Temporary GP contract changes to support Winter pressures and the COVID-19 Vaccination program
Last Friday, following discussion with GPC, NHSE/I published a letter announcing changes to QOF and IIF and changes to the COVID vaccination DES. It has now provided further guidance on these changes.
Given the announcement on QOF and IIF, we hope practices will be able to consider how they could support the national vaccination effort while continuing to clinically prioritise patients who need them. We recognise the significant unprecedented challenges you are all facing at present and know that you will do your best in the days and weeks to come, as you have been doing these past 20 months. Thank you for all that you are doing for your patients, for your communities. Read our press statement.
Secretary of state for health and social care Sajid Javid has written a letter to primary care, thanking staff for their efforts on the COVID vaccination programme.
Pandemic response – Plan B
It is important to reiterate that the current guidance on isolation and infection prevention and control remains in place. The main amendments include face masks becoming compulsory in most public indoor venues, other than hospitality, NHS Covid passes to be mandatory in specific setting, using a negative test or full vaccination via the NHS Covid Pass, vaccines and testing to remain the best line of defence and people are being asked to work from home if they can.
A reminder to colleagues of the recently updated infection prevention and control (IPC) guidance published by the UK Health Security Agency, issued jointly by the Department of Health and Social Care, NHS England and the devolved nations’ public health departments. It covers seasonal respiratory viruses and supersedes the previous COVID-19 specific guidance.
It recommended that face masks for staff and face masks/coverings for all patients and visitors should remain as an IPC measure within health and care settings over the winter period.
It also recommended that physical distancing should be at least 1 metre, increasing whenever feasible to 2 metres across all health and care setting, and that it should remain at 2 metres where patients with suspected or confirmed respiratory infection are being cared for or managed.
It is recommended that screening, triaging, and testing for SARS-CoV-2 continues over the winter period. Testing for other respiratory pathogens will depend on the health and care setting according to local / country-specific testing strategies / frameworks and data
This followed the specific recommendations for changes to IPC guidance in primary care published on October. The BMA have already stressed that 1 metre social distancing will be difficult for some smaller surgeries and as such there will still have to be a reduced capacity in some practices. The guidance strongly emphasises that local decisions and risk assessments will ultimately decide whether a face-to-face consultation is appropriate and where physical distancing can be safely reduced. It is therefore for practices to determine what arrangements they have in the surgery.
We are working with RCGP on updating our joint workload prioritisation document. https://www.bma.org.uk/media/4386/bma-rcgp-covid-workload-prioritisation-aug-2021.pdf
The BMA responded to the prime minister’s announcement on Wednesday 8 December that the Government will be implementing Plan B for dealing with COVID and the Omicron variant. Read more.
NHS COVID-19 vaccination programme
It was the one year anniversary on Wednesday for the NHS COVID-19 Vaccination program. Since its inception, GPs and their teams all over the country have played a pivotal role in rolling out at pace the most successful vaccination campaign to date. The NHS has delivered now over 100m doses in just 12 months, including 18m booster jabs. The lion’s share of this vaccination program has been delivered by General Practice, its been a massive undertaking at significant personal costs for many of you, a huge team effort delivered in partnership with your communities. In coming days and weeks many of you will continue to step up to the national priority of boosting this country through a surge of Omicron. Thank you for all that you have achieved and all that you will continue to do for your communities and for this nation.
To support you in this national effort, changes to the vaccination schedule now allow greater flexibility to move vaccines to individual practices.
Moving vaccines within a PCN grouping
Considering the need to rapidly expand capacity, the MHRA has expanded the circumstances in which the COVID-19 vaccine may be moved from a PCN Grouping’s designated site(s) to another location.
GP practices within a PCN Grouping may move COVID-19 vaccine from their Designated Site to collaborating individual GP practices within the PCN Grouping to increase the possibility of opportunistic administration of the vaccination to increase take up of the vaccine. Movement continues to be subject to:
all requirements and guidance on the movement, storage and handling of COVID-19 vaccines being adhered to;
there being no onward movement of the vaccine. For example, it is not permitted for a PCN to transport the COVID-19 vaccine from the PCN Grouping’s designated site(s) to a collaborating individual GP practice and then onto a pop-up site or care home etc; and
the arrangements being reflected in the PCN Grouping’s Collaboration Agreement
The NHSE template Collaboration Agreement has now been updated to reflect these changes.
UK's most vulnerable people to receive life-saving COVID-19 treatments in the community
Thousands of the UK’s most vulnerable people will be among the first in the world to access life-saving, cutting-edge antiviral and antibody treatments from today, the government has announced.
A national study called PANORAMIC, run by the University of Oxford in close collaboration with GP hubs, has now launched and is recruiting around 10,000 UK patients at risk of serious illness from COVID-19 to have the opportunity to take the treatment molnupiravir at home after receiving a positive PCR test.
Those at highest risk who test positive for the virus – for example, people who are immunocompromised, cancer patients or those with Down’s syndrome – will also be able to access either molnupiravir or the novel monoclonal antibody Ronapreve outside of the study from 16 December 2021.
Supporting general practice
Read about how we are campaigning against abuse of GPs and their staff on our Support Your Surgery campaign page, which includes a number of resources that practices can use.
NHSE/I workforce staff survey development
The NHSE/I workforce team has commissioner Picker, an independent health and social care research charity, to develop a new questionnaire for the Primary Care Staff Survey Pilot. They are looking for volunteers (both clinical and non-clinical staff) to make sure the questionnaire is clear, easily understood and relevant to staff working in General Practice and Primary Care Networks. If you volunteer you will need to:
Attend a one-to-one 60 minute interview with research from Picker, over MS Teams.
During the interview you will be required to complete the questionnaire, voicing your thoughts throughout completion.
An interview will be arranged at time convenient to you, during one of the rounds detailed below.
Round 1 – 16th December to 20th December
Round 2 – 4th January to 6th January
Round 3 – 12th January to 14th January
This will be extended into the 2022/23 financial year and NHSE/I have now removed the requirement to apply within six months of commencing a partnership role. Following a review of the timeframe to apply for the scheme, and in acknowledgement of the challenges the deadline presented to busy new partners as well as the additional pressures created by the COVID-19 pandemic, NHSE/I has removed the six-month deadline, including for submitted applications that meet all other eligibility criteria. When the scheme comes to an end, there will be a cut-off deadline after the scheme closure date by which applications from eligible individuals must be submitted, and NHSE/I will give advance notice of this.
NHSE/I continues to encourage all individuals who have commenced in an equity share partnership on or after 1 April 2020 to submit their application as soon as they can after they become eligible. They are now reviewing all applicants this affects and updating their guidance to reflect the changes. Read NHSE/I’s primary care bulletin
Changes to QOF and IIF
BMA GP committee chair Dr Farah Jameel made a number of comments in the media, following the announcement by NHSE/I last Friday that some contractual requirements on GP practices would be relaxed to allow increased capacity to deliver the COVID-19 vaccination campaign. In her BMA statement she said that there was a fine balance to be had between “the clear national priority to deliver booster vaccinations to as many people as possible with ensuring that people who need care and treatment from their GP practice and the wider NHS continue to receive it”. She was quoted in the Guardian, Daily Mail (print), i News, Pulse, BBC News and GP Online. On Saturday morning she appeared on BBC Radio 4’s Today programme (from 1hr14) and later on Times Radio (9 mins40). Her comments on the Today Programme received widespread further pick-up across the media, including the BBC.
Dr David Wrigley, BMA council deputy chair, appeared on Times Radio (from 2hrs38) and on the BBC News Channel on Saturday, with his comments picked up across BBC News bulletins throughout the day. I was also interviewed by ITV News on Friday evening on the same topic.
NHS on life support
The Spectator ran a piece on the NHS being on life support, which includes a line on GPs refusing to see patients (“Too many GPs are still refusing to see patients in person”). The BMA has published a letter in response from Dr Chaand Nagpaul, Chair of BMA Council.
Covid-19: General practice is at breaking point, warns BMA
The BMA featured in ITV News yesterday warning that general practice is at breaking point, with GPs under pressure to speed up the rollout of booster jabs alongside their usual clinical duties.
Dr Danielle McSeveney, BMA Yorkshire regional council deputy chair, said: "Some practices around the country have felt that they cannot continue to keep going with vaccinations at the rate they, that it is compromising their day-to-day care of patients and they just can't do it."
General practice: GPs will balance needs of patients alongside increased vaccination drive
The BMA featured in iNews yesterday discussing the need to balance the increased vaccination rollout with the needs of patients.
Dr Farah Jameel said: "We will continue to work with the Government to ensure GPs and practices are supported and enabled to effectively balance the needs of all our patients along with this increased vaccination drive.
"The ever-changing demands of the pandemic means that it is important to constantly assess the situation to ensure that practices are being best supported to cater to the most pressing needs of their patients and their communities at any given time."
The BMJ ran an article with GP leaders and the RCGP expressing serious concerns about the roll out of the new cholesterol lowering drug inclisiran in primary care.
London News Today ran an article highlighting staff shortages and recruitment schemes to get more staff.
The Northern Echo ran an article on the need for greater understanding from patients amid the additional workload and pressures resulting from the Covid-19 pandemic.
Pulse ran an article announcing that GPs are now contractually required to ‘offer and promote’ remote consultations during core hours, new NHS England guidance has confirmed.
Dr Andrew Buist, chair of GPC Scotland was reported in the Scotsman – NHS Covid crisis: I worry about health service’s future and we need to be realistic about what it can do.
Northern Ireland: Continue to exercise caution by following Covid rules, says BMA
Dr Frances O’Hagan, deputy chair of the British Medical Association Northern Ireland GP Committee, appeared on UTV View from Stormont to discuss concerns over the Omicron variant (watch from 15:06).
Commenting on the Omicron variant, Dr O’Hagan said: “It is an evolving situation and until we know the facts we should be very careful. What we do know is Omicron is very infectious. We know that it can be transmitted very easily, but we haven’t got enough data yet on how severe the infection is.”
Dr O’Hagan reminded viewers to continue to wear masks, social distance, wash their hands and get the vaccine and booster jab when it is offered.
Dr Tom Black, Chair of BMA NI Council, a Derry GP says that the ‘relentless pressure’ exerted on the NHS since the start of the Covid pandemic is set to continue for months to come.
Read the BMA’s GP bulletin here.
Farewell to LMC colleagues
As our time on the executive team comes to an end, I want to take this opportunity to thank LMC colleagues for your support and camaraderie over the years. Richard Vautrey, Mark Sanford-Wood and I will be handing over to the new executive team in the next few days, and we wish you, the team and the profession well in these challenging times. It has been a privilege to represent you all these years and we hope the future is a positive one for General Practice.