Primary Care Bulletin - this week's round-up

3 September 2021

Dear colleagues,

Proposed COVID-19 vaccine booster programme

Thank you to all PCN groupings and community pharmacies for your planning and preparation to be ready for a potential COVID-19 booster programme. We’d like to remind all Local Vaccination Services which have opted in to Phase 3 that you must not start providing booster vaccinations, or provide the primary course of vaccinations under the Phase 3 Enhanced Service specification for general practice or the Phase 3 Local Enhanced Service for community pharmacy, until final JCVI guidance has been received, the government has approved the start of a booster programme, and NHS England and NHS Improvement has notified sites that vaccinations can start. This has not yet happened. The primary course of vaccinations to eligible patients can of course continue under the Phase 1 and 2 arrangements.

We are expecting final JCVI guidance in the coming weeks and will commence the booster programme as quickly as feasible thereafter, giving LVS sites sufficient notice as required to be ready for this. Please await further guidance.

We are all operating in very challenging environments and we are grateful for all your hard work and dedication.

Nikki and Ed

COVID-19 updates

Vaccinations for children aged 12-15 years and considered clinically at risk

Colleagues working in general practice are reminded that children aged between 12 and 15, considered to be clinically at risk, should be supported to receive their COVID-19 vaccination. If a practice considers it is unable to provide the vaccination, they should refer affected individuals to the local CCG so they can organise alternative provision, rather than contacting and referring to 119 in this instant. Please review the letter issued to the system on 13 August available here, for further details.

COVID-19 Vaccination Programme – workspace

General practice

Blood tubes shortage - update

Becton Dickinson has alerted us to a shortage of products from their Blood Specimen Collection Portfolio that is impacting across most main blood tube supplies.

The supply position remains constrained and is forecasted to become even more constrained over the coming weeks. While it is anticipated that the position will improve from the middle of September, overall supply is likely to remain challenging for a significant period. Alternative products are being sought to alleviate these constraints; and all labs that will be switching to these supplies have received samples for testing and validation. However, it will take time for these products to be imported and delivered in volume to services.

To safely manage demand for these products, NHS England and NHS Improvement has issued a letter providing guidance on actions to reduce demand, this letter must be actioned immediately.  

Top-tips for patients - making the most of your video and phone appointments 

The South East London Cancer Alliance have launched a video about making the most of virtual consultations that they have co-produced with patients. It’s an excellent resource for any patient having phone/video consultations. They have also published ‘How can you make the most of your virtual consultation’ Q&As, which can be read online.  

General practice - latest updates

Pharmacy

Pharmacy Quality Scheme 21/22

The Pharmacy Quality Scheme (PQS) 2021/22 commenced from 1 September 2021.

Under the scheme and in collaboration with the new service requirements for Primary Care Networks and IIF, Community Pharmacy will again be asked to focus on medication safety and improving patient outcomes  by increasing access to primary care services and creating a more sustainable NHS. This PQS is year 3 of a five-year deal and builds upon previous criteria.

The criteria include working collaboratively with GPs in PCNs to support patients starting to take a new medicine (NMS), increase uptake within their population of flu vaccinations, delivering a high-risk medicine (anticoagulation) audit,  driving high uptake of flu vaccination, training and actions to address health inequalities, a weight management referral service, antimicrobial stewardship, remote consultation skills and supporting the clinically effective and sustainable use of inhalers.

PCNS should collaborate with pharmacy teams locally to jointly work on these initiatives.

New Medicine Service 21/22

From 1 September 2021, pharmacy teams will be supporting more patients who are starting to take new medicines. The new therapeutic areas include heart failure, high cholesterol, Parkinson’s Disease, epilepsy, gout and osteoporosis.

To support pharmacy teams to provide the best patient outcomes for individuals that might have missed this support because of the pandemic restrictions, a catch-up NMS has been introduced from 1 September 2021. 

Further therapeutic areas will be piloted through the Pharmacy Integration Fund as part of a fully integrated service model. General practice and pharmacy staff are encouraged to work collaboratively to make best use of this development to support patients in the eligible groups.

The Pharmacy Access Scheme (PhAS)

The Pharmacy Access Scheme (PhAS) was introduced as part of the 2016/18 CPCF funding settlement, in order to ensure that a baseline level of patient access to NHS community pharmaceutical services in England is protected. The updated 2022 PhAS as part of the 2021/22 CPCF agreement will apply from 01 January 2022.

The objective of the 2022 PhAS is to create a scheme that is more targeted and representative of the pharmacy market as it is now, and that better targets support to pharmacies that are deemed essential for local provision of physical NHS pharmaceutical services. A list of pharmacies eligible for the 2022 PhAS has been published, together with updated eligibility criteria and a guidance document by DHSC.  

The 2022 PhAS retains a review process, managed by NHSEI; to deal with any inaccuracies in relation to pharmacy premises addresses or any unforeseen circumstances affecting access, such as a permanent roadblock. The review application window to submit applications is between 4 January 2022 and 4 February 2022. Further details of how to apply for a review will be provided in November and December 2021.

COVID-19: What can pharmacists learn from people’s experiences of services?  

Healthwatch have gathered information about what the public thought worked well, and what could have been better when it came to the support community pharmacies provided during the pandemic. Read Healthwatch’s findings here.  

Dentistry

Dental bulletin

Your NHS dentistry and oral health update - 31 August issue is available to read online now.

Primary care

End to temporary suspension of patient signatures on pharmacy, dental and eye care forms

Since 1 November 2020 to 31 August 2021 the requirement for patient (or their representatives) signatures on NHS prescription, dental and eye care forms was temporarily suspended. The requirement for community pharmacies to submit certain EPS tokens was also suspended.

From 1 September 2021 patients (or their representatives) will again be required to sign NHS prescription, dental and eye care forms or tokens. Starting with claims for September NHS prescriptions, pharmacy contractors are required to submit any relevant EPS tokens to the NHSBSA with their monthly prescription bundles.

Dental and pharmacy contractors can visit the NHSBSA website for further details.

Pulse oximeter use for people with darker skin 

The Medicines and Healthcare products Regulation Agency (MHRA) have detailed factors affecting the accuracy of pulse oximeters, including skin colour, movement, nail polish, henna dye, and tattoos. They are not aware of any incidents where skin colour has adversely affected the use of pulse oximeters when providing effective clinical care. 

We continue to recommend, that patients onboarded to COVID Oximetry @home record a baseline oxygen saturation, and subsequent changes are compared to this baseline. Clinicians should also remain vigilant for other signs of deterioration. It is important that all COVID-19 patients that could benefit have access to pulse oximeters to detect silent hypoxia.

Consensus statement for information sharing and suicide prevention

The Department of Health and Social Care has worked with the organisation Zero Suicide, Royal Colleges and other partners to develop guidance for frontline staff on how and when they should share information about patients, where this may help prevent suicide.

Know Your Numbers! Week: Benefits of home blood pressure monitoring  

Know Your Numbers! Week, from 6-11 September aims to raise awareness of high blood pressure and the opportunity to improve blood pressure control both now, and in the future. Regular blood pressure monitoring could prevent up to 500 heart attacks and almost 750 strokes over five years across 50,000 patients. Encouragingly, around 30% of patients with hypertension already have their own monitor.

This is supplemented by the Blood Pressure @home programme, which has allocated a number of home blood pressure monitors to CCGs to help support patients to monitor their blood pressure at home. If you’d like to understand what is happening in your area, please go to our FutureNHS workspace (login required) to find your local contacts. 

Key dates

6 – 12 September – Know your Numbers Week, blood pressure testing and awareness event

12 September – closing date for the NHS Race Equality Strategy – all staff consultation

1 October 2021 – Primary Care Network Contract DES to take effect

Upcoming events and webinars

7 September, 6.30 – 7.30pm. RCGP: Quality improvement in primary care networks

9 September, 5pm - 6pm. General Practice Webinar

13 September, 4pm – 5:15pm. Health Inequalities - Priority 2: Mitigating against digital exclusion

21 September, 6.30pm – 7.30pm. RCGP: QOF QI module for care of people with learning disabilities

23 September, 9am - 10am. Introducing innovation to the lipid management pathway

29 September, 5.30-7pm. Enhanced Health in Care Homes: primary care networks and community health

30 September, 11am -2:15pm. Health Inequalities - Priority 3: Ensuring datasets are complete and timely

Link of the day

How does patient experience of general practice vary with deprivation?