23 December 2020

Dear colleagues,

The vaccination programme continues apace, and we know many of you will be working over the Christmas holidays with more local vaccination centres stepping up next week.

It is so important that we vaccinate this priority cohort of patients as per the JCVI guidance as soon as we can unless there is a clinical reason as to why they cannot have the vaccine. 

We have asked all wave 1, 2 and 3 local COVID vaccination sites to prioritise wherever possible care home residents and staff to ensure this priority group are vaccinated against the coronavirus as quickly as possible.  We appreciate the additional time and resources needed to deliver this complex vaccine in a care home setting, especially at such a busy time of the year. Therefore, we will be providing an additional supplement of £10 per dose on top of the item of service fee for all vaccines delivered in a care home setting.

The supplement will be payable on completion of the second dose for all vaccines administered between 14 December and 31 January. Where exceptional circumstances (as defined in the enhanced service specification) means that only one dose was able to be delivered, and this dose was delivered on or before 10 January, the supplement will be payable on the first dose only. 

Arrangements have also been put in place to support PCNs with additional workforce for care home vaccinations – at no cost to the PCN in specific circumstances. Further details of the additional workforce support can be found here. We also shared a care homes vaccination mobilisation support pack.

Further information on the reporting and payment arrangements will be made available shortly. 

We hope that some of you will get some rest of the Christmas break. Thank you once again for the extraordinary efforts you have gone to over this year. You have been truly incredible. Can we particularly dedicate this bulletin to those who keep us afloat day in, day out. Our practice managers, reception and admin staff. Those who have been reading everything we send out, calling patients in to vaccination clinics, organising staff to ensure we can deliver despite the busiest of times. It is truly appreciated.

Raj and Ali

COVID-19 updates and guidance

Novel variant of COVID-19

A novel variant of COVID-19 has been identified which has spread rapidly within the UK. Public Health England have published a technical briefing document on novel SARS-COV-2 variant which gives further information. They have assessed this variant as having substantially increased transmissibility with high confidence. 

Vaccine provision for care homes

The standard operating procedure states that PCNs may access vaccines for use in care homes as follows: 75-dose pack(s) available for order and can be used for large care homes; and 5-dose vial(s) extracted from 975-dose vaccine pack(s) ordered primarily for PCN site-based vaccinations. For small and medium sized care homes, if the full 15 vials (75 doses) are not required, then the appropriate number of vials can be taken to the care home and the remainder left in the refrigerator for use at the PCN site.

Indemnity arrangements for the Covid-19 vaccination programme

A joint letter from NHS Resolution, NHS England and NHS Improvement and the Department of Health and Social Care has been issued to providers and commissioners to reassure healthcare professionals and others working and volunteering in the NHS in England about the indemnity arrangements that are in place for the Covid-19 vaccination programme.

Further Tier 4 Areas Advised to Shield

The Government has decided that several areas of England across the East and South East will be moving into Tier 4 from 26 December. Shielding guidance for clinically extremely vulnerable people is to be reintroduced in these areas, as well as support including free delivery of medicines (where friends, family, or local volunteers are unable to provide help) and statutory sick pay where unable to work from home. You can find the tier of your local area here. Government will be writing to affected CEV individuals in Tier 4 areas to inform them of the advice and support available. It is expected that Government will also be sending text messages and emails to affected patients where the NHS holds the relevant contact information.

Change in process to access lateral flow tests for vaccination sites from wave 5

Staff working at vaccination sites becoming operational from January onwards should receive lateral flow antigen tests through their participating primary care contractors. In order to ensure that vaccination site staff can access lateral flow antigen tests, all individual primary care contractors working together in the PCN grouping delivering vaccinations should order tests for the staff working at the site as part of their ordering process for test kits through Primary Care Services England (PCSE).

This differs from what previously stated on the 16 December letter regarding deliveries of tests to vaccination sites, as the PCSE ordering system is now up and running. As contractors are asked to order one box of test kits for each one of their patient-facing members of staff, they should include in that order one box for each member of their staff working in their vaccination PCN grouping.

If there is any staff working at the vaccination site who have been brought in exclusively to work at the site, but do not normally work in any of the primary care contractors in the PCN grouping, the primary care contractors should agree one contractor who will order boxes of test kits for this staff as well.

Primary care contractors and their staff are reminded that recording of all results (positive, negative, invalid) from lateral flow devices is a statutory requirement. The results from the lateral flow antigen test for primary care staff should be documented at home by the individual using the NHS Digital online platform.

Guidance in flu vaccines and the COVID-19 response

New guidance is now available on the NHSX Information Governance portal on flu vaccines and the COVID-19 response. It describes how data is being used to help ensure that those who are entitled to a flu vaccine receive one. This includes data relating to both health and care staff and patients. 

COVID-19 Vaccination Programme – workspace

General practice

Queries from the public about when they will be vaccinated

We are aware that GPs are getting calls from the public about when they will receive confirmation about their vaccination, especially if their local GP surgery is currently not offering vaccinations.

As you know, the NHS is currently offering the COVID-19 vaccine to people most at risk from coronavirus. The vaccine is being offered in some hospitals and hundreds of local vaccination centres run by GPs and will be offered more widely, and at other locations, as soon as possible.

People are urged to wait to be contacted. Practices are asked to ensure this message is communicated to patients who may be enquiring and they are not directed to contact other NHS services for information. The key message is that the NHS will let you know when it's your turn to have the vaccine and it's important not to contact the NHS for a vaccination before then. We have also produced a patient comms pack for primary care to help you manage your communications to patients. For the latest details please direct people to the COVID-19 vaccine webpage for guidance. 

Tools and guidance to support recruitment to primary care

To help ease the pressures on general practice expanding the workforce is a top priority. The additional roles reimbursement scheme (ARRS) provides PCNs with funding to recruit and. to help you to do this, the PCN Development workspace on FutureNHS has been updated. It provides guidance and tools aligned to the Network DES to support the planning, recruitment and embedding of new roles under the ARRS, including sample job descriptions and adverts.

This area of the workspace is designed to support PCNs, CCGs and ICS / STPs as well as CSUs, Training Hubs and the voluntary, community and social sectors and provides relevant information about the each of the roles, including job descriptions, case studies and more. There is also a developing community of practice through a discussion forum to further connect colleagues and share experiences. If you are not a member of the workspace you can join by emailing P_C_N-manager@future.nhs.uk using an NHS or similar professional email address.

Remote consultation guidance

The Royal College of General Practitioners has guidance for general practice on using online, phone and video consultations during the COVID-19 pandemic, alongside continuing face-to-face care where there is clinical need. Macmillan have also created new resources to support telephone and video consultations in primary care as part of their ’10 top tips’ series. There is a resource for patients and a resource for healthcare professionals on our FutureNHS space.

Patient experience survey to launch in January

The 2021 GP Patient Survey launches on Monday 4 January. You can help promote it by displaying a downloadable poster or talking about it in social media. Last year, almost 740,000 people gave feedback on around 6,800 GP practices across England. It is a key source of information about the performance of GP practices and CCGs. Due to changes made as a result of COVID-19, it is more important than ever that we hear about experiences of using local GP and health services. For more information or to request social media resources please contact: england.insight-queries@nhs.net.

General practice – latest updates

Community pharmacy

Community pharmacy explained

Community pharmacy is a critical part of primary care in England, but its role and relationship to the wider NHS is often poorly understood. This explainer from the King’s Fund looks at the community pharmacy sector in England, explaining how pharmacies are contracted and funded, the types of services they provide and future trends in the sector.

Dentistry

Contractual arrangements for Q4

A letter has been sent to all dental providers with the detail of the contractual arrangements for Q4. The NHS Business Services Authority (NHSBSA) has also published guidance to support dental contract management arrangements for the 2020/21- year-end reconciliation.

Primary care

Managing medication: supporting people to deal with the hidden burden of medication

Being prescribed many medicines places a huge, often hidden, burden on older people in the community and on their families or carers. The National Institute for Health Research’s (NIHR) MEMORABLE study aimed to understand the difficulties patients have in managing medication. Researchers interviewed health and social care professionals, older people and family carers and also reviewed scientific papers on the subject. The study recommends that doctors, pharmacists and nurses consider burden when prescribing or changing medicines. Find out more in this NIHR Evidence Alert.

BMJ Best Practice resource now free to all NHS staff

BMJ Best Practice is a clinical decision-making resource providing the latest evidence-based information to use at the point of care. Funded by Health Education England, it is free NHS professionals and learners in England. Rated as one of the best support tools worldwide, staff using BMJ BP will have access to essential resources to support healthcare professionals with diagnosis and management of COVID-19, as well as the latest evidence on thousands of clinical topics, medical calculators, videos on common procedures and nearly 500 patient information leaflets.

Go to bmj.com/hee and register via NHS OpenAthens (instructions here). Download the app once registered.

Snapshot wellbeing survey of the primary care workforce

We would like to ask you to take part in a short survey as part of the Institute for Employment Studies’ ongoing work on behalf of NHS England and NHS Improvement. The survey should take no longer than 15 minutes to complete and will contribute to important research aiming to understand the wellbeing of the primary care workforce through the COVID-19 pandemic. It is important to carry out surveys such as this one at multiple times to help us understand how the situation is changing over time, so you may recall taking part in a similar survey earlier this year.

If you feel like you need someone to talk to, our confidential #LookingAfterYouToo coaching service remains available to all primary care colleagues, including over the festive period.

Video: Walsall Covid Vaccination Hub Goes Live

The first Walsall-based Primary Care Covid Vaccination Hub has gone live and has begun vaccinating patients. The team share details of their remarkable achievement in such a short time frame and how they are going above and beyond to protect some of our most vulnerable patients.

Dates for your diary

Tuesday 29 December, 1.30pm - 2.15pm. COVID-19 Vaccinations webinar for the PCN rollout to care homes

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

• Wednesday 6 January 2021, 1pm - 2pm. ‘Reaching out to communities at speed’ – Elliot Hall Practice Heroes project during COVID-19
• Wednesday 13 January 2021 12pm - 1pm. ‘A masterclass on conducting telephone surveys’
• Tuesday 26 January 2021 12pm - 1pm. ‘A masterclass on surveys’

Tuesday 12 January 2021, 1pm - 2pm. COVID Oximetry @home: an overview for primary care. 

Wednesday, 13 January 2021. 2pm - 3.30pm. Common Challenges and Proven Solutions for Teledermatology: (Part 2/3)