January 2022 Newsletter

Included in this edition:

  • Elections for new LMC Committee term
  • Message from Norwich Medical School – undergraduate teaching opportunities
  • Firearms – Medical Information Proforma
  • Covid Vaccination Programme Update
  • Fit testing of FFP2 and FFP3 respirator
  • Extension of free PPE to the health and care sector
  • Face coverings in practice premises
  • Mandatory Covid Vaccinations for Staff
  • National Standards of Healthcare Cleanliness 2021
  • Proof of vaccination for 12-year olds (and older) via the NHS app
  • How can GPs effectively care for patients with long-term conditions in the current climate?
  • Self Certification
  • Dispensing Services Quality Scheme – Briefing note from NHSEI to the LMC
  • Practice Vacancies


Information, Guidance and News

Elections for new LMC Committee term

The LMC wishes to advise that the elections for the new committee term from April 2022 will be undertaken during February 2022 and constituents will shortly receive an email and nomination form from Mr Simon Jones.  All completed nomination forms are to be submitted to simonjones@suffolklmc.co.uk  by midnight on Monday 28 February 2022.  The closing date of any constituency elections will be Friday 18 March and votes will be counted on Tuesday 22 March.

Message from Norwich Medical School – undergraduate teaching opportunities

You may have seen a letter from us inviting expressions of interest in teaching on the Norwich MB BS course. We still have a number of teaching vacancies to fill and would be delighted to hear from you.

Teaching for Norwich Medical School is different from the models employed by other medical schools. Students attend in small groups (typically 8-10) and the focus is generally on structured patient contact. Whilst this might seem initially challenging, the remuneration package reflects the scale involved so that practitioners can be released from clinical commitments to focus purely on the learning experience for students. Nealy all teaching takes place on a one day a week, weekly basis, so practices do not have prepare for long periods of continual placement with the disruption that can entail.

For informal enquiries and an information pack e-mail d.young@uea.ac.uk

Firearms – Medical Information Proforma

Practices may wish to use the following proforma document with mail merge options for medical information requests from the police in respect of firearms applications

Firearms Medical Info Proforma.docx

Covid Vaccination Programme Update

NHSEI has agreed to extend the period during which the £10 supplement is attracted for vaccinations given to immunosuppressed people – this was due to end on 31st January 2022 but is now extended to 31 March. The ES specification has been updated on the NHSEI website. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/01/C1570-enhanced-service-specification-covid-vaccination-programme-phase-3-version-7.pdf

Fit testing of FFP2 and FFP3 respirator

Current IPC (Infection Prevention and Control) guidance advises that clinicians seeing patients with any known or suspected respiratory infections should wear FFP3 respirators to prevent nosocomial transfer. It is also a requirement of the Health and Safety Executive (HSE) that FFP2 masks are fit tested in the same way as FFP3 masks. HSE advises against the use of FFP2 unless we are in contingency measures as these provide a lesser filtration rate than FFP3. 

GPC England (GPCE) has persistently made the case that COVID-19 is transmitted by airborne means and that effective respiratory protective equipment (RPE) is of vital importance to protect healthcare staff and patients.  GPC has worked hard with NHSE/I in order to protect colleagues and patients. This latest guidance acknowledges these facts and provides a framework by which practices can access appropriate RPE.

Practices can access FFP respirators, including FFP3s, via the PPE portal if they have risk assessed their environments and require these.  In addition, practices can access fit-testing for their FFP respirators through their local commissioners, and CCGs have been informed that where risk assessments have shown it to be necessary, fit-testing should be provided by the CCG. 

The CCGs have issued the following position statement here  This also provides details of the organisations that can provide fit testing for practices.

Read the BMA guideline for practices to use, about making risk assessments and on infection control protocols. 

Extension of free PPE to the health and care sector

The government has extended the central, free provision of all items of COVID-19 PPE to the health and care sector, including primary care, 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.

The recently updated UK Health Security Agency guidance on infection control states that “an FFP3 respirator (or equivalent), must be worn by staff when caring for patients with a suspected or confirmed infection spread by the airborne route (during the infectious period)”.

The Department of Health and Social Care (DHSC) has advised in its  response to the consultation on provision of PPE to the health and social care sector, that practices can use the DHSC PPE portal to access PPE free of charge. 

NHSE/I has confirmed that this includes FFP3 respirators, and that CCGs have been informed that where risk assessments have shown it to be necessary that fit-testing should also be provided by the CCG. 

Face coverings in practice premises

On 19 January the Prime Minister announced that face masks will no longer be mandated, though people are still advised to wear coverings in enclosed or crowded spaces and when meeting strangers. 

IPC guidance for health settings has not changed and states “Universal masking with face coverings or surgical masks (Type II or IIR) to prevent the transmission of SARS-CoV-2 and other respiratory infectious agents in health and care settings, as a source control measure, should continue to be applied for all staff, patients, and visitors”

Furthermore, practices should carry out risk assessments of their environments and assess what level of respiratory protective equipment should be worn by different groups in various settings. Health and Safety law makes it your responsibility to protect staff and other patients based upon these risk assessments, thus making mask wearing a legal requirement if your risk assessment suggests masks should be worn.

If challenged by patients not wanting to wear a mask you can advise the about the IPC guidance and your risk assessments and inform the patient that “the law imposes on me the duty to expect you to wear a mask, and on you the duty to wear one in these premises”.  Download our poster about using face coverings in practices.

Mandatory Covid Vaccinations for Staff

With effect from 31st January 2022, it is now no longer a mandatory requirement.  The intention is to remove this from statute after a short period of consultation. 

National Standards of Healthcare Cleanliness 2021

Members and practices have been asking if the implementation of the National Standard of Healthcare Cleanliness is mandatory in Primary Care. NHSEI have confirmed that, while contractors must have regard to NHSEI guidance, it is not a mandatory requirement.

CQC acknowledge in their advice on Infection prevention and control in General Practice that it will continue to regulate in line with its own regulations and the existing Code of Practice.

 Proof of vaccination for 12-year olds (and older) via the NHS app

In summary, from 3rd Feb 2021 13-15-year-olds will be able to sign up to the NHS app using their own e-mail address and as long as they pass validation with a passport they will get access to covid vaccine certificates and also recovery certificates which will appear ten days after a positive covid PCR test, and remain valid until 180 days after the date of the test. They will be able to order repeat prescriptions, if they have any, but won’t be able to have automatic access to the medical record. For this, they will need to approach their GP who will have to assess competence.

In addition to this, 12-year-olds and older will be able to request vaccine certificates online via https://www.nhs.uk/conditions/coronavirus-covid-19/get-digital-covid-pass/ or ring to request them via 119. Adults can already do this. For the online route an NHS login will need to be created. For the 12-year-olds they’ll be able to use this to get into the app (I hope) once they reach age 13. Recovery certificates will be available via the online route but only vaccine certificates will be available via the 119 postal route.

Any certificate issued will be valid a month and if a longer duration is needed it must be requested again via 119, or the relevant website visited again to trigger generation of a fresh QR code with a new validity period.

How can GPs effectively care for patients with long-term conditions in the current climate?

Dr Matt Kearney (GP and UCLPartners Programme Director for CVD Prevention and Proactive Care) and Helen Williams (Consultant Pharmacist UCLPartners Clinical Adviser and National Specialty adviser for CVD Prevention, NHSE/I) highlight the importance of search and stratification tools to help primary care safely prioritise patients with long term-conditions, in this blog. 

This approach helps manage GP workflow at a time when there is so much pressure on staff and they have such limited capacity due to covid cases and the vaccination programme. By starting with the patients at highest risk but still supporting proactive care for all patients, this method provides benefits for patients and practices. Read the blog

Self Certification

A reminder that the self-certification period reverts to seven days for absences beginning on or after 27 January 2022.

Dispensing Services Quality Scheme – Briefing note from NHSEI to the LMC

NHS England and NHS Improvement (NHSE/I) East of England is writing to advise of the approach to reviewing submissions for DSQS this year.   There are no known plans to waive or pause DSQS this year and like last year, East of England will be taking a proportionate and supportive approach when reviewing submitted documentation from dispensing GP practices.

All participating GP dispensing practices are required to confirm that they have a named dispensing lead (GP), staff have received relevant training and they have appropriate SOPs in place to ensure quality and safe dispensing of medicines.  Practices are required to complete a number of Dispensing Review of Use of Medicines (DRUMs) and a clinical dispensing audit. Like last year, the usual requirement for DRUMs has been reduced from 10% of their list to 7.5%. DRUMs can be conducted remotely rather than face to face.

In terms of the clinical dispensing audit, East of England wants to take a proportionate approach when reviewing audits in recognition of the additional workload throughout the pandemic and the vaccine roll out.  As in previous years, East of England has already shared with all dispensing practices, the 12 areas we would expect to see covered in a clinical audit. This includes but is not limited to, a clear aim and objective, results, recommendation for change/improvement and learnings.

Pre pandemic, the expectation would be that all areas were covered however we are proposing to take a proportionate approach due to the on-going impact of Covid-19 and the vaccine programme.

In summary we will be:

  • Reviewing all audits, including a flexible approach to late submissions made after the indicative deadline of 4 January 2022.
  • Adopting a “common sense” approach to the review of audits where a successful submission will have achieved approximately 8 out of the 12 criteria we would normally expect to see.
  • Allowing any practice that falls below the required standard, the opportunity to re-submit additional information.
  • Allowing any practice who does not complete the ‘Self-Assessment’ in its entirety by the indicative deadline of 1 March 2022, a further opportunity to submit the required information.
  • Reducing the DRUMs target from 10% to 7.5% of the dispensing patient list size as of 1 January 2022.
  • Allowing DRUMs to be conducted remotely.

NHSE/I East of England, hopes to have undertaken all initial reviews by no later than w/c 21 March 2022, with any final subsequent reviews being conducted during the final week in March 2022. This will of course be dependent on dispensing practices making the required submissions prior to 31 March 2022. Where practices are required to submit additional information, they will be contacted at the earliest opportunity to allow time for a resubmission.

All dispensing practices that have met the proportionate requirements of DSQS will be paid at the end of April 2022 in line with the Statement of Financial Entitlement.

In very exceptional circumstances, East of England may make a payment to a practice after April 2022 and this would be made on the next available payment run.

Any practice that has not made a submission will not be paid. Any practice that does not provide any additional information if notified that they have not met the proportionate requirements, may not be paid. East of England is willing to share (if required) information with LMC colleagues regarding those practices we are proposing not to pay following the request for additional information.

LMCs should note that this proportionate and flexible approach is being applied for 2021/22 only in acknowledgement of the pandemic and associated workload and does not set a precedent for future years.

Practice Vacancies

Can be found on the LMC Website http://www.suffolklmc.co.uk/jobs

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