Primary Care Bulletin - this week's round-up

3 December 2021

Dear colleagues,

Following the JCVI advise on accelerating the COVID-19 vaccination to increase protection ahead of any wave of infection and help reduce the impact of the Omicron variant, we have outlined the next steps for primary care.

We recognise the pressure all local services are under, however the immediate priority for all systems, supported by all local partners, is to increase capacity for the vaccination programme. We know the need to focus attention in the next two months on the covid vaccination booster programme will cause more demand on workforce, time and capacity. In recognition of this, several measures will now be put in place and further details are outlined in the letter.

The Secretary of State for Health and Social Care has written to primary care staff thanking them for their support.

We’d like to thank you again for your continued dedication to your patients and communities in such rapidly evolving, challenging circumstances.

Nikki and Ed

COVID-19 updates

Pulse oximeter use for people with darker skin

There has been recent media interest in the accuracy of pulse oximeters in people with darker skin. The extent to which this effects COVID-19 patients is unknown and the Medicines and Healthcare products Regulatory Agency are not aware of any incidents where skin colour has had an adverse effect on the use of pulse oximeters. We have asked the National Institute for Health Research to undertake rapid research in this area and DHSC have announced an independent review of medical devices. NHS advice remains that all patients should continue to use pulse oximeters, regardless of their skin colour, and record baseline oxygen saturation to compare subsequent changes in saturation readings. 

Clinicians should also remain vigilant for other signs of deterioration and patients should seek help if any of their symptoms get worse. For further information and/or to request pulse oximeters please contact england.home@nhs.net.

COVID-19 Vaccination Programme – workspace

General practice

Winter Access Fund claims portal

The NHS is gearing up for a very challenging winter, with access to general practice an essential part of winter plans. To support general practice and improve access including face-to-face appointments with GPs, the £250m Winter Access Fund has been made available until March 2022, alongside other support.

The existing Primary Care Workforce Portal has been expanded to allow practices to submit claims to their CCG for agreed support to access the Winter Access Fund. If you have previously used the portal for ARRS claims you will be able to use the same login to submit Winter Access Fund claims. A user guide and videos to support you to use the portal are available on FutureNHS.  

Digital solutions for the deployment of sessional clinical capacity in primary care

To support the continued delivery of the primary care flexible staff pools, we have published the framework for digital solutions for the deployment of sessional clinicians in primary care. This includes information on which digital suppliers have been awarded a place on the framework and will help commissioners understand the requirements of the call-off, helping them follow best practice when procuring a digital solution to support this deployment.

Making use of the framework will also support commissioners/ICSs to meet the requirements of the Winter Access Fund. For any further information not referenced in this guide related to call-off or ongoing contract management please contact digitalsupplier.framework@nhs.net.  

New digital GP Contract requirements and guidance to support GP practices 

In October 2021 new requirements for general practice came into effect in the GP Contract relating to digital services. To help explain what these requirements are and to support the implementation of them we have published new guidance for GP practices.

Becton Dickinson Blood Specimen Collection Portfolio – supply disruption update

A further update has been published this week regarding the supply disruption to Becton Dickinson’s (BD) blood specimen collection portfolio. Due to the mitigations in place and the efforts of colleagues across the NHS the supply situation has continued to improve. Although there is some constraint on supply, the use of BD US stock continues to ease pressure. 

Phase 2 of NHS Cervical Screening Programme National Ceasing Audit

In the last edition we referenced phase 2 of the national ceasing audit of the NHS Cervical Screening Programme which is expected to commence in January 2022. This phase will require GPs to audit patients ceased since 1 April 2010 (not 2020 as stated last week) for all ceasing reasons except no cervix who did not receive a ceasing notification letter. Further updates on phase 2 will be provided in due course.

General practice - latest updates

Dentistry

Your NHS dentistry and oral health update

The Chief Dental Officer, Sara Hurley, and, NHS England Director of Primary Care, Ed Waller, have issued an update to the dental profession regarding the updated Standard Operating Procedure which was published in light of changes to Infection Prevention and Control guidance.

Special focus bulletin: mouth cancer prevention

The Chief Dental Officer, Sara Hurley, and National Lead for Dental Public Health, Anna Ireland, have issued an update to the dental profession with a special focus on mouth cancer prevention.

Community pharmacy

Amended approved particulars relating to the annual patient survey

The requirements for the annual patient survey have been updated in the approved particulars so that pharmacy contractors no longer have to use CPPQ.

Changes have been agreed with PSNC and Contractors will be able to adopt a variety of methods for collecting feedback rather than using the CPPQ.   Each year, NHSE&I and PSNC will agree up to three topics which all Contractors must include in their collection of feedback from patients.  These topics are currently under discussion for 2022/23 and the agreed list will be published shortly.

Contractors who have already undertaken the CPPQ in 2021/22 need take no further action. Contractors who have not yet undertaken the CPPQ in 2021/22 can choose to work in line with the revised Approved Particulars or can continue to use the CPPQ in 2021/22 to meet their contractual obligations.

The changes will apply to all Contractors from 2022/23.

Primary care

Primary care staff survey pilot

The People Plan 2020/21 committed to explore the implementation of a national staff survey for primary care to ensure that everyone working within the NHS has a voice and the opportunity to feedback on their experiences at work.

Following a feasibility study last autumn, we have commissioned Picker Institute to undertake a pilot primary care staff survey (PCSS) to develop and test the methodology and questionnaire for measuring workforce experience in primary care and support future national roll-out. Further information about the PCSS and how you may get involved will be shared soon.

Primary care SMI physical health checks learning catalogue

Health Education England has worked jointly with NHS England and Improvement to develop a catalogue of learning resources to support primary care professionals to deliver annual checks for people with severe mental illness (SMI) as set out in the NHS Long Term Plan.

People with an SMI are at risk of dying prematurely, in some cases 20 years earlier than the general population. Many of these deaths are preventable if conditions like high blood pressure, diabetes and cardiovascular problems are identified and treated early through psychical health checks. 

The learning resources are now available on the NHS Learning Hub and include a free 15-minute e-learning module that explores the morbidity and mortality issues associated with SMI, and highlight physical health checks good practice. 

Health Inequalities Improvement Dashboard now live

The Health Inequalities Improvement dashboard is now available to regions, systems, primary care networks, NHS providers and local authorities. The dashboard builds on learning from the COVID-19 pandemic around the importance of good quality data to provide insights to drive improvements in reducing health inequalities.

Whilst several individual tools exist, this new dashboard provides key strategic indicators relating to health inequalities all in one place. The dashboard covers the five priority areas for narrowing health inequalities in the 21-22 planning guidance and data relating to the five clinical areas in our Core20PLUS5 approach.

Nursing Associate Q&A resource

Trainee Nursing Associates and Nursing Associates bridge the gap between healthcare support workers and registered nurses. They can bring vital skills to primary care and work across PCNs as part of a multidisciplinary team. We interviewed Nursing Associate Michelle Nicholls about her career journey into general practice and why she would recommend recruiting the role to support general practice teams.

Pre-study course for entry to the Training Nursing Associate role

Health Education England (HEE) are offering existing Health Care Assistants / Health Care Support Workers, including those without a professional qualification, the chance to undertake a free of charge pre-study course to enable entry to the Training Nursing Associate (TNA) course. The pre-course will consist of one day a week for 3 months and will include a refresh on study skills and identification of any further support that may be required.

Presently the salary and on-costs for the TNA role is funded through the Additional Roles Reimbursement Scheme and employers can claim the apprenticeship levy to cover the cost of the TNA training course. Funding is available from HEE of £4,000 per year (£8,000 for 2 years training) to be used flexibly by the employer to support this, for example to fund additional supervision provided by the practice. To ensure candidates from primary care networks are supported a pre-study course starting in December 2021 is being offered free of charge. This will also support those who presently do not have the functional skills Math and English at level 2 to enable them access to the TNA course.

Expressions of interest should be sent to nationalnursingteam@hee.nhs.uk by Friday 3 December 2021.

Social Prescribing in Action webinar – Spotlight LONDON

Our popular monthly webinars are designed for those involved in the established and management of social prescribing programmes in PCNs. Designed specifically for PCN/ICS teams and commissioners, the aim is to share the latest learnings and best practice to help embed social prescribing locally across the country. Our next webinar will take place on Wednesday 8 December at 1pm-2.30pm, and focus on London, our biggest regional network with over 300 SPLW. Hear the latest updates from London Social Prescribing Network including how they’ve built vital strategic partnerships; developed community chests to fund local activities; supported high intensity users and established specialist mental health link workers in Bromley by Bow.

Get involved

Volunteers for research on General Practice Workforce Management Tools

NHS Business Services Authority (NHSBSA) is seeking volunteers from general practice in England and Wales to share their experiences with existing workforce management tools (e.g. tools for staff scheduling, personnel records, training and compliance, payroll).

This research will help to understand how future solutions could better meet user needs, reduce administrative burden and improve efficiency to better support staff recruitment, retention, movement, and workforce planning.

Please take part in this short survey to share your thoughts. If you’d like to be involved in a subsequent interview you can register your interest at the end of the survey.

Upcoming events and webinars

2 December, 8pm – 9pm. Unpacking the DES: October 2021 Update

3 December, 2pm – 3pm. Promoting equitable uptake of physical health checks for people with severe mental illness

7 December, 12pm – 1pm. Inclusive access routes to general practice campaign materials

7 December, 5pm – 6pm. Improving access to GP IT systems webinar

8 December, 9.30am – 4pm. 10 steps to working with people and communities (training)

8 December, 1pm – 2.45pm. Best Practice in Social Prescribing: Spotlighting the innovation in the London Region

8 December, 8pm – 9pm. Anticholinergics – Protecting Patients from Harm – A Call to Action

9 December, 3pm – 4pm. Community of Practice launch – helping VCSE and Primary Care Networks collaborate 

9 December, 5pm – 6pm. General Practice webinar

15 December, 12pm – 1pm. Sharing early learning: a population health approach to innovation in lipid management

15 December, 12pm – 2pm. Everything we thought we knew about commissioning and providing services for people was wrong

15 December, 1pm – 3.30pm. Core20PLUS5; An approach to reducing health inequalities

15 December,  3pm – 4.30pm. Multi Region – Flexible working and pensions – Very Large (500 Staff) – unrestricted (ideally General Practice Nurses and AHPs aged 50+)

16 December, 3pm – 4.30pm. Multi Region – Pensions Tax – Very Large (500 Staff) - unrestricted (ideally GPs and consultants aged 50+)

16 December, 12.30pm – 1.30pm. Meaningful Conversations – Disability

Link of the Week

Looking beneath the negative patient comments