10 November 2020

Dear colleagues,

COVID vaccination programme

Rapid progress is being made on the development of a Covid vaccine and primary care will play a critical role in the national roll out. NHS England and NHS Improvement has agreed with the BMA General Practitioners Committee that a vaccination service will be nationally commissioned as an enhanced service (ES).

Our plans for deployment of a COVID-19 vaccine builds on the tried-and-tested rollout plans for influenza vaccine, which we deploy every autumn. Given the uncertainty over whether, and when, a vaccine may be approved, we are planning to be ready from any date from December.

Where a practice agrees to participate in this enhanced service, it will need to work collaboratively with other practices to deliver vaccinations in PCN groupings, and we anticipate at least one site being designated initially per PCN grouping. Those sites will need to collaborate with other community vaccination providers, as part of a co-ordinated local approach.

We are asking PCN groupings who wish to participate to submit (using the specified form) to the CCG no later than Tuesday 17 November 2020.

Further details on the designation process and the key features of the specification are on our website. We know you will have lots of questions and we will do all we can to support you to deliver one of the most important vaccine programmes the NHS has ever delivered.

We will be holding a webinar on 12 November at 7pm to talk you through the initial planning.

We also see community pharmacy playing an important role in the vaccine programme and we will have further information on this in the coming days.

Thank you in advance for your commitment and support.

£150 million for general practice

We have established a new General Practice Covid Capacity Expansion Fund. £150 million of revenue is being immediately allocated through ICS to CCGs for general practice, for the purpose of supporting the expanding general practice capacity up until the end of March 2021. The fund is ringfenced exclusively for use in general practice. Systems are encouraged to use the fund to stimulate the creation of additional salaried GP roles that are attractive to practices and locums alike. The fund could also be used for the employment of staff returning to help with Covid, or to increase the time commitment of existing salaried staff. And in line with commitments already made in the GP contract, support will be available to establish flexible pools of employed GPs (including returners) and other staff to deploy across local communities.

Nikki and Ed

COVID-19 updates and guidance

Mink-variant SARS-CoV-2 virus in Denmark

Denmark was removed from the UK travel corridors list on Friday 6 November and any travellers from Denmark returning to the UK will now be required to self-isolate for 14 days according to the national guidance and legislation. A new CAS alert was issued to highlight some immediate actions for the NHS, including all primary care providers.

General practice 

Network Contract DES: Additional Roles Reimbursement Scheme claim form update

Following the addition of nursing associate and trainee nursing associate roles to the Additional Roles Reimbursement Scheme under the Network Contract DES from 1 October, the ARRS claim form has been updated to allow PCNs to claim reimbursement for these roles.

PCNs are reminded that monthly claims must be submitted to the commissioner for review and approval on a timely basis. Commissioners must ensure that local processes are as straightforward as possible, with clear deadlines for submission of claims, and claims should be processed promptly. 

Continuing to support people with a learning disability

Delivering proactive health checks for people with a learning disability continues to be an important activity to promote the health of this group of patients. 

Healthcare professionals should discuss with the patient (if considered to have mental capacity), their carer or their advocate the most suitable and safe way to conduct a health check. Where this can be delivered safely on a face to face basis this should continue. Where this is not possible, or where the patient has other medical conditions which require them to shield or socially isolate, the review could be conducted remotely with as much of the physical review completed as is practicable in these circumstances.

Practices should use their clinical judgement and knowledge of the patient, together with the advice of family or other carers, in determining whether they would be able to participate in a remote review. Reasonable adjustments should be made to accommodate the needs of patients and carers as well as considering the capacity and capability of the GP practice whilst working in different ways. Where practices can demonstrate that they are taking an individual approach to health check delivery and are completing as much of the prescribed elements as practicable then they will be eligible for payment under the DES during 2020/21.

The delivery of care to this group of patients is further supported this year through the amended QOF Quality Improvement requirements and an additional incentive for health check coverage available to the Primary Care Network through the Investment and Impact Fund.

General practice - latest updates

Community pharmacy

The National Health Service (Charges and Pharmaceutical and Local Pharmaceutical Services) (Amendment) Regulations 2020 - changes to the terms of service for pharmacy contractors

A number of changes to the terms of service for pharmacy contractors came into effect on 9 November 2020. These include requirements regarding accessing the Summary Care Record, updating NHS website and Directory of Services profiles, accessing NHSmail and facilitating remote access to services. Contractors must register their premises specific NHSmail account with the Medicines and Healthcare products Regulatory Agency (MHRA) to receive Central Alerting System (CAS) notifications. We have managed a bulk upload of premises specific NHSmail accounts to the MHRA CAS system and will be following up outstanding pharmacies who will have a requirement to register manually. We will be producing further guidance on these changes.

Importance of flu vaccinations for people with a learning disability

Community pharmacy teams are being asked to ensure people with a learning disability (and autistic people in an at-risk group) receive their flu vaccinations as a priority cohort alongside people over 65 and pregnant women. Particular attention is being paid this year to making sure that everyone with a learning disability who requests their free flu vaccination within a community pharmacy setting receives one. New easy read resources have been produced to help with communications.

COVID-19 vaccination in community pharmacy

Sir Simon Stevens has announced that community pharmacy will have a role working within primary care networks in delivering a COVID-19 vaccination programme when a vaccine becomes available. A COVID-19 vaccination is likely to be commissioned as a local enhanced service in the first instance. Further details will be published in the near future.

Self Care Week 16 – 22 November

Self Care Week is an opportunity to promote self care messages and help people to ‘live self care for life’. We are encouraging community pharmacies across the country to support their communities to take care of their health and wellbeing through self care.

The Self Care Forum has provided resources for download which include posters, fact sheets, leaflets and a ‘last minute activity guide for pharmacists’.

Primary care

Implementation support for COVID-19 remote pulse oximetry services

NHS England and NHS Improvement is working with the Academic Health Science Network (AHSN) and local areas to support the continued set-up of 'COVID Oximetry @home' services (also known as 'COVID virtual wards'). This is one of the priority goals for the additional £150m General Practice COVID Capacity Expansion Fund and is already used in many areas to help detect earlier deterioration of people with COVID-19, both in the community and in care homes.  To find out more, including the support available, CCG colleagues are invited to attend one of two national webinars listed below.

All CCGs can continue to request oximeters for local use by emailing  england.home@nhs.net. Allocation will take account of local infection rates and previous requests. Primary care network colleagues should contact their CCG if they feel there is an urgent requirement of which their CCG is not already aware. Oximeters will be transferred to CCGs so there is no VAT liability for practices or PCNs.

Cervical screening tips for communicating with patients

A blog and short film has been developed by Jo’s Trust in collaboration with NHS England and NHS Improvement and Public Health England colleagues. For any queries, please contact england.phs7apmo@nhs.net.

Dates for your diary

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 7pm – 8pm. General Practice webinar with Nikki Kanani and Ed Waller. To attend please ensure you register by 3pm on 12 November.

Thursday 12 November, 12pm - 1pm. The UCLPartners Frameworks: High Risk Conditions for CVD – How to do things differently at scale.

Thursday 12 November, 4pm - 5pm. Digital Primary Care - Proxy Access Guidance overview and DEMO

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.

Implementation support for COVID-19 remote pulse oximetry services. CCG colleagues are invited to attend one of two national webinars:

• Monday 16 November, 11am -12pm
• Wednesday 18 November, 3-4pm

Monday 23 November, 1pm - 2pm. Antimicrobial Stewardship in Primary Care webinar

Wednesday 25 November, 2pm - 3pm. Harnessing health and housing support to improve population health

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

Various dates - REACT Mental Health Conversation training

Link of the day

RCGP: Delivering Mass Vaccinations During COVID-19 guidance