GPC Chair's News: 22 December 2021

Season’s greetings from GPC England executive team

2021 has been a year of enormous challenge and yet there is much for General Practice to be proud of. Over the last 12 months you have led the most ambitious vaccination program ever undertaken, delivered record numbers of appointments to patients in need, and been voted the most trusted profession in the world. You have done all of this with 1,139 fewer GPs than last year, substandard premises, closer scrutiny than any other profession, and an inadequate budget. You have done this with heart and soul, many a time putting your own health at risk in the face of extreme unknown adversity through a pandemic, you have done this because you care about people, because patients matter, because your communities matter to you.

For 2021, General Practice has given the nation the gift of life. You have saved lives, prolonged lives, and given quality to lives. You are tireless, ordinary people working in utterly extraordinary ways, and we are proud to be amongst you. But for many of you, this has taken its toll on you, you have questioned whether anyone is listening, whether anyone cares and who will take it upon them to make the day job possible once again.

We are resolute that 2022 will be better, and we know that this will be achieved by cohesive and robust representation, delivering you with the tools that you need to better look after patients. Because without you, there is no general practice, without you, patients will struggle to access care.

This will be our final newsletter of the year and we will write to you again in the new year. Over this festive period, please take time to look after yourself and those who you love. Afterall, there are no greater gifts than time, good health, and happiness. On behalf of the committee, we wish all those celebrating a very Happy Christmas. Thank you for all that you have achieved on behalf of general practice, and will continue to do. You are immensely valued.

GPC England Executive Team:

Farah Jameel (chair)

Dean Eggitt

Kieran Sharrock

Richards Van Mellaerts

NHS pressures and joint workload prioritisation guidance

The emergence of the COVID-19 Omicron variant, with ever increasing demand on healthcare services and rising numbers of staff sickness rates has the potential to significantly impact the delivery of general practice.

Whilst GPs and their teams will do their best to continue to prioritise the care they offer alongside providing COVID-19 vaccines, patients will be understandably be concerned that some appointments will need to be postponed in order to ramp up the booster campaign.

Produced at the request of NHS England to help practices plan their participation in the booster programme, we at GPC England (GPCE) worked with the RCGP to update our joint workload prioritisation guide, to support clinicians working in general practice across England to prioritise clinical and non-clinical workload, and to support practices in their planning. Read the guidance

This follows the announcement of CQC Suspension last week and temporary changes to Fit notes and Certification to support general practice teams with workload and in supporting the vaccination campaign.

Media

Pulse and GP Online both reported on the Workload prioritisation document.

Infection prevention control guidance

The national COVID-19 infection prevention and control (IPC guidance) has been updated in light of the rapid spread of the Omicron variant.

While the IPC guidance should act as a further shield against harm - in general practice, as it currently stands, more clarity and support are needed to ensure its effectiveness. In particular section 2.1 which now advises: “Where an unacceptable risk of transmission remains, it may be necessary to consider the use of respiratory protective equipment (RPE) in clinical areas where suspected or confirmed COVID-19 patients are being managed.”

Given what we know to date about Omicron’s high rate of transmissibility, we have continued to call for GPs to have access to RPE where needed. We also continue to highlight that many GP premises lack space and necessary ventilation for suspected COVID-19 patients to be seen in an appropriate and safe setting. We have recommended for pathways to be urgently implemented for patients with COVID related symptoms, to be seen in an appropriate and safe setting, such as COVID Hubs.

The Department of Health and Social Care has subsequently confirmed that with regards to primary care access to FFP3, if a local risk assessment has been undertaken and primary care providers have been assessed as needing FFP3, the DHSC’s PPE portal should be contacted with the result of the risk assessment and they will arrange access to FFP3s. Staff would need to be fit tested to FFP3s before the PPE portal can give access to the appropriate masks to which staff have been fitted.

The World Health Organization has earlier today released a statement with recommendations on mask use by health workers providing care to patients with suspected or confirmed COVID-19, in light of the Omicron variant of concern. Chair of Council Dr Chaand Nagpaul is writing on behalf of the profession for access to RPE in all settings. The Government has also produced a poster about using face coverings in healthcare settings

To support doctors through the booster vaccination campaign, the BMA has called for infection control measures to be reintroduced in all healthcare settings, and for the Government to introduce robust infection control measures in the community, especially where people mix in indoor settings. Read the statement by the BMA Chair of Council.

Expression of thanks from the UK CMOs

The UK Chief Medical Officers (CMOs) have published a letter of thanks to the health profession:

“As 2021 draws to a close we mainly wanted to give an enormous thanks to all medical and wider health server staff. We have never been prouder to be members of the medical profession than over the last two grinding years.”

COVID-19 vaccination programme

Amendments to the Enhanced Service Specification for Phase 3

The updated Enhanced Service Specifications for Phase 3 of coronavirus vaccinations have now been published. The amendments include:

  • Extension of eligible cohort to include those aged 16 and over

  • Clarification that where there may be conflicting guidance by JCVI, NHSE, MHRA and UKHSA, NHS England will confirm which guidance shall be adopted

  • Financial supplements and extension of enhanced Item of Service fee to support practices during the national priority booster phase of the ongoing COVID-19 vaccination campaign

We had also suggested that NHSE/I made available a reference guide to summarise which vaccines can be given to which groups, and when patients become eligible for a second, third dose or booster, and NHSE/I has shared this chart (available on FutureNHS), which is updated weekly.

Second dose for 12-15 year olds

As part of the national mission to get people protected against the new Omicron variant, 12-15 year-olds are now eligible for their second COVID-19 vaccinations dose, if they had their first dose more than twelve weeks ago, in line with updated guidance from the JCVI published on 29 November.

Responding to vaccination data queries

The Vaccine Data Resolution Service (VDRS) aims to resolve missing or incorrect vaccination records for people vaccinated in England, Scotland or Wales who have a current NHS number and are registered with a GP practice in England. You can raise data quality issues directly with the VDRS team and you can direct your patients to access the service via 119. More information is available on FutureNHS.

Recording overseas vaccinations in the National Booking Service

Eligible people can now book a face-to-face appointment via the National Booking system at a selected vaccination centre to show evidence of MHRA-approved COVID-19 vaccinations administered abroad and have them recorded in the National Immunisation Management System (NIMS). Support is also provided through 119 to signpost the service, or to make bookings on behalf of users. More information is provided when the user books an appointment.

COVID-19 vaccine has been approved for use by children aged 5 to 11

The Pfizer BioNTech COVID-19 vaccine has been approved for use by children aged 5 to 11 by the Medicines and Healthcare products Regulatory Agency (MHRA), after finding it safe and effective.

Updates to the Network Contract DES

Following the letter of 3 December announcing changes to QOF and IIF and the temporary GP contract changes to support COVID-19 vaccination programme, NHSE/I has now updated the Network Contract DES

PCSE patient list validation requests

Following the issue being drawn to our attention, we asked NHSE/I to pause PCSE emails to practices requesting full patient list validation exercises. NHSE/I agreed to this and have instructed PCSE to stop sending them until the beginning of February, when the decision will be reviewed.

Further to this, we challenged the mention in these PCSE requests of a requirement to respond to the requests within five working days. NHSE/I agreed with us that the contractual requirement is actually 30 days. They will raise this with PCSE but, should the wording remain unchanged when these requests are resumed, we would advise practices that they can actually use the full 30 days.

Application window for 2019/20 Pensions Annual Allowance Charge Compensation Policy

The third GP application window for 2019/20 Pensions Annual Allowance Charge Compensation Policy applications is now open on the PCSE website 2019/20 Pensions Annual Allowance Charge Compensation Policy - Primary Care Support England. It closes on Friday 11 February 2022.

New annual leave guidance for employers of salaried GPs

This newly published guidance produced by the sessional GP committee provides advice to the employers of salaried GPs to ensure that the process for processing and allocating annual leave is fair, transparent and flexible. Read more here

Media

GP online reported on the BMA’s statement last week asking for government support for doctors through the booster campaign and concerns about staff shortages, in response to which I said: “ The reduction of some GP services or even temporary closure of surgeries due to staff sickness from COVID-19 is incredibly worrying and yet another reason why we need to see more measures from government to contain the spread of Omicron now.”

Read the BMA’s GP bulletin here.

Read the latest Sessional GPs newsletter here

Read my twitter page Dr Farah Jameel (@DrFJameel) / Twitter and General Practice (@BMA_GP) / Twitter


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