COVID-19: 15th May COVID-19 round-up for primary care
Yesterday evening, in response to advice from the independent JCVI, the Government set out further action aimed at tackling rising cases of the COVID-19 B1.617.2 variant.
The instruction is 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. This is to ensure people across the UK have the strongest possible protection from the virus at an earlier opportunity.
Those aged under 50 will continue to get their first dose, with their second dose at 12 weeks, as has been the deployment strategy so far.
The immediate priority for all delivery models is to ensure that there is sufficient capacity for those who need to book a first dose or re-book a second dose appointment. For those in cohorts 1-9 who have already received a first dose of a vaccination and have an appointment booked for a second dose in the next 10 days (up to and including 24 May) no action is required and appointments should continue as scheduled.
For those in cohorts 1-9 who have their second dose appointment scheduled on or after 25 May the following action now needs to be taken:
For PCN-led Local Vaccination Services: all second dose appointments for those in cohorts 1-9 scheduled on or after 25 May (where that is more than 8 weeks after their first dose) should be brought forward. Plans to do this should include working with your ICS to bring in additional workforce to run additional clinics. In addition to using the stock already in the network, revised second dose supply delivery schedules will be communicated shortly in the usual way. If PCN sites have exhausted all opportunities to bring forward second doses and still have insufficient capacity to bring forward second dose AstraZeneca clinics, they may wish to redirect patients to book via the NBS.
Further details can be found in this letter.
Additional financial support, as well as supporting communications materials, will be made available to primary care network-led LVS to cover the administration costs of this activity.
Further information will be shared with practices shortly.
Thank you again for all your hard work on the vaccination programme. Over 30 million adults, in England, have received their first vaccine dose, and over 16 million have now had their second jab. You should all be very proud of this amazing achievement.
Best wishes
Nikki and Caroline
COVID-19: 20th May COVID-19 round-up for primary care
Supporting people to access the care they need
It’s been more than a year since the NHS introduced remote triage as the default for accessing general practice, in response to the pandemic, to keep patients and staff safe. We are very grateful to everyone who adapted rapidly to new ways of working, and your continued delivery of the largest vaccination programme we have ever carried out.
Your dedication and hard work has not gone unnoticed, and we are now managing higher levels of demand than ever before. As we ease out of the pandemic we must build on the innovation and achievements, focussing on a primary care service which is right for patients and staff both now and in the future. It is a key ambition of the NHS Long Term Plan that we provide a digital option for every patient, improving fast access to convenient primary care, navigating people to the most appropriate member of the general practice team. 14 new roles have been introduced into PCNs and utilising this expansion of the workforce is critical to the sustainability of primary care. For many of you, this blended approach has been part of your patient offering for a long time.
However, we need to bring patients with us, and although we know over 50% of appointments are now face-to-face, and as GP teams you have been working constantly throughout, some patients have still struggled to get access to their GP. Both Healthwatch and the Patients Association have reported challenges which we cannot ignore.
The message that primary care continues to be open is an important one, because we know that many people over the course of the pandemic have put off seeking medical attention, including for symptoms which could be cancer or other serious conditions. But this message can only be effective if it is matched by people’s experience when they do then try to come forward, or the experience of their family and friends.
With restrictions across wider society easing, we need to keep in step and be accessible, while adhering to IPC guidelines, ensuring the remote triage offer facilitates a balance of online and face to face care. We know that this for some means more change, but this is important for ensuring that patients who do not have easy access to phones or other devices are not disadvantaged in their ability to access care.
Both the BMA and the RCGP have recently called for clarity on next steps in terms of access, and our latest GP Standard Operating Procedure (SOP) provides that, making clear that practices should continue to engage with local populations regarding access models and you should actively adapt your processes as appropriate, in response to feedback. We know that many practices are already providing an excellent balance, offering face to face services and making best use of remote working for those patients for whom this works well, and keeping people safe. This update to the Standard Operating Procedure has been welcomed by patient groups including the Patients Association.
We know this is a complex issue and one size does not fit all, as we discussed in a recent article for Pulse. We hear you when you describe the changing and increasing workload and we want to work with you as the General Practice operating model evolves, to ensure we are supporting our patients and staff in the best possible way, making the best possible use of the skills and expertise of the wider primary care workforce.
As GP teams, working with patients, you are best placed to ensure the best balance for the communities you serve, and we will do all we can to support you through the most difficult time you have experienced.
GPs and every part of the primary care team have responded amazingly to be there for patients during the greatest challenge the NHS has ever faced. Our challenge now is to build on all of that good work and together continue improving primary care for the future, with the mix of remote and face to face appointments we know our patients want and need.
Funding for primary care
We have written to CCGs and ICSs outlining all the funds available to primary care via regions, systems and CCGs. It covers areas including workforce growth and development, technology and practice and PCN resilience and development. This large and vital investment in primary care will help to support general practice both now and in the future. With the onus shifting to recovery, it is now even more important to deliver these transformation programmes, we must all make full use of the funding available. Further guidance on the support on offer is here.
Nikki and Ed
Vaccination programme updates
We are now beginning to accelerate second doses for priority cohorts 1-9 as outlined in our letter published 15 May.
Following advice from the Joint Committee on Vaccination and Immunisation (JVCI), second dose appointments 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. This is to ensure people across the UK have the strongest possible protection from the virus at an earlier opportunity.
This week, 34 to 37 year olds have been invited to book their COVID-19 vaccination through the National Booking Service (online at nhs.uk or by calling 119). People will be contacted by text and will receive a letter later in the week. This phased approach is being taken in line with available supply.
Hospital hubs and PCN vaccination sites should continue to work through vaccination of cohort 11. This is alongside continued action to increase uptake across all eligible cohorts and action set out last week to ensure there is sufficient capacity for those in cohorts 1-9 who need to bring forward their second dose appointment.
Second dose FAQs
The updated set of FAQs on COVID-19 vaccine second doses have been published. Changes reflect recent JCVI and MHRA advice and include:
- the newly recommended second dose interval of 8 weeks (56-63 days) for people in priority cohorts 1-9;
- updated situations where it may be appropriate to give a different vaccine for the second dose than was given for the first.
Extra support for PCN-led sites
We have issued a letter to all PCNs and General Practices today setting out the support available to PCN groupings following the change in advice on the second dose interval for people in priority cohorts 1-9. This includes:
- an additional payment of £1,000 for each PCN grouping for rescheduling second dose appointments on or after 25 May in line with the revised guidance;
- signposting to a template patient letter, script, text message and website copy to help with rescheduling appointments;
- asking CCGs and ICSs to offer all possible support, including for Lead Employers to work with PCN groupings to help them drawdown additional workforce capacity from national supply routes.
Updated Enhanced Service Specification
We have updated the General Practice COVID-19 vaccination programme 2020/21 Enhanced Service Specification to reflect the revised JCVI guidance on second dose appointments. The changes have been agreed with the British Medical Association.
Vaccinations for eligible frontline social care workers
All eligible frontline social care workers who have not already had their COVID-19 vaccine can book a vaccination online through the National Booking Service, or by contacting their GP. When you book your vaccine, you will only be offered appointments for vaccines that are recommended for you based on your age, any underlying health conditions, and whether you are pregnant. If anyone has any problems in obtaining a vaccination, they should contact their employer and/or their local authority vaccination lead.
National protocol for COVID-19 Vaccine AstraZeneca (ChAdOx1-S [recombinant]) - updated
Public Health England has published its updated protocol for the administration of COVID-19 Vaccine AstraZeneca (ChAdOx1-S [recombinant]) to individuals in accordance with the national COVID-19 vaccination programme. Version 4 includes amends to:
- identify in the Criteria for inclusion and Cautions sections the preference for an alternative COVID-19 Vaccine for healthy individuals under 40 years of age
- identify in the Cautions section COVID-19 mRNA vaccine BNT162b2 (Pfizer BioNTech) or COVID-19 Vaccine Moderna as the preferred vaccines to offer to pregnant women
- minor rewording of breastfeeding paragraph.
Vaccinating unpaid carers – communications toolkit
DHSC has published an updated communications toolkit to be used by local authorities and carers’ organisations to provide information and advice to unpaid carers in England about the COVID-19 vaccines and how those caring for people vulnerable to COVID-19 can be vaccinated. Links to resources on the COVID-19 vaccines are included.
All eligible unpaid carers who are known to health and care services have now been contacted by the NHS and given information about how they should book their appointment. Unpaid carers who have not already made themselves known to their local health and care services should contact their GP practice to be assessed and registered as a carer so they can receive their COVID-19 vaccination.
