Primary Care Bulletin

7 July 2022

Dear colleagues,

The NHS Parliamentary Awards took place yesterday in London, giving MPs the opportunity to say thank you and to celebrate the outstanding work of health and care organisations across the country.

The winner of the Excellence in Primary Care and Community Care Award went to the Homeless and Vulnerable Person Outreach Service (HVPOS) in Hackney. The team formed in May 2020 as a response to the 'Everyone In' government policy initiative, implemented to provide temporary accommodation for everyone experiencing rough sleeping and other forms of homelessness during the pandemic. The HVPOS team is proud to have been laying the foundations to address health inequalities in primary care and improve access for anyone struggling with rough sleeping. A huge well done!

Anne Gachango, who leads The Haven (a specialist primary healthcare service for asylum seekers and refugees at Sirona Care and Health) was also highly commended for the award. During the pandemic, 250 asylum seekers were moved to Bristol. Within 24 hours, Anne galvanized the support of many health and third sector organisations to ensure the health needs for this group of hugely vulnerable people were met and they were able to access the NHS support they desperately needed.

Last Friday (1 July) marked a considerable milestone in the development of integrated care systems (ICSs) as 42 ICSs were formally established across England on a statutory basis. These arrangements will strengthen existing partnerships between local health and care organisations and their work to deliver more joined-up care, reduce bureaucracy and improve the health of their population.

Integrated Care Boards (ICBs) have assumed delegated responsibility for primary medical services and nine ICBs have also taken on delegated responsibility for one or more pharmaceutical services, general ophthalmic services, and dental services (primary, secondary and community).

Each of the 42 integrated care systems is now legally underpinned by an NHS integrated care board and an integrated care partnership, whose task is to drive the delivery of better, more efficient and joined-up care for patients, improvements in physical and mental health, and reductions in inequalities among the communities they serve. To support delegation, a new standard delegation agreement has been developed that covers pharmaceutical services, general ophthalmic services, and dental services, while continuing the current delegated arrangements for primary medical care.

We hit another milestone this week as the NHS celebrated it’s 74^th birthday on Tuesday, and as part of the celebrations, I (Nikki) recorded a short video message highlighting the vital services primary care offers our patients, at the very heart of our health service. Our colleague David Webb, Chief Pharmaceutical Officer for England, also recorded a similar message whilst out visiting a community pharmacy in Honley, West Yorkshire, shining a light on pharmacy teams across England. Our NHS has endured some monumental challenges since it was established in 1948, not to mention that last two years alone. We are truly grateful for all that you do to support your patients and local communities. Thank you.

Nikki and Ursula

General practice

New fit note guidance and training package
In last week’s issue we announced that, from 1 July, new legislation allowed nurses, occupational therapists, pharmacists, and physiotherapists to legally certify fit notes, in addition to doctors.

More detailed guidance has now been published confirming who can issue fit notes: guidance for healthcare professionals and their employers.

A fit note training package is also available for all healthcare professionals, including doctors. GP IT systems are expected to be updated by the start of September. However, GPs should check with individual suppliers as they are operating on different timescales.

Replacement of Gardasil® by Gardasil 9® vaccine in the NHS national HPV immunisation programme

The vaccine supplied by UKHSA via ImmForm for the Human papillomavirus (HPV) immunisation programme will change from Gardasil® to Gardasil®9 during July and August 2022. This change will affect school-aged immunisation contracts, GP delivered opportunistic catch up services, and the MSM programme delivered in Sexual Health Clinics.

The two vaccines are interchangeable and vaccination should not be delayed due to preference for either vaccine. There is no impact on the dose schedule currently in place.

Immunisers should ensure HPV vaccine is recorded by product/vaccine name (i.e. Gardasil® or Gardasil 9®) in their clinical IT systems to maintain the accurate reporting and recording of vaccines administered and support additional reporting requirements to align vaccination status with screening programmes, for example, for young females who become eligible for the NHS Cervical Screening programme.

The bipartite letter provides more information and further details are available in the revised Green Book chapter, PGD template, and materials for healthcare professionals.

Data Processing Deed assurances

The processing of personal data outside of the UK, including through third-party sub-processors, is strictly prohibited through the Digital First Online Consultation and Video Consultation (DFOCVC) and GP IT Futures (GPITF) frameworks as under-written by the Data Processing Deed (DPD).

Such processing is only allowed if a GP, as data controller, has provided specific consent, such as a written instruction. It is the responsibility of suppliers to demonstrate to GPs that they have complied with DPD and broader GDPR requirements.

NHS Digital is working with relevant parties to improve awareness and assurances. The ICO has also provided guidance on international data transfers and a helpful compliance checklist.

Roll out of new digital firearms marker for GP practices

To make firearms licensing safer and the system quicker for practices, NHS Digital is introducing a standardised digital firearms marker in England. This marker matches relevant medical conditions against a firearms code, triggering an automatic flag to the doctor.

The marker will start to be rolled out by different GP IT suppliers from July 2022 when it will be available to apply to a patient EPR. It cannot be used retrospectively on those patients who already have previous firearms licences/flags.

IT suppliers will be issuing communications and advice on using the marker system to support the rollout.

General practice - latest updates

Community pharmacy

New Inclusive Pharmacy Practice (IPP) Bulletin

Sign up to receive the new bi-annual Inclusive Pharmacy Practice (IPP) bulletin, and read the first issue today, which highlights examples of community pharmacy and primary care good practice.

The IPP is a joint initiative by NHS England with the Royal Pharmaceutical Society and the Association of Pharmacy Technicians UK and 13 other national partner organisations.

Primary care

Shared Decision Making (SDM) technique for clinicians to use during patient consultations 

Following on from their Shared Decision Making (SDM) module, the Personalised Care Institute has launched a short video on Teachback consultations, which is an evidence based technique for clinicians to use during consultations to ensure that patients understand information they have been provided and can make use of it.

It is particularly helpful when talking to people with limited or lower levels of health literacy so we can be assured that they have fully understood the information and can participate in decisions and choices about their health and care.

For the latest updates and information on SDM please see our collaboration platform or contact the team ENGLAND.shareddecisionmaking@nhs.net.

Easy read guides to health choices and questions to ask 

Health Education England has worked with people with lived experience to produce two easy read health guides. Designed to help people navigate healthcare information, the guides could help people get the treatment they want and the answers they need to understand information they are given. This could include information about medication, appointments, or treatment, and how it is provided, for example by letter or email. 

‘Get ready to talk about your health’ prepares people for what to do before they go for a healthcare consultation. ‘3 questions for better health’ suggests important questions to ask during an appointment.

Nursing Documentation Standard guidance: feedback needed

It is vital nursing practice is supported by good documentation that supports and evidences professional decision making and care. The Digital Nursing Programme’s vision is to create a standardised framework for nursing documentation across England, and the first step towards this is the development of guidance.

Created for nursing by nurses, the draft guidance on nursing documentation standards outlines guiding principles on good documentation practice.

You are invited to review the draft and share your thoughts by joining the Digital Nursing FutureNHS space before the 21 July. All comments will be reviewed for the final publication.

Invitation to sign-up to Primary Care Appeals’ new monthly email updates

NHS Resolution’s Primary Care Appeals service is responsible for the prompt and fair resolution of disputes between primary care contractors and NHS England.  It has recently launched a monthly email update, providing details of the service’s decisions in the previous calendar month. These updates also highlight any new or updated guidance or resources published by the service. To sign-up to receive the monthly email update, please register your details on the dedicated Primary Care Appeals Updates page, and select the primary care contractor group that applies to you.

Upcoming events and webinars

Various dates, July. Public participation online learning sessions about working with people and communities.

11 July, 3pm -4.30pm. CVD prevention webinar series: Cholesterol priorities and the national procurement programme

12 July, 1pm -2pm. Personal health budget lunch and learn 

12 July, 6pm – 7pm. ENT digital playbook webinar

12 July, 7pm – 8pm. NHS Community Pharmacy Smoking Cessation Service

14 July, 4pm – 5pm. Renal digital playbook webinar 

14 July, 10.30am – 12pm. Race and ethnicity; addressing healthcare inequalities using digital products

15 July, 9.30am - 5.30pm. Health & Climate conference

20 July, 10am – 11.30am. Respiratory webinar; Core20PLUS5 - reducing healthcare inequalities

20 July, 1pm – 2.30pm. Implementing the Proactive Social Prescribing Service Specification

21 July, 2pm - 3pm. An introduction to working with people and communities  

27 July, 10.30am - 12pm. Recruiting patient and public voice (PPV) partners  

28 July, 11am - 12pm. Fleetwood: connecting professional stakeholders to support the growth of the community

Link of the week

College of paramedics leads the way with first international paramedics day