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Primary Care Bulletin - this week's round-up
12 August 2021
Dear colleagues,
Becton Dickinson supply disruption guidance
Becton Dickinson has alerted us to a global shortage of products from their Blood Specimen Collection Portfolio. This supply disruption is expected to last for a significant period of time.
NHS England and NHS Improvement issued urgent guidance on recommended actions earlier this week. This guidance must be shared with all clinical staff and acted on immediately. This guidance applies to all organisations regardless of supplier to ensure equity of care as well as preserving alternative stocks to support mutual aid.
The measures set out in this guidance seek to ensure that there is no disruption to urgent care, and services for patients are able to continue as clinically appropriate. Failure to enact this guidance could limit the availability of tests.
NHS Supply Chain has issued an Important Customer Notice which details the products impacted and the measures they have put in place.
General Practices that secure these products from Primary Care Support England (PCSE) should continue to order in this way. GP practices that do not usually order from PCSE can also order via their process.
Vaccinations for staff entering care homes
DHSC has published guidance on new regulations which make COVID-19 vaccination a requirement for NHS staff entering care homes. This includes all staff in NHS commissioned services going into care homes. The regulations will come into force on 11 November to give care homes, services, and staff time to prepare.
While most NHS staff have been vaccinated, there are exemptions for those who have not, due to medical reasons. The guidance details the exemptions, which also include health service staff deployed for emergency response. Further advice for the NHS will follow. Please email england.ageingwell@nhs.net if you have any questions.
GMC registration
Thank you to all the doctors who have returned to practice during the pandemic using the GMC emergency registration. We greatly value your contribution and while we continue to be in a pandemic, with an ambitious vaccination programme still underway, we will need your expertise well into the new year. We have been given assurances that plenty of notice will be provided if there are plans to change the emergency registration process. Further details on emergency registration and licences to practice can be found on the GMC website.
Raj and Ed
Raj Patel
Deputy Medical Director, NHS England and NHS Improvement
Ed Waller
Director for Primary Care, NHS England and NHS Improvement
COVID-19 updates
Publications to support COVID-19 vaccination of children
On 18 July the JCVI advised that children at increased risk of serious COVID-19 disease are offered the Pfizer-BioNTech vaccine, which includes children aged 12 to 15 with severe neurodisabilities, Down’s syndrome, immunosuppression and multiple or severe learning disabilities. The JCVI also recommends that children and young people aged 12 to 17 who live with an immunosuppressed person should be offered the vaccine. Under existing advice, young people aged 16 to 17 with underlying health conditions which put them at higher risk of serious COVID-19 should have already been offered vaccination.
All providers offering the COVID-19 vaccination should now place orders for the following two leaflets:
- Simple text guide for children and young people aged 12-15 years – product code to order from Health Publications: COV2021WYP. To order for print and download, in stock Monday 9 August.
- What to expect after your vaccination for children and young people – product code to order from Health Publications: COV2021YP. You can download and print locally or order paper copies for delivery visit.
Further resources relating to the vaccination programme are available on the government website.
Patient Group Direction for COVID-19 mRNA vaccine BNT162b2 (Pfizer/BioNTech)
The Patient Group Direction for COVID-19 mRNA vaccine BNT162b2 (Pfizer/BioNTech) was updated on 6 August.
General practice
Complete your workforce planning template now
The updated workforce planning submission template is now available on our website for PCNs to submit information about their workforce planning for 2021/22. As per the 2021/22 Network contract DES, Primary Care Networks (PCNs) are required to submit this information by 31 August 2021.
These submissions contribute to workforce planning all levels and it is important that all PCNs provide this information to help us shape how investment, training and resource is directed across primary care. Please ensure your template is completed and sent to your CCG by the deadline.
Further supporting guidance is also available on FutureNHS. If you have any questions, please email england.primarycareworkforce@nhs.net.
GP mythbuster 105: Do not attempt cardiopulmonary resuscitation (DNACPR)
This DNACPR mythbuster from the CQC aims to reduce confusion clarify, signpost and share guidance for providers. It aims help providers manage and maintain effective oversight of DNACPR decisions.
SNOMED CT codes for new Steroid Emergency Card
In July 2020 the Royal College of Physicians (RCP) and Society for Endocrinology (SfE) issued ‘Guidance for the prevention and emergency management of adult patients with adrenal insufficiency’. The guidance recommended that all eligible patients be issued a Steroid Emergency Card. To support the introduction of the card NHS England and Improvement issued a National Patient Safety Alert.
NHS Digital have developed 8 new SNOMED CT codes available to view/ download on their TRUD website and will be available via main GP IT system suppliers from 1 October 2021.
Dentistry
Infection prevention control guidance
There has been a minor change to dentistry's infection prevention control guidance - post AGP down time (fallow time) is not considered necessary for successive appointments between members of the same household. Further details can be found in the latest issue of Your NHS dentistry and oral health update.
Pharmacy
Community Pharmacy Seasonal Influenza PGD published
The 2021-22 Community Pharmacy Seasonal Influenza PGD was published on 6 August to accompany the previously published Seasonal Influenza Advanced Service Specification. Community pharmacies may wish to become involved in this service, which remains separate from the COVID-19 vaccination Local Enhanced Service. We are still awaiting JCVI recommendations about whether influenza and COVID-19 vaccinations can be administered at the same time and will update you as more information becomes available. Information regarding the Influenza PGD for general practice will follow through the usual communication routes.
Primary care
Cancer campaign and useful resources
The latest phase of our ‘Help Us, Help You’ campaign, due to go live next week, will focus on possible signs of cancer, highlighting urological and abdominal symptoms, as well as symptoms of lung cancer. The campaign encourages people with these symptoms to talk to their GP and reminds the public the NHS is here for them.
Rapid Diagnostic Centre (RDC) pathways are being implemented so that every cancer patient gets the right tests at the right time in as few visits as possible.
Learn about the Rapid Diagnostic Centre (RDC) pathways in this new video which covers the components of an RDC pathway and the new non-specific symptom pathway. For more information visit the Faster Diagnosis webpage.
Target Ovarian Cancer have undertaken research to identify difference in geographical approaches to ovarian cancer investigation and diagnosis to help reduce regional variation. The second phase involves working in partnership with primary care pilot sites to develop and test pathway interventions. Please get in touch to express your interest in improving early diagnosis.
Supporting healthcare providers to diagnose asthma through FeNO testing
Over 5.4 million people in the UK suffer from asthma and 30% of patients currently diagnosed with asthma are suspected to have been misdiagnosed. We are working with Wessex AHSN to roll out FeNO testing to help improve the diagnosis of asthma. The FeNO test works by measuring fractional exhaled nitric oxide (‘FeNO’) in the breath of patients and providing a score. Nitric oxide is a biomarker for asthma which provides an indication of the level of inflammation in the lungs. As part of this roll out, Wessex AHSN has produced an extensive online resource area to help implement FeNO testing locally.
Merton Social Prescribing Programme Evaluation
Merton CCG and Merton Council set out to test a model of Social Prescribing that would connect medical care with local voluntary and community resources. Healthy Dialogues was asked by Merton Council to do a formative and summative evaluation of the initial results from the Social Prescribing programme as well as produce recommendations for upscaling across Merton in its second year. An update of the Merton social prescribing evaluation report was completed in August 2021.
Social prescribing: migrant health guide
Public Health England has advice and guidance for healthcare practitioners on the health needs of migrant patients, including a summary of findings from a recent evidence review that PHE completed on social prescribing for migrants in the UK. It also provides a series of recommendations for referrers to social prescribing services, link workers, social prescribing monitoring and evaluation, and future research. Doctors of the World have also recently launched a toolkit for link workers to support migrants to access healthcare.
Resettlement of families from Afghanistan (ARAP Programme)
The UK is supporting the relocation of Afghan workers and their families under government policy which recognise their support for UK forces in dangerous and challenging situations.
Families are entitled to access all NHS healthcare services under their 5 years ‘Leave to Enter the UK’ immigration status.
Commissioners should ensure they are engaged in local multi-agency meetings / strategic migration partnerships to support the local health response which will be required at short notice as hotels are confirmed, including support for GP practice registration. Public Health England have produced guidance to help primary care professionals to assess and address the health needs of relocated individuals. Please email england.primarycareops@nhs.net if you have any queries.
Meeting the health needs of destitute asylum seekers housed in hotel accommodation
The use of hotels and other sites for the initial accommodation of asylum seekers has been unprecedented during and due to the pandemic with consequent challenges for local health services in meeting the needs of this vulnerable population.
CCGs are reminded of their responsibilities to support the health needs of this vulnerable population while in hotel accommodation, including support for GP registration. We continue to support the use of initial health assessments to understand and manage the complex health and care needs that can arise in this vulnerable population with some funding support available to CCGs when hotels are stood up in their area.
GP practices are reminded all asylum seekers are entitled to register for GP services regardless of their immigration status and nobody should be refused registration due to the inability to provide proof of ID or address. Please email england.primarycareops@nhs.net if you have any queries.
Blogs, case studies and podcasts
BLOG: From coachee to coach – how NHS England coaching planted a seed
Rebecca Hall is an Advanced Nurse Practitioner working in primary care. She signed up for #LookingAfterYouToo coaching available to the primary care workforce to improve her confidence and resilience. In this #LAYT blog, she talks about what she learnt and how her positive experience gave her a fresh outlook and presented new opportunities.
BLOG: Exploring issues faced by general practice services led by GPs from an ethnic minority background
In this blog published by the CQC, Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care highlights some of the challenges facing primary care and some specific work we are doing to respond to concerns we’ve heard on the impact of regulation.
Get involved
Research into how the NHS recruits its volunteers
We have commissioned a piece of research to start in early September to look into how the NHS recruits its volunteers, and whether there may be a need and benefit to having a single place for NHS volunteer opportunities to be advertised. We want to hear views from as many people that are directly responsible for recruiting NHS volunteers.
The research activity will include a survey, some in-depth one-time interviews (around the weeks of 20 and 27 September), a workshop to help us map the NHS volunteer recruitment pathway(s) and explore some of the questions in more depth. Please let us know if you are interested by emailing the voluntary partnerships team.
PPE Customer Engagement Panel Recruitment for Pharmacy Staff
The Department of Health & Social Care is recruiting panel members to the Pharmacy PPE Engagement Panel to gather feedback on the quality and quantity of PPE provided to meet service needs. Staff from a variety of pharmacy roles can join including pharmacists, pharmacy assistants / medicines counter assistants, pharmacy technicians, those that order PPE, and other pharmacy staff.
If you would like to express an interest in joining or would like to view the panel’s Terms of Reference for more information, email the team with your name, role and contact details.
We need your help modernising and standardising the way that people register with a GP practice
As part of the GP bureaucracy review, NHS Digital, NHS England and NHSX are undertaking a joint project aimed at modernising and standardising the way that people register with a GP practice. This includes developing a solution that will allow people to register online and reducing administrative processing for practices.
To help shape this work, we would like to know more about the information and data items that GP practices collect from patients at the time of registration and how this information is used. We are inviting all interested GP practice colleagues to let us know via this form, which should take no more than 10 minutes to complete.
Key dates
- 17 August - Deadline to apply for GP specialty training
- 27 August - application deadline for the Health and Wellbeing Fund 2021/22
- 31 August - Workforce planning submission deadline
Upcoming events and webinars
18 August, 1:30pm – 2:30pm. Social Prescribing Link Worker Webinar Series - Substance Misuse & Addiction
19 August, 6.30pm – 7.30pm. RCGP: How to undertake a quality improvement (QI) project for QOF
23 August, 3pm - 4.15pm. Health Inequalities - Priority 1: Restoring NHS services inclusively
25 August, 12.30pm – 2pm. Peer Learning: Supporting migrant communities and people with refugee status
31 August, 2pm – 3.50pm. Higher Education Institution webinar
29 September, 5:30pm – 7:00pm. Enhanced Health in Care Homes: primary care networks and community health
Link of the day
