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Primary Care Bulletin - this week's round-up
30 September 2021
We are pleased to confirm that additional funding is available to vaccinate all eligible primary care contractors and their frontline staff for this influenza season. Significantly and for the first time, this also includes frontline patient-facing NHS primary dental or general ophthalmic contractors and their frontline staff. Details of how dental and optometry staff can access the flu jab are outlined in this letter along with further details on the flu vaccine rollout through community pharmacy and general practice. The Patient Group Direction and National Protocol for Influenza vaccine will be updated shortly.
For general practice, the updated Enhanced Service Specification: Seasonal Influenza Vaccination Programme 2021/22 also includes co-administration and synergistic delivery of influenza vaccine with COVID-19.
COVID-19 updates
Improving identification of unpaid carers in primary care
Phase 3 delivery of the COVID-19 booster vaccinations includes unpaid carers prioritised in cohort 6. As in Phase 1, those currently in receipt of a carer’s allowance or identified in March 2021 as receiving support from a Local Authority or Carers Organisation, are being called nationally for booster vaccinations providing it’s been six months since they completed their primary course.
To create a sustainable process for calling unpaid carers for any future COVID-19 vaccinations, a letter from NHS Call and Recall will be sent to nationally identified unpaid carers instructing them to show it to their GP practice and request they’re recorded as a carer on their record. Unpaid carers are aware practices may ask some routine questions before making any changes to their GP record. Please refer to NICE guidance for identifying new unpaid carers.
Improving the recording of carers on their GP records may also help support access to the opportunistic flu vaccination and other primary care interventions to improve health outcomes.
Reminder that shingles vaccines cannot be co-administered with COVID-19 vaccination
We know that clinicians often use the flu programme as a way of opportunistically offering shingles vaccine to eligible people this is an effective way of getting people to have the shingles vaccine. Flu, shingles and PPV vaccinations can all be co-administered, and a fair proportion are administered in this way each year.
However, we wanted to remind you the shingles vaccine cannot be co-administered with COVID-19, and there needs to be a gap of at least 7 days. As ever, before you vaccinate for COVID-19 please check if your patient has received their shingles vaccine in the last week and refer the green book for more details, as well as reinvite/book the patient in for a subsequent shingles vaccine if applicable. The question in the point of care systems remains to ensure a check is in place.
COVID Oximetry @home standard operating procedure
Updates to the COVID Oximetry @home standard operating procedure reflect the changing cohort of people at most risk of becoming seriously unwell. The pathway should be available to people who are
- Diagnosed with COVID-19 and symptomatic AND EITHER
- Aged 65 years or older OR under 65 years and at higher risk from COVID-19, or where clinical judgement applies considering individual risk factors such as pregnancy, learning disability, caring responsibilities and/or deprivation.
A lighter touch, full self-management, pathway should be available to any adult aged 18 – 64, that has tested positive and has not been double vaccinated. CCGs, trusts and ambulance services can request oximeters free of charge: england.home@nhs.net.
Boosters for health and social care workers
Colleagues in eligible frontline roles can now book their booster vaccinations through the National Booking Service (NBS). They will need to present official proof of this status, including for appointments through local booking services and walk-in clinics, as well as through the NBS. Forms of identification that are accepted are: a workplace photo ID; letter from their employer from the past three months; or a payslip from the past three months which shows their employer.
Health and social care workers are required to show this ID when they arrive for their appointment, and their eligible professional status should be recorded in the Point of Care system. As outlined in the green book, eligible frontline colleagues aged 16 -17 should receive the two dose primary course of the Pfizer vaccine.
Vaccine Data Resolution Service (VDRS)
The Vaccine Data Resolution Service (VDRS) aims to resolve missing or incorrect vaccination records for people vaccinated in England who have a current NHS number and are registered with a GP practice in England. A pilot of outbound calls was launched on 3 August to patients identified as having a second dose but where no first dose is showing on the national immunisation database (NIMS). This service continues to operate. An inbound service has now been launched, and referrals to the VDRS can be made via any of the services accessed via 119.
Please note: 119 and VDRS call agents will not provide clinical advice and cannot assist at this time with queries related to vaccinations received overseas. If the query relates to personal information that is incorrect on the patient record (e.g. name, address), these will still need to be resolved by their GP practice.
If a member of the public believes they have missing or incorrect COVID-19 vaccination data, please advise them to call 119 and ask the call agent to make a referral to the VDRS team on their behalf. The VDRS team will then call the person back within five working days.
Vaccination eligibility for children with Williams Syndrome
We have received recent reports from parents of children with Williams Syndrome of difficulties getting their children aged 12-15 immunised with Pfizer – BioNTech (Comirnaty), in line with recent JCVI and Green Book guidance. There is a strong association for those with Williams Syndrome and having a mild or moderate learning disability. It is therefore important that all children with Williams Syndrome and a learning disability are captured on local practice learning disability registers and call/recall offers made in line with recommended guidelines.
Please ensure Learning Disability Registers are as up to date and accurate as possible in order to ensure appropriate immunisation offer and delivery, as well as any offer of other health interventions for which individuals may be eligible e.g. an annual health check for those aged 14 years and above. Additional guidance and a list of syndromes where a learning disability may be associated is available.
Enhanced Service for Long COVID
We are delighted that the take up of the enhanced service for Long COVID has been high with 93% of practices nationally signing up to it. We would like to ensure that every practice has the opportunity to benefit from the support it provides. Therefore, the deadline for sign up has been extended to 29 October 2021 for those remaining practices. Practices who sign up now will be paid for the remainder of the year on a pro rata basis. Access the service specification and the light touch self-assessment template.
General practice
2021/22 seasonal flu vaccine reimbursement
Similar to last year’s flu season, 2021/22 flu reimbursement claims are expected to be reviewed. This means you might get asked to submit information to support your reimbursement claims. Throughout the flu season you should keep records of the vaccines you order, receive and administer. These records are important to enable accurate and timely submission of reimbursement claims. In preparation for the 2021/22 flu vaccine season, NHS Business Services Authority (NHSBSA) has published some hints and tips to help you with your reimbursement claims.
National flu programme call and recall communications for 2 and 3 year olds
From w/c 11 October national call and recall communications will be sent to all parents/guardians of 2 and 3 year olds eligible for a flu vaccination, via letter, email and text message, advising parents/guardians to contact their GP practice to book a flu vaccination appointment. This national call and recall activity is in addition to local arrangements, so GP practices should continue with their usual call and recall activity for eligible cohorts. You may wish to book some of your flu clinics and invite children to attend during the October half term break to maximise the ability to attend.
The uptake target for 2 and 3 year olds is at least 70% but with the ambition for most practices to achieve higher. Please make sure you have ordered sufficient vaccine to vaccinate at least the levels of uptake achieved in 2020/2021, and with the aim of exceeding the 70% uptake target. Vaccine can be ordered through Immform.
2020/21 government-secured flu stock
Access to government-secured flu stock in 2020/21 included a requirement for GP practices to engage in a post payment review of reimbursement payments. NHSBSA will now be contacting some GP practices to ask for additional information about your 2020/21 flu vaccine claims. You do not need to do anything unless the NHSBSA contact you. For more information about the post payment review, contact nhsbsa.gpsupport@nhs.net.
NHS 111 Booking into General practice
During the pandemic a temporary change was made to the requirement for practices to make available to NHS 111 one appointment per 3000 registered patients to one appointment per 500 registered patients. This temporary change will stop at the end of September 2021 and the contractual requirement will revert to 1:3000. It is important that when this takes place that patient care continues to be managed effectively. This will require sufficient booking opportunities to be made available in practice systems.
The existing NHS Pathways system utilised by NHS 111 providers currently produces dispositions with a range of response timescales. NHSE will work with GP Connect to support both NHS 111 providers and practices to implement an effective booking process and facilitate further discussions around IT system capabilities. Further details are available on FutureNHS.
Dentistry
HEE’s Advancing Dental Care (ADC) Review Report
HEE’s Advancing Dental Care (ADC) Review Report has recently been published, the culmination of a three-year review to identify and develop a future dental education and training infrastructure that produces a skilled multi-professional oral healthcare workforce, which can best support patient and population needs within the NHS.
Community pharmacy
Extension of the Community Pharmacy Medicines Delivery Service
The Medicines Delivery Service will continue to be commissioned from community pharmacies and dispensing doctors for self-isolating patients from 1 October 2021 until 31 March 2021. The service specifications and guidance is available to read online.
NHS Confederation Report ‘Freeing up opportunities in community pharmacy’
NHS Confederation have published a report in collaboration with the NPA and PCPA On ‘Working collaboratively in an ICS – freeing up opportunities in community pharmacy’. The report is the output from a roundtable with PCN and Federation members along with the national pharmacy stakeholder organisations. This short version is for PCNs to help guide them in their relationships with community pharmacy; the long read sets out the opportunities for community pharmacy and what needs to happen to overcome some of the challenges.
Hypertension Case-Finding Service Starting 1 October 2021
The Service Specification for the new Hypertension Case Finding Service has been published ahead of the service starting on 1 October 2021 Contractors can now register to deliver the service through Manage Your Service. The service will involve identifying people at risk of hypertension and offering them blood pressure measurement and where clinically indicated, offering 24-hour ambulatory blood pressure monitoring (ABPM). The blood pressure test results will then be shared with the patient’s GP to inform a potential diagnosis of hypertension.
We are working with PSNC to host a webinar for you to find out more about delivering the service on 7 October. Register here.
Primary care
National review of overprescribing published
A new national overprescribing review report looking at reducing inappropriate prescribing has been published by the Department of Health and Social Care. The review, led by Chief Pharmaceutical Officer Dr Keith Ridge and guided by patients, doctors, pharmacists, policy makers and academics, recommends changes in primary and secondary care to address the problem of overprescribing through the role of digital technologies, research, culture change, social prescribing, repeat prescribing, transfers of care and shared decision-making between clinicians and patients.
Children and Young People with Asthma
NHS England and NHS Improvement has published a National Bundle of Care for Children and Young People with Asthma. Produced in collaboration with experts from across the NHS and across the country, as well as asthma patients and their families, the Bundle outlines clear standards of asthma care that need to be met to improve asthma care and reduce unnecessary emergency admissions across the country, along with the resources and tools to facilitate delivery. More information can be found on the NHS England and Improvement website.
Get involved
Survey: Share your views on pharmacy’s role in improving oral health
Pharmacy teams are invited to participate in a PSNC research study which aims to understand the key aspects of oral health care, from a community pharmacy perspective, and the areas that are the most challenging to manage. The brief survey should take around 5-10 minutes to complete and is open to all community pharmacy staff, but the researchers are keen to obtain the views from medicines counter assistants, who are often the first point of contact with patients.
Survey: Lateral Flow Device digital reader
Following the release of digital reader capability for COVID-19 lateral flow device (LFD) reporting in primary care and as part of the continuous evaluation of the LFD digital read service, primary care teams are invited to complete a short survey to share your feedback on the experience of using the service, to help us to improve the service
NHS Digital will also be conducting a number of opt-in follow-up interviews to explore people’s feedback in more depth, to design and build a good quality service (a £20 voucher incentive is provided for those participating). The survey will close at 5pm on Thursday 7 October.
Key dates
- 30 September – PCN and practice workforce data submission deadline
- 1 October 2021 – Primary Care Network Contract DES to take effect
- 29 October 2021 – Deadline to sign up to the Enhanced Service for Long Covid
Upcoming events and webinars
6 October, 5pm – 6pm. How to make local services work best for your patients
7 October, 10am - 12pm. Primary Care Improvement Community Unconference
7 October, 5pm - 6pm. General Practice webinar. With guest speaker Dr Sarah Jarvis presenting on the GP Community Pharmacist Consultation Service (CPCS)
7 October, 7:30pm - 8:30pm. Hypertension Case-Finding webinar
8 October. #LinkWorkerDay2021 – conference and awards
12 October, 10.30am - 12pm. Personal health budget back to basics webinar
12 October, 11:15am - 1pm. Introduction to Proactive Care @home
- Session 1 – Introduction to Proactive care @home, 11:15am – 12:05pm. Open to all.
- Session 2 –– Wave 2 site induction, 12:15pm – 1pm. Open to wave 2 sites only.
13 October, 5pm - 6pm. The key ingredients for access improvement
14 October, 11am - 12.15pm. Health Inequalities - Priority 4: Accelerating Preventative Programmes
14, 19 and 21 October, 9.30am - 12pm. Same Day Emergency Care (SDEC) 2021 webinars
21 October, 11am - 12.15pm. Health Inequalities - Priority 5: Strengthening leadership and accountability
28 October, 12pm - 2pm. Physician Associate Apprenticeship – Employer Engagement Webinar
Link of the day
