29 October 2020

Dear colleagues,

The Appointments in General Practice data for September 2020 was published today, showing a 20% increase in appointments compared to August. Since March 143.4 million appointments have been delivered - 26.7 million appointments in September, with 56.6% of appointments were face to face, and an average number of appointments per working day of 1,225,455.

These figures show what many of us have known intimately throughout the pandemic - that our general practice teams (because it has been a team wide effort) have been working incredibly hard to rapidly adapt to how they offer care to keep patients and staff safe while maintaining services.

To ensure patients get access to healthcare advice safely, we have offered remote triage, with telephone, video and face to face consultations as clinically appropriate.

We want to take this opportunity to thank our staff and colleagues across primary care for everything they have done throughout the pandemic. We want to thank those working late into night - chasing advice, checking on shielded patients, reassuring your patients. We want to say thank you for the amazing work you've done in delivering flu vaccinations in new ways, in car parks, at weekends and in the pouring rain.

We want to specifically thank our practice managers, our receptionists and our admin teams, our nursing colleagues, pharmacists, and allied health professionals, because without you, general practice doesn't work. Thank you also to our colleagues from different ethnic backgrounds who have delivered care whilst feeling worried about their own health, and for missing special festivals that are usually celebrated with so many others.

We know you are feeling tired, and we know you are doing the very best you can in an incredible difficult time - please do try to take some time to rest and recharge knowing that you are valued and appreciated.

Nikki and Ali

General practice

Childhood Influenza Enhanced Service 2020/21 – Update

The updated flu letter issued on 5 August indicated that an inactivated vaccine may also be offered to those children whose parents refuse the live attenuated influenza vaccine (LAIV) due to the porcine gelatine content.

From mid-November, practices are able to offer the alternative vaccine as part of the current childhood influenza vaccination programme enhanced service 2020/21 for those 2 and 3 year olds who are not at risk, whose parents request the alternative vaccine. Practices will be able to claim an item of service fee for administering the alternative vaccine. 

Supporting skilled refugees into the NHS - new pilot

NHS Employers is working with the Department of Health and Social Care and refugee non-governmental organisations (NGOs) to develop a supportive programme of work to help employers recruit skilled refugees and displaced people into NHS. Their aim is to launch a pilot programme to match suitable candidates to vacant posts. If your organisation is interested in becoming part of the pilot programme, are interested in this as an alternative source of recruitment, or can share existing best practice on the recruitment of refugees in the NHS, please email adele.bunch@nhsemployers.org. The closing date for pilot expressions of interest is 31 October. 

General practice - latest updates

Community pharmacy

NHS Test and Trace advice

We understand that some pharmacies are being impacted by the need for staff to self-isolate. If pharmacy staff have been in contact with a COVID-19 positive case outside of work they must follow the self-isolation guidance. 

It is important to maintain a COVID-19 secure environment throughout the working day by following IPC guidance, including maintaining social distancing, working behind screens, regular handwashing and wearing appropriate PPE. Thought should also be given to staff rest breaks and minimising the possibility of transmission at this time.

If a member of the pharmacy team tests positive and there is a risk to the provision of pharmaceutical services then advice regarding the individual circumstances should be sought from the local Health Protection Team (specific individual circumstances will be considered and advice may therefore appear to differ). You should also contact your NHS England and NHS Improvement Regional Office regarding possible disruption to provision of pharmaceutical services.

If a member of staff receives a negative test they do not need to self-isolate as long as:

• everyone they live with who has symptoms tests negative
• everyone in their support bubble who has symptoms tests negative
• they were not told to self-isolate for 14 days by NHS Test and Trace or the NHS COVID-19 App – if they were, see what to do if you've been told you've been in contact with someone who has coronavirus
• they feel well – if they feel unwell, they should stay at home until they are feeling better.

Dentistry

Updated standard operating procedures and IPC guidance
Our standard operating procedure for urgent dental centres and standard operating procedure: transition to recovery have been revised with reference to the recently published dental annex to UK infection prevention and control (IPC) guidance. Revisions include guidance on environmental decontamination including calculation of post aerosol-generating procedure downtime (fallow time).

Stay up to date with the latest NHS dentistry news by signing up to the new dentistry and oral health bulletin. You can read the first issue online, which includes important information on fallow time, infection control and an update from Chief Dental Officer Sara Hurley.

Primary care

CVDPREVENT: A national primary care audit to identify opportunities and drive improvements

CVDprevent is a national primary care audit to support professionally led quality improvement in the diagnosis and management of six high risk conditions that cause stroke, heart attack and dementia: atrial fibrillation (AF), high blood pressure, high cholesterol, diabetes, non-diabetic hyperglycaemia and chronic kidney disease.

The audit data will support practices and Primary Care Networks (PCN) to identify gaps, inequalities and opportunities for improvement in clinical care. It is expected to provide the core data to assist PCNs meet the requirements of the PCN Directed Enhanced Service for CVD prevention.

We would ask that you encourage practices to participate in this new service. This is a participation only service, no data will be recorded in CQRS. Practices should have received the Data Provision Notice outlining the collection and further information can be found on the CVDPREVENT web page.

Expert advice and support for workforce planning templates

A series of resources have been created by the teams at Healthy London Partnership and Health Education England to help Clinical Directors complete the Workforce Planning Templates returns due at the end of October 2020. The resources, which are available on the HLP website includes a podcast with detailed information for Clinical Directors, advice around workforce planning in identifying the health needs of the population and how to utilise different professional groups to meet the needs of the population.

The information also includes links to workforce planning templates and resources and guidance around the Additional Roles Reimbursement Scheme roles as well as information on how to access support from local training hubs.

Dates for your diary

Tuesday 3 November 11am-12.30pm. Social prescribing focus group. Email england.socialprescribing@nhs.net if you're interested in taking part.

Wednesday 4 November, 1pm - 2pm. Digital Nurse Network webinar

Thursday 5 November, 5pm - 6pm. General Practice Webinar with Ed Waller and Nikki Kanani. To attend please ensure you register by 12pm on 5 November. If you have registered for the previous two webinars you will not need to register again as we are using a rolling registration system. 

Monday 9 November, 11.30am - 12.30pm. Integrated Care webinar series: The future of place – planning recovery in partnership

Thursday 29 October, 4pm - 5pm. Digital Primary Care Influenza webinar

Wednesday 11 November, 9am - 8pm. NHS Confederation: PCN Network virtual conference

Wednesday 11 November, 12.30pm. Supporting CVD Prevention in Primary Care

Thursday 12 November, 6pm-7pm. Community pharmacy webinar with Keith Ridge and Ed Waller. To attend please ensure you register by 12pm on 12 November.

NHS Volunteer Responder programme update webinars

Fortnightly webinars are being held to provide regular updates on the NHS Volunteer Responder programme.

• Thursday 12 November, 10.30 – 11.30am - Join Microsoft Teams Meeting
• Thursday 26 November, 10.30 – 11.30am - Join Microsoft Teams Meeting
• Thursday 10 December, 10.30 – 11.30am - Join Microsoft Teams Meeting

Link of the day

Please watch this video for information about contacting your GP remotely