Primary Care Bulletin - this week's round-up

1 April 2022

Dear colleagues,

Ramadan begins this weekend, and many of our colleagues and patients will mark this holy month of fasting with introspection and prayer. Fasting plays an important role in many major religions and is a central feature in all the Abrahamic faiths. In Islam, adult Muslims who are able, are required to fast during the month of Ramadan. Ramadan lasts for 29 - 30 days and ends with the celebration of Eid-ul-Fitr, which is likely to be on Sunday 1 May.

The NHS Muslim network has developed this guide with specific advice to support managers and colleagues across the NHS to be aware of key advice relating to Muslim colleagues who may be fasting during the month of Ramadan. The British Islamic Medical Association have produced some evidence-based clinical guidance on managing patients with chronic conditions in Ramadan.

The COVID-19 vaccination Ramadan toolkit has also been updated. It includes advice, resources, and links for further information to help build confidence, reduce barriers to access, and support uptake of COVID-19 vaccination among the Muslim community during the month of Ramadan. Additional resources, including translated materials, are available from the Vaccine Equalities Connect and Exchange Hub.

For more information and to join other events during Ramadan, please visit the NHS Muslim network website. To our Muslim colleagues; a healthy and safe Ramadan Mubarak!

Nikki and Ursula

Ukraine crisis updates

The latest on the humanitarian crisis in Ukraine

The scale of the humanitarian crisis in Ukraine and the surrounding region continues to grow each day and as a result of various visa schemes being established we are starting to see Ukrainian citizens arriving in the UK either to join family members already in the UK or as part of the government’s Homes for Ukraine scheme.

The Government has already announced that all Ukrainians arriving in England will be able to access NHS healthcare free of charge, including GP and nurse consultations, hospital services, and urgent care centres. They will also be offered COVID-19 vaccines and medical screenings. Information on how to access health services is part of a cross government welcome pack, which is due to be published shortly. Equally all new patients are entitled to a new patient consultation to check their health needs as appropriate and we encourage this to be offered as early as possible following registration by GP practices. Additional work is also ongoing to plan for how the NHS can support those that have been injured in the conflict. 

The UK Health Security Agency is expected to publish guidance shortly for primary care professionals on the health needs and recommended health checks for people arriving from Ukraine. Existing advice and guidance on health needs of migrants from Ukraine is available here.

The World Health Organisation has also published translated health information, in English and Ukrainian, on how the NHS works. 

We would like to remind colleagues that to be most effective for the people who need it, these support efforts must be properly co-ordinated, as part of the overall UK Government-led response. As such, we ask that, rather than trying to contact Ukrainian or neighbouring authorities directly with offers of support, NHS organisations direct their contributions to England.incident14@nhs.net. 

COVID-19 updates

Expiry of Coronavirus Act – Death certification and cremation forms

Changes to death certification processes for all doctors are now in force following the expiry of the Coronavirus Act on 24 March 2022. The changes are outlined in our updated information for medical practitioners. Updated guidance has been published by General Register Office/HM Passport Office and Ministry of Justice.

Myocarditis and pericarditis after COVID-19 vaccination: clinical management guidance for healthcare professionals

The UK Health Security Agency (UKHSA), in partnership with the Royal College of General Practitioners (RCGP) and the Royal College of Emergency Medicine (RCEM), has updated their clinical guidance to support the detection and management of clinical cases of myocarditis and pericarditis associated with coronavirus (COVID-19) vaccination. The updates to the guidance include information on giving further COVID-19 vaccine doses in those who have been diagnosed with confirmed myocarditis following COVID-19 infection or vaccination and guidelines on returning to pre-existing levels of physical activity post vaccination.

COVID-19 Vaccination Programme – workspace

General practice

GP Contract Updates for 2022/23

Yesterday (31 March) we published documentation supporting the arrangements set out in the letter of 1 March 2022 for General Practice contract arrangements in 2022/23. This includes the revised Network Contract Directed Enhanced Service (DES) and associated guidance and FAQs; guidance on the Quality Outcomes Framework (QOF) and the Impact and Investment Fund (IIF); guidance on the service specifications for Personalised Care, Early Cancer Diagnoses and Enhanced Health in Care Homes; and an updated ready reckoner. FAQs are available here.

Pay Transparency Arrangements for 2022/23

Last year, the Secretary of State for Health and Social Care confirmed that the implementation of general practice pay transparency was delayed until 2022. Amendments to the GP Contract Regulations have now been laid in parliament which, subject to the will of parliament, will remove the requirement for individuals within scope of the general practice pay transparency provisions (GMS Regulation 27A, PMS Regulation 21A, AMPS Direction 7A) to make a self-declaration of their 2020/21 NHS earnings by 30 April 2022.

Individuals within scope of the pay transparency provisions should therefore not take any action ahead of 30 April 2022, and commissioners should not seek to enforce this contractual requirement. As previously communicated, commissioners should also continue to not enforce the requirement for individuals within scope of the pay transparency provisions to have declared their 2019/20 earnings by 12 November 2021. These amendments implement the delay that the Secretary of State for Health and Social Care confirmed last year and are made with the expectation that this policy will resume at a later date.

New features of the GP Registrations Data Platform

The GP Registrations Data Platform now provides practices with even more information about GP2GP patient record transfers. You can now view practice level information about the number of registrations that triggered a GP2GP transfer in the month.

You can also download practice and Clinical Commissioning Group data into CSV format and we’ve increased the available data to six months to use for your own reporting. Don’t forget, you can still see integration times for practices and transfers not integrated within eight days trigger the paper process, so avoiding this will help reduce the administrative burden on your practice.

Enhanced Service Specification Responsibilities

Following a patient safety incident, we would like to remind all practices to check that vaccine alerts have been switched on.

Decreasing coverage of MenB vaccination in infants

Although we acknowledge the challenges the pandemic has posed, we ask that you continue to maximise efforts to increase coverage of MenB vaccination during early childhood (the most at-risk group) and raise awareness of susceptibility amongst adolescents and university aged students. Latest quarterly COVER data shows a decline in coverage of MenB vaccination in infants. Coverage of the MenB booster measured at 24 months is lower than that for the PCV booster, Hib-MenC booster or MMR vaccination given at this age.

Improvements to benefit eligibility at the end of life

From Monday 4 April 2022, eligibility for the Special Rules is changing. These currently apply to people who have six months or less to live and will now apply to people who have 12 months or less to live. Two working-age benefits will be impacted by this change. To support people accessing these benefits and to find out more about the new process and medical evidence form, DWP have published this guidance.

General practice - latest updates

Community pharmacy

CQUIN for acute trusts to increase referrals to DMS

As part of the Commissioning for Quality and Innovation (CQUIN) scheme for 2022/23 which is reintroduced on 1 April, acute trusts will now be incentivised to increase referrals into the community pharmacy NHS Discharge Medicines Service (DMS). The DMS aims to reduce avoidable patient harm and readmissions caused by medicines, by supporting medicines reconciliation for patients discharged from hospital. For queries contact e.cquin@nhs.net.

Primary care

Primary care access during the Bank Holiday periods

Local systems will need to check and update their plans for ensuring appropriate levels of cover over the upcoming bank holiday weekends, including the extra bank holiday to mark The Queen’s Platinum Jubilee, covering access to extended GP access services and out of hours GP access through integrated urgent care pathways.

Community pharmacies should work with LPCs within their area to address any issues that arise at this stage, including where local urgent care services are being commissioned.

Bowel Cancer Awareness Month

April is Bowel Cancer Awareness Month, an opportunity to raise awareness of the fourth most common cancer in the UK. Every 15 minutes someone is diagnosed with the disease, that’s nearly 43,000 people each year. 

Bowel cancer is also the UK’s second biggest cancer killer; however, it shouldn’t be because it’s treatable and curable especially if diagnosed early. Nearly everyone survives bowel cancer if diagnosed at the earliest stage, but this drops significantly as the disease develops. For more information about bowel cancer and details of how to get involved in Bowel Cancer Awareness Month, visit www.bowelcanceruk.org.uk.

Cervical screening campaign - easy read resources

The Office for Health Improvement and Disparities, with the support of NHS England and NHS Improvement, has recently delivered a national cervical screening campaign.

The campaign was about raising awareness of the risks of cervical cancer and highlighted the preventative benefits of screening. The overall aim of the campaign was to increase the number of those eligible attending their screening.  Easy read resources are available to download, including other accessible formats.

Campaign to tackle deconditioning

The Chartered Society of Physiotherapy (CSP) has launched a new campaign to equip healthcare professionals with the skills, knowledge and resources to encourage their patients to strengthen. The campaign, called Stronger My Way and supported by National Lottery funding distributed by Sport England, is built around a central hub with two entry points – one for the public and one for the professionals.

It features evidence, training and resources for professionals and advice, videos and inspirational stories for people to improve their quality of life. The campaign can be accessed on the CSP website and shared on social media using #StrongerMyWay.

Pocket book of primary health care for children and adolescents

The World Health Organisation has created guidance for the management of common conditions which primary health care providers encounter when they care for children and adolescents. It also includes information on conditions generally managed by specialists so that primary health care providers can coordinate the routine care of children and adolescents with complex or chronic conditions.

Key dates

6 April 2022 – The NHS Parliamentary Awards 2022 – applications

30 April 2022 – Workforce data submission deadline for practices

Upcoming events and webinars

Various dates to the end of June. Getting ready for patients to have access to their future data. For GPs / operational staff and primary care commissioners.

Sessions April - June. Demand and Capacity series. Sessions include a new module exploring ways to manage failure demand through practice-based examples. 

4 April, 12pm – 1pm. Online workshop: Patient, professional and public activation

6 April, 10am – 11am. Online workshop: Getting Unstuck

6 April, 12pm – 1.30pm. Cancer webinar; Core20PLUS5 - reducing healthcare inequalities   

6 April, 5pm – 6.30pm. Looking after our primary care people – Health and wellbeing engagement event

7 April, 5pm – 6pm. General practice webinar

12 April, 1pm – 2pm. Personal health budget lunch and learn

13 April, 1pm – 2.30pm. Children and young people’s social prescribing approaches

13 April, 7pm - 7.55pm. NHS Community Pharmacy Blood  Pressure Check Service webinar - how to run the Advanced Service and latest update

20 April, 2pm – 3pm. An introduction to working with people and communities

26 April, 7pm – 9pm. Inclusive Pharmacy Practice: Population Health Management webinar for community pharmacy professionals

Link of the week

Plan ahead for a healthy Ramadan