26 January 2021

Dear colleagues,

We know that in communities across the country, general practice and community pharmacy colleagues are working effectively together to provide care to the communities they jointly serve to support them through the pandemic, and we thank you for that. We are also hearing of fantastic collaboration between GP and pharmacy-led vaccination services in getting their local populations vaccinated as soon as possible.

We ask that both general practice and community pharmacy continue to support each other in this important joint programme. The Essential Service for general practice and the Local Enhanced Service for community pharmacy mirror each other as closely as possible, the item of service fee and training requirements are the same, clinical supervision is required for both, and both are working to the same standard operating procedures. By working together, we can ensure capacity and resilience in the system so that all communities can get access to the vaccination as quickly as possible.

Pharmacy Local Vaccination Services appointments are offered alongside appointments at the larger Vaccination Centres to patients booking via the National Booking Service. We are also trying to expedite the vaccination of frontline health and social care workers by allowing pharmacy Local Vaccination Services to vaccinate this cohort.

Thanking your colleagues

The Countess of Wessex spoke at the Lincolnshire GPN conference last week. She warmly thanked GP nurses and the NHS for the vaccination programme, and for the personal effect this has had for her.

Previously, we notified you of a ‘thank you letter’ template from Dr Nikki Kanani, addressed to the children of primary care colleagues. We have now developed a further three letters (for practice staff, front line staff and colleagues) which are also available to download and share. Each letter thanks our NHS colleagues for their continued support and dedication to the NHS and patients throughout the pandemic.

Kiren and Ned

COVID-19 updates and guidance

UK Infection Prevention and Control guidance – updated

The UK Infection Prevention and Control (IPC) guidance has been updated to reflect the most up-to-date scientific understanding of how to prevent and control COVID-19 infection. Amendments have been made to strengthen existing messaging and provide further clarity where needed, including updates to the care pathways to recognise testing and exposure. Appendices to support the remobilisation and maintenance of dental, mental health and learning disability services have also been added.

Following extensive clinical and scientific review, no changes to the recommendations, including PPE, have been made in response to the new variant strains at this stage, however this position will remain under constant review. Organisations who adopt practices that differ from those recommended in the national guidance are responsible for ensuring safe systems of work, including the completion of a risk assessments approved through local governance procedures.

All NHS organisations should ensure reliable application of all IPC recommendations and assurance on adherence, that PPE is available and in supply, and that all staff training is up to date.

Valved respirator masks

Previous guidance has confirmed valved non-shrouded FFP3 respirators should be worn with a full-face shield if blood or bodily fluid splashing is anticipated. This updated guidance clarifies that valved respirators should not be worn by a healthcare worker/operator in sterile areas such as theatres/surgical settings or while undertaking a sterile procedure, such as central line insertion, as the exhaled breath is unfiltered.  In these settings, please follow the approach of fit testing staff to one or more of the seven non-valved masks currently available. New fit testing should focus on non-3M models, in line with the ongoing national resilience strategy.

For support with fit testing, please contact Anton Miedziolka in the Government’s National Fit Testing Team: Anton.Miedziolka@gstt.nhs.uk.

Community Champions to give COVID-19 vaccine advice and boost take up

The Government has announced over £23 million of funding has been allocated to 60 councils and voluntary groups across England to expand work to support those most at risk from COVID-19 and boost vaccine take up. The funding will also support areas to tackle misinformation and encourage take-up as the vaccination programme expands across the country.

New COVID-19 vaccine easy read leaflet

Public Health England has produced a COVID-19 vaccination easy read leaflet for people with a learning disability and their families and carers.

COVID-19 vaccine communication resources

Our communications resource pack includes key messages, guidance, templates and resources to share and engage with different audiences. It’s especially important to ensure that both patients and staff, when eligible, are getting the COVID-19 vaccination. This pack includes considerations for communicating with Black, Asian and minority ethnic (BAME) communities about the vaccines.

Public Health England’s Campaign Resource Centre has lots of materials to communicate the progress and delivery of the COVID-19 vaccines which can be used to help increase take up of the vaccinations.

COVID-19 Vaccination Programme – workspace

General practice

General Medical Services (GMS) registration

The contractual requirement of the General Medical Services (GMS) Contract 2017/18 (page 64) to accept patients from the secure estate prior to their release has increased importance during the COVID-19 pandemic.

Pre-registration will support the smooth rollout of the COVID-19 vaccine. For individuals leaving the secure estate between the first and second doses of their vaccination who have been registered with a community GP, their GP record will be updated with their vaccination status. GP practices are asked to ensure that processes are in place to meet their contractual requirement, with information on how to do this here.

General practice – latest updates

Community pharmacy

Supporting pharmacy professionals through the ongoing COVID-19 pandemic

Chief Pharmaceutical Officer for England Keith Ridge, along with the UK’s three other Chief Pharmaceutical Officers and regulators, has written to the profession thanking colleagues and acknowledging the extreme pressures that pharmacy teams may be working under during the ongoing COVID-19 pandemic.

The joint letter asks employers, statutory education bodies, professional bodies and national NHS and health and social care organisations to continue to support pharmacy professionals at this time and thanks colleagues for their support of the COVID-19 vaccination programme and continued provision of essential services to patients and the public. 

It also emphasises that frontline pharmacy workers are among the high priority groups identified by the JCVI for receiving a vaccine and health and care services are working hard to get this to them as soon as possible.

Primary care

Recognition of musculoskeletal (MSK) conditions which require urgent or emergency referral to secondary care

In the current context it is important that we continue to recognise Musculoskeletal (MSK) conditions that require urgent or emergency referral to secondary care services. The updated guidance follows the specialist guidance document produced during the first phase of the coronavirus pandemic. It supports primary and community care practitioners in recognising serious pathology which requires emergency or urgent referral to secondary care in a patient who present with new or worsening MSK symptoms.

Enhanced Health in Care Homes: A guide for care homes

The Care Provider Alliance has published a guide for care homes on the Enhanced Health in Care Homes (EHCH) service. This guide provides advice for care home managers on how to support their residents to benefit from the service. It also provides information on how to work effectively with their Primary Care Network clinical lead to ensure the health of their residents is improved. The guide was developed with NHS England and NHS Improvement’s community services and ageing well team. For more information on EHCH please visit our workspace on FutureNHS. 

New street outreach guidelines launched

The Homeless and Inclusion Health Service Standards for Commissioners and Service Providers (‘The Standards’) are produced by The Faculty for Homeless and Inclusion Health as a framework for the commissioning and provision of health services for excluded people.

They draw upon the latest evidence of best practice and provide quality assurance for supporting vulnerable and excluded patients with multiple and complex needs, commonly referred to as inclusion health patients.

The aim of the street outreach guidelines is to assist services to plan new health related street outreach projects, or to review services’ existing outreach. Homeless health services cover a range of locations, and the demographics of people sleeping rough in these areas may differ widely. This outreach document is designed as a flexible tool for sharing best practice and innovative ideas, allowing services to use them as appropriate to their areas. (January 2021). Download an electronic version of the street outreach guidelines

These new street outreach guidelines will support teams who are developing plans to deliver the vaccine on an outreach model.

NHS e-Referral Service (e-RS) – improved advice and guidance functionality

The NHS e-Referral Service (e-RS) advice and guidance functionality allows a primary care clinician to seek advice from a secondary care clinician. Improvements to the core e-RS advice and guidance functionality are being made and will be available by the end of January 2021, with greater interoperability with provider IT systems available before the end of March 2021.

These enhancements include changes which enable a service provider to convert an advice and guidance conversation into a referral (when authorised), as well as provide advice back to the referrer and improved integration of e-RS with provider IT systems which means it will be quicker and easier for clinicians to use.

More information, including training materials and details of awareness sessions, is available on the NHS Digital website. 

Digital DS1500 service

If you need to complete a DS1500 form, you can do it online at ds1500.dwp.ncrs.nhs.uk. This significantly reduces the time it takes for a patient to claim benefits. To access the online service, sign-in to the NHS Spine portal using your Smartcard. When you complete the form, you can download a copy of the DS1500 for your records. You can also print off the fee claim form, if eligible. If you experience issues accessing the DS1500 link, please ensure your NHS Trust has added the link to your browser's 'Trusted Sites'. Contact your NHS Trust’s service desk for more details.

Dates for your diary

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

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:

• Thursday 28 January, 10.30am – 11.30am. ‘Building and developing trusted connections with communities’
• Thursday 28 January, 4pm – 5pm. ‘Connecting with Inclusion Health Communities’

Thursday 28 January, 5pm – 6pm. General Practice Webinar with Kiren and Ned (with a COVID-19 vaccination programme update from Nikki and Ed). 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.

Thursday 4 February, 10am – 11.45am. Supporting our Working Carers in the NHS

Link of the day

Black and Asian Medics Urge Britain's Minority Communities: Get the Covid Jab