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Primary Care Bulletin - this week's round-up
4 November 2021
Dear colleagues,
Happy Diwali to those celebrating today.
Diwali is about hope, optimism, knowledge and prosperity – themes so relevant to us working in primary care right now. In the spirit of these important themes, we want to help set primary care on a supported and optimistic course, recognising the complex challenges we have been facing.
Last month we published a package of support for general practice to address some of these challenges as we head in to another winter. We hope you have had time to read the document itself, rather than simply the commentary around it, because the plan does provide support for some of the things that practices tell us needs to happen:
- new funding, through the Winter Access Fund;
- more staff, including GPs and additional roles;
- more communications about how patients are able to access care
- zero tolerance of abuse
- and continued chipping away at avoidable administrative burdens.
Ensuring good access to general practice is a complex issue, and one that has come under a great deal of unfair scrutiny in the media recently. Thankfully, we know the vast majority of practices provide accessible, high-quality care and this is evidenced in the annual GP patient survey which shows the majority of patients had a good overall experience of their GP practice. And while we can’t ignore the concerns from some patients and patient groups who have struggled to get the care they need, neither do we ignore what GPs and their teams are telling us would make a difference.
The objectives of the Winter Plan are about good access for patients, and hands on support for general practice, especially areas who have had the least investment or struggle the most with resourcing. It is not about ‘naming and shaming’ and ICSs had freedom to identify those in need to enhanced support in the best way locally with the option to submit plans without practice names. The funding in the plan is new winter funding for primary care, which we have often asked for, and is not from existing CCG resource which may previously have been deployed to support over winter locally.
Importantly, all practices can access support. For practices that are in most need of support, additional help outside of simple funding will be crucial – money alone won’t help.
We are making good progress on implementing many aspects and we will talk through the plans in more detail at our next GP webinar on Tuesday 16 November.
We know practices are currently grappling with the emergent challenges of redesigning the service model while simultaneously managing an increased demand, a growing and changing workforce and patients with increasingly complex needs. We hope you will engage with us on the Winter Plan and work with us to find solutions that will make the best use we can of the resources and opportunity we now have to improve the outcomes for our patients.
Nikki and Ed
Dr Nikki Kanani
GP and Medical Director for Primary Care,
Deputy SRO, COVID-19 Vaccination Deployment Programme
NHS England and NHS Improvement
Ed Waller
Director for Primary Care, NHS England and NHS Improvement
COVID-19 updates
Reminder: requirement to provide first and second doses
Please note that all PCN-led and community pharmacy-led sites delivering COVID-19 vaccinations Phase 3 are required to provide first and second doses, as well a booster doses, to eligible patients. This is part of the ongoing NHS offer to encourage those not yet vaccinated to come forward. Eligible patients attending vaccination sites should be able to receive a first, second or booster dose as required.
Vaccinations for NHS staff entering care homes
We have updated our FAQs to reflect the latest information from the Department of Health and Social Care on medical exemptions and how to prove you are exempt. People will be able to self-certify a medical exemption until 24 December 2021. From 25 December 2021 people will no longer be able to self-certify a medical exemption. Instead, they must by that date have applied for and obtained proof that they have a medical exemption and then they will need to use the NHS COVID Pass system to show they are exempt. People can continue to self-certify for vaccination overseas after 24 December.
General practice
NHS e-Referral Service (e-RS) – improving the referral experience
Feedback from users of the NHS e-Referral Service (e-RS) has generated a programme of improvements to make the service easier to navigate and more intuitive. The next phase of this programme goes live on Friday 5 November when referrers using e-RS will notice changes to the way worklists are displayed. The improvements include:
- worklists being displayed in a dashboard format, providing information in a clearer, more accessible manner
- some worklists being separated to improve visibility
- new labels on the dashboard allowing users to easily see new and overdue referrals
- improved dynamic filtering.
To find out more, please visit the NHS Digital website.
Survey on high-risk flags following closure of the Shielded Patient List (SPL)
As part of the managed closure of the SPL, NHS Digital would like to engage with GP teams to understand how the high-risk flag has been used to support patient care.
The aim of this engagement is to minimise the impact of closing the list on local healthcare services. Your feedback is very important and will help determine when the high-risk flag will be updated to moderate or low-risk in medical records.
Submit your responses using this online form. The survey will close on Friday 19 November 2021.
Free access to tailored digital resources to support unpaid carers
Working with leading national charity Carers UK, we are giving unpaid carers free access to new digital resources. The Digital Resource for Carers is an online platform that hosts a wealth of resources for carers to help them build resilience in their caring role.
The resources can help primary care to deliver on the NHS Long Term Plan Commitments to unpaid carers and includes e-learning, guides and comprehensive signposting, access to MyBackUp, a simple contingency planning tool for what might happen in an emergency, and Jointly, Carers UK’s care co-ordination app.
Carers UK have published guidance for health professionals which explains how the offer works and includes an access code to provide unpaid carers as well as ideas and tips for how to refer them for support.
Pulse oximeters to provide support over the winter
Four thousand paediatric pulse oximeters have been bought by NHS England and NHS Improvement to support GPs and primary care over the winter and aide the assessment of children with respiratory conditions. The pulse oximeters are being distributed by regional teams and those receiving the oximeters will be provided links to information, training, guidance on the E-Learning for Healthcare portal alongside a dedicated email for product support.
Measuring oximetry in young children can be challenging and the supplied equipment has been procured with reliability and ease of use in children in mind. The project will provide a valuable learning opportunity to understand the benefits of using pulse oximeters within primary care and qualitative evaluation will be undertaken to inform any future decisions on a wider roll-out.
Primary care
A message of thanks from Amanda Pritchard
Earlier today, Amanda Pritchard sent a message of thanks to all staff for everything you continue to do to put patients first in what is a challenging time as we head into winter.
Impact and Investment Fund – taking account of environmental impact in inhaler prescribing
Four new indicators in the Investment and Impact Fund (IIF) will support primary care teams in reducing carbon emissions from inhalers, while improving outcomes for patients who use them.
Primary Care Networks (PCNs) are now rewarded for:
- Reducing their proportion of non-salbutamol Metered Dose Inhalers (MDI) prescribed, where clinically appropriate.
- Prescribing lower carbon salbutamol inhalers.
From April 2022, two more indicators will support regular prescribing of inhaled corticosteroid for asthma patients and reductions in avoidable SABA prescribing.
This is also aligned with patients. A recent study from Asthma UK and The British Lung Foundation (AUK/BLF) suggests that most patients believe the environmental impact of inhalers should be a consideration in treatment choices.
Pharmacies should work collaboratively with their local PCNs to support patients prescribed a new or different inhaler by offering the New Medicine Service, checking inhaler technique, checking children have appropriate spacer devices and personalised asthma action plans, and encouraging patients to return their inhalers to the pharmacy for more environmentally friendly disposal.
Practical recommendations can be found in the Greener Practice’s guide on How to reduce the carbon footprint of inhaler prescribing, endorsed by the NHSEI Inhaler Working Group and AUK/BLF. See the Greener NHS’ FutureNHS workspace for further resources.
Changes to NHS Volunteer Responders referral time
From 1 December patient referrals for regular NHS Volunteer Responder (NHSVR) support must be renewed every four weeks. Therefore, all open-ended patient referrals for regular NHSVR support will close on 1 December and patients still needing regular support will need a new referral every four weeks.
Please check your GoodSAM dashboard to see if this is applies to your patients. Patients can continue to refer themselves to NHSVR by ringing the Support Team on 0808 1963646. One-off patient support can be requested at any time, and there is no change to the provision of vaccination Steward Volunteers.
Resources to help you promote Self Care Week
Self Care Week (15 – 21 November) is the annual UK-wide national awareness week that focuses on embedding support for self-care across communities, families and generations. The theme this year is ‘Practise Self Care for Life’ and its organiser, the Self Care Forum, has produced free resources to help with planning activities, including an 8 Point Plan.
Self Care Week provides the perfect opportunity to support people in their physical health and mental wellbeing - be part of the self-care movement. A series of fact sheets are also available to download, including one on Long COVID/Post COVID Syndrome. Take a look at the website or get in touch with the charity for more details at selfcare@selfcareforum.org. You can also subscribe to the newsletter.
World Antimicrobial Awareness Week: 18-24 November
This year’s World Antimicrobial Awareness Week (WAAW) is focused on encouraging healthcare professionals to continue to work together to prevent serious infections – including COVID-19 – while reducing inappropriate antibiotic use.
To avoid inappropriate antibiotic prescribing in the context of COVID-19 and other viral infections, it is recommended that healthcare professionals follow current NICE guidelines.
Find out how you can support raising awareness in the WAAW resource toolkit and register your organisation’s activities with the new UK Health Security Agency.
Resources available for the Winter Vaccinations public facing campaign
There are now more resources available for the Winter Vaccinations public facing campaign, as well as more coronavirus resources from Public Health England.
These include social animations for over 50s and Long Term Health Conditions, TV advert, alternative formats for social animations and large print posters, alternative TV advert with BSL and subtitles, and a communications toolkit.
There are also coronavirus materials available for download, including schools testing, festivals and celebrations and COVID-19 response.
Good patient experience for babies, children and young people
The National Institute for Health and Care Excellence (NICE) has produced guidelines on good patient experience for babies, children and young people. The guidelines provide recommendations on how this can best be delivered across a range of healthcare settings. The aim is to make sure all babies, children and young people using health care services have the best possible experience.
Get involved
NHS England and NHS Improvement ‘Core20PLUS5’ approach
The ‘Core20PLUS5’ approach is designed to support Integrated Care Systems to reduce health inequalities. If you have a role or interest in health inequalities, or are from an organisation that represents some of the groups at risk of health inequalities, find out more about Core20PLUS5 and share your views on the approach via our online survey. The survey is open from 1-19 November 2021. Survey responses will be used to support the development of the Core20PLUS5 approach, its implementation across the NHS and further engagement with key stakeholder groups.
Support innovation to reduce health inequalities
The Yorkshire and Humber Academic Health Science Network is working together with the CQC to create a toolkit for GPs in deprived areas to help them develop innovative projects. They are seeking support for case studies, interviewing you around your experience of innovation in primary care and stakeholders for a peer round table event. Please contact lucie.shaw@yhahsn.com by 12 November 2021 to get involved.
Identifying the key determinants towards providing health checks for autistic people
The Centre for Research in Autism and Education (CRAE) at the UCL Institute of Education has designed a survey to understand your experiences of conducting annual health checks, and to gauge your views on annual health checks for autistic people, including the barriers you may face in providing them and the enablers that would support you.
Blogs, case studies and podcasts
Case study: Supporting weight loss in mid Essex - Colne Valley Primary Care Network Low Carb Programme
The next in a series of case studies that aim to demonstrate how organisations across mid and south Essex are coming together to work in partnership to improve people’s lives. The Colne Valley Low Carb Programme is an initiative that was developed by a group of GPs at the Freshwell Health Centre. It has helped many people lose weight and improve their health and wellbeing through adopting a real food low carb lifestyle.
Upcoming events and webinars
8 - 12 November. #CLEARweek. Join a series of events, workshops and interactive sessions focussing on practical insights into healthcare transformation and workforce redesign.
10 November, 11am – 12.30pm. Carers, young carers and Universal Personalised Care webinar
10 November, 1.30pm – 2.45pm. Innovation in Social Prescribing, a Spotlight on the North East, Yorkshire and Humber region.
16 November, 10am – 11.30am. Personal health budget community of practice
16 November, 6pm. General Practice Webinar
19 November, 2pm – 4.30pm. English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) Report. Hear about the latest national surveillance report on antimicrobial prescribing, resistance and stewardship.
30 November, 9.30am – 4pm. 10 steps to working with people and communities (training)
Complaints training handling workshops - 2022 dates
A programme of complaints handling training workshops was recently delivered around the country, earning positive feedback. These workshops have been developed to support you and your practice team in handling complaints effectively. AM and PM sessions are available at all venues:
- 13 January 2022 – Jurys Inn Plymouth, 50 Exeter St, Plymouth PL4 0AZ
- 14 January 2022 – Hotel Mercure Bristol Holland House, Redcliff Hill, Redcliffe, Bristol BS1 6SQ
- 27 January 2022 – DoubleTree by Hilton Hotel Leeds City Centre, Granary Wharf House, 2 Wharf Approach, Leeds LS1 4BR
- 28 January 2022 – Jurys Inn Newcastle, Scotswood Rd, Newcastle upon Tyne NE1 4AD
To book a place, please email england.complaints-training@nhs.net.
Link of the Week
