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Primary Care Bulletin - this week's round-up
16 September 2021
Dear colleagues,
One of the greatest inequalities for children is in their oral health. Approximately only one in 10 children under two has an NHS dental check-up, but a first dental visit by a baby’s first birthday will help prevent the tooth decay experienced by a quarter of England’s five year olds. We can all help tackle poor child oral health through promoting dental check-ups by educating children and families on tooth brushing and a healthy diet and promoting high impact clinical interventions.
We have also produced an implementation tool for dental teams to support NICE guidance, which assists dental professionals in the recall of children for a dental appointment.
Becton Dickinson Blood Specimen Collection Portfolio – supply disruption update
A letter has been sent to the NHS providing an update on the supply disruption related to BD blood collection products. Best practice guidance for primary care has been issued encouraging clinicians to think twice, check twice and order once.
The availability of alternative products and improvement in BD’s production capabilities, alongside the efforts of NHS staff to manage use, mean that the supply situation is no longer as constrained as when we wrote to you on 26 August. However, the issue has not yet been completely resolved.
The letter advises primary care that testing activity in primary and community care, in line with the best practice guidance, can resume, stocks permitting from 17 September. We ask that any backlog of tests is worked through over a period of at least eight weeks, prioritising as required, in order to spread out demand for tubes.
All organisations are asked regularly review their stock holding and upcoming planned care requirements and aim not to re-stock to more than one week’s worth of tubes based on demand from June and July 2021.
Don’t miss out on your third dose of the vaccine if severely immunosuppressed
To all our staff who are severely immunosuppressed, a third dose of the vaccine has been made available to you as recommended in guidance by the Joint Committee on Vaccinations and Immunisation (JCVI).
If you are severely immunosuppressed due to treatment for conditions such as cancer or have a long-term condition where your immunity is affected by medication (as defined within JCVI guidance), you are offered a third dose of the COVID-19 vaccine as part of the primary course of the vaccination.
If you haven’t been already, you will be contacted by your GP team or consultant so please look out for the contact. And please remember the third dose is not the booster vaccine - the third dose is part of the primary course of immunisation and is recommended to be given at least eight weeks after the second dose. So please take up the offer and ensure you are protected as we go into the winter season.
Nikki and Ed
Dr Nikki Kanani
GP and Medical Director for Primary Care,
Deputy SRO, COVID-19 Vaccination Deployment Programme
NHS England and NHS Improvement
Ed Waller
Director for Primary Care, NHS England and NHS Improvement
COVID-19 updates
Enhanced Service Specification: Phase 3 coronavirus vaccination
We have updated the Enhanced Service Specification to inform GP practices planning to support phase 3 of the COVID-19 vaccination deployment programme.
From 11 November all staff entering a care home need to be vaccinated unless exempt – reminder of action required
Further to our letter and FAQs published last month, we’d like to remind you that all staff need to have had their first vaccination by Thursday 16 September (as eight weeks is required between the 2 doses) if they are to be permitted to enter a care home from 11 November. We expect that many of you will already be discussing this with relevant staff and you should continue to do this. If you have not done so already please take immediate action to familiarise yourself with our FAQs, which should be read alongside the DHSC medical exemptions and DHSC operational guidance.
End of the shielding programme and managing the closure of the Shielded Patient List (SPL)
The Government set out in a Written Ministerial statement yesterday their decision to end the shielding programme. Patients will not be advised to shield in the future and a managed closure of the SPL will be taking place.
NHS Digital will retain the capability to identify high-risk patients in the future. Relevant patients will be written to directly to inform them of this change and support still available. You do not need to inform patients yourself.
Future changes to the COVID-19 risk status for patients in your care will no longer be captured on the national list.
We will be in touch shortly with further updates.
Long COVID Enhanced Service 2021/22
Long COVID or post -COVID syndrome is an increasingly widespread condition which can have a substantive impact on the quality of life of those affected by it. The Long COVID Enhanced Service 2021/22 details a care pathway for patients suffering with symptoms, including the option to refer them to a post COVID assessment clinic. Up to £30 million is available to general practice to help you support patients with long COVID and the funding can be used for pathway development, education, and training. Further details on the clinical pathway can be found here.
Changes to the COVID-19 test kit distribution service
An amended COVID-19 test kit distribution service will begin from 4 October. As part of the changes, people will be asked to register on www.gov.uk or via 119 for a collect code to pick up test kits. More information is available from the Service Specification on the NHS BSA website.
To support this change resources have been produced for pharmacies which consist of A3 and A4 posters, and A5 leaflets. These will be delivered by DX this week and will be clearly marked as NHS Test and Trace. Please display these from Monday 13 September onwards. If you do not receive delivery by 15 September, please contact: PharmacyCollect@dhsc.gov.uk.
The URL on the resources will be live from Monday 13 September and people will be able to register for the collect code from 1 October.
Additional resources will be available on the Coronavirus Campaign Resource Centre from 13 September at: coronavirusresources.phe.gov.uk/pharmacy-collect. This includes co-branding templates, suggested copy for social media and additional posters translated into 12 languages.
General practice
Medicines Monitoring – Specialist Pharmacy Service (SPS), the first stop for professional medicines advice
The Medicines Monitoring tool gives suggestions for drug monitoring in adults in primary care. It has been written using publications and expert opinion and is designed to save clinician time and reduce duplication of effort. This tool is an ideal resource for GPs, primary care pharmacists and nurses involved in the prescribing of medication and patient monitoring.
The Medicines Monitoring tool does not replace professional responsibility and you should ensure an individualised monitoring plan is developed in partnership with the patient, taking account of any locally agreed advice and guidance.
Guidance on Rotavirus vaccination at 8 weeks of age in relation to the evaluation of the introduction of newborn screening for Severe Combined Immunodeficiency (SCID).
Following communication regarding the evaluation of screening for Severe Combined Immunodeficiency (SCID) from September 2021, and the impact on BCG vaccination, a further letter has been issued informing providers of action needed for administration of Rotavirus vaccine.
Rotavirus (Rotarix®) oral vaccine is a live vaccine given routinely from 8 weeks of age and is not recommended in babies with SCID. Practices are asked to update protocols to ensure that where SCID results (including SCID screening not offered) are received by the practice, they are available to the patient record for the practice nurse at the 8 week immunisation appointment.
As with the changes to the BCG programme, it is necessary to adopt this guidance for Rotavirus vaccination nationally to ensure consistency and safety for all babies nationwide.
Follow links for further information including information for HCPs and training slides, a flyer and leaflet for parents, and NHS vaccine pages.
Encouraging Automation funding bids
Feedback received through the GP bureaucracy review has highlighted the growing evidence on the use of robotic process automation (RPA) to automate low value and repetitive tasks and the benefits it can deliver in freeing up clinical and administrative time to focus on higher value work. This has particular significance in light of current pressures.
A total of £2.5m seed funding has now been made available through the NHSX Unified Tech Fund for general practice and primary care organisations. £1m has been allocated to funding bids that focus on spreading proven RPA solutions whilst £1.5m has been earmarked to support RPA proof of concept.
If you are interested to know more about the fund and the bid and application process, please visit Unified Tech Fund page via the above link. The application process is now live and bids must be received by 30 November 2021. If you have any questions, please email: digital.productivity@nhsx.nhs.uk.
Dentistry
Your NHS dentistry and oral health update
Chief Dental Officer for Sara Hurley, and NHS National Clinical Director for Children and Young People Simon Kenny, have issued an update to the dental profession with the latest advice and guidance on children’s oral health and paediatric dentistry.
Community pharmacy
NHS CPCS IT: Guide for community pharmacy contractors published
The Community Pharmacist Consultation Service (CPCS) ‘provider pays’ model will come into effect on 01 April 2022, when the responsibility for the cost of CPCS IT solutions transfers to community pharmacy contractors.
Contractors are encouraged to act promptly to sign up to one of four assured CPCS IT providers from mid-November 2021:
A guide for contractors is available, setting out options and actions required in the move to ‘provider pays’.
A CPCS IT Buyer’s Guide will be published shortly to aid contractors to choose and purchase a CPCS IT solution. A supporting webinar will take place on Thursday, 14 October 2021 from 7pm – 8:30pm, please register to attend.
Primary care
Digital social prescribing health systems support framework service line launch
Digital social prescribing case management and workflow systems are now available to commission via the Health Systems Support Framework (HSSF). The HSSF provides a route to contract support services from third party suppliers. Suppliers are accredited by NHS England and NHS Improvement for quality of product, adherence to digital standards and business viability.
Organisations can register for access to the HSSF FutureNHS workspace via this form. Here, organisations can access information to assist with the procurement and contracting process, including a buyers’ guide for this service line. Questions about the HSSF and contracting can be directed to: hssf.enquiries@nhs.net.
NHS Smartcards
Please follow the instructions on the Additional Roles Reimbursement Scheme (ARRS) FutureNHS workspace to correctly assign smartcards to your PCN staff.
Changes are being introduced to the list of Health Care Professional (HCP) types for NHS Smartcards, to support assignment of PCN roles reimbursable through the ARRS. This is to enable these roles to have appropriate access to clinical systems to deliver services to patients. Further information has been published setting out what PCNs and practices should do to enable appropriate assignment of these roles from October 2021. Further questions should be directed to your digital team.
Volunteers needed to read draft FTSU Guidance
The national Freedom to Speak up (FTSU) Team at NHS England are currently working with the National Guardian’s Office to bring together existing FTSU guidance from NHS England and NHS Improvement into one document that could be used by primary care and secondary care.
The team are looking for volunteers to read through the draft guidance and provide us with feedback about how workable the revised guidance is for primary care. It will take a couple of hours between 11 October and 22 October.
The team hope to use the revised guidance as the basis of a new practical support offer to help senior leaders develop their FTSU arrangements in 2022/23. Please contact: Rachel.clarke31@nhs.net to register your interest by Friday 1 October.
Refreshed Data Security and Protection Toolkit for 2021/22
It is important that all organisations that deal with NHS patient data and access NHS IT systems follow good data security practices and handle personal information correctly. This online toolkit has been designed to help relevant organisations, including primary care, to self-assess and measure their performance in implementing nationally mandated data security and information governance standards.
In response to feedback through the GP bureaucracy review, several simplifying changes to the toolkit content and return process have been made to help ease the burden on practices, which can be found at the above link.
It is possible to complete your assessment now and all self-assessments must be finalised and published by 30 June 2022. If you have any questions or require any help with your assessment, please contact the Helpdesk.
NHS e-Referral Service enhancements
Two important enhancements have been made to the NHS e-Referral Service (e-RS), which provides a streamlined, two-way communication and referral channel between primary and secondary care using digital Advice and Guidance (A&G).
Secondary care provider teams can now convert an A&G request to a referral, and simultaneously provide advice to support care while on the outpatient waiting list, where appropriate. Hospital systems may now interface with e-RS so that A&G conversations can be automatically processed and viewed within the hospital electronic patient record. Contact enquiries.ers@nhs.net for further information.
Tackling loneliness module
Tackling Loneliness and Social Isolation - module. Health Education England have launched a new module on tackling loneliness and social isolation. This module will help health and care professionals understand the importance of loneliness and social isolation, and potential negative health outcomes; recognise and understand risk factors; cover evidence-based interventions; and provide practical advice on having meaningful and compassionate discussions with people who are lonely and isolated.
You will need to register with E-learning for Healthcare to access this module and it is suitable for all staff working in primary care.
New BMJ Lymphoedema learning module
The Lymphoedema Support Network has commissioned a new BMJ learning module aimed specifically at those managing the condition in a primary care setting. The module is free to access and carries one hours CPD on successful completion. It has been written by three professors, a specialist nurse and a GP and has been peer reviewed, and is an excellent resource that has the potential to improve patient outcomes as well as reducing unplanned admissions and empowering GPs to help patients with a chronic condition in a planned and managed way.
The module looks at how GPs and other primary care practitioners can manage chronic oedema/lymphoedema and support patients in self-management. It covers prescribing and measuring for compression, skin care, weight management, treating cellulitis in lymphoedema, movement and exercise, frequently asked questions and more.
Get involved
Quality and Outcomes Framework - Quality improvement support for General Practice expressions of interest
Submit your expression of interest to provide 'expert' quality and improvement support to general practice to help them implement each of the QI modules within the Quality and Outcomes Framework. Support and guidance may be in the form of webinars, case studies, QI material including guidance.
Blogs, case studies and podcasts
Blog: Population Health – the ‘driving force’ behind Integrated Care Systems
Calderdale have been working with the National Association of Primary Care to embed population health management into our culture as the route to improving health and wellbeing. This blog by Dr Helen Davies, GP and Lead for Community and Population Health Management, Calderdale CCG, describes how we are using this approach to improve outcomes for our homeless and complex needs population.
Key dates
- 1 October 2021 – Primary Care Network Contract DES to take effect
Upcoming events and webinars
21 September. UKPGx Network & ABPI Joint Long COVID Workshop
21 September, 1pm - 2.30pm. Chief Nursing Information Officer (CNIO) virtual event - the future of nursing in a digital world
21 September, 6.30pm - 7.30pm. RCGP: QOF QI module for care of people with learning disabilities
23 September, 9am - 10am. Introducing innovation to the lipid management pathway
29 September, 5.30pm - 7pm. Enhanced Health in Care Homes: primary care networks and community health
30 September, 11am - 2.15pm. Health Inequalities - Priority 3: Ensuring datasets are complete and timely
30 September, 1pm - 2pm. Implementing the two-hour crisis response at scale across systems
8 October. #LinkWorkerDay2021 – conference and awards
Link of the day
