

We have developed national workforce supply routes to compliment local recruitment. The access to this workforce supply is through the Lead Employer who can help you to draw down for the following roles:

• Vaccinators, Clinical Supervisors and Registered Healthcare Professionals from the NHS Professional recruitment process. These candidates will require local onboarding, training and checks before being deployed to a site.
• Volunteer vaccinators, patient advocates and post-vaccination observers supplied by St John Ambulance
• Volunteer stewards supplied by NHS Volunteer Responders, led by Royal Voluntary Service
• Clinical and GP Returners who have offered to support the NHS by vaccinating people

 Deploying GP returners to support local vaccinations

Following a communication to all GPs who had returned to the GMC register as part of the emergency response, over 1100 have responded wishing to support their local vaccination services. Those who have responded have been provided with the lead provider and PCN/CCG contact details to discuss how they can support the services. We are keen to encourage their utilisation within PCN sites. Thank you to all those who have come forward.

COVID-19 Vaccination Programme – workspace

General practice

NHS Cervical Screening Programme - Sample Taker Training guidelines

Further to the information that was included within the Primary Care Bulletin on 9 February, we would like to clarify the training guidance for new sample takers within the NHS Cervical Screening Programme. 

As outlined in Public Health England's training guidelines new sample takers should not be taking samples without completing a minimum of 12 hours initial training (not 3 as stated in last week’s bulletin) which includes 3 hours practical training (classroom or virtual), and should not be taking samples without supervision until they have had an interim sign off conducted by the cervical screening mentor. 

General practice – latest updates

Community pharmacy

Extension to engagement phase for GP referral to Community Pharmacist Consultation Service implementation

Contractors engaging with PCNs and practices over embedding the GP referral pathway to Community Pharmacist Consultation Service (CPCS) across a PCN, will now have until 30 June to undertake this work and collect evidence to claim their engagement fee and until 5 July 2021 to submit claims. This change will be included in the March Drug Tariff.

This extension from the original deadline of 31 March to complete the activity and 5 April 2021 for submitting claims, recognises the impact of the COVID-19 vaccine programme on the ability of some areas to make progress with implementation of the pathway since its introduction as a national service on 1 November 2020.

To help with engagement with practices and PCNs, a new animation published by the PSNC explains how the pathway works and how practices can refer into it and two blogs published by the RPS describe the benefits the service provides to patients from a practice and community pharmacist perspective.

For those ready to start with the service, the RPS in partnership with the Royal College of General Practitioners, are delivering free CPD sessions designed to upskill pharmacists in their clinical knowledge to enable them to help patients.

Optometry

Vaccine portal for locums and non-NHS practices

The Local Optical Committee Support Unit (LOCSU) has created a vaccine portal for locum or non-NHS provider practice staff to help ensure they are registered locally to receive the COVID-19 vaccination. Find out more.

Primary care

Easter bank holiday opening - Good Friday (2 April) and Easter Monday (5 April)

With the Easter bank holiday weekend fast approaching, we wanted to confirm there are currently no plans to ask all of primary care (general practice, community pharmacy, dentistry and optometry) to routinely open again. However, we continue to keep this position under review, subject to the changing demands of the pandemic.

Commissioners should continue to work with their providers to ensure sufficient cover arrangements are in place to meet expected demands for primary care services over the bank holiday weekend.

Local vaccination services remain the exception, where necessary providing a 7-day service, including bank holidays. Further communications on that will follow. We are extremely grateful to those who will be working over the Easter weekend but hope that everyone will be able to benefit from additional rest days.

NHS Discharge Medicines Service launched

The NHS Discharge Medicines Service (DMS) launched yesterday (Monday 15 February) and is available in all community pharmacies in England. The service has been established to ensure better communication of changes to a patient’s medication following discharge, with NHS trusts referring appropriate patients. Through community pharmacy checking and discussing medicines with patients, it will improve outcomes, prevent harm and reduce readmissions.

Resources for the DMS are on the NHS England website. This includes guidance, a cross-sector toolkit and training and assessment materials to support clinical teams across community pharmacies, PCNs and hospitals to deliver the service.

Pharmacy contractors must be ready to receive referrals and provide the service. PCN pharmacy teams should ensure that the DMS is included in 2021 medicines optimisation and safety plans.

RESTORE2™ mini training

The learning disability and autism team have been working with partners to coproduce a version of RESTORE2mini™ tailored for people who care for those with a learning disability. 

RESTORE2™ mini is an award winning tool specifically designed for carers to help them identify soft signs of deterioration and use SBARD to communicate effectively with health care professionals, so they can get the help they need at the right time. The training is being rolled out by care provider organisations who aim to train at least 5,000 carers by the end of May 2021 with NHS England and NHS Improvement offering training to at least a further 1,000 people.

Those trained carers may contact you when they spot signs of deterioration in the people they care for. They may use the terms SBARD, RESTORE2 or RESTORE2mini or soft signs and you will know that they have been on this training. To access the resources they have been given please email england.lederprogramme@nhs.net. If you know a carer of someone with a learning disability aged over sixteen who you think might value this training please direct them to the training landing page to sign up to one of our sessions.  

Inclusion Health Self- Assessment tool has launched

A partnership of voluntary sector organisations launched an online Inclusion Health Self-Assessment Tool. This simple and quick online tool is aimed at supporting Primary Care Networks and will highlight those people and communities within their populations whose voice they may not be hearing. The tailored report received on completion of the tool, outlines many different resources and contacts to support PCNs to plan their approaches to reaching out to those communities and addressing health inequalities. The tool consists of five sections and takes around 10 minutes to complete.

Consultation on changes to the data on written complaints

NHS Digital is currently collecting data on complaints regarding NHS primary care services – collected annually via the KO41b return from GP and Dental practices. The data collection will stay open for 6 weeks until the 26 March. You can respond to the consultation online.

Integration and Innovation: working together to improve health and social care for all

The Department of Health and Social Care (DHSC) has published a White Paper “Integration and Innovation: working together to improve health and social care for all”, which sets out new proposals to build on the successful NHS response to the pandemic and bring health and care services closer together to improve care and tackle health inequalities.

There was a significant response to NHS England and NHS Improvement’s recent engagement on placing Integrated Care Systems (ICSs) on a statutory footing and, in response, we have made five recommendations to Government to inform the forthcoming legislation. This response built on the bespoke sessions held last year with stakeholders including clinical commissioners, staff representative groups including GPs and allied health professionals, which identified and recommended that clinical leadership was fundamental to the success of ICSs. We will be producing advice for ICSs on embedding system-wide clinical and professional leadership at every level of governance, including through their health and care partnership. This should include a central role for GPs and primary care networks.

Further details are available in the press release, a letter sent out to System Leaders, as well as a set of frequently asked questions (FAQs). The changes set out will help to shape our future work, which at its heart is about enabling everyone we serve to live a healthier and happier life for longer, with more convenient, responsive services when people need them.

Next phase of Help Us, Help You launches, with a focus on lung cancer  

Today marks the launch of the next phase of the Help Us, Help You campaign, urging people to come forward and seek advice if they are worried about possible symptoms. The focus of this stage is to raise awareness of the key symptom of lung cancer – a cough that lasts for three weeks or more. The campaign will encourage those most likely to get lung cancer and who have this symptom and not COVID-19 to contact their GP Practice, reminding the public that cancer remains a priority and that the NHS is here to see them safely. TV and radio adverts will go live from today, with media activity planned for Wednesday 17 February.

Dates for your diary

Wednesday 17 February, 6pm - 7pm. Community Pharmacy Webinar – next steps in delivering the COVID vaccination programme

Wednesday 24 February, 1pm – 2pm. Development of digital solutions for home-based and care home management

Wednesday 24 February, 1.30pm – 3pm. New advancements in technology and pathway redesign, within Teledermatology: Part 3/3 Webinar Series

Thursday 25 February, 10am – 11.15am. Flexible Working - the case for change in the NHS

Wednesday 3 March, 1pm – 2pm. The IGPM progress update: Recognition, representation and membership

Friday 5 March, 12pm – 1.15pm. The opportunities for systems to improve patient outcomes using digital and data

Wednesday 17 March, 3.30pm – 5pm. Inclusion Health Self- Assessment tool live demonstration

Link of the day

BIMA debunks myths surrounding the COVID-19 vaccine