Primary Care Bulletin - this week's round-up

5 August 2021

Dear colleagues,

As we tackle the backlog of patients as a result of the pandemic, our new podcast looks at how primary and secondary care can work together to support patients and staff. GP Dr Ursula Montgomery is joined by secondary care clinicians, Professor Joseph Dias and Professor Chris Moran, to discuss how the use of system wide resources and increased patient outreach with targeted help and support can ensure a greater focus on quality of life for the patients as they wait.

Our understanding of Long Covid continues to grow as we seek to support patients with this new condition. To support this intelligence, The Office of National Statistics have produced a short report on information from ongoing studies investigating long COVID including the COVID-19 Longitudinal Health and Wellbeing National Core Study-CONVALESCENCE Study, and the COVID Symptom Study App.

The RCGP have released a new podcast about the definition of post-COVID-19 syndrome, people who are affected, common symptoms, investigations, diagnosis and prescribing. Additionally, we have published a Long COVID Self-Assessment Template 2021/22 in easy-to-use word format.

Finally, we are very sad that Dr Keith Ridge has announced his retirement as Chief Pharmaceutical Officer. In his 16 years in the role, Keith's achievements include transforming pharmacy professional education and training as well as delivering a new system for the governance of controlled drugs. Read more in the Pharmaceutical Journal. Keith has been a fantastic colleague and a passionate advocate for improving the quality of patient care and primary care, and championing inclusive practice. We wish him all the best.

Nikki and Ed

COVID-19 updates

Updated JCVI guidance for the vaccination of children and young people  

On 4 August 2021, the Joint Committee on Vaccination and Immunisation (JCVI) published an updated statement on COVID-19 vaccination of children and young people aged 12 to 17 years to advise that all 16 to 17-year-olds should be offered a first dose of Pfizer-BNT162b2 vaccine. This is in addition to the existing offer of 2 doses of vaccine to 16 to 17-year-olds who are in ‘at-risk’ groups. We have published a letter with updated guidance in relation to COVID-19 vaccinations for children and young people following the JCVI statement. 

Enhanced service specifications updated in line with latest JCVI guidance 

Further to the JCVI’s recent announcements we have updated the COVID-19 enhanced service specification for phases 1 and 2 and the enhanced service specification for phase 3 to include the new eligible patients. 

Practices delivering COVID-19 vaccinations under the phases 1 and 2 Enhanced Service (ES) can start vaccinating eligible children and younger people immediately subject to meeting the requirements of the ES. That includes eligible 12–15-year-olds and a first doseall 16- and 17-year-olds.  

Until Public Health England (PHE) update the national protocol and Patient Group Direction (PGD), sites will need to use a Patient Specific Direction (PSD).   

If a PCN grouping is signed up to the ES for phases 1 and 2 but does not wish to vaccinate eligible 12–15-year-old patients (cohort xiii), they must opt out of delivering COVID-19 vaccinations to cohort xiii by 23:59 on 13 August in writing to their local commissioner (CCG), which is providing administrative support to NHS England so alternative provision can be secured.  Further details and support on running searches and identifying eligible 12–15-year-old children will be shared shortly. 

In addition to these changes, the ES specification for phases 1 and 2 has also been extended until the end of October 2021 to enable any PCN groupings not participating in the phase 3 enhanced service to complete any remaining second doses for eligible patients. We have also made a few updates to align both the phases 1 and 2 and phase 3 ES specifications and future proof them. The amendments are highlighted in the specifications. 

If you have any queries, please contact: england.pccovidvaccine@nhs.net. 

Vaccinating Children and Young People in Community Pharmacy LVS sites 

Following the publication of today’s letter, this is a notification that ALL patients aged 16 and 17 years are now included in the list of cohorts of those who are eligible for vaccination as per section 4.2 of the Community Pharmacy Covid-19 vaccination local enhanced service. Community pharmacy LVS sites can start to vaccinate patients in this cohort as walk ins or via local booking, subject to completion of the clinical criteria, in the checklist, as a self-assessment process, and where the site is operating under a PSD and where the requirement is for a first dose. Please note that the PGD and national protocol do not currently cover 16 and 17-year-olds unless they are in cohort 2, 4 or 6 or are aged 17 years and 9 months or over per our letter of 22 July.  We anticipate that they will be updated in the coming weeks. 

All Pharmacy Contractors delivering services under the Local Enhanced Service: COVID-19 vaccination programme 2020/21 are required to carry out the service in compliance with their Terms of Service which include having appropriate safeguarding procedures in place for those receiving vaccinations. Appropriate safeguarding procedures that are considered acceptable by NHS England in relation to vaccinating 16/17 years olds with a first dose are set out in the checklist. 

Vaccination in pregnancy – latest resources 

Sites are reminded that the most up to date leaflets and posters on vaccination in pregnancy are available from PHE and RCOG. Please ensure any out-of-date materials are replaced with these. The Royal College of Midwives also has a number of helpful resources for maternity staff to support pregnant women get the vaccine.

Suspension of workforce recharging arrangements extended until end of August for local vaccination sites 

In June, we announced the temporary suspension of recharging requirements between lead employers and local vaccination services. Some of you took advantage of this arrangement to increase capacity, over and above your local staffing and provide local workforce resilience. This support has now been extended until the end of August or until the funding allocation for your integrated care system is exhausted.  

Please contact your lead employer for more details about what is available in your area. In addition, we have prepared the national workforce support offer toolkit, specifically designed for local vaccination service leads which explains in more detail the types of staff and volunteers that can be supplied. 

Please see our FutureNHS pages LVS Workforce and the recently published NHS guidance for PCN groupings and community pharmacy and contact the national workforce team direct via PCNCP.workforceescalation@nhs.net. 

New rapid guideline to diagnose and treat rare blood clotting condition associated with COVID-19 vaccination 

NICE has published a new rapid COVID-19 guideline to help healthcare staff identify and treat patients who develop the rare syndrome vaccine-induced immune thrombocytopenia and thrombosis (VITT) after receiving COVID-19 vaccinations.

COVID-19 Vaccination Programme – workspace

General practice

NHS Non-Emergency Patient Transport Services (NEPTS) review

The recommendations of the recently published non-emergency patient transport services (NEPTS) report support the aims of the GP bureaucracy review in making the best use of GP time and minimising unnecessary involvement. This will be achieved by making it easier for GPs to signpost patients into the service alongside clarifying patient eligibility. Patients will also benefit from a universal transport support offer for journeys to and from renal dialysis.

It is proposed that responsibility for arranging this service will move to ICSs in future and primary care are considered important partners in helping to design how the service and eligibility assessments will work in practice locally. The review also establishes a new national framework for non-emergency patient transport to reach net zero carbon emissions and improve procurement and contracting. 

Informing your regional team of your named lead for vaccination services

We previously wrote to practices confirming contractual changes to vaccination and immunisation programmes as part of the two year transition to the 2020/21-2023/24 contract agreement. We would like to remind practices of the requirement to have a named lead for vaccination services who will take responsibility for oversight of these services. We would be grateful if practices could inform their NHS England and NHS Improvement regional Public Health Commissioning team by 20 August 2021 of the name and contacted details of their nominated lead.

Step by step guide on visa sponsorship

Gaining the right to be a UK visa sponsoring practice has many advantages and could form an important part of your general practice workforce planning. A step by step guide to applying for a visa sponsorship licence is now available. The guide has been tailored to primary care needs. It does not replace official Home Office sponsor guidance but should help you work through the registration process. A slide-pack presented by the Home Office in June and some common questions and answers are also available.

NHS Diabetes Prevention Programme re-procurement

The Healthier You NHS Diabetes Prevention Programme supports those identified in general practice at high risk of Type 2 diabetes by referral onto a behaviour change programme. The current provider framework expires in April 2022 and NHS England will be commissioning new services to expand the scale of the programme and to build on learning.

NHS England is now consulting on proposals relating to this re-procurement and changes to the service model for the benefit of our patients, general practice and local health systems. Please complete the survey by 18 August 2021 to provide your thoughts.

General practice - latest updates

Pharmacy

The Shared decision-making programme is now open to all NHS pharmacy professionals in a patient-facing role in England. 

NHS England and NHS Improvement has commissioned CPPE to develop a programme of learning centred on embedding shared decision making into patient consultations.

Shared decision making and personalised care are core elements of the NHS Long Term Plan. Shared decision making is linked to improved outcomes for patients and puts patients at the centre of their own care, making them experts in their own healthcare decisions.

The programme is delivered online and consists of an e-course and two full day online workshops. More information can be found on the CPPE website.

Primary care

Workforce planning submissions for 2021/22

As per the 2021/22 Network contract DES, Primary Care Networks (PCNs) are required to submit workforce planning returns providing details of their updated recruitment plans by 31 August 2021 for 2021/22; and by 30 October 2021 for 2021/22-23/24.

An updated template will be available next week, for every PCN to complete and submit information about their workforce for 2021/22. The template also asks extra questions to help better support Mental Health practitioners. Once completed, the template will need to be emailed to your CCG by 31 August.

Further supporting guidance, including an FAQs and videos will be available on the FutureNHS platform to help PCNs to complete the template. Information about the various roles PCNs can recruit is also available on the PCN Development workspace.

Access to primary care for holidaymakers – call your own GP first

As people flock to holiday spots around the country, general practice in popular locations is under increasing pressure to manage the huge influx of patients.

The message to visitors wherever they are staying is to call your own GP at home if you need health care or advice. Patients can be assessed and treated by their own practice by phone or video consultation in most cases. Managing your own patients when they are on holiday around the country, without referring them to a local practice, is an important way you can support colleagues in general practice this summer.

The message for pharmacy is to visit a local pharmacy where people are staying; pharmacists can help with minor health concerns like tummy troubles, aches and pains and many more.

Primary Care Networks: two years on report

The NHS Confederation have produced a report on Primary Care Networks – two years on. It looks at their progress and successes so far as well as the opportunities that lie ahead with the move to greater system working.

Tackling Cholesterol Together launches education programme for primary care

The NHS Accelerated Access Collaborative (AAC) and The AHSN Network are partnering with the cholesterol charity, HEART UK, to launch a new education programme for healthcare professionals called Tackling Cholesterol Together.

Led by key national figures in cardiovascular disease, Tackling Cholesterol Together is the national professional education programme supporting the NHS England and NHS Improvement three-year lipids workstream in order to raise awareness amongst healthcare professionals that Cardiovascular Disease (CVD) is preventable yet currently kills 136,00 people every year.

The programme will support healthcare professionals to address under diagnosis and under treatment at scale and use new models to manage cholesterol. Find out more information and access content. You can also register for a webinar on 18 August.

Blogs, case studies and podcasts

Case study: Sheffield vulnerable patient visiting service

Read our latest case study about how a group of seven GP practices in Sheffield worked together during the pandemic to develop a proactive home visiting service for their most vulnerable patients.

Podcast: Primary and secondary care working together to support patients waiting for care

GP Dr Ursula Montgomery is joined by secondary care clinicians, Professor Joseph Dias and Professor Chris Moran, to discuss how closer working between primary and secondary care has benefited patients waiting for the next stage of their care.

Key dates

• 16 August – Opt-in deadline for general practice to the Seasonal Influenza Vaccination Programme 2021/22 enhanced services
• 17 August – Deadline to apply for GP specialty training

Upcoming events and webinars

• 4 August, 1.30pm – 2.30pm. Social Prescribing Link Worker webinar series - Homelessness
• 12 August, 5pm - 6pm. General Practice webinar
• 19 August, 6.30pm – 7.30pm. RCGP: How to undertake a quality improvement (QI) project for QOF
• 25 August, 12.30pm – 2pm. Peer Learning: Supporting migrant communities and people with refugee status
• 31 August, 2pm – 3.50pm. Higher Education Institution webinar

Link of the day

New resources for parents during coronavirus