May 2021 Newsletter

Included in this edition:

  • NHS Pension
  • COVID-19 vaccination programme
  • NHS Standard Contract 2021/22 – New “interface” provision (England)
  • Updated guidance for HGV medicals (UK)
  • DWP Forms
  • CQC – mythbusters
  • Maternal mental health
  • PCSE New GP Pay and Pensions system
  • Workforce data and GP pressures
  • Face-to-face appointments – Dr Richard Vautrey Statement
  • Central procurement for Pneumovax®23 from 1 June 2021
  • COVID vaccine status
  • NHS App and patient messaging facility
  • Online Consultations – Contractual Requirements (England)
  • DPN for GP Data for planning and research (GPDPR), legal direction (England)
  • Practice Vacancies

Download Word Doc Version >

 

Information, Guidance and News

Key Matters reviewed by the Committee this month 

  • Adolescent mental health
  • EoE gender dysphoria service
  • Expansion of COPD service (pilot)
  • SNEE long covid
  • Spirometry
  • Phlebotomy
  • Waiting list management
  • Steroid cards
  • CCG liaison
  • ESNEFT Liaison meeting
  • West Suffolk Hospital liaison meeting
  • SNE APC update

 

NHS Pension

The LMC urges constituents to ensure they are aware of the changes to the NHS Pension Scheme following the McCloud judgement.  This is relevant to members who joined the scheme on or before 31.2.2012 and who were still members of the scheme on 1.4.2015.  It will not affect those who joined the scheme on or after 1.4.2012.  

The government will be introducing new legislation following the judgement and processes will be implemented to support members to make a choice once they retire. The legislation is intended to be in place by 1 October 2023, or earlier if the schemes allow.

The following links are helpful:

McCloud Judgement – NHS Employers

February 2021 update on government changes to public service pension schemes | NHSBSA

TES TEST MCCLOUD JUDGEMENT ZURICH PAGE LOOK | Chase de Vere Medical

 

COVID-19 vaccination programme  

COVID-19 vaccination: accelerating second doses for priority cohorts 1-9 

Following the recommendation by JCVI that reducing the dosing interval to help protect the nation from the COVID-19 B1.617.2 variant, the Government has instructed that appointments for a second dose of a vaccine will be brought forward from 12 to 8 weeks for the remaining people in the top nine priority groups who have yet to receive their second dose. People should continue to attend their second dose appointments, and nobody needs to contact the NHS. The NHS will let those who should bring their appointment forward know, when they are able to do so. 

Vaccination sites will receive an increase of the AZ vaccine to support with rescheduling second dose appointments. 

The letter from NHSE/I promised additional financial support would be made available to vaccination centres to cover the administration costs of this activity and GPC have pushed for this to be made. NHSE/I has now published Further details on the support available for PCN-led sites, including CCGs and ICSs to bring in additional workforce where possible, and additional payment of £1,000 for PCN groupings for rescheduling second dose appointments on or after 25 May 2021. They have also updated their FAQs on providing second doses

Updated Enhanced Service Specification 

The Enhanced Service Specification for the COVID-19 vaccination programme 2020/21 has been updated to introduce a 3 month maximum period within which payment claims must be made, a change to restrict PCN groupings to using a single Point of Care system, as well as a change to permit the administration and payment claim of a single dose vaccine.

Changes to National Booking Service (NBS) for pregnant women 

The new NBS functionality will enable pregnant women to book appointments at a site that offers the Pfizer-BioNTech or Moderna vaccine following a series of screening questions. This is in line with JCVI guidance and the Green Book.  

Every woman who is pregnant or thinks she might be, should be offered a discussion on the potential risks and benefits of vaccination with a clinician, so that she can make an informed choice about whether to receive it. Pregnant women will be able to have a conversation with a healthcare professional at their vaccination appointment or can speak to their maternity team or GP service. 

Storage of Pfizer vaccine 

Following reports by the European Medicines Agency that the approved storage period in a fridge for the Pfizer vaccine could be extended from days to weeks, the MHRA has approved new storage conditions for the vaccine, extending the length of time the thawed vaccine can be stored at normal fridge temperatures from 5 days to 31 days. NHSE/I has published a letter about the change to shelf life of the Pfizer vaccine when stored in refrigerators at 2-8C. This change makes a big difference to the remaining vaccination campaign, however, work still needs to be done on trying to reduce pack sizes.  GPC have also questioned again the continued need for a 15-minute observation period after vaccination. 

 

NHS Standard Contract 2021/22 – New “interface” provision (England)  

Following reports from GPs regarding inconsistent implementation of NHS Standard Contract requirements on secondary care providers relating to the interface with local primary care teams, the BMA has worked with NHS England on the introduction of a new provision in the contract to improve collaboration between clinical teams.   

The new provision requires that secondary care providers work with their local commissioners to assess by the end of September, and annually thereafter, their compliance to the interface requirements of the contract.  The commissioners and providers will have to agree an action plan to address any deficiencies identified by their assessment and ensure that this action plan is informed by discussion with and feedback from the relevant LMCs, and they also need to ensure that the action plan is adopted in public by their Governing bodies, and that progress on its implementation is shared with the relevant LMCs.  

The hope is that this will provide a suitable forum to highlight the escalating issues around inappropriate transfer of workload from the hospital to GPs.  The LMC will be actively seeking the CCGs plans for how they plan to implement this new instruction.     

 

Updated guidance for HGV medicals (UK) 

Due to the pandemic, a decision was taken by DVLA in April 2020 to waive the medical requirement for a D4 licence renewal application for those aged 45 and over. Applicants were instead issued with a single, one-year licence.  

After talks with the DVLA, the BMA has agreed to aim to accommodate D4 medical appointments for working drivers to make sure that drivers are available to the transport industry. We would therefore encourage practices to enable working drivers to have this medical examination when necessary, as much as public health guidelines and individual priorities allow. This excludes car driving licence renewals with small lorry (C1, C1E (107)) and minibus (D1 (101) and D1 (101,119)) entitlements issued before 1997 where these entitlements are used for driving large recreational vehicles rather than for working in the transport sector. 

Further information and guidance on this can be found on the DVLA website

 

DWP Forms 

Further to a recent meeting between GPC and DWP, they have agreed to supply copies of all relevant GP forms prior to their publication on the HCP pages of Gov.UK. Please see attached PDF copies of the available forms.   

 

CQC – mythbusters

With the re-establishment of practice inspections by CQC practices may wish to bring themselves up to date with the CQC mythbusters – the full list can be found at

GP mythbusters: Full list of tips and mythbusters by latest update | Care Quality Commission (cqc.org.uk)

We would draw your attention in particular to No 12 which gives the relevant searches that CQC will often request practices to do.  

https://www.cqc.org.uk/guidance-providers/gps/gp-mythbuster-12-accessing-medical-records-during-inspections 

 

Maternal mental health  

As a result of our 2020/21 contract negotiations, additional funding was secured to support a dedicated postnatal check-up for new mothers.  Whilst recognizing the current difficulties, and as practices plan for the coming year, we would encourage the offer these dedicated appointments to all new mothers, and to do this at a different time from the regular baby health check.   

 

PCSE New GP Pay and Pensions system 

Following a number of delays, it appears that the new GP Pay and Pensions system will become available to practices and GPs on 1 June 2021. PCSE has this week written to both LMCs and practices, advising on next steps and what practices will need to consider in preparation. GPs themselves are due to receive information and guidance on using the new system in the coming weeks. 

 

Workforce data and GP pressures 

The latest GP workforce data report has been published recently, which shows that the overall number of FTE GPs has seen little growth since 2015, with the number of GP partners significantly decreasing in that time.  

Between March 2020 to March 2021, the number of older, more experienced GP partners reduced by 546 doctors. Factoring in this decrease, the number of qualified GPs increased by 1541 (salaried and locum GPs only) in that time. Looking at this on a FTE basis (37.5 hours per week), the number of fully qualified FTE GPs only increased by 110.7 (to 28,096) over the past year. 

The number of patients per practice is 22% higher than it was in 2015, but the GP workforce has not grown with this demand. As a result of this stasis, there are now just 0.46 fully qualified GPs per 1000 patients in England – down from 0.52 in 2015. This is significantly below the average number of physicians per 1000 patients in comparable OECD nations (3.5). 

Read the BMA’s full analysis of the figures on the GP pressures page which has clear graphical analysis, with the chart resource pack here which can be posted as individual images as part of social media interactions. 

 

Face-to-face appointments – Dr Richard Vautrey Statement

Here is a copy of the statement to GPs sent last week.  You can also read the full press statement here 

GPC met last week and passed a vote of no confidence in NHSE leadership over failure to support general practice.  The press statement can be seen here:

GP leaders deliver damning vote of no confidence in NHS England leadership over failure to support general practice – BMA media centre – BMA

A response has yet to be received from NHSE.

 

Central procurement for Pneumovax®23 from 1 June 2021 

From 1 June 2021 the Pneumococcal Polysaccharide Vaccine (PPV 23) will be centrally procured.  In line with other national immunisation programmes, Public Health England will supply this vaccine for the routine immunisation programme and immunisation of those with underlying medical conditions, rather than providers locally procuring the vaccine.  The vaccine will be available to order from PHE’s ImmForm website. Read more here

 

COVID vaccine status 

The Government has announced that from 17 May 2021, people will be able to demonstrate their COVID-19 vaccine status for travelling purposes, by accessing the NHS app, or by calling 119. People are also strongly advised not to contact their GP to prove their vaccine status. 

 “Do not contact your GP surgery about your COVID-19 vaccination status. GPs cannot provide letters showing your COVID-19 vaccination status.” 

In preparation for the requests that may arrive in general practice, practices can use the following draft text to inform messages on your websites and to signpost patients to: 
 

“Thank you for contacting the surgery enquiring about COVID vaccination certification.

We are unable to issue this certificate at the practice.

Please see the Gov.uk website for further information.

Proof of your vaccination status will be available on the NHSapp, which is also valuable for accessing your health records and ordering repeat prescriptions.

The NHSapp can be downloaded from here for iPhone or here for android.  

Alternatively, you can call the NHS helpline on 119 (from 17 May) and ask for a letter to be posted to you. This must be at least 5 days after you’ve completed your course of the vaccine, the letter may to take up to 5 days to reach you.

Kind regards *Your Surgery* “ 

 

NHS App and patient messaging facility

Following the recent announcement that the NHS App will feature prominently in plans for digital proof of COVID vaccination status we wanted to flag to practices that the App also contains a direct GP messaging feature for patients.

It is an individual practice decision to enable or disable this feature. The screenshots below show how, at a practice level, you may toggle the feature/check your practice status.

Setup > Users & Policy > Organisation Preferences, then as in the screenshot below:-

For EMIS Web, it’s under EMIS > System Tools > EMAS Manager > Patient Facing Services –  screenshot with tickbox below:-

 

Online Consultations – Contractual Requirements (England) 

There are growing number of concerns relating to NHSE/I guidance suggesting, and local commissioners requiring, practices to maintain online consultations and remote triage systems.    

Before the pandemic, as part of the 2019 GP contract deal GPC England agreed that it would eventually become contractual for practices to offer online consultations during core hours. This agreement has not yet been added to the contract regulations, so is not currently a contractual requirement. However, GPCE also agreed that practices should offer online consultations as early as possible, provided that the necessary infrastructure is in place, but it would not become a requirement until it is entered into the contract regulations. It is therefore for practices to determine how best they use online consultation systems, including what hours they are available, and they should try to use them in such a way that helps with triage and workload management, enabling the delivery of a safer and more accessible service to all their patients. 

 

DPN for GP Data for planning and research (GPDPR), legal direction (England) 

NHS Digital issued a Data Provision Notice (DPN) on 12 May to all practices in England notifying them of their intention to begin extracting data as part of the GP Data for Planning and Research (GPDPR) programme. GPDPR is the successor to the GP Extract Service (GPES) and it is a legal requirement for practices to comply with the DPN.  

Practices need to comply with DPN; update Privacy notices; consider as a practice if you will proactively be contacting patients to inform them of what is changing; and register type1 opt outs in a timely fashion. 

See also these key documents/links 

Data Provision Notice (DPN) 

Privacy statement 

Patient information on GPDPR 

Transparency notice 

Type 1 opt-out form 

Next steps for GPs 



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