Primary Care Bulletin - this week's round-up

14 January 2022

Dear colleagues,

Thank you to Community Pharmacy

Yesterday (13 January) marked the one-year anniversary of community pharmacy delivering the COVID-19 vaccination and we would like to thank you and your teams, including the many volunteers for your invaluable contribution over this past year. On top of what has been an incredibly busy time, community pharmacy teams continuously step up to address the current ongoing winter pressures and are supporting the response to the Omicron variant by issuing lateral flow tests and delivering well over 22 million jabs as part of the vaccination programme. We have seen a 50% increase in the number of pharmacies delivering boosters compared from October 2021 to January 2022. Watch Dr Emily Lawson, Vaccination Lead for NHS England and NHS Improvement’s video thanking community pharmacy staff.

Phase 2 guidance: Vaccination as a Condition of Deployment (VCOD)  

New guidance and resources have been published today to help organisations who provide CQC regulated NHS services to meet their regulatory requirements on vaccination as a condition of deployment (VCOD).

A VCOD workspace on the FutureNHS web platform has been set up to house all relevant policy information, guidance and supporting resources, and includes links to other resources, including communications materials to support vaccine confidence. If you have an nhs.net or nhs.uk email you can self-register to join. For people with other healthcare sector emails, you can request to join the platform and the Futures support team will approve.  

There will also be a webinar especially for NHS comms leads on 17 January from 2pm – 3pm.  

Campaign to promote NHS mental health services

On Monday 17 January, NHS England are launching a campaign to promote NHS mental health services, encouraging anyone experiencing feelings such as anxiety or depression to seek help through talking therapies. The campaign will promote self-referral through nhs.uk/help but also note that you can be referred to talking therapies through your GP practice. The targeted campaign will run on channels in paid social, radio and catch up TV.

Reminder: reporting staff sickness absence  

The COVID-19 staff absence tracker for Primary Care is now available. It is essential that we get a clearer picture both regionally and nationally of staff absences, in order to support service continuity and resilience plans. The staff absence tracker is our first step in improving data on staff absence across primary care. The user interface has been improved to make it as easy to use and not place unnecessary burden onto frontline primary care teams and all primary care organisation and contractors have been included in the database, so please do use it to report staff sickness absence.

Updated UK Health Security Agency (UKHSA) guidance – isolation

We have published an update following further changes for the general population announced by the UKHSA on isolation, and the implications for the NHS.

Nikki and Ed

COVID-19 updates

PPE consultation response and extension of free PPE to the health and care sector

The government has announced its decision to extend the central, free provision of all items of COVID-19 PPE to the health and care sector by up to one year to March 2023 or until the infection prevention and control (IPC) guidance on PPE usage for COVID-19 is either withdrawn or significantly amended (whichever is sooner). The press release announcing the decision to extend is available here.

The government has also published its response to the public consultation. The formal response is available on GOV.UK here. The government has also published its response to the public consultation. The formal response is available on GOV.UK.

Operational guidance following JCVI advice on the booster vaccination of eligible 12 to 17-year olds and household contacts of immunosuppressed people

On Saturday 8 January, NHS England and NHS Improvement issued operational guidance on boosters for eligible 12 to 17 year olds including household contacts of immunosuppressed people. The updated PGD and National Protocol were published on 7 January, and so the guidance outlines that PCN and Hospital Hub/Hospital Hub+ sites can begin to invite and vaccinate eligible groups via local booking systems.

Please read the guidance if you have not already done so. The guidance is to be read in conjunction with our system letter from 23 December 2021 and JCVI advice from 22 December 2021.

Access to NHS 111 Appointment Slots for CCAS

We have recently re-implemented the national Covid Clinical Assessment Service (CCAS) in order to support NHS 111 providers during the current wave of the pandemic. As previously, the CCAS will need to have the ability to book patients (via GP Connect) into general practice appointment slots should a patient need referral.

Please ensure your practice system is configured to allow the CCAS to have access to NHS 111 appointment slots. More information and advice can be found on the NHS Digital website.

COVID-19 Vaccination Programme – workspace

General practice

Fit notes for Statutory Sick Pay purposes

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 advance of this date. 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.

New Standard GMS, PMS and APMS Contracts Published

We have published new standard General Medical Services (GMS), Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts, along with their contract variation notices. The documentation incorporates changes made to the contract Regulations and Directions in December 2020, April 2021 and October 2021. Commissioners are required to send these updates to GP practices to formally notify them of changes to their contracts.

Action required on EMIS WEB to enable GP Connect: Access Record Structured 

EMIS has been granted Full Roll-Out Approval (FRA) for GP Connect Access Record: Structured using their Web product. This allows EMIS to join SystmOne in sharing patient Medications and Allergies data with compliant consumer systems such as Lincolnshire Care Portal and Devon Mental Health Services.

To allow consumers to make use of this structured data, GP Practices using EMIS Web should follow these instructions. You can read more at the GP Connect website.

General practice - latest updates

Community pharmacy

More opportunities for referrals to community pharmacy from NHS 111 

More minor illness symptoms can be referred to the NHS Community Pharmacist Consultation Service (CPCS) from NHS 111, following a review of the NHS Pathway algorithms by an expert group of Integrated Urgent Care clinicians and pharmacists.

Additional referrals will include three new condition types (scratches and grazes, teething, sinusitis) and incorporate general health information requests. Referrals will also be made for some conditions which are already well managed by CPCS, but that have been previously triaged as having higher acuity requirements depending on the patient’s declared history, e.g. diarrhoea, vomiting, bites and stings, cough, cold and flu, constipation, skin rash, sticky or watery eyes.

The changes to the 111 Directory of Services Pharmacy profiles to enable these new triage outcomes have been made. Based on 2021 data, this review could generate 275,000 additional referral opportunities from 111 annually to CPCS.

Vaccination stewards ready and waiting to support community pharmacists

Thousands of NHS Volunteer Responders are available to support community pharmacists deliver COVID-19 vaccinations. Pharmacists can request volunteer support online using the GoodSAM platform. They can help with welcoming and directing patients, and reducing their anxiety, wiping down surfaces.

All Volunteer Responders are ID checked, given guidance on their role and provided with high-vis clothing by Royal Voluntary Service, which delivers NHSVR for NHS England. Find out how to request volunteers in a few easy steps, and how to manage and support your volunteers so they want to come back.

New Discharge Medicines Service CQUIN indicator published

Following the suspension of the Commissioning for Quality and Innovation (CQUIN) scheme in 2020/21 and 2021/22, CQUIN will be reintroduced from April 2022. The 2022/23 scheme has now been published and includes an indicator which incentivises referrals into the community pharmacy NHS discharge medicines service (DMS) from acute trusts.

The DMS aims to reduce avoidable patient harm and readmissions caused by medicines by supporting medicines reconciliation for patients discharged from hospital.

For queries on the CQUIN scheme contact: e.cquin@nhs.net.

CPCS IT deadline approaching: Have you confirmed your choice of system?

The national procurement of IT support for the NHS Community Pharmacist Consultation Service (CPCS), will cease at the end of March 2022.

Community pharmacy contractors that want to continue providing CPCS, must confirm their choice of CPCS IT system by no later than February 2022. Failure to do so could impact referrals and service continuity.

The CPCS IT switching guide and NHSX CPCS IT Buyers guide list the verified system suppliers and explains the options:

1.    Switch to another CPCS IT provider - you should inform them well in advance so they can confirm the switch has been successful.

OR

2.    Stay with existing CPCS IT provider - you must notify them so they can confirm a new service agreement with you.

Dentistry

Your latest NHS dentistry and oral health update

Sara Hurley, England’s Chief Dental Officer and Ali Sparke, Director for Dentistry, Community Pharmacy, Optometry and the NHS Standard Contract, have issued an update to the dental profession regarding exceptional circumstances.

Primary care

Seasonal flu vaccination programme: support for increased uptake

Flu vaccination uptake for over 65s is the highest ever, and we are grateful to colleagues for their work to achieve this.

National call/recall activity is planned to support uptake for two and three-year olds, and those with learning disabilities new to the cohort, advising to book an appointment. Wider activity is planned to encourage pregnant women to take up the vaccine, and a national call to parents of school-aged children. This is additional to practice call and recall activity for eligible cohorts which should continue. Practices are asked to support the programme, offering flu vaccinations until the end of the season.

Ensuring the delivery of annual health checks for people with severe mental illnesses (SMI) and people with a learning disability

The NHS is committed to delivering annual health checks for people with SMI and/or a learning disability. These checks are a key lever to address the reduced life expectancy for both groups. In our 12 January letter, it is reminded that continued delivery of physical health checks for our most vulnerable populations remains a high priority alongside the vaccine booster roll out. Primary care is being asked to work with commissioners on a plan to prioritise checks based on clinical risk, accounting for inequalities.

Reducing health inequalities in Clacton-on-Sea

Dr Bola Owolabi, Director for Health Inequalities, recently visited a Breaking Barriers project in Clacton which seeks to reduce health inequalities through building employment and skills. The project brings together local government, the community and voluntary sector and the NHS to help residents in one of the most deprived areas in England. Jon Bashford, Director of Research at Breaking Barriers Innovations discusses the project in this new blog.

Drive to find vulnerable groups helps 100 at risk of heart failure

More than 100 people discovered to be at risk of heart failure in inner city Bristol had their medication reviewed and were offered specialist appointments to help them stay well. The group was identified as part of an NHS drive to find vulnerable people struggling to access the right services and offer more personalised help.

Local multidisciplinary teams including GPs, data analysts, public health consultants and social prescribers worked together on the population health management programme – which has been offered in every area in the country – to design new care models for at-risk groups.

Join the PHM Academy to read more case studies.

Health and wellbeing support for all throughout winter and beyond

The national health and wellbeing offer continues to be available for all NHS colleagues throughout winter and beyond and includes how to access your local mental health hubs and the new physical health offer.

We have partnered with Be Military Fit (BMF) to offer a new dedicated, physical health and wellbeing offer that has been specifically developed for our NHS people. This offer is for colleagues of all abilities.

The online platform also features a learning and development programme that aims to help you look after and improve your wellbeing, particularly through winter. Explore what’s on offer, try something new and see what works for you.

Upcoming events and webinars

January – March 2022 (multiple dates). CPCS workshops with RPS & RCGP

17 January, 12pm – 1pm. Best practice: health and social care working with people experiencing homelessness

18 January, 10am – 11.30am. Personal health budget community of practice

19 January, 12pm – 1pm. Transitional Safeguarding

19 January, 1pm – 1.30pm. Supporting practice nurses and AHPs to recognise suspected lung cancer symptoms

19 January, 1.30pm – 2.30pm. Social Prescribing Link Worker Learning and Development Webinar Series: Tackling Health Inequalities

20 January, 12.30pm – 2pm. Getting started series: Redesigning appointment systems to match capacity

2 February, 9am – 12pm. Digital Health Innovation Collaborative – free online event

Link of the Week

Innovative approach to vaccine hesitancy sees over 1000 homeless people vaccinated in Devon