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Primary Care Bulletin - this week's round-up
21 April 2022
Dear colleagues,
As Ramadan continues this month, to support COVID-19 vaccine uptake among Muslim communities this updated guidance aims to build confidence and reduce barriers to accessing the vaccine.
Reminder: Revised UK IPC guidance
Last week, UKHSA published revised UK IPC guidance. This revised guidance contains important changes in relation to the isolation of COVID-19 positive inpatients and their contacts. These changes to the UK IPC guidance signal a further step in the transition back to pre-pandemic IPC measures.
New COVID-19 testing arrangements introduced from 1 April should also be followed, outlining implementation of UKHSA’s advice on NHS patient and staff testing, including agreed protocols for the use of PCR and LFD tests. Our letter setting out these changes is available here.
Nikki and Ursula
Dr Nikki Kanani
GP and Medical Director for Primary Care,
Deputy SRO, COVID-19 Vaccination Deployment Programme
NHS England and NHS Improvement
Dr Ursula Montgomery
GP and Interim Director for Primary Care NHS England and NHS Improvement
General practice
Investment and Impact fund (IIF) respiratory indicators
The Investment and Impact Fund recommenced in full on 1 April 2022, with four respiratory indicators. These aim to tackle the UK’s poor respiratory outcomes, whilst reducing carbon emissions from inhalers (3% of the NHS footprint).
The indicators reward Primary Care Networks for: improving steroid inhaler prescribing and reducing SABA overuse for patients with asthma, reducing the proportion of non-salbutamol Metered Dose Inhalers, and prescribing lower carbon salbutamol inhalers. These indicators should be applied where clinically appropriate, as part of a shared decision-making process with patients.
For more information, please see this short guide, Quality Improvement toolkit and our FutureNHS page.
Green Social Prescribing Conference - 10 May 2022
The cross government Green Social Prescribing (GSP) Programme team will be hosting the GSP Conference next month. The event will provide GPs and their teams with the opportunity to explore the benefits of GSP and to engage in strategic discussion about how to scale and embed GSP into practice to prevent and tackle mental health. This is great opportunity to reflect on the programme's achievements over the past year and share emerging learning. The event coincides with Mental Health Awareness Week. Spaces are filling up quickly for this event, register to secure your ticket with an option to attend virtually.
Working as a GP through the pandemic: using online tools as part of a hybrid model of care to meet the needs of patients and staff (blog)
Dr Minal Bakhai reflects on the increased usage of digital systems in general practice as a result of the pandemic, giving patients the choice to use different routes for appointments. NHS England and NHS Improvement have been working with the Improvement Analytics Unit (IAU) to understand how these tools are used and what they mean for general practice and patients.
Primary care
World Immunisation Week – 24-30 April
This week is a reminder for people of how important it is to keep up to date with routine vaccinations. The annual event is championed by the World Health Organisation (WHO) and promotes the use of vaccines to protect people of all ages against preventable diseases, ranging from pre-school vaccinations like MMR, to flu and shingles which are available to older age groups.
All stages of the NHS vaccination schedule are vital for protecting the wider population’s health. If people didn’t manage to book their own or their child’s vaccine appointments when invited during the pandemic, they are urged to make an appointment with their GP practice as soon as possible. Find more information on the NHS vaccination schedule.
NHS Cervical Screening Programme – updates
The purchase of Human Papillomavirus (HPV) self-sampling home testing kits is increasing. Results of these private tests will not be acted on by the NHS Cervical Screening Programme (NHS CSP) and cannot be recorded in an individual’s NHS screening record. If a private test result is positive, the person should be advised that having HPV does not mean they have or will get cervical cancer.
Individuals who have a private test remain eligible for the NHS CSP. Most HPV infections clear themselves without causing problems. If someone has persistent HPV infection, it will be identified when they accept their next NHS CSP invitation. Cervical cancer usually develops slowly over 10 years, in three stages: infection with HPV; development of abnormal cells if the immune system does not rid the HPV infection; and development of cancer if abnormal cells are not treated.
Testing in the NHS CSP changed in 2019 and now individuals are screened first for high risk-Human Papillomavirus (hr-HPV). The cervical screening care pathway can be found here. This test is more sensitive to high grade cervical intraepithelial neoplasia (CIN) than the previous test, cytology alone. Screening first for hr-HPV has unlocked new opportunities in the NHS CSP, including HPV self-sampling as an alternative to the traditional clinician taken cervical screening sample. Further information on the HPValidate study is available in this screening blog.
New resources to support re-conditioning for older people
The National Falls Prevention Coordination Group (hosted by NHS England and NHS Improvement) with support from AGILE has developed a suite of resources in response to recommendations in Public Health England guidance (now the UKHSA); Wider impacts of COVID-19 on physical activity, deconditioning and falls in older adults. They are designed to support all Primary Care staff to take action to overcome the reduction in physical activity and resultant deconditioning effect of the COVID-19 pandemic on older people. Visit the British Geriatrics Society website to access and download the resources.
New national Commissioning Guidance for DOACs
Our national plan to accelerate the uptake of direct oral anticoagulants (DOACs) could see over 600,000 more patients receive treatment over the next three years, with the opportunity to prevent tens of thousands of stroke events. NHS England (NHSE) recently published Commissioning Guidance for DOACs which recommends that clinicians should use edoxaban, where clinically appropriate, consistent with the latest guidance from the National Institute for health and Care Excellence (NICE). This approach has also been endorsed by the UK’s leading stroke charity, Stroke Association.
New Primary Care IIFs to drive uptake of DOACs
To support new Commissioning Guidance for DOACs, NHSE has funded two new Primary Care Network (PCN) Investment and Impact Fund (IIF) indicators for 2022/23; CVD-05 encourages more AF patients to be treated with DOACs and CVD-06 encourages, where clinically appropriate, more patients treated with DOACs to be prescribed edoxaban. Both the Commissioning Guidance and the IIF indicators reflect NICE’s updated AF guideline which recommends DOACs as the preferred anticoagulant for patients with AF, unless contraindicated, not tolerated or not suitable. Colleagues are urged to support the implementation of the Commissioning Guidance to deliver improved patient outcomes as outlined in NHSE’s 2022/23 planning guidance.
National Confidential Enquiry into Patient Outcome and Death: Review of Health Inequalities Short Report
The Healthcare Quality Improvement Partnership (HQIP) has published the report ‘National Confidential Enquiry into Patient Outcome and Death (NCEPOD): Review of Health Inequalities. The review looked for evidence of healthcare inequalities within all NCEPOD reports over the last 15 years, as well as within current data collections. Overall, the report identified four areas of healthcare inequalities: protected characteristics – age and disability, socioeconomic deprivation, organisation of healthcare services and inclusion health groups.
Key dates
30 April 2022 – Workforce data submission deadline for practices
Upcoming events and webinars
April – Demand and Capacity series
April – May. Core20PLUS5 - reducing healthcare inequalities series covering the five clinical priority areas outlined within the Core20PLUS5 approach.
April – July. Public Participation online learning sessions about working with people and communities.
26 April, 1pm – 2pm. What are decision support tools and how you use them in your practice
27 April, 1.30pm – 2.30pm. SPLW Webinar Series: Supporting refugees
28 April, 10am – 4pm. Start with People conference
This virtual conference is open to anyone working in health and care with an interest in engaging or improving engagement with people and communities.
28 April, 7pm – 8pm. Pharmacy team experience with CPCS
5 May, 5pm - 6pm. General practice webinar
6 May, 3pm – 4.30pm. Severe mental illness webinar: Core20PLUS5 - reducing healthcare inequalities
11 – 12 May. NHS Big Conversation for Improvement
18 May, 2pm – 3pm. May's Wellbeing Wednesday community event
19 May, 7pm – 9pm. Inclusive Pharmacy Practice: Population Health Management webinar for Community Pharmacy Professionals
30 May, 3pm – 4pm. Partnerships with people and communities in primary care: The art of the possible
Link of the week
