Primary Care Bulletin - special edition

15 December 2021

Dear colleagues, 

On Sunday 12 December the government announced that the COVID-19 booster programme is to accelerate, so that all eligible adults will be offered a booster jab by the new year. Bookings for a booster jab are now open to every adult over 18 who has had a second dose of the vaccine at least three months ago. The NHS Booking System will be open for these younger age groups from today. This rapid acceleration to the vaccine programme is in direct response to the Omicron variant which is spreading much faster than previous variants. NHS England have written to systems preparing the NHS for the potential impact of the Omicron variant and other winter pressures.

The urgent expansion of the vaccine programme means that we are asking primary care to help get our communities vaccinated as quickly as possible but also to ensure our patients continue to get the care they need. The programme is already making excellent progress with Monday seeing the second highest day for booster bookings and community pharmacy having their best day ever, vaccinating over 185,000 people in a single day, and topping off their best ever week of vaccinations. 

The JCVI have recommended the lifting of the 15-minute wait after vaccination with mRNA vaccine for COVID-19. This is in light of the need to speed up vaccination and boosting in response to the Omicron variant. 

The CQC have also confirmed that they are suspending inspections in general practice to support the booster programme activity.    

Practices are encouraged to continue to use care navigation and triage to help provide patients with timely advice and care from the right healthcare professional in a way that is matched to their needs. Online systems can support triage and provide an additional option for patients to access their practice remotely, which may help free up the telephone for non-digital users. 

Primary care will always be there for their patients, and we need to make sure people do not delay in coming forward with health concerns and we get the balance right. We know you will use your clinical judgement and strike the right balance and work as PCNs and with your local pharmacies to do what is right for your populations. We have seen some amazing work during the vaccination programme combining vaccination and health check appointments for patient groups most at risk of poor clinical outcomes, such as those with severe mental illness or learning disabilities.  

Shared decision making remains important - use your clinical judgement, supported by triage processes, as to when patients should be asked to attend the practice in person and when remote care would be more appropriate – tailoring the approach to the person, their circumstances and needs, and balancing this against the risk of exposure to COVID-19. 

At a national level we will continue to provide messaging on the most appropriate routes to get care including NHS 111 and pharmacy services. We have also made available posters, leaflets and digital campaign materials on how to access GP services to help manage expectations at this incredibly busy time. 

Please also make sure you are looking after yourself and your teams. We have a range of health and wellbeing support to help you stay well, including confidential wellbeing coaching, a staff support line operated by the Samaritans and free access to a range of mental health and wellbeing apps. Access this support and find out more on our health and wellbeing section of FutureNHS. 

Nikki and Ed

COVID-19 updates

COVID-19 treatments for patients at highest risk  

From 16 December the NHS is rolling-out neutralising monoclonal antibodies (nMABs) and antiviral treatments for patients at the highest risk of severe disease and hospitalisation from COVID-19. Potentially eligible patients, defined by a DHSC commissioned independent advisory group and approved by UK four nations, will be made aware of how they can access the treatments. The UK policy was published on 8 December.  

Separately, the Government also announced the PANORAMIC national study for oral antivirals treatment for at-risk patients. The study will allow medical experts to gather further data on the potential benefits of oral antivirals for the UK’s predominately vaccinated population. 

COVID-19 Vaccination Programme – workspace

Community pharmacy

Support the wider system in prioritising COVID-19 vaccination uptake and delivery -Community Pharmacy Contractual framework easements for all pharmacy contractors

Recognising the significant contribution of the pharmacy workforce to the COVID-19 vaccination programme in all delivery models, NHS England and DHSC have agreed with PSNC that there will be an extension to the deadline for meeting the requirements of the Pharmacy Quality Scheme for all contractors wishing to take part in line with the arrangements put in place for 2020-21 (further details will shortly be published as a Drug Tariff determination on the NHSBSA website). In addition, contractors will not be required to complete the Community Pharmacy Patient Questionnaire for 2021/2022 and the requirements to complete both a national audit and the local multidisciplinary clinical audit will be waived. The three parties will keep the situation under ongoing review