In this bulletin:
- COVID-19 Vaccination Update
- 21-year-olds and 18-year-olds
- Vaccinations and Surge Response to the Delta Variant
- Acceleration of second doses for cohort 10 (40 to 49-year-olds)
- Shielded Patient List
- Update to GP Contract Arrangements for 2021/22
- Further funding will be provided for PCN Clinical Director support
- New Weight Management Enhanced Service
- New Long COVID Enhanced Service
- Integrated Care Systems (ICS) Design Framework
- Complaints Training
- Sodium Valproate Risks During Pregnancy
COVID-19 Vaccination Update
- Following the opening of vaccines offered to people aged 21 and over, it is expected that all over-18s will be invited for COVID vaccines this week as the NHS reaches the final hurdle in its plan to offer the vaccination to everyone by July. The last step down through the cohorts and age groups will mean that any adult can get a COVID vaccine if they want one
- There are some areas which have seen a more significant increase in the number of positive COVID-19 cases of the Delta (B1.617.2) variant. Currently, there are eight areas experiencing surge. Therefore, NHS England has produced a system guide for a vaccinations and surge response. It explains these three actions to respond to the number of cases and what local teams need to do in ‘surge’ areas:
- Every effort is made to promote vaccine uptake in those who remain unvaccinated in priority cohorts 1 to 9
- For those in cohorts 1-9 (over 50s, under 50s who are clinically vulnerable or extremely vulnerable, and Health and Social Care workers), their second doses are brought forward from 12 weeks to 8 weeks
- Capacity of vaccination sites are maximised to continue to roll out the vaccine as quickly as possible
- In response to advice from the independent JCVI, the Government has set out that appointments for a second dose of the COVID-19 vaccine will be brought forward from 12 to 8 weeks for the remaining people in cohort 10 (people in their 40s) who have yet to receive their second dose. This is to ensure priority groups have the strongest possible protection from the Delta variant of the virus at the earliest opportunity possible. However, second dose vaccinations should not be offered earlier than 8 weeks except in accordance with the guidance by the JCVI and the Green Book
- The guidance for Practices has been updated to ensure patients who are identified as at high risk from developing complications from coronavirus continue to be on the Shielded Patient List (SPL). The guidance can also be used to inform decisions about whether individual patients should be classified as clinically extremely vulnerable (CEV)
Update to GP Contract Arrangements for 2021/22
Changes have been made to the GP Contract regarding General Medical Services (GMS) contractual arrangements that will apply in England in 2021/22. In a letter to GP Practices and Primary Care Network Clinical Directors, NHS England and NHS Improvement have confirmed further funding will be provided for PCN Clinical Director support for the period from July to September 2021.
The letter also gives details about two new enhanced services:
- Weight Management Enhanced Service
- To encourage practices to develop a supportive environment for clinicians to engage with patients living with obesity about their weight, and provide up to £20m funding for referrals to weight management services
- Long COVID Enhanced Service
- To support general practice in managing this new and complex condition, NHS England will provide up to £30m from 1 July via a Long COVID Enhanced Service
Integrated Care Systems (ICS) Design Framework
In our GP weekly roundup on 6 May, we briefly explained the Integrated Care Systems (ICS), and that it will remove the traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services.
NHS England has published documents this week that set out how Integrated Care Systems (ICSs) will operate from April 2022. It also includes guidance regarding the employment commitment, its application in practice and how it will affect people.
Key points to note for general practice include:
- One member of each ICS Board is expected to be from local primary medical services (general practice) providers
- Primary care networks (PCNs), serving the patients of the constituent general practices, will play a fundamental role to improve health outcomes and join up services
- There will be running cost allowance budgets for acute, community and mental health services (currently CCG commissioned) and primary medical care (general practice) services (currently delegated to CCGs)
- There will be support for the expansion of primary care and integrated teams in the community
- The contracts that health service providers hold (NHS Standard, or national primary care supplemented locally) are expected to evolve to support longer term, outcomes-based agreements, with less transactional monitoring and greater dialogue on how shared objectives are achieved. Primary care contracts will continue to be negotiated nationally
All primary care professionals will have a fundamental role to play in ensuring that ICSs achieve their objectives, and the success of the efforts to integrate care will depend on primary care and other local organisations working together to deliver change across health and care systems.
Primary care should be represented and involved in decision-making at all levels of the ICS, including strategic decision-making forums at both place (geographical) and system level. It should be recognised that there is no single voice for primary care in the health and care system, and so ICSs should explore different and flexible ways for seeking primary care professional involvement in decision-making.
In particular, primary care should have an important role in the development of shared plans at place and system, ensuring they represent the needs of their local populations at the neighbourhood level of the ICS, including with regards to health inequalities and inequality in access to services.
ICSs should explore approaches that enable plans to be built up from population needs at neighbourhood and place level, ensuring primary care professionals are involved throughout this process.
Complaints Training
Dealing with complaints can be resource intensive and time-consuming, as well as being very stressful. A new and free training programme has been launched for 2021 for Practice Managers, or the senior responsible person. Places at facilitated workshops can be booked by emailing [email protected]. Booking will commence from Friday, 18 June 2021.
Sodium Valproate Risks During Pregnancy
A letter will be sent by the National Director for Patient Safety to women and girls aged 12-55 who are currently prescribed sodium valproate which contains important reminders of safety considerations, including around contraception, pregnancy and regular prescribing reviews. These patients will be reminded that they must have a review of their treatment every year and they must not stop taking valproate unless they have spoken to a doctor or nurse.