Primary Care Bulletin - today's round-up

10 February 2022

Dear colleagues,

On Tuesday 8 February, the plan for tackling the COVID-19 backlog of elective care was published. This plan has been developed with expert contributions from a wide range of partners, setting out a progressive agenda for how the NHS will recover elective care over the next three years. The plan aims to boost capacity and improve patient outcomes, and has been developed to take into account the challenges that the NHS and primary care continues to face.

The impact of the COVID-19 pandemic is not limited to elective care and has been seen and felt across the entire healthcare system. For those of us working in primary care, it’s important we come together to jointly address the recovery and restoration of services and tackle the backlog of deferred care. Work is already underway on these challenges by teams across the NHS and social care, and our 27 January letter highlights the three key priority areas that we are asking practices and Primary Care Networks to focus on.

Update: Vaccination as a condition of deployment (VCOD) for all healthcare workers 

As you will be aware, government has announced it is not going to proceed with the legislation that was due to come in from 1 April requiring vaccination as a condition of deployment (VCOD), subject to parliamentary process. Further to this letter on 31 January, we have now shared some frequently asked questions to support HR directors and organisations in this interim period. 

Nikki and Ursula

COVID-19 updates

Supporting our NHS people affected by Long Covid

We have recently published some new, best practice guidelines for supporting our NHS people affected by Long Covid. Developed in collaboration with colleagues from across the NHS, Department of Health and Social Care, Health Education England, NHS Employers and colleagues with lived experience of Long Covid, the guidelines offer advice and best practice for line managers and leaders. This includes details on what Long Covid is, advice on HR elements, and practical tips on the benefits of regular welling conversations.

COVID-19 Vaccination Programme – workspace

General practice

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. The full IPC guidance is set out here, and an updated risk assessment tool has been published.

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.

DHSC have published additional updates for PPE portal users, including a series of FAQs on FFP3 use and fit testing.

The weblink includes a number of useful contacts for PPE related queries: NonAcutePPECustomerDemand@dhsc.gov.uk, ppe.complaintsandenquiries@nhs.net and productqueries@ppeenquiries.com. For fit test queries please contact the helpline on 07376 304545 or 07376 304546.

Weight Management Enhanced Service 2021/22

We would like to remind practices that we have reviewed the basis for payments for referrals made under the Weight Management Enhanced Service. Currently, this says that claims should be based on referrals coded based on the SNOMED code: 1326201000000101 ‘Referral to weight management service’.

We have agreed that payments may also be made based on referrals coded as follows:

• Diabetes Prevention Programme for those with non-diabetic hyperglycaemia: SNOMED code is 1025321000000109 ‘Referral to National Health Service Diabetes Prevention Programme (procedure)’
• Low Calorie Diet: SNOMED code is 1239571000000105 ‘Referral to total diet replacement programme (procedure)’

Duplicative training and employment checks removed as requirements for inclusion onto England’s National Medical Performers List

In response to the GP bureaucracy review, four duplicative training and employment checks will be removed as requirements for inclusion onto England’s National Medical Performers List. Reducing the documentary evidence required will make the process less burdensome for clinicians wishing to work in, or return to, primary care as well as help speed up their application process. In addition, GPs joining the list will be provided with appropriate support, based on individual need, to help facilitate their pathway into general practice.

These changes will take effect from 11 February 2022 and apply to applications that are received on and after this date. For further details of the requirement changes, a copy of the revised policy position will be made available. Please email england.pscentralteam@nhs.net for any queries relating to this and its implementation.

Transfer of Care – Acute Inpatient Discharge Standard

Feedback through the GP bureaucracy review suggested that information relating to patient discharge can, if not done well, impact on timely and safe patient care and create unnecessary workload for GPs. In response, a set of national information standards are to be implemented to standardise and regulate the content of discharge summaries, in a secure electronic format, that secondary care sends to general practice.

The first standard, relating to Acute Inpatient Discharge for implementation by secondary care providers, has now been published. EMIS Web and SystmOne are already compliant with the Transfer of Care initiative and practices using these systems are already able to receive these electronic messages, based on Fast Healthcare Interoperability Resources (FHIR) directly into their workflow. This capability is expected in other Foundation IT systems shortly. More information and a resource library is available. 

General practice - latest updates

Community pharmacy

2022 Pharmacy Access Scheme (PhAS)

The review application window for the scheme opened on 4 January 2022 and was planned to close on 4 February 2022. This enabled contractors who met all other eligibility criteria, except distance, to apply for review on the grounds of inaccuracies in pharmacy premises location or physical feature route anomalies (e.g. a semi-permanent roadblock or steep hill).

In recognition of the impact of the recent wave of infections and contributions to the COVID-19 vaccination programme, we have agreed with PSNC to extend the PhAS review application window until midnight on 4 March 2022.

We encourage contractors to submit applications as soon as possible and all other deadlines remain the same - we are still seeking decisions from relevant PSRCs to be made and communicated to contractors by the end of May 2022 to enable the payments to be made in a timely manner.

New NHS Profile Manager

We are launching the new NHS Profile Manager for Pharmacy colleagues in early March and will confirm the exact date nearer the time. NHS Profile Manager is where you’ll go to update your service information, such as opening times and contact information. 

The new system will be simple, more accessible, and easy to use, helping you to keep your information accurate and up to date. Moving to the new system will make it quicker and easier to update your information, removing duplication, and freeing up your time to deliver crucial pharmacy services to the public. 

Get ready for this change and register for the new NHS Profile Manager with your personal NHSmail address.

Primary care

Pulse oximetry for care homes

Care home residents remain eligible for COVID oximetry @home and COVID virtual ward. We recommend care homes have one oximeter for every ten residents with a minimum of two oximeters per care home. PCN clinical leads or CCGs may wish to check with care homes in their area to ensure care homes retain sufficient oximeters. Additional oximeters may be provided through existing stock of pulse oximeters held locally. Requests for further oximeters from the national supply should be placed by CCGs via the NHS @home: Pulse oximeter request form (100 minimum order quantity). If you have any queries, please email england.home@nhs.net.

National Apprenticeship Week 2022 (7 – 13 February)

To support National Apprenticeship Week 2022 (#NAW2022) we encourage teams to consider promoting the range of apprenticeships available within primary care, including business administration, nursing, customer service, healthcare and team leading. You can download a primary and social care information pack from Skills for Health full of useful hints and tips to support you on your apprenticeship journey.

Over 100,000 people with a personal health budget

We want to thank our CCG colleagues for their hard work and dedication in delivering personal health budgets (PHBs) during what has been an extremely difficult time for the NHS. We have seen PHBs used in a flexible way throughout the pandemic, giving people more choice and control over the way their health and care is managed. Over 100,000 people in England received a PHB in quarter 3, 2021-22. This is an increase of almost 21,000 people compared to quarter 2, 2021-22. You can view the latest data return via the NHS Digital website. 

New education resources and upcoming webinars on managing uncontrolled asthma

The Accelerated Access Collaborative (AAC) Rapid Uptake Programme for Asthma Biologics is developing an education package for those involved in the case of patients with uncontrolled or diagnosed severe asthma. There is currently a podcast and poster available (on the HASTE tool) to help with the review of patients with uncontrolled asthma and explains when to refer. Additionally, a series of webinars on identifying and managing uncontrolled asthma and discussing the new pathway for managing it will be available during March.

Targeted Deployment of AVs and nMABs – Priority PCRs

On 31 January 2022 we wrote to GP practices, Community Pharmacists and Regional Chief Pharmacists, setting out some key updates to the policy for COVID-19 treatments for highest risk non-hospitalised patients aged 12 years and over. From 10 February patients can also demonstrate coronavirus infection via a positive lateral flow test (LFT) result that has been registered via gov.uk or 119. They will also be encouraged to also take a confirmatory PCR test in line with national guidance and to support coronavirus surveillance. 

Most of the highest risk patients have received a letter or email telling them in advance they may be eligible for these treatments if they test positive for COVID-19. They should also have received a priority PCR test to keep at home. Any ‘new entrants’ to cohorts (e.g. new diagnoses of multiple sclerosis) will be made aware of the policy via their hospital specialists, but GP practice teams might also identify newly eligible patients under their care.

From 7 February 2022, newly diagnosed eligible patients can request a priority PCR test directly via 119, which they can keep at home and use promptly if they get symptoms of COVID-19. These priority tests will then be automatically replenished by UK Health Security Agency (UKHSA) home testing team.

Upcoming awareness campaigns

Cervical screening

The Office for Health Improvement and Disparities (OHID), supported by NHS England and NHS Improvement, is running a campaign from 14 February – 14 March 2022 to encourage those eligible for the NHS Cervical Screening Programme – women and people with a cervix aged 25-64 – not to ignore their invitation and to book an appointment. GP practices may see increased demand from patients for NHS Cervical Screening sample taking.

The campaign will raise awareness of the risks of cervical cancer and highlight the preventative benefits of screening, whilst also providing reassurance and addressing misconceptions around HPV primary screening. Communications resources to support the campaign will be available through the Campaign Resource Centre.

Prostate cancer

We have partnered with Prostate Cancer UK to deliver a cancer risk awareness campaign from 17 February 2022 until the end of March. It will encourage men to use the PCUK clinically-approved risk checker to understand their risk and take action by speaking with a PCUK specialist nurse or seeing their GP to discuss. Messages have been extensively tested and tailored for different audiences, with activity weighted towards black men over 45. Find out more.

Upcoming events and webinars

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

16 February, 1pm – 2pm. Diabetes, obesity and lipids 

16 February, 1.30pm – 2.30pm. 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

2 March, 2pm – 3pm. PCC support - open dental contracting surgeries

3 March, 1.30pm – 3pm. Vaccinating the under 30s from underserved communities

15 March, 10 – 11.30am. Personal health budget community of practice. This session will focus on step six of the implementation framework - monitoring, review and evaluation.

Link of the Week

Children’s Mental Health Week (7 – 13 February)