Primary Care Bulletin - this week's round-up

1 June 2022

Dear colleagues,

We have published a letter outlining the next steps for the delegation of some direct commissioning functions to integrated care boards (ICBs), alongside a roadmap for specialised commissioning. ICBs will become legally and operationally established on 1 July 2022.

From this date, all ICBs will assume delegated responsibility for primary medical services (currently delegated to all CCGs) and nine ICBs will also take on delegated responsibility for one or more pharmaceutical services, general ophthalmic services, and dental services (primary, secondary and community). Three of the ICBs are in the North West and six in the South East. More details are set out in the letter.

Infection prevention and control (IPC) guidance has continued to evolve throughout the pandemic to meet the challenges of COVID-19 and risk management to protect patients and staff. The UK Health Security Agency (UKHSA) has updated its UK IPC guidance with new COVID-19 pathogen-specific advice for health and care professionals. This advice should be read alongside the National Infection Prevention and Control Manual (NIPCM) for England and applies to all NHS settings including primary care.

Any IPC measures beyond those contained in those publications is a matter for local discretion. We understand that there may be a period of transition as providers make changes to their operating procedures, especially given local variation in COVID-19 infection levels. Further details to support you to interpret UKHSA’s advice is available in our letter published today. The exact interpretation will depend on your local risk assessments.

This weekend is the Queen’s Platinum Jubilee, marking 70 years of the Queen’s service. As part of these celebrations, there is a national Thank You Day on Sunday 5 June and you can join in and share your personal thanks with the hashtag #ThankYouDay. Find out more about how you can get involved. We’d personally like to thank you all for your continued hard work and we hope you get some rest and some quality time with friends and family this bank holiday weekend.

Ursula and Raj

Key updates

Deployment of COVID-19 treatments for highest risk non-hospitalised patients

On 30 May 2022, the Department of Health and Social Care (DHSC) published an Independent Advisory Group report which identifies cohorts deemed to be at the highest risk of an adverse COVID outcome. The UK-wide clinical access policy for COVID-19 treatments for non-hospitalised patients has been updated to include additional groups of patients the report identifies as potentially eligible for treatment. These changes take effect from 13 June 2022.

Most patients will be contacted by a COVID-19 Medicine Delivery Unit (CMDU) following their positive registered test result to arrange assessment and treatment. However, a small proportion of patients may need to be referred by GP practices or 111. More information is outlined in this policy update and letter.

Principles for monkeypox control in the UK: 4 nations consensus statement

UKHSA has advised that cases of monkeypox have increased recently but the risk to the UK population remains low. UKHSA has confirmed that community transmission is occurring in the UK with multiple generations of spread. Illness appears to be generally mild, consistent with other information about the West African clade.

A letter has been sent to NHS organisations outlining the response.

Anyone can get monkeypox. Currently most cases have been in men who are gay, bisexual or have sex with men, so it's particularly important for these people to be aware of the symptoms.

Patients should contact a sexual health clinic if they have a rash with blisters and either:

• have been in close contact, including sexual contact, with someone who has or might have monkeypox (even if they've not been tested yet) in the past 3 weeks
• have been to west or central Africa in the past 3 weeks.

Patients who meet these criteria should be assessed and tested in line with UKHSA guidance. If patients are not able to contact a sexual health clinic they should call 111. Additional information for patients is available on nhs.uk.

COVID-19 Vaccination Programme – workspace

General practice

Long term conditions recovery guidance

Following COVID-19, primary care and the wider healthcare system have already started to tackle the challenge of recovering routine care for patients. With emerging evidence that there has been an impact on non-COVID-19 long term conditions (LTC) management, general practice and systems are already starting to tackle this challenge.

This guidance, produced by the Royal College of General Practice with input from NHS England, outlines suggestions for how actions might be sequenced during the year (2022/23) to support those at highest risk or those with health inequalities. Though primary care plays a key role in LTC management, this guidance also offers suggested recommendations for system actions to support primary care in LTC recovery.

GP Connect and Summary Care Record - additional information to continue beyond COPI

The temporary changes made to GP Connect and Summary Care Record Additional Information in response to the COVID-19 pandemic will continue in place beyond the end of the Control of Patient Information (COPI) Notice. You can be assured that you have the legal basis to continue to provide and use these vital services, under the UK General Data Protection Regulation (UK GDPR) and the Common Law Duty of Confidentiality. The changes made to both services have shown benefits, including improved patient safety.

Looking after your team – GP partner case study

Dr K is a GP Partner in a large, busy practice which is comprised of several staff teams. COVID-19 brought many challenges, including experiencing high levels of patient demand. Although it was thought that teams were adapting well, there was clear pressure for all staff, and there was the perception that wellbeing amongst practice teams was reducing. This case study talks about how accessing the Looking After Your Team coaching helped Dr K learn how he could support himself and his nursing team more proactively.

Access the Looking After Your Team coaching here.

Next Generation GP Podcast - episode 29 with Dr Bola Owolabi

The Next Generation GP leadership programme has a monthly podcast interviewing inspiring leaders in the NHS and beyond. The latest episode is an interview with Dr Bola Owolabi, Director of Health Inequalities for NHS England. In this fascinating conversation, Bola talks about her “why”, her leadership journey so far, and shares some great reflections, lessons, and advice for all leaders.

Shape the future of GP data sharing   

NHS Digital want your views to help them to shape their thinking and to drive change on national access and use of data. Please complete this five-minute survey. We want to hear from all members of staff, so please send the link to others in your team. The survey will close on Friday 10 June 2022. 

General practice - latest updates

Community pharmacy

Implementation of Shared Care Records in community pharmacy

Guidance is available to aid the implementation of Shared Care Records in community pharmacy, community and ambulance services, as well as downloadable comms materials and case studies.

A webinar on 23 June from 2pm – 3pm, will highlight the key benefits for the community pharmacy sector in accessing shared care records, as well as addressing some of the barriers to implementation, providing examples of areas which have already started implementation and encouraging feedback from participants on the guidance.

Primary care

NHS Smartcard renewal pressures

NHS Digital expect a large influx of NHS smartcard renewal requests in the next four weeks as 140,000 cards are due for renewal on 27 June 2022.

Affected users have received automated messages on authentication that they have one month to renew. If you receive this message, please self-renew as soon as possible. If NHS Digital do not manage to increase the rate of renewal now, it will inevitably result in a rush of users requiring smartcard renewals through the Care Identity Service with increasing urgency. This could lead to delays in access to systems and services, due to backlogs of renewals being requested for processing by Registration Authorities.

Any impact on the Care Identity Service will not affect authentication and access to clinical systems for users with a valid smartcard. Guidance on how to self-renew can be found on the NHS Digital website.

Over 124,000 people have a personal health budget

124,964 people in England received a personal health budget in quarter 4, 2021-22. This is an increase of almost 24,000 people compared to quarter 3, 2021-22 and means more people of all ages have greater choice and flexibility over how their assessed health and wellbeing needs are met. You can find out more about personal health budgets on our website or join our FutureNHS platform by emailing england.personalhealthbudgets@nhs.net.

Help improve the Electronic Prescription Service 

NHS Digital would like to talk to prescribers and dispensers across different care settings about their experience of using the Electronic Prescription Service (EPS), including any challenges. User feedback is essential to help inform future improvements and the next generation of the service. If you can spare some time please do sign up to provide your views and help us to improve EPS.

Vaccination history and patient notifications – survey

A discovery project is underway for vaccination history and notifications within NHS Digital. The aim is to identify any potential benefits to patients having easier access to their vaccine history through digital channels and whether visibility or the use of notifications would increase vaccination uptake and reduce administration work on the NHS.

If you work directly with vaccine appointments and/or enquiries, please help us gather feedback by answering a short survey. For additional information, please contact susana.santos4@nhs.net or sofia.western@nhs.net.

Experiences of racial discrimination and harassment in London primary care – HEE report

A pan-London survey of the primary care workforce has been published by Health Education England (HEE). The report gathers information on the experiences of those working in primary care and provides evidence of discrimination by patients, colleagues, and managers across London primary care and the impact of this on individuals, the workforce, recruitment, retention, wellbeing and the safety and quality of care. The report informs initiatives jointly agreed between HEE and NHS England to address racial discrimination and harassment in the sector.

Upcoming events and webinars

June. Community Pharmacist Consultation Service training for practices - leading change - CPPE

June. NHS staff pension seminars

June. Community Pharmacist Consultation Service training for practices - PCC

June. Demand and Capacity series designed to help gain a deeper and practical understanding of what demand and capacity are.

June – July. Public participation online learning sessions about working with people and communities.

1 June, 3pm – 4pm. Working with health inclusion groups in primary care: what to consider

8 June, 9am – 1pm. Personalised care at scale - working with multi-disciplinary teams

8 June, 1pm – 2.30pm. Social Prescribing national webinar series. Expanding your SPLW worker workforce, targeted roles and their impact

 9 June, 5pm – 6pm. General practice webinar

13 June, 2pm – 3pm. CVD prevention series: data-informed interventions

14 June, 1pm – 2.30pm. Wessex AHSN - FeNO Learning Collaborative 3. A series of online events to share learning from FeNO testing implementation and use across the country.

14 June, 1pm – 2pm. Personal health budget lunch and learn.

15 June, 1pm – 2pm.  Honours week event - health and social care sectors

To celebrate the Queen’s Platinum Jubilee, an event is being held for the health and social care sectors to hear from a variety of inspirational honours recipients and learn how you can make your own nomination.

15 June, 2pm – 4pm. Super Skills: involving children and young people - an open space discussion workshop

21 June, 12pm – 1pm. Wessex AHSN and NHS BSA Opioid Prescribing Comparators webinar

22 June, 1pm – 2.30pm. Supporting the development of your personalised care ARRS funded workforce

23 June, 2pm – 3pm. Supporting community pharmacy services to connect with their local shared care record

Link of the week

The King's Fund podcast: Nikki Kanani: vaccines, values and a vision for general practice