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Primary Care Bulletin - this week's round-up
20 January 2022
Dear colleagues,
Vaccination as a condition of deployment
Last week we shared Phase 2: VCOD Implementation Guidance and a set of Frequently Asked Questions to support employers who provide CQC regulated NHS services to meet their regulatory requirements on vaccination as a condition of deployment (VCOD). We have included some more information on what this means below.
IPC guidance remains in primary care settings
Following yesterday's Government announcement that from next Thursday (27 January) face coverings will no longer be mandatory in public places, we want to remind primary care colleagues that the UK Health Security Agency's infection prevention control (IPC) guidance remains in place for all staff and patients, in GP practices, dental practices, optometrists and pharmacies to ensure that everyone is protected. Please continue to encourage patients to wear a face covering to keep staff and other patients safe.
Resources supporting IPC guidance, including social media assets and posters to use at entrances to notify visitors that they need to wear a face covering, are available to download from the Campaign Resource Centre.
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
Vaccination as a condition of deployment (VCOD)
On 6 January 2022, the Government made new legislation, approved by Parliament, which amended the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (“the 2014 Regulations”). This means it is now legislation to be enacted by 1 April 2022.
Those working in general practices and dental practices aged 18 and over, who have direct, face to face contact with service users will be required to evidence that that they have received a complete course of a Medicines and Healthcare products Regulatory Agency (MHRA) approved COVID-19 vaccine, subject to specific exemptions and conditions.
This will include front-line workers, as well as non-clinical workers not directly involved in patient care but who nevertheless may have direct, face to-face contact with patients, such as receptionists and cleaners.
Further information is available in our Frequently Asked Questions.
Key dates
- 6 January 2022 – the 12-week grace period between the regulations being made and coming into force, commences. This period is intended to give providers and staff time to prepare and meet the new regulatory requirements. Communication and engagement with staff, supportive in nature, should have commenced with workers before this date, to respond to vaccine hesitancy and drive vaccination uptake.
- 3 February 2022 - the last date for those in scope of the regulations to get their first dose of an authorised vaccine (unless exempt) so they can be fully vaccinated with a complete course of doses of an authorised vaccine by 1 April 2022.
- 31 March 2022 – the day by which those in scope will have had to receive their second vaccination dose. In scope workers who believe that they are exempt from having the COVID-19 vaccination must provide evidence of their exemption as soon as possible but at the latest by 31 March 2022.
- 1 April 2022 - the regulations take effect.
Guidance for employers
NHS England and NHS Improvement issued Phase 2: VCOD Implementation Guidance for organisations registered with CQC for the purposes of providing health care. This followed from the previous Phase 1 planning and preparation guidance.
The guidance and principles set out can generally be applied to organisations providing NHS-commissioned services, such as primary care services and to the independent sector, including general practice and NHS dental practices.
The approaches to formal processes detailed in this guidance may vary from organisation to organisation, depending on the facts and circumstances in each case, and as such, it is recommended that organisations seek their own legal advice on such matters. However, we encourage all registered persons (registered managers, registered providers) to read the guidance and FAQs to support you with compliance with the regulations.
Workforce impact
Organisations should identify the potential for workforce capacity pressures, (alongside existing pressures e.g. due to staff absences), and the potential impact on service provision, and plan mitigating actions to ensure effective arrangements are in place to continue to deliver appropriate care to patients and service users.
Business as usual escalation routes apply for service disruption. Commissioners and systems should be informed of likely or actual service disruptions, which they can escalate to NHS England and NHS Improvement regional teams as needed.
From 21 December, the Calculating Quality Reporting Service (CQRS) included a request for voluntary information on the COVID-19 vaccination status of general practice staff employed or otherwise deployed in general practice. This data will support ongoing planning around capacity and service provision due to new regulations.
Increasing vaccination uptake
NHS England and NHS Improvement has curated resources to aid 1:1 conversations to support staff to take up the COVID-19 vaccine offer. Additionally, there are some nationally provided health and wellbeing resources that may be of support to you.
Resources and support
COVID-19 updates
FFP3 face masks for general practice
The Department of Health and Social Care (DHSC) have confirmed FFP3 face masks are now available for general practices to order via the PPE portal. Practices must have undertaken the necessary risk assessments and arranged for staff to have been fit tested before ordering the equipment. It is a legal requirement on employers that all tight fitting RPE, such as, FFP3 masks must be fit tested on all health and care staff who may be required to wear one to ensure an adequate seal/fit according to the manufacturer’s guidance. Fit testing is specific to the brand of FFP3 mask being deployed. Details on the requirements and how to access fit testing are available in the letter sent to all practices from the DHSC.
For queries about PPE supply please contact the portal customer services team on 0800 876 6802 for any queries contact the infection prevention control team.
Booster vaccines to be offered to young people aged 16 to 17 and 12 to 15 who are in a clinical risk group, SMI or who are a household contact
Following updated JCVI Guidance, the NHS is now offering boosters to all 16 and 17 year olds, and 12 to 15 year olds who are in a clinical risk group, are severely immunosuppressed or who are a household contact of someone who is. It’s vital these groups receive a booster vaccination to protect themselves and those around them from COVID-19, especially with the Omicron variant in circulation.
All 16 to 17 year olds can now book their booster vaccine using the National Booking Service or attending a walk in site. 12 to 15 year olds in a clinical risk group or who are severely immunosuppressed will be contacted by local vaccination services or can visit a walk-in site by taking either a national invitation letter or an invitation from their GP/specialist confirming eligibility. Both groups should visit NHS walk-in sites before attending their local walk in site in person to ensure they attend a site which can vaccinate them.
For more information, please see updated operational guidance on 16 to 17 year olds and eligible 12 to 15 year olds and household contacts of immunosuppressed. We’re updating the primary care Booster Comms Toolkit to share with you shortly.
Alternative hexavalent vaccine in the NHS national vaccination programme
From 31 January 2022 there will be a new vaccine available, Vaxelis® as an alternative to Infanrix hexa® (DTap/IPV/Hib/HepB). There will be no change to the ordering process.
Both vaccines are interchangeable, however where possible, it is preferable that the same vaccine is used for all three doses of the routine primary immunisations scheduled at 8, 12 and 16 weeks of age. Vaccination should not be delayed if the vaccine used previously is not available or unknown.
Use of both Vaxelis® and Infanrix hexa® is included in the hexavalent vaccine DTaP/IPV/Hib/HepB PGD national template, version 03.00 and further details can be found in the Vaxelis® Summary of Product Characteristics. Further information regarding training and updated information for HCP’s will be available in due course.
General practice
CQC’s report Ethnic minority-led GP practices: impact and experience of CQC regulation
In February 2021, CQC began work to examine concerns raised by some GPs that ethnic minority-led GP practices were more likely to have a poorer experience or outcomes from regulation than non-ethnic minority-led practices. This report identifies contextual factors which can disproportionately affect ethnic minority-led practices and their ability to demonstrate how they provide good care.
Fit Note restart reminder
The Department for Work and Pensions suspended the requirement for fit notes for benefit purposes between 17 December 2021 and 26 January 2022. Claimants whose fit notes expire, and those who make new claims due to a health condition between 17 December and 26 January (and are still ongoing), will need to provide medical evidence from 27 January, and may therefore contact their GP for a fit note in the next week in advance of the 27 January. These should be issued.
Fit notes for Statutory Sick Pay purposes will be required for absences which begin on or after 27 January and last for longer than 7 days. Individuals whose sickness began between 10 December and 26 January inclusive will continue to be able to self-certify their absence for up to 28 days.
Getting ready for patients to have access to their GP health records
From April 2022, patients with online accounts such as through the NHS App, will be able to read new entries in their health records. This applies to patients whose practices use TPP and EMIS systems. Further information on the programme is available through the NHS Digital website.
To help GPs, practice staff and primary care commissioners support patients to access their GP-held records, we have a series of webinars which explain what this means for you, and what you will need to do next to prepare for this. Dates are available throughout January and February.
Update to PPV23 Vaccine Reimbursement Claims
The 30 April 2021 letter advised of the move to central supply of PPV 23 vaccine from 1 June 2021. Practices should ensure that remaining locally procured PPV23 vaccine be administered in the first instance to use up this stock. From 1 April 2022 practices will no longer be able to submit claims to the NHS BSA for reimbursement of locally procured PPV23 vaccines administered from April 2022 onwards, and all practice’s should only be using centrally procured PPV23 vaccine for immunising their eligible population. The PPV23 vaccine is available to order via the ImmForm website.
Community pharmacy
Point of Care Testing in Community Pharmacy Guidance Published
We are delighted to announce the Point of Care testing in Community Pharmacy guidance has been published. This document describes the standards and safe environment required for the use of point of care testing equipment and devices for diagnosis, monitoring and screening in community pharmacy. It is a guide for commissioners and community pharmacies delivering NHS services and should be used as a reference guide when planning, designing, implementing, and providing POCT services in community pharmacies. Clearly defined expectations will help regulators and auditors maintain high standards, and community pharmacists will get clarification on the expectation for professional conduct and care.
Resources for Better Health Weight Management Health Campaign 2022
The Better Health Weight Management campaign which forms part of the mandated health campaigns agreed for 2021-2022 by ourselves and the Pharmaceutical Services Negotiating Committee (PSNC) is now live.
Community pharmacies should have now received printed resources from the Office for Health Improvement & Disparities. Packs include a guidance leaflet to support community pharmacy teams’ conversations with patients and display materials. If packs have not yet been received, please email the team with ‘Weight Management Pharmacy Packs’ in the subject line and the pharmacy name and address in the email.
Further information, social media and digital resources are also available on the Campaign Resource Centre. This campaign will run for 5 weeks from receipt of the resource packs, ending by 18 February 2022.
Pharmacy Access Scheme 2022 (PhAS) review portal
The 2022 PhAS review portal, managed by NHS England and NHS Improvement (NHSEI), is open to applications until midnight on 4 February 2022. Reviews may be submitted by contractors who believe they have been incorrectly deemed ineligible for PhAS due to the distance criteria only, yet meet all other qualifying criteria in the guidance.
Contractors who may be eligible for review should have been contacted by their regional contract management team and NHSBSA with guidance on submitting a review. If you require any further assistance, please contact your regional contract management team.
Dentistry
Your latest dentistry and oral health update
Read issue 39, which focuses on vaccination as a condition of deployment (VCOD) with a summary of the key information on what this means for dental teams, including new guidance the NHS has produced for employers.
On Monday 24 January at 7pm, the team will be hosting a webinar for dental colleagues on VCOD.
Primary care
Snapshot wellbeing survey of the primary care workforce
You’re invited 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. It is important to carry out surveys such as this one at multiple times to help us understand how feelings of wellbeing change and develop over time, so you may recall taking part in a similar survey last year. The survey should take no longer than ten minutes to complete and closes 31 January.
Chief Sustainability Officer’s Clinical Fellow Scheme – applications open
Climate change presents a major threat to our health, which is why the NHS became the world’s first health service to commit to reaching net zero emissions.
The NHS Chief Sustainability Officer’s Clinical Fellow Scheme offers clinicians with a passion for sustainability a unique opportunity to help build a greener NHS and improve health now and for generations to come.
Successful candidates will step out of clinical practice for 12 months to work with NHS senior leaders and teams on key projects that will accelerate progress towards a net zero health service, while strengthening their leadership and management skills
The scheme welcomes applications from allied health professionals, dentists, doctors in training, healthcare scientists, nurses, midwives, and pharmacists from across the UK. Apply by 23 February 2022.
Edward Jenner programme leadership programme
New for 2022, the Edward Jenner programme has been refreshed to equip you with skills to grow in confidence to thrive in your role and support your career path. You will be able to apply your learning immediately to the day-to-day challenges of working and leading in health and care.
This includes developing inclusive leadership practices and culture within your team to support greater team satisfaction and delivery of the best possible care for patients and service users. The Edward Jenner programme is designed to be flexible through online delivery and is free to access for all health and care staff.
NHS Knowledge and Library Hub
The new HEE funded NHS Knowledge and Library Hub is a ‘one-stop’ gateway which connects NHS staff and learners to a range of free, high-quality knowledge and evidence resources, services, tools and databases. Content includes over 7,000 journals, e-books (including OUP handbooks), clinical decision support tools (such as BMJ Best Practice), NICE pathways and guidelines and clinical and medical databases.
Start your search or learn more through our short user guides. Updates will be posted on our new Twitter channel – follow us @NHSKFH.
Developing professional practice and personal leadership skills for healthcare support workers in primary care - short course
Healthcare support workers play a key role in delivering excellent patient care within general practice, and therefore developing and retaining those workers is key to developing a workforce that is capable of meeting the future needs of the NHS.
With Education for Health, we have developed a 12-week online learning course plus one Essentials Clinical Workshop (2 x two-hour sessions).
Register online and select the course date you require. You will then need to use the code CC-X209A-4219 when purchasing to ensure that you are not charged for this course. Please be aware that places are limited and are allocated on a first come, first served basis. Future dates will be released quarterly.
Registration for cohort 2 closes at 5pm on 18 October (course starts 1 Nov). Other dates are also available.
New Fractional exhaled Nitric Oxide (FeNO) in Asthma e-learning modules now available
The second e-learning module for FeNO in asthma has now been released. FeNO testing can help diagnose asthma in patients more speedily and accurately by showing the level of inflammation in the lungs. The Accelerated Access Collaborative (AAC) helped develop the modules alongside Health Education England e-learning for healthcare, the Wessex AHSN and the Office for Life Sciences. Please visit the website for more information.
Consultation on the development of a Consensus Pathway for uncontrolled asthma
The Accelerated Access Collaborative (AAC) Rapid Uptake Programme for Asthma Biologics has launched a consultation on the development of a Consensus Pathway for uncontrolled and severe asthma. Developed by a subgroup chaired by Dr Hitasha Rupani (a clinical champion for the programme), this tool will inform and raise awareness of consensus best practice and start conversations to redefine asthma pathways both locally and regionally. Give your views online now (consultation closes on 31 January).
Help improve patient records technology
NHS Digital want to hear from those of you who use the Summary Care Record, Summary Care Record application, and any other local shared care records, to better understand your experience (including challenges and frustrations) to help them tailor future developments based on your needs. Find out more and take part in the research.
Upcoming events and webinars
January – March 2022 (multiple dates). CPCS workshops with RPS & RCGP
21 January, 12pm – 1pm. Online Abuse by Staff with Indecent Images
24 January, 7pm. VCOD dental webinar
2 February, 9am – 12pm. Digital Health Innovation Collaborative – free online eve
3 February, 1.30pm - 3pm. Bridging the uptake gap in areas of multiple deprivation
3 February, 5pm – 6pm. General practice webinar
16 February, 1pm – 2pm. Diabetes, obesity and lipids
16 February, 1.30pm – 2.30pm. Social Prescribing Link Worker (SPLW) Series: New Link Workers
17 February, 1.30pm - 3pm. Ensuring vaccinations are accessible to paid and unpaid carers and people with long term conditions
2 March, 1.30pm – 2.30pm. SPLW Series: Developing your SPLW workforce
16 March, 1.30pm – 2.30pm. SPLW Series: Befriending & Social Prescribing - working together to create connections
30 March, 1.30pm – 2.30pm. SPLW Series: SP Data processes / Evidence and impact
Link of the Week
