21 January 2021

Dear colleagues,

Thank you for your continued efforts in delivering the largest vaccination programme the NHS has ever undertaken, as well as providing care to people across the country.

Another 65 pharmacy sites are joining the vaccination programme over this week and early next week with more to come. These sites will support the programme by expanding vaccination services into areas not yet covered by a vaccination site, helping us to vaccinate vulnerable people even faster.

Supporting general practice in 2021/22

NHS England and NHS Improvement and the BMA General Practitioners Committee England have today published a letter setting out further measures to support general practice in 2021/22. We have agreed that too much remains unclear to confirm contractual arrangements for the whole of 2021/22, but that some reassurance and certainty can be offered now. This includes further new roles through the Additional Roles Reimbursement Scheme, QOF arrangements, and confirmation that new PCN services will not be introduced at the beginning of the year from April 2021 given the reprioritisation necessitated by the pandemic.

The BMA held a vote of GPs in England on whether the Network Contract Directed Enhanced Service (DES) should continue and inform the BMA's future negotiations. 80% were in favour giving the GPC England the mandate to proceed with negotiations on the Network Contract DES for 2021/22. Thank you to those that voted.

Thank you letter to children of primary care colleagues

Dr Nikki Kanani has developed a thank you letter which is available to download and edit, to give to children whose parent/carer works within primary care. The letter thanks children of primary care colleagues for what they are doing to support their parent/carer in working hard to support the NHS throughout the pandemic. Please do download a copy of the letter and give it to your child, to show how proud we are of them during this difficult time.

Kiren and Ali

COVID-19 updates and guidance

Reminder calls following national COVID-19 vaccination booking letters being sent

The national NHS Immunisation Management Service is starting to call people that have received letters to book their COVID-19 vaccination appointments through 119 or www.nhs.uk, where they haven’t already booked an appointment. The number that people will see when receiving the call is 0300 561 0240.

The service will make it clear that if people have already had their first dose, they just need to wait for their local NHS services to contact them about the second dose. They will be clear that booking through 119 or www.nhs.uk is one option and they can wait to be contacted through their local GP services if they haven’t been already. The callers will remind people that they will not book people into appointments on the phone.

As always, the NHS will NEVER:

• ask people for their bank account or card details
• ask people for their pin or banking password
• ask people to prove their identity by sending copies of personal documents such as your passport, driving licence, bills or pay slips

If anyone believes they are a victim of fraud or identify theft they should report this directly to Action Fraud on 0300 123 2040.

Co-administration of flu and COVID-19 vaccine

Regarding the co-administration of the flu and COVID-19 vaccines, there is no evidence of any safety concerns, although it may make the attribution of any adverse events more difficult. Therefore, the green book advises that there should ideally be an interval of at least 7 days between the two to avoid incorrect attribution of potential adverse events. However, if this is not possible, then it is acceptable to give both together as the green book states that: “as both of the early COVID-19 vaccines are considered inactivated (including the nonreplicating adenovirus vaccine), where individuals in an eligible cohort present having received another inactivated or live vaccine, COVID-19 vaccination should still be considered.” This is to avoid any further delay in protection and to avoid the risk of the patient not returning for a later appointment.

COVID-19 vaccine and fertility

Royal College of Obstetricians and Gynaecologists have published information and advice for pregnant women about the COVID-19 vaccine, including an updated Q&A section. The College also released a press notice, responding to misinformation around the COVID-19 vaccine and fertility.

COVID-19 Vaccination Programme – workspace

General practice

Support to increase GP capacity in primary care workforce

To support the COVID-19 response, vaccination roll out, and the implementation of the Primary Care Flexible Staff Pools locally, a framework of six approved digital suppliers is now available.

This framework contains digital suppliers whose digital solutions, to be utilised by PCNs and practices, can match additional GP workforce capacity with primary care demand and facilitate flexible staffing pools. Solutions can also facilitate clinician approval, (including onboarding checks), and payment processes, further reducing the admin burden for practices.

Systems may consider using their allocation for the GP Flexible Pools initiative (up to £120k each) to procure digital solutions from this Framework. Commissioners are able to call-off one of six approved digital suppliers: Binary Health (Hyre app); Lantum; Locum Tap (trading as Patchwork); Midlands & Lancashire CSU (Find me a Locum app); My Locum Manager (MLM Flex); and Pairoo.

Further information on the Framework including call-off guidance is available upon request by emailing digitalsupplier.framework@nhs.net.

Reminder: seeing patients who are not wearing face coverings

The safety of both our staff and our patients is of paramount importance and face coverings or face masks should be worn by patients in a practice setting, in-line with government guidance. However, not all patients are able to wear a face covering and a patient should not be refused access to care if they are unable to, or refuse to, wear a covering. For these patients, practices should ensure that they can take all reasonable steps to identify practical working solutions with the least risk to all involved. For example: offering the patient a mask, if the patient is willing to wear one; booking the patient into a quieter appointment slot, or in a separated area or providing care via a remote appointment.

Next Generation GP virtual programmes – open now

The ‘Next Generation GP’ is a programme for emerging leaders in general practice designed by, and for, a group of early-career GPs and trainees. Their aim is to inspire early career GPs to be informed leaders as well as excellent clinicians, with the insight and connections they need to change and improve the system in which we work.

Applications are now open for virtual programmes; any GP trainee or newly-qualified GP (approx. first 5-7 years post qualification) can apply by submitting a brief expression of interest.

General practice – latest updates

Community pharmacy

Flu vaccinations in community pharmacy

Thank you for the work you continue to do in community pharmacies in vaccinating patients for flu. The Department of Health and Social Care (DHSC) has confirmed that community pharmacies can now offer private patients and those covered by occupational health schemes a vaccine that has been centrally supplied, alongside NHS eligible cohorts. This is reflected in updated DHSC stock guidance for pharmacies.

Please retain some vaccines specifically for NHS eligible cohorts, as some may come forward later in the season, such as newly pregnant women or others who have not received their vaccine yet.

New standards for initial education and training of pharmacists introduced

The General Pharmaceutical Council has published new standards for the initial education and training of pharmacists, which have been welcomed in a joint letter from the Chief Pharmaceutical Officers of Great Britain.

The implementation of these new standards will transform the education and training of future pharmacists, so they are able to play a much greater role in providing clinical care to patients from much earlier on in their careers and they will be independent prescribers from their first day on the register.

The changes will help meet the increasing demand for high quality professional pharmacist skills from patients and the NHS. To ensure the whole profession is able to meet this demand, it is also important that all the current professional workforce has the opportunity to develop existing skills and experience as required, so that they too can practice at this enhanced clinical level.

NHS Community Pharmacist Consultation Service IT licence – extension to 30 September 2021

Additional funding has been agreed so that all regions can arrange an additional six months for the community pharmacy CPCS IT licence for the period 1 April 2021 – 30 September 2021, on behalf of contractors.

Since March 2020, Pharmacy Integration Fund resource has been provided to regions to fund the community pharmacy CPCS IT licence to allow contractors to offer the service without additional IT costs being incurred.

This funding was due to end on the 31 March 2021, after which point contractors would be required to purchase their own IT from the range of system suppliers in the market offering CPCS functionality. This change is part of a package of interventions that NHSE&I has made to support contractors during the pandemic. Further information will follow locally from NHSE&I regional teams.

Primary care

Guidance to support care homes to view GP records and order medications online

Do you need support to help care staff to order residents’ medications and access their GP record online? New step-by-step guidance from NHSX and the LGA, contains practical tools and information to help GP practices using TPP and EMIS GP practice systems to give authorised care staff proxy access to their residents’ GP online accounts. Enabling staff to order medications online, provide greater personalisation of care and make timely care decisions based on up to date information. The guidance also includes access to local implementation support. 

Cervical cancer prevention week 18-24 January

Cervical screening in primary care should continue to be prioritised alongside cancer referrals, including both high risk and regular call/recall invitations to screening. People on the Shielded Patient List should continue to be invited to and encouraged to attend screening appointments as normal. For cervical cancer prevention week, we would like to share messages that invitations are being issued, screening appointments are going ahead and that all NHS services have put in extra safety measures. There are helpful communications materials that Jo’s Trust have produced as part of prevention week which can be used on your external channels.   

Stroke Prevention Day: Prevention in Primary Care

Last Thursday (14 January) saw the first ever Stroke Prevention Day – an awareness day introduced by the Stroke Association, encouraging people to  make one small change to reduce their risk of stroke.

Stroke prevention is a key priority for primary care and a vital part of this is improving the detection and management of high-risk conditions including Atrial Fibrillation (AF). In this blog, Shahed Ahmad, National Clinical Director of Cardiovascular Disease (CVD) Prevention, along with two other clinical experts in CVD prevention provide an overview of ongoing work to improve outcomes for patients with AF in England, which includes initial findings from a national programme supporting 23 CCGs to improve the rate of anticoagulation in patients with AF, which is proven to reduce the risk of a AF-related stroke. The blog also discusses leaning from Darlington CCG’s ‘Detect, Protect, Perfect’ model and some of the actions that primary care teams can take to detect AF, protect patients against AF-related strokes and perfect AF management.

Dates for your diary

January webinars on working with people and communities in PCNs
Our webinar series for colleagues working in primary care networks continues this month, helping PCNs to provide inclusive services for people and communities from the most marginalised groups, who experience the greatest health inequalities. They include:

• Tuesday 26 January, 12pm - 1pm. ‘A masterclass on surveys’
• Thursday 28 January, 10.30am - 11.30am. ‘Building and developing trusted connections with communities’
• Thursday 28 January, 4pm - 5pm. ‘Connecting with Inclusion Health Communities’

Wednesday 27 January, 1pm – 1.30pm. COVID-19 Vaccine for Cancer Patients

Thursday 28 January, 5pm – 6pm. General Practice Webinar. Please ensure you register to attend by 3pm on 28 January. You do not have to register again if you have booked for our previous GP webinars.

Link of the day

RCGP online learning: Management of obesity and overweight