Guidance

Financial wellbeing support offer  16/11/2020

NHSE & Improvement are working with the Money Advice Service to provide all health and social care staff with free and independent financial support. We have a variety of offers that you are able to access or signpost colleagues to who may need this support:

  1. Support line: Free and impartial money advice
  2. Online support: Hub of Resources
  3. Virtual interactive events: Managing Your Money 

If you need support now, you can contact the Money Advice Service for free, confidential and impartial money advice by telephone on 0800 448 0826, via WhatsApp to +44 7701 342 744 and via web chat

NHS and care staff with an interest in rapidly deploying and scaling digital technologies in response to COVID-19 are invited to attend our virtual event to mark the formation of the NHSX national Innovation Collaboratives. Health and care staff will be at the forefront of accelerating digital technology within health and social care and this event will provide an overview of the Innovation Collaborative and the national support available to you and how to get involved.

Monday 23 November, 1pm - 2pm. Antimicrobial Stewardship in Primary Care webinar

Wednesday 25 November, 2pm - 3pmHarnessing health and housing support to improve population health

Abdominal Cancers’ ‘Help Us, Help You’ campaign resource materials  16/11/2020

On Monday 9 November, together with Public Health England, NHSE & Improvement launched the ‘Abdominal Cancers’ phase of the ‘Help Us, Help You’ campaign. This follows the general cancer symptoms campaign that launched on Friday 9 October.

The campaign focuses on abdominal symptoms of cancer (persistent bloating, diarrhoea or discomfort in the tummy area for three weeks or more). These symptoms can be signs of a number of cancers, including oesophageal, stomach, pancreatic, ovarian, colorectal, kidney and uterine. This campaign will encourage anyone who has had any of these symptoms to speak to their GP. The campaign messages will be seen across a full range of communication channels such as TV advertising, social media and regional press. You can access resources for promoting the campaign on the Public Health England Campaign Resource Centre. 

Video consultations – translated resources now available   16/11/2020

Translated versions of ‘Video consulting with your NHS’, a quick guide to video consultations for patients, have been added to our website. This is a visual resource intended to support patients use video technology for their appointments, the guide is relevant to any technology and any clinical setting and is now also available to download in Arabic, Bengali, Bulgarian, Italian, Polish, Punjabi, Romanian and Urdu. 

Primary Care Network (PCN) Development Support Guidance 2020/21  16/11/2020

We have published updated 2020/21 PCN Development Support Guidance building upon the guidance published in 2019/20. It sets out the PCN development priorities for 2020/21 and guidance about utilisation of national £43.7m funding for 2020/21. Funding was made available to integrated care systems (ICSs) and sustainability and transformation partnerships (STPs) in August 2020. It is imperative that this funding is used to support PCN development, and that PCN clinical directors are key parties in discussions about how funding is deployed, alongside their CCG and system.

QOF income protection  16/11/2020

As practices will be aware, Quality and Outcomes Framework (QOF)  2020/21 has been revised to reflect the impact of COVID-19 on general practice. We recognise that practices need to reprioritise aspects of care not related to COVID-19 and the QOF requirements have been modified for 2020/21 to support this and to help release capacity in general practice. Practices and commissioners have been asked to work together to confirm that any population stratification is clinically appropriate for their local population.  Clinical system suppliers have recently updated QOF indicators and prompts. In some instances, this may have impacted on practices’ records of progress to date. Practices should be reassured that the indicators affected by this update are those that are subject to income protection as outlined in 2020/21 QOF guidance.  Practices are not expected to re-code or re-review patients for indicators affected by this system update, unless there is a clinical need to do so.

Supporting the NHS during resurge phases of COVID-19 and the ongoing pandemic: managing the training workforce  16/11/2020

Health Education England (HEE) has published guidance that outlines the process for governing HEE’s decisions, operational activity and management of general practice students and trainees during a resurgence of COVID-19 and expected winter pressures over the first quarter of the academic year. The guidance draws on HEE’s experience and lessons learned from the first wave of the pandemic in March to July 2020.

COVID Oximetry @home standard operating procedure published   16/11/202

NHSE & Improvement published the COVID Oximetry @home standard operating procedure on 12 November 2020. It is recommended that all clinical commissioning groups (CCGs) should put in place a “COVID Oximetry @home” model as rapidly as possible during November 2020, further to guidance on the use of pulse oximetry first published in June 2020.

Further information on the COVID-19 Vaccination Programme  16/11/2020

This workspace provides a community for colleagues across the country who are working to deliver the COVID-19 vaccination in primary care. We will be regularly updating the space with resources, webinars, links to key policy document and for you to ask questions, learn and share from others using the discussion forum. If you are not already a member, please register to join the platform using an NHS or similar professional email address by emailing: P_C_N-manager@future.nhs.uk.

Reminder of dates   16/11/202 

  • PCN groupings to advise CCGs of nominated site for designation Tuesday 17 November
  • CCGs complete designation assessment process for nominated sites and submit recommendations to NHS England and NHS Improvement regional teams Thursday 19 November.
  • NHS England and NHS Improvement decision communicated to PCN groupings along with formal commissioner offer to practices with access to an approved designated site to sign up to deliver the Enhanced Service Monday 23 November

All the documents associated with the above can be found on our website.

The CQC have also published some advice on registration requirements for those delivering the flu and COVID-19 vaccination programmes.

We will be hosting a webinar for primary care networks, general practice, CCGs and community pharmacy on Wednesday 18 November at 1pm to talk in more detail about the COVID-19 vaccination programme. If you have previously signed up to our general practice webinars, there is no need to sign up again but for those who have not joined us before, please register for this event.

General Practice – COVID-19 updates and guidance 16/11/2020

The Chief Medical Officers, the General Medical Council and Academy of Medical Royal Colleges and ourselves, have written to doctors including general practice providing a COVID-19 wave two update and collective support to the profession. Similarly, the Chief Dental Officers have written to the dental profession with a similar message and a letter from the Chief Pharmaceutical Officer will be sent to community pharmacy colleagues.

GatewayC webinar on Improving Early Diagnosis   12/11/2020

Register here to join us for a FREE GatewayC webinar on Improving Early Diagnosis and collect 1 hour of CPD. This webinar will be held on Wednesday 18th November, 13:00 - 14:00.

In this webinar, our speakers will explore the challenges surrounding the early diagnosis of cancer in general practice and relevant decision-making tools.

COVID-19 National Guidance Updates – List and Briefing   12/11/2020

The attached document (attachment 3 - is available fron the primary care team  is being developed as a ‘one stop shop’ for all national guidance relating to COVID-19.  This will brief practices about guidance that has been newly published or updated. 

Dates for your Diary  12/11/2020

Implementation support for COVID-19 remote pulse oximetry services. CCG colleagues are invited to attend one of two national webinars:

Monday 23 November, 1pm - 2pm. Antimicrobial Stewardship in Primary Care webinar 

Wednesday 25 November, 2pm - 3pmHarnessing health and housing support to improve population health 

NHS Volunteer Responder programme update webinars. Fortnightly webinars are being held to provide regular updates on the NHS Volunteer Responder programme. 

Various dates - REACT Mental Health Conversation training 

Cervical screening tips for communicating with patients 12/11/2020

blog and short film has been developed by Jo’s Trust in collaboration with NHS England and NHS Improvement and Public Health England colleagues. For any queries, please contact england.phs7apmo@nhs.net. 

Continuing to support people with a learning disability   12/11/2020

Delivering proactive health checks for people with a learning disability continues to be an important activity to promote the health of this group of patients. 

Healthcare professionals should discuss with the patient (if considered to have mental capacity), their carer or their advocate the most suitable and safe way to conduct a health check. Where this can be delivered safely on a face to face basis this should continue.  Where this is not possible, or where the patient has other medical conditions which require them to shield or socially isolate, the review could be conducted remotely with as much of the physical review completed as is practicable in these circumstances. 

Practices should use their clinical judgement and knowledge of the patient, together with the advice of family or other carers, in determining whether they would be able to participate in a remote review. Reasonable adjustments should be made to accommodate the needs of patients and carers as well as considering the capacity and capability of the GP practice whilst working in different ways. Where practices can demonstrate that they are taking an individual approach to health check delivery and are completing as much of the prescribed elements as practicable then they will be eligible for payment under the DES during 2020/21. 

The delivery of care to this group of patients is further supported this year through the amended QOF Quality Improvement requirements and an additional incentive for health check coverage available to the Primary Care Network through the Investment and Impact Fund. 

Network Contract DES: Additional Roles Reimbursement Scheme claim form update   12/11/2020

Following the addition of nursing associate and trainee nursing associate roles to the Additional Roles Reimbursement Scheme under the Network Contract DES from 1 October, the ARRS claim form has been updated to allow PCNs to claim reimbursement for these roles.

PCNs are reminded that monthly claims must be submitted to the commissioner for review and approval on a timely basis. Commissioners must ensure that local processes are as straightforward as possible, with clear deadlines for submission of claims, and claims should be processed promptly. 

Video Consultations  12/11/2020

Please find below a link about video consultations from BMJ which you may find useful. 

https://best.barnsleyccg.nhs.uk/news/medicines-managment-newsletter/video-consultations-in-primary-care/119611

 Reporting positive Covid cases in staff to PHE    12/11/2020

Following a recent query from a practice please note: if the member of staff (or patient) has not been in the practice setting (e.g. on leave) and there are no potential health care worker contacts or patient contacts, you do not need to let PHE know (household/social contacts should be managed by NHS T&T).  However, please continue to inform the primary care team of ANY positive cases in staff members. 

COVID-19: Reviewing High Risk (Shielding) Patients  12/11/2020

The latest update to the SPL in EMIS Web is SPL29, which has been added to EMIS Web GP systems in England this afternoon. 

SPL29 includes patient additions and patient subtractions; all patients in this cohort have been identified centrally by NHS Digital and NHS England, and will be contacted by them – practices do not need to contact any patients identified within SPL29, unless clinical review indicates that they should be considered as either moderate or low risk instead.

In addition, practices are encouraged to continue to add patients to the list themselves, where indicated 

Remember not every practice will receive lists of affected patients in every SPL cohort. 

How are these patients identified in my system?

SPL29 may include up to two new lists of patients, added to the folder titled ‘EMIS Health: COVID-19 searches’ within your local Population Reporting folders (not in the EMIS Library). 

They will not create any lists where there are no patients to populate those - as this process matures, the number of patients identified obviously decreases. It is possible your practice may only have one of the lists described below, or may not receive any of these lists, in which case you have no affected patients in either cohort. 

  • The list of new SPL29 additions is titled ‘Shielding patients identified centrally, added 9th November’.
  • The list of SPL29 subtractions is titled 'Patients removed from SPL 9th November'

These lists will be in the following location in your EMIS Web system:
EMIS Ball > Reporting > Population Reporting > *your practice name* > EMIS Health: COVID-19 searches 

 The SystmOne (TPP) searches can be found in the COVID folder:

- LOT 26 High Risk COVID-19 code added 09/11/20 without a more recent Low Risk or Moderate Risk code 

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news. 

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022  

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT 

 

 

COVID vaccination programme12/11/2020

Rapid progress is being made on the development of a Covid vaccine and primary care will play a critical role in the national roll out. NHS England and NHS Improvement has agreed with the BMA General Practitioners Committee that a vaccination service will be nationally commissioned as an enhanced service (ES).

The plans for deployment of a COVID-19 vaccine builds on the tried-and-tested rollout plans for influenza vaccine, which NHSE deploy every autumn. Given the uncertainty over whether, and when, a vaccine may be approved, they are planning to be ready from any date from December. 

Where a practice agrees to participate in this enhanced service, it will need to work collaboratively with other practices to deliver vaccinations in PCN groupings, and it is anticipated at least one site being designated initially per PCN grouping. Those sites will need to collaborate with other community vaccination providers, as part of a co-ordinated local approach. 

NHSE are asking PCN groupings who wish to participate to submit (using the specified form) to the CCG no later than Tuesday 17 November 2020. 

Further details on the designation process and the key features of the specification are on NHSE website.  NHSE know practices will have lots of questions and will do all that they can to support practices to deliver one of the most important vaccine programmes the NHS has ever delivered. 

NHSE will be holding a webinar on 12 November at 7pm to talk you through the initial planning.  Community pharmacy will also be playing an important role in the vaccine programme and further information will be available on this in the coming days. 

Thank you in advance for your commitment and support. 

Vaccination and GP funding letters 12/11/2020

Please see attached (2a, 2b and 2c) the following documents: 

They can also be found on the NHSE website here: https://www.england.nhs.uk/coronavirus/publication/preparedness-letters-for-general-practice/

Immediate Actions in response to mink-variant SARS-CoV-2 virus in Denmark - List 12/11/2020 

Any patient who has a travel history to Denmark in the proceeding 14 days and develops COVID-19 symptoms must be transported by ambulance to ED with a pre-alert.  These patients require strict isolation.

This advice has been obtained from PHE clarifying the CMOs notification on 7th November.  Please see attached (1) for further information.

Guidance to support care homes to order medications through proxy access  9/11/2020

New step-by-step guidance from the NHS and LGA explains what a care home, GP practice and pharmacy needs to do to set-up care staff with proxy access to a resident’s GP online account so they can quickly, safely and securely order resident’s medications online. The guidance, linked to TPP and EMIS GP practice systems, also covers the necessary security and governance requirements. 

Directed Enhanced Service Specification (DES) for flu updated  9/11/2020

An updated Directed Enhanced Service Specification (DES) for the seasonal flu and pneumococcal vaccination programme 2020/21 has been published. This version (version 3) replaces the version published in September, and has been updated in part 2 to reflect the arrangements for practices accessing, administering and claiming payment for administering centrally supplied flu vaccines in line with the process laid out by the Department of Health and Social Care

National guidance on Long COVID   9/11/2020

Last month NHS England and NHS Improvement launched its five-point plan to support people with Long COVID. NICE, SIGN and RCGP have now published the scope for the forthcoming guideline on the long-term effects of COVID-19. 

Guidance to assist local healthcare systems to establish post-COVID assessment clinics has been published on NHSE website. 

Work is underway and an update will be provided in due course for clinics to be available to patients diagnosed with long COVID, whether they were hospitalised or not, enabling physical, cognitive and psychological assessments of those experiencing enduring symptoms. 

In addition, guidance is available for the Your COVID Recovery platform, a digital, interactive and tailored recovery programme which has been developed by experts to provide rehabilitation support for patients to manage their recovery at home. 

Shielded Patient List update - November 2020 9/11/2020

Updated guidance has been issued by NHS England and NHS Improvement regarding clinically extremely vulnerable patients (i.e. those on the Shielded Patient List (SPL)).

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0830-i-gp-update-update-clinically-extremely-vulnerable-2nov.pdf

See attached (attachment 1) summary of the actions that practices have been asked to undertake regarding the SPL.

New guidance helps primary care teams deliver best CVD services during the pandemic 5/11/2020

A new practical guide has been produced to help primary care teams across England overcome limitations created by COVID-19 and continue to deliver quality cardiovascular disease (CVD) prevention services. The new guidance, produced in a collaboration between the Oxford Academic Health Science Network (Oxford AHSN) and the Getting It Right First Time (GIRFT) programme, is co-authored with the Primary Care Cardiovascular Society (PCCS) and aims to signpost primary care professionals to the right resources to address these and related issues. For further information visit:
https://pccsuk.org/2020/en/node/newsitem-new-guidance-helps-primary-care-teams-deliver-best-cvd-services-during-the-pandemic

Virtual Issues & Answers Conference  5/11/202

Please see attached (2) flyer for further information about the conference.  

Dates for Your Diary 5/11/2020

Thursday 5 November, 4.30pm - 5.30pm. NHS dentistry webinar with the Chief Dental Officer

Thursday 5 November, 5pm - 6pm. General Practice webinar with Ed Waller and Nikki Kanani. To attend please ensure you register by 12pm on 5 November. If you have registered for the previous two webinars you will not need to register again as we are using a rolling registration system. 

Monday 9 November, 11.30am - 12.30pm. Integrated Care webinar series: The future of place – planning recovery in partnership

Wednesday 11 November, 9am - 8pm. NHS Confederation: PCN Network virtual conference

Wednesday 11 November, 12.30pm. Supporting CVD Prevention in Primary Care

Thursday 12 November, 6pm - 7pm. Community pharmacy webinar with Keith Ridge and Ed Waller. To attend please ensure you register by 12pm on 12 November.

C030: letters to trusts and GP practices about clinically extremely vulnerable people 5/11/2020

As you will be aware, on 31 October the Government announced new national restrictions to help control the spread of the virus that will apply from 5 November. The reason we are writing is that the government, advised by the Chief Medical Officer: 

  • will be updating the advice and support available for people who are clinically extremely vulnerable alongside the new national restrictions
  • has identified two additional groups of people who should now be considered as clinically extremely vulnerable to COVID-19:
  • has highlighted the urgency of clinicians completing the process of reviewing – and, where appropriate, removing – children and young people on the Shielded Patient List (SPL).
  1. adults with stage 5 chronic kidney disease 
  2. adults with Down’s syndrome

We know this is an extremely challenging time for practices. However, given the vulnerable nature of those on this list, we are asking your practice to take the following specific actions: 

  1. Familiarise yourself with the updated guidance for clinically extremely vulnerable people when it is published here. Publication is expected imminently and will be communicated to all patients on the SPL by letters, which we expect will begin arriving from the middle of this week. These letters will provide evidence for Statutory Sick Pay purposes if required. We will seek to provide primary care with any additional information following that publication here
  1. Immediately review any children and young people remaining on the SPL who your practice added and, where appropriate, remove them from the SPL. You should also plan to urgently respond to calls from parents and guardians of children on the SPL seeking a review – parents and guardians will be advised by Government to contact their child’s specialist or their GP, if they are still unsure whether their child should remain on the SPL.  

We want to highlight that the vast majority of children and young people who have been reviewed to date using the Royal College of Paediatrics and Child Health (RCPCH) guidance have been found to be no longer considered clinically extremely vulnerable. Given the detrimental impact to children’s wellbeing of following unnecessary additional restrictions, it is important we complete this exercise as soon as possible.  

  1. Urgently identify, contact, and flag adults with Down’s syndrome. You may also want to take the opportunity to ensure they receive a flu vaccine and to schedule an annual health check if these are needed (Annex 2).  
  1. Ensure you continue to maintain the SPL by adding a high-risk flag for patients you identify as being clinically extremely vulnerable, and notifying the patient of their status and the advice they should follow. Information on maintaining the SPL can be found on the NHS Digital website. 

For the full details, the information can be found on the NHS England letter sent on the 2nd November 2020:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0830-i-gp-update-update-clinically-extremely-vulnerable-2nov.pdf or attached (3). 

Expert advice and support for workforce planning templates 2/11/2020

A series of resources have been created by the teams at Healthy London Partnership and Health Education England to help Clinical Directors complete the Workforce Planning Templates returns due at the end of October 2020. The resources, which are available on the HLP website includes a podcast with detailed information for Clinical Directors, advice around workforce planning in identifying the health needs of the population and how to utilise different professional groups to meet the needs of the population.

The information also includes links to workforce planning templates and resources and guidance around the Additional Roles Reimbursement Scheme roles as well as information on how to access support from local training hubs.

DUK update mailing - Life Beyond Diabetes, Type 1 and tech 2020, Cheque for tech and #NailingDiabetes  2/11/2020

Please see attached update from Diabetes UK. (attachment  5)

Supporting CVD Prevention in Primary Care  11 November, 12:30-14:00  2/11/2020

Join UCL Partners and the British Heart Foundation to learn more about the resources available to help primary care teams support patients to prevent CVD, using a 'virtual first' approach.  Speakers will include Dr Matt Kearney, Director for CVD and Primary Care Innovation at UCL Partners and other primary care clinicians, who will share examples of changes they have made to practice since the start of the pandemic, how they have implemented the changes and what lessons there are for others looking to take a similar approach.  Find out more and register to attend

Primary Care Outbreak Management   2/11/2020

Please see attached (attachment 1a and 1b) COVID-19 Outbreak Management Plan for Primary Care, Community Pharmacy and Optometry practices and also a Public Health England flow chart regarding what to do if you have a case of COVID-19 in your setting.

COVID-19: Reviewing High Risk (Shielding) Patients 2/11/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients was currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.   

The latest update to the SPL in EMIS Web is SPL28, which includes patient additions and patient subtractions; all patients in this cohort have been identified centrally by NHS Digital and NHS England, and will be contacted by them – practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate or low risk instead. 

In addition, practices are encouraged to continue to add patients to the list themselves, where indicated 

Remember not every practice will receive lists of affected patients in every SPL cohort. 

How are these patients identified in my system?

SPL28 may include up to two new lists of patients, added to the folder titled ‘EMIS Health: COVID-19 searches’ within your local Population Reporting folders (not in the EMIS Library). 

They will not create any lists where there are no patients to populate those - as this process matures, the number of patients identified obviously decreases. It is possible your practice may only have one of the lists described below, or may not receive any of these lists, in which case you have no affected patients in either cohort. 

Following customer feedback, we have altered the naming convention for both new and existing SPL lists to make these easier to identify. 

  • The list of new SPL28 additions is titled ‘Shielding patients identified centrally, added 29th October 2020 (SPL28)’.
  • The list of SPL28 subtractions is titled 'Patients removed from SPL 29th October 2020 (SPL28)'

These lists will be in the following location in your EMIS Web system:
EMIS Ball > Reporting > Population Reporting > *your practice name* > EMIS Health: COVID-19 searches 

 The SystmOne (TPP) searches can be found in the COVID folder:

- LOT 25 High Risk COVID-19 code added 30/10/20 without a more recent Low Risk or Moderate Risk code 

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news. 

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022  

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT 

CVDPREVENT: A national primary care audit to identify opportunities and drive improvements    2/11/2020

CVDprevent is a national primary care audit to support professionally led quality improvement in the diagnosis and management of six high risk conditions that cause stroke, heart attack and dementia: atrial fibrillation (AF), high blood pressure, high cholesterol, diabetes, non-diabetic hyperglycaemia and chronic kidney disease.

The audit data will support practices and Primary Care Networks (PCN) to identify gaps, inequalities and opportunities for improvement in clinical care. It is expected to provide the core data to assist PCNs meet the requirements of the PCN Directed Enhanced Service for CVD prevention. 

NHSE encourage practices to participate in this new service as it will support the delivery of the PCN CVD specification due for release next year.  This is a participation only service, no data will be recorded in CQRS. Practices should have received the Data Provision Notice outlining the collection and further information can be found on the CVDPREVENT web page 

Workforce Position Spreadsheet 2/11/2020

All practice managers have been sent an email to inform them that we will be reinstating the Workforce Position Spreadsheet. The Workforce Spreadsheet should be submitted to the Primary Care Team Inbox (barnsleyccg.primarycare@nhs.net) by 1pm every Monday, commencing Monday 2 November 2020. 

If you are a practice manager and have not received this email please can you let us know as soon as possible by contacting the Primary Care Team. 

DON’T BE A CONTACT 2/11/2020

All practice managers have been sent an email to inform them that we will be reinstating the Workforce Position Spreadsheet. The Workforce Spreadsheet should be submitted to the Primary Care Team Inbox (barnsleyccg.primarycare@nhs.net) by 1pm every Monday, commencing Monday 2 November 2020. 

If you are a practice manager and have not received this email please can you let us know as soon as possible by contacting the Primary Care Team. 

With infection rates rising practices may want to consider revisiting their work place risk assessment to ensure that, if a member of staff develops symptoms, colleagues do not become contacts:

The definition of a contact is any of the following without appropriate PPE**:

  • Direct face-to-face contact (e.g. talking) for any length of time

Or

  • Being within 1m for 1 minute or longer

Or

  • Being within 2m for 15 minutes or longer

 **WEARING ONLY A FACE MASK DOES NOT CONSTITUTE APPROPRIATE PPE

Key message is therefore to maintain social distancing measures (2 metres) whenever possible – both in the workplace and outside of work:

  • Do not have face to face meetings, unless 2m apart
  • Do not car share, if possible – you would be classed as a contact should a co-passenger be positive
  • Do not gather in communal areas, e.g. at lunchtime, unless 2m distance can be maintained
  • Consider everybody to be a potential carrier of the virus and do not be a contact

Staff MUST NOT attend work if they develop any of the 3 Covid-19 symptoms - they must self-isolate immediately and NOT wait until they have been tested or have their result.  Some of the most infectious period for Covid-19 is in the 48 hours before symptom onset.  

Further information regarding workplace assessment, including templates, can be found on HSE website here: https://www.hse.gov.uk/coronavirus/working-safely/index.htm  

The Infection Prevention Control (IPC) Specialist nurses at BHNFT are available for advice and can be contacted on 01226 432825 (Monday-Friday 8-5) or email bdg-tr.infectioncontrol@nhs.net

To stop the spread of the virus remember: Hands. Face. Space.

Please refer to the Primary Care Outbreak Management SOP (attachment 1a) for further information on IPC, self-isolating, getting tested and remember to contact the primary care team to inform them of any staff that are needing to self-isolate or that test positive for Covid-19.

Workforce data – reminder to practices   29/10/2020

From October 2020, NHS Digital will be publishing general practice workforce statistics on a monthly basis. The next data extraction will be on 31 October; please could practices ensure that they have recorded any changes in the last month, including any locum support, on the National Workforce Reporting System (NWRS) before the deadline. More information on how to register and use the NWRS and the latest published statistics are available on the NHS Digital website

COVID-19: Reviewing High Risk (Shielding) Patients  29/10/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  

The latest update to the SPL in EMIS Web is SPL27, which includes patient additions and patient subtractions; all patients in this cohort have been identified centrally by NHS Digital and NHS England, and will be contacted by them – practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate or low risk instead.

In addition, practices are encouraged to continue to add patients to the list themselves, where indicated

Remember not every practice will receive lists of affected patients in every SPL cohort.

How are these patients identified in my system?

SPL27 may include up to two new lists of patients, added to the folder titled ‘EMIS Health: COVID-19 searches’ within your local Population Reporting folders (not in the EMIS Library).

They will not create any lists where there are no patients to populate those - as this process matures, the amount of patients identified obviously decreases. It is possible your practice may only have one of the lists described below, or may not receive any of these lists, in which case you have no affected patients in either cohort. 

Following customer feedback we have altered the naming convention for both new and existing SPL lists to make these easier to identify. 

  • The list of new SPL27 additions is titled ‘Shielding patients identified centrally, added 26th October 2020 (SPL27)’.
  • The list of SPL27 subtractions is titled 'Patients removed from SPL 26th October 2020 (SPL27)'

These lists will be in the following location in your EMIS Web system:
EMIS Ball > Reporting > Population Reporting > *your practice name* > EMIS Health: COVID-19 searches

 The SystmOne (TPP) searches can be found in the COVID folder:

- LOT 24 High Risk COVID-19 code added 26/10/20 without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Workforce Position Spreadsheet 29/10/2020

All practice managers should have received an email today to inform them that we will be reinstating the Workforce Position Spreadsheet. The Workforce Spreadsheet should be submitted to the Primary Care Team Inbox (barnsleyccg.primarycare@nhs.net) by 1pm every Monday, commencing Monday 2nd November 2020. 

If you are a practice manager and have not received this email please can you let us know as soon as possible by contacting the Primary Care Team.

Supporting the health and wellbeing of our NHS people in primary care  26/10/2020

NHS England & NHS Improvement has produced a document (attachment 3) outlining the national health and wellbeing support offer that is available to all NHS staff, including those working in primary care. Please do promote and share this resource and encourage staff to access the appropriate help when needed.  This can be accessed via FutureNHS Primary Care Networks platform.  If you are not a member, please email P_C_N-manager@future.nhs.uk.

CQRS website update  26/10/2020

As per previous communication, CQRS have been making some additional improvements to the CQRS welcome page since it launched on 12 October.

The CQRS service has remained available through all of the usual links while this work was undertaken, and they can now confirm that no further changes are planned and so there should be no further downtime.

The welcome page can be found at welcome.cqrs.nhs.uk and provides a wealth of information relating to CQRS, as well as access to the CQRS service. Going forwards, it will be the central point of information for all developments on CQRS local. 

Sharing your SystmOne patient records with South West Yorkshire Partnership NHS Foundation Trust (SWYPFT) 22/10/2020

In April 2020, a notice was issued under the Health Service Control of Patient Information Regulations (2002). This meant that SWYPFT had to share service user’s health records, via SystmOne, with other health and care organisations to support them in providing care and treatment in relation to coronavirus.

SWYPFT has had lots of positive feedback from GP’s and primary care staff that the record sharing has been very helpful throughout the Covid-19 crisis.

In March 2021, the sharing of health records will be reviewed and potentially revoked nationally by the Health Secretary. When these temporary rules cease, organisations such as SWYPFT will return to a ‘explicit consent’ sharing model; where only those records of patients who have approved consent for sharing out can be seen by other services such as GP practices.

In order to prevent challenges down the line, health and care services now need to work towards business as usual solutions for continued sharing of patient records between different services.

SWYPFT have already begun this process, writing out to all service users to record their consent, alongside staff having discussions and logging service user’s consent choices.

GP practices are therefore encouraged to do the same with their patients.  Please remember to ask and record your patient’s preferences for sharing their primary care records with other services like SWYPFT.

Dates for your Diary 26/10/2020

Thursday 29 October, 4pm - 5pmDigital Primary Care Influenza webinar 

Wednesday 11 November, 9am - 8pm. NHS Confederation: PCN Network virtual conference

NHS Volunteer Responder programme updates - new webinars

Fortnightly webinars are being held to provide regular updates on the NHS Volunteer Responder programme. 

Looking after your own Health and Wellbeing 22/10/2020

Did you know that NHS England and NHS Improvement have created a range of support offers to suit different needs for staff’s health and wellbeing. Please share the links with your team and make full use of the tried and tested resources available from Our NHS People, as well as NHS Employers.

CQC Transitional Regulatory Approach  22/10/2020

All practices should have received a letter from the CQC regarding the adoption of their Transitional Regulatory Approach from this month. Please see link below for information.  

https://www.cqc.org.uk/news/stories/joint-statement-cqc%E2%80%99s-chief-inspectors-deputy-chief-inspector-lead-mental-health

Additionally, please find below a link to information of external consultation and information sharing events relating to the transitional regulatory approach.

https://www.eventbrite.co.uk/e/now-next-future-our-transitional-regulatory-approach-strategy-webinars-tickets-122964013675

First Contact Practitioners and Advanced Practitioners in Primary Care: (Musculoskeletal) A Roadmap to Practice 22/10/2020

This Primary Care Educational Roadmap was developed by Health Education England. It provides a clear educational pathway from undergraduate to advanced practice for clinicians wishing to pursue a career in primary care.

New GP Payment and Pensions system 22/10/2020

Practice payments are currently calculated by a system called NHAIS (the National Health Application and Infrastructure Service). This system is at the end of its working life and needs to be replaced. We commissioned Primary Care Support England (PCSE) (Capita) to build a replacement system to calculate practice payments including Global Sum (GSUM), vaccinations and immunisations payments.  

The new payments system was due to go live in October 2020 but PCSE has now put this back. The final assurance tests identified some areas for improvement and PCSE are working on these before launching the new software. We will keep you updated on the new launch date over the coming weeks. Practices do not need to take any specific action at this time – the existing payments systems and processes will continue for the time being.

A small number of practices have been approached by PCSE to undertake a reconciliation of their practice patient list. This work will continue to ensure the most accurate patient data is available when the system launches and we, therefore, ask those practices contacted to continue to engage with this exercise.

NEW WEBINAR: Asthma 2020 - What are the experts saying? 22/10/2020

Join us for an hour of live interactive learning on Thursday 29th October at 7.00pm.

Here's your opportunity to hear what are the key messages the experts have been talking about and ask your questions: 

  • What's the latest advice from GINA?
  • What's the latest research telling us about prevention, treatment and diagnosis?
  • Does obesity make a difference?
  • What's the best way to deliver asthma care during the pandemic?

PLUS

  • Downloadable factsheet with practical top tips
  • CPD certificate for live attendees

Upcoming Webinars   19/10/2020

Tuesday 20 October, 2pm – 4pm. COVID-19 Infection Prevention and Control in care homes

Tuesday 20 October, 8pm - 9pm. Taking A Break From Covid-19: How to Escape, Unwind & Reboot

Thursday, 22 October, 1.45pm – 3pm. Managing hypertension in primary care.  This webinar will outline public health and general practice perspectives on tackling hypertension during COVID-19, including a case study from Cheshire and Merseyside Health and Care Partnership. If you have any queries on the session, please email: england.clinicalpolicy@nhs.net.

Wednesday 11 November, 9am - 8pm. NHS Confederation: PCN Network virtual conference

NHS Volunteer Responder programme – regular updates webinars

Update on complaints (KO41b form) data collection for 19/20 period and refining approach for future years 19/10/2020

It is important that general practice and dentistry continue to record and manage complaints effectively during this period. However, in light of the current pressures faced by general practice and dentistry in responding to COVID-19, NHS Digital has confirmed that the annual information requirement relating to the 19/20 period will not be collected as usual. Instead, we encourage you to continue using the information you collect locally for local service improvement purposes.

NHS Digital is planning to improve and refine the data collection and the reporting method for future years. If you would like to help shape the revised approach, please contact: nhs.comp@nhs.net.  

COVID-19 Outbreak Management Plan for Primary Care, Community Pharmacy and Optometry practices 19/10/2020

Please find attached a copy of the Outbreak Management SOP for Primary Care (attachment 4a) and Summary (attachment 4b)

This document has been developed by the CCG in collaboration with BMBC/PHE and NHSE/I and includes the following:

  • Key Guidance
  • Practice planning
  • Symptoms of Covid-19
  • What to do if a staff member becomes unwell with Covid-19 symptoms at home
  • What to do if someone becomes unwell with Covid-19 symptoms in a health setting
  • How to get a test
  • What to do if there is a confirmed case of COVID-19
  • Close contacts
  • What to do in the event of an outbreak
  • Confidentiality
  • Contact details

Please note: As COVID-19 is a rapidly evolving situation; guidance may change at short notice. Please check the latest date and version of this guidance here or contact the CCG Primary Care team.

MHRA - Medical Devices Safety Bulletin  19/10/2020

This is a new, regular bulletin from MHRA to inform health and care professionals in the UK of new or ongoing safety issues with medical devices.

This forms part of the changes to MHRA safety messaging highlighted in CHT/2020/002 issued on 17 September.  Access this bulletin

Call for members to join the NHS Race and Health Observatory Board  19/10/2020

The NHS Race and Health Observatory, hosted by the NHS Confederation, is a new group who will identify and tackle the specific health challenges facing people from BAME backgrounds. Following a meeting with stakeholders on 28 September, applications to join the board panel are now open. 

The group is asking for applications from a variety of backgrounds – community representatives, academics, healthcare leaders and service providers – to help deliver their ambitious work programme. Further information regarding Board membership applications is available online.

Discussion at the stakeholder meeting also identified the need for an Academic Reference Group, to provide focused advice and support. More information about how to join this group will be circulated in due course.   

COVID-19: Reviewing High Risk (Shielding) Patients  19/10/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  

The latest update to the SPL in EMIS Web is SPL26, Which includes patient additions and patient subtractions; all patients in this cohort have been identified centrally by NHS Digital and NHS England, and will be contacted by them – practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate or low risk instead.

In addition, practices are encouraged to continue to add patients to the list themselves, where indicated

Remember not every practice will receive lists of affected patients in every SPL cohort.

How are these patients identified in my system? 

SPL26 may include up to two new lists of patients, added to the folder titled ‘EMIS Health: COVID-19 searches’ within your local Population Reporting folders (not in the EMIS Library).

They will not create any lists where there are no patients to populate those - as this process matures, the amount of patients identified obviously decreases. It is possible your practice may only have one of the lists described below, or may not receive any of these lists, in which case you have no affected patients in either cohort. 

  • The list of new SPL26 additions is titled ‘Shielding patients identified centrally, added 14th October 2020 (SPL26)’.
  • The list of SPL26 subtractions is titled 'Patients removed from SPL 14th October 2020 (SPL26)'

These lists will be in the following location in your EMIS Web system:
EMIS Ball > Reporting > Population Reporting > *your practice name* > EMIS Health: COVID-19 searches

 The SystmOne (TPP) searches can be found in the COVID folder:

- LOT 23 High Risk COVID-19 code added 06/10/20 without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Cardiovascular Disease Prevention Audit   19/10/2020

 “CVDprevent is a national primary care audit to support professionally led quality improvement in the diagnosis and management of six high risk conditions that cause stroke, heart attack and dementia: atrial fibrillation (AF), high blood pressure, high cholesterol, diabetes, non-diabetic hyperglycaemia and chronic kidney disease.  The audit data will support practices and Primary Care Networks (PCN) to identify gaps, inequalities and opportunities for improvement in clinical care. It will provide the core data to assist practices and PCNs meet the requirements of the PCN Directed Enhanced Service for CVD prevention, (scheduled for April 2021) as well as local improvement schemes.”       Dr Matt Kearney, GP and Clinical Lead for CVD prevent. 

We encourage practices to participate in this new service. This is a participation only service, no data will be recorded in CQRS.  We encourage practices to accept the offer of participation by the 30 November 2020, to be included in the first extract.  Practices can still participate after this date, but will not be included in the first extract.

Practices should have received the Data Provision Notice outlining the collection, and further information can be found on the CVDPrevent web page.

Flu data user guidance   19/10/2020

Please see the User Guidance (attachments 3aattachment 3battachment 3cattachment 3d) that has been devised from ICS Flu Board, this process will ensure data is captured accurately and will be followed across SYB.

NHS England & NHS Improvement - advancing Mental Health Equalities Strategy  19/10/2020

Please find the recently published Advancing Mental Health Equalities Strategy.

Supporting the Delivery of the Primary Care Agenda 15/10/2020

Could practice managers and leaders in your PCN benefit from support to develop their skills and management techniques to successfully lead their practices within Primary Care Networks (PCNs)?

HFMA, NAPC and Capsticks have collaborated to create the Diploma in Advanced Primary Care Management - a one-year online masters level programme, designed specifically for practice managers, GP's and other staff who are managing primary care locally and at scale.

The introduction of PCNs has transformed primary care services and presented new opportunities and challenges. This diploma offers those leading on the development and delivery of these networks and models of care robust leadership skills, knowledge and insight to successfully drive the future of primary care.

Find out more:

https://www.hfma.org.uk/qualifications/explore-our-qualifications/advanced-qualifications/detail/diploma-in-advanced-primary-care-management?_

Dates for your Diary  15/10/2020

Thursday 15 October, 5pm - 6pm. General Practice Webinar with Ed Waller and Nikki Kanani. To attend please ensure you register by 12pm on 14 October. If you have registered for the previous webinar on 1 October you will not need to register again as we will now use a rolling registration system.  

20 – 22 October. HETT Leading Healthcare Innovation Summit. This virtual event will consider how both patients and clinicians are adapting to innovative tools and new ways of working towards a digitally connected ecosystem.

Wednesday 11 November, 9am - 8pm. NHS Confederation: PCN Network virtual conference

Flu vaccination public messaging 15/10/2020

Thank you to GP and community pharmacy teams for your work to protect the public through providing flu vaccinations to at risk groups this autumn. Thousands of people have already been vaccinated and many more booked in for their future appointments as the flu season progresses.

Public Health England published new information for the public about flu vaccination supplies and why some people may need to wait for their flu jab last week, along with a leaflet to be shared with the public. Please read and share the materials within your teams and with the public to provide reassurance that sufficient supply is available nationally to vaccinate all eligible patients and to explain the different phases of the supply of vaccine and that there are several types of vaccination.

National flu marketing campaign posters are also available to download. These, along with a briefing, are being delivered to providers. Please use these in line with the supplies of vaccine and proactively communicate to the public with the assets available. Further briefings and updates will be shared via this bulletin as they become available.

Safeguarding Awareness Week 15/10/2020

Can you please share the link to all the SAW events within your organisation and encourage staff to take up this offer.

 https://www.barnsley.gov.uk/services/children-families-and-education/safeguarding-families-in-barnsley/safeguarding-news/safeguarding-awareness-week-events/

https://barnsley.learningpool.com/course/index.php?categoryid=225

Visiting healthcare inpatient settings principles during the COVID-19 pandemic guidance and trigger tool 15/10/2020

C0751 - Visiting healthcare inpatient settings principles during the COVID-19 pandemic, is available from the primary care team.

Change in Password Reset Policy 15/10/20020

Please find attached (2) the Change in password reset policy for your information.

IT Comms October 2020 Newsletter 15/10/2020

Please find attached (1) the BBS IT Services Newsletter October 2020 for your information.

Review of all Children and Young People (CYP) identified as Clinically Extremely Vulnerable 15/10/2020

On 8 July 2020, the Chief Medical Officer for England and NHS Medical Director asked clinicians to review all CYP who had been identified as CEV to COVID-19 and included on the Shielded Patient List (SPL).  This was because only a small proportion of children should still be considered at highest risk during the pandemic and remain on the SPL.

Paediatricians have been reviewing their patients and removing them from the list as appropriate. For those which have not yet been removed, the majority were added by GPs. If they have not done so already, practices are asked to review remaining patients under the age of 18 on the SPL, make contact with the family to review whether they should still be considered clinically extremely vulnerable according to guidance from the Royal College of Paediatrics and Child Health, and adjust the flag in the patient record, marking the person as “moderate” or “low” categories for developing complication from coronavirus disease. If unsure, GPs should request advice from a specialist on whether the patient should be considered clinically extremely vulnerable, using an ‘advice and guidance’ approach where appropriate. Guidance is published here.

Local Covid Alert Level guidance and associated update to guidance for people who are Clinically Extremely Vulnerable (on the Shielded Patient List 15/10/2020

The Government has issued guidance on the new approach to managing outbreaks. Every local area will be assigned a Local Covid Alert Level (medium, high, very high) determining the regulations/guidance that will apply in an area.   

Alongside this, the Government has also published updated guidance on shielding and protecting people who are Clinically Extremely Vulnerable (CEV - those on the Shielded Patients List). This provides advice on additional precautions people at highest risk may wish to take at each Local Alert Level.  

In the future, the government will only reintroduce formal shielding advice in the very worst affected local areas and for a limited period of time. This will only apply to some, but not all, Very High Alert Level areas and will be based on advice from the Chief Medical Officer.

It is essential that everyone who needs to access health services is supported to do so. Individuals who are CEV may be particularly anxious about attending health settings, and this should be taken into account in care planning and in communications about attending appointments and visiting NHS sites.    

We know that practices could be faced with the need to clinically prioritise care for those most in need of support, including those with urgent healthcare needs. We have already described (in our 9 July letter) the local flexibilities that could be made available, subject to commissioner agreement, to support practices to prioritise capacity where that is required. Those arrangements still apply and we would encourage you to have an early conversation with your commissioner if you need further support. Local commissioners will need to liaise with the NHS England and NHS Improvement national team via regions where requests for support relate to the national GP contracts.

We will write again if there is specific action for the NHS.

Invitation to participate in survey to inform Independent Investigation 15/10/2020

Do you have any experience of using the One to One Midwives service? – We need your help!

In July 2019 NHS Commissioners were advised that One to One (North West) Limited had taken the decision that they were unable to continue with their contract to provide community midwifery services and they went into administration on Wednesday 31st July 2019.

 NHS England and NHS Improvement have commissioned Niche Health and Social Care Consulting to complete a wholescale review of this service from the start in 2011 until entering into administration last year.

Did any of your patients receive care and support from this service? We would like to hear from you about your experience of the care and support provided to your patients – this will help to inform the NHS about the provision of future services.

Please complete the questionnaire from the link below.

https://www.surveymonkey.co.uk/r/CF83M26

Diabetes UK 'Let’s talk about feet' webinar 20 October 2020 15/10/2020

Please find attached (5) information about this forthcoming Diabetes UK event that may be of interest.

Long COVID  12/10/2020

Emerging evidence suggests that an estimated 10% of people who contract COVID-19 cannot shake off the effects of the virus months after initially falling ill – a phenomenon described by some as ‘Long Covid’.  Many of you will have already seen patients displaying some of the symptoms: breathlessness, chronic fatigue, brain fog, anxiety and stress linked to Long Covid. Therefore NHS England & Improvement announced a raft of measures being put in place to help affected patients. These will include development of new guidance to support clinicians, including GPs and allied health professionals, as well as investing £10million to help develop multidisciplinary diagnostic services. More services will also be added to Your Covid Recovery from the end of this month.  A ‘Long Covid Taskforce’ will be established to oversee these and further developments and we will keep you updated of progress.

Get Fit First Policy in the current COVID19 environment (v2.0)   12/10/2020

In July the CCG communicated that it had reviewed the Get Fit First for surgery commissioning policy in light of the potential for increased waits for non-urgent elective surgery.  Additional guidance was provided asking GPs to use their clinical judgement and make referrals in parallel with starting the 6 month period of health improvement (being mindful that patients with elevated BMIs might not meet pre-assessment criteria).  

Following the first 3 month review point this arrangement has been extended until the end of March 2021.  Further details are attached (attachment 3).

DHSC flu stock guidance for GP’s  12/10/2020

Please see the attached DHSC flu stock guidance 09.10.2020 for GP’s (attachment 2).

Regional COVID-19 Incident Coordination Centre, North East and Yorkshire, NHS England and NHS Improvement, Email: england.eprrney@nhs.net

Phone: 07702404046

Operating Hours: Mon-Fri 08:00-18:00

                                Sat-Sun 09:00-16:00

Learning from Hospital Onset Covid-19 Outbreaks in NHS Services  12/10/2020

In the current context of rapidly increasing rates of COVID-19 in the community NHS England & Improvement thought it would be helpful to share regional learning in relation to COVID-19 outbreaks in NHS services. Please note the recurrent themes outlined in the attached letter (attachment 1) and disseminate this with colleagues across your organisation to reinforce key messages to minimise risk to both staff and patients.

contact of a confirmed case is anyone meeting any of the following criteria without appropriate PPE being used (in the 2 days before the person was symptomatic up to 10 days from onset of symptoms):

    • Direct Face-to-face contact (e.g. talking) for any length of time; or
    • Being within 1m for 1 min or longer; or
    • Being within 2m for 15 mins or longer

See Appendix 1 in recently circulated Outbreak Management SOP for Primary Care and here for more details regarding who may be considered a contact

Please note: if contact with a confirmed case occurs that breaches social distancing, full PPE must have been worn to avoid the need to isolate as a contact (ie, mask, gloves, apron +/- eye protection depending on risk).  Wearing only a mask would not be considered full PPE.

 

Dates for your Diary 8/10/2020

8 - 9 October. UK Annual Social Prescribing Link Worker Day Awards and Conference. A virtual awards ceremony and conference is set to mark the day.

Tuesday 13 October, 11am - 12pm. Building back from COVID-19: Involving citizens in the next phase of pandemic response

Thursday 15 October, 5pm - 6pm. Save the date: General Practice webinar with Ed Waller and Nikki Kanani.

Wednesday 11 November, 9am - 8pm. NHS Confederation: PCN Network virtual conference

12 – 13 November. PCRMM Virtual Conference 2020

Community Pharmacy

HEE Mental Wellbeing Films 8/10/2020

Health Education England has produced two animated films, the first designed to raise awareness among learners of the support they can access from their workplace should they be living with mental ill health. The second film is aimed at supervisors, helping them to be aware of the support they can offer their learners.

It is important that those experiencing mental ill health know they can talk about it and receive help if they need it. Those in a position of authority should also know what is required of them and how they can help if they are approached by someone who is experiencing mental ill health.

The two new films can be viewed here https://www.hee.nhs.uk/our-work/supporting-your-mental-health-wellbeing. Direct links to the films are here: Learners: https://www.youtube.com/watch?v=QPA3Y4th38g, Supervisors: https://www.youtube.com/watch?v=S9oGLqNiQtI

The strategy and the films, while devised before COVID 19, will be critical to ensuring the sustained health and capacity of the NHS workforce as they respond to the pandemic and beyond. It may take some time for learners and staff to realise the impact of the crisis on their mental wellbeing.

UCL Partners Searches and Risk Stratification Tools 8/10/2020

Risk stratification tools for Asthma, COPD, Type 2 diabetes and Hypertension and search description guides to provide an overview of the criteria that have been used. these are available from the Primary Care Team.  The Primary Care Innovation Team at UCL Parters have developed defined search and stratification tools to help primary care teams identify people with long term conditions. These tools stratify patients into low, medium and high risk of deterioration.

These easy-to-deploy tools have been designed for the management of patients with Asthma, COPD, Type 2 diabetes and Hypertension. All tools have been developed by their clinical team, working with the Clinical Effectiveness Group based at Queen Mary University of London. The search criteria used draws on national guidance.

How to run the search

Watch our webinar which provides details of how to run searches, taking you through these tools in action.

Please click to view the SystmOne video here and EMIS video here

For more information on the LTC support package please visit website here

Diabetes Clinical Network Y&H Update Bulletin: October 2020 8/10/2020

Please find attached (4) the latest bulletin from the Diabetes Clinical Network for Yorkshire & the Humber. Please do get in touch with any feedback, questions or comments using our generic email address: england.yhdiabetes@nhs.net.

COVID-19: Reviewing High Risk (Shielding) Patients 8/10/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  

The latest update to the SPL in EMIS Web is SPL24 and SPL25 - these have both been received and processed in the past 24 hours.

Remember not every practice will receive lists of affected patients in every SPL cohort.

Both SPL24 & SPL25 includes both patient additions and patient subtractions; all of which have been identified centrally by NHS Digital and NHS England, and will be contacted by them – practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate or low risk instead.

In addition, practices are encouraged to continue to add patients to the list themselves, where indicated

How are these patients identified in my system?

SPL24 and SPL25 updates may each include up to two new lists of patients, added to the folder titled ‘EMIS Health: COVID-19 searches’ within your local Population Reporting folders (not in the EMIS Library).

They will not create any lists where there are no patients to populate those - as this process matures, the amount of patients identified obviously decreases. It is possible your practice may only have one of the lists described below, or may not receive any of these lists, in which case you have no affected patients in either cohort. 

  • The list of new SPL24 additions is titled ‘Shielding patients identified centrally, added 30th September 2020 (SPL24)’.
  • The list of SPL24 subtractions is titled 'Patients removed from SPL 30th September 2020 (SPL24)'.
  • The list of new SPL25 additions is titled ‘Shielding patients identified centrally, added 1st October 2020 (SPL25)’.
  • The list of SPL25 subtractions is titled 'Patients removed from SPL 1st October 2020 (SPL25)'

    These lists will be in the following location in your EMIS Web system:

    EMIS Ball > Reporting > Population Reporting > *your practice name* > EMIS Health: COVID-19 searches

 The SystmOne (TPP) searches can be found in the COVID folder:

LOT 22 High Risk COVID-19 code added 06/10/20 without a more recent Low Risk or Moderate Risk code

- LOT 21 High Risk COVID-19 code added 06/10/20 WITH a more recent low/moderate code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Diabetes UK updates  - Keeping well as lockdown eases, Diabetic Eye Screening, DUKPC 8/10/2020

Keeping well as lockdown eases

We have a new leaflet ‘Keeping well as lockdown eases’ available for order on our website shop and will replace the current ‘Staying at home and managing diabetes.’ The new leaflet aims to help less digitally literate people feel confident and supported as lockdown restrictions start to ease and change.

Let’s talk about feet, a conversation about good foot care - Tuesday 20 October 8pm-9:30pm

The North of England Diabetes UK team are presenting an online zoom session for people living with diabetes, which will be full of practical advice around good foot care. There will be talks from podiatrists, a live foot check session as well as hearing from a patient who has had a lived experience of a foot problem.  Anyone interested can sign up to this event via Eventbrite by clicking on the link here

Coronavirus Updates – Diabetic Eye Screening

We’ve added a coronavirus update to our eye screening information page. Many appointments were postponed because of the pandemic, but services are beginning to resume for some people now. We've also added information so users can find out more about the services local to them.

Hypo Awareness Week  5 – 11 October 2020

This week is Hypo Awareness Week, so make sure you look out on our social media channels where we're sharing our amazing new video about spotting the signs of a hypo, a very sweet video made by 2 of our young supporters, and an interactive quiz!

Diabetes UK Professional Conference Online Series

Taking place from 13 October to 25 November 2020, our brand new online series has been designed to bring you the latest developments around coronavirus, focusing on what we have learnt over the past few months and how services have adapted to continue to deliver excellent care.

With eight days' worth of educational content designed by healthcare professionals, you'll leave each session with the most up-to-date diabetes knowledge you need to provide the best care for your patients.

  • Hear from inspiring speakers about the latest developments in diabetes care. Sessions include:
    • Inequalities, deprivation and the impact on Black and Minority Ethnic communities during the coronavirus outbreak
    • Diabetes UK South West Professional Conference: Emotional and psychological wellbeing masterclass
    • Remodelling of diabetes services during the coronavirus pandemic
    • UK Diabetes in Pregnancy masterclass
  • Ask the expert speakers your questions during the live Q&A within each session
  • Choice of attending each day's session at one of two time slots
  • CPD accredited.

To view the conference programme and information on how to register can be found on our website by clicking here

Psychology support in Diabetes Care Webinars

Roche are hosting a session on 13th October 2020 at 5pm where panellists (Prof. Partha Kar, Dr. Julia Platts and Dr. Rose Stewart) will discuss the role of psychology within diabetes care, the evidence and the future of patient psychology support.

This session is a part of Roche’s Psychology and Diabetes webinar mini-series, you can also register to attend a session on the 20th October at 5pm for the ‘COVID-19 learns overview - health and wellbeing in the workplace’ webinar where Prof. Partha Kar, Dr. Julia Platts and Dr. Rose Stewart will consider the impact of the current pandemic situation on working practices and wellbeing.

If you would like to register for this webinar, you can do so by clicking here.

 These are non-promotional webinars provided free of charge. These webinars will be hosted in Roche Zoom and will be recorded.

Free Wills Month

We're pleased to be one of the charities behind Free Wills Month, where people who are 55 or over will be able to update or write their will for free, enabling them to provide for their family and friends and also give hope to the next generation of people living with diabetes.  Look out on our Facebook pages where we’ll be promoting the scheme.

Don’t forget

We continue to update our webpages; our advice for healthcare professionals on coronavirus (COVID-19) and diabetes and coronavirus advice page for people living with diabetes and their families. These pages are based on the most recent guidance available and also signpost to other relevant sources of support and information.

We have some helpful information to help people staying at home and managing their diabetes and to help people cope with stress and other emotions. There is also a useful coronavirus thread on our online forum, where members are sharing information and experiences. People can follow and keep up to date with us and our advice and support on our North of England Diabetes UK Facebook support group,  Diabetes UK Facebook and Twitter feeds. For anyone not able to access face to face diabetes education or support during this time our Leaning Zone is a good place to access simple information from our Diabetes UK clinical team, and sensible advice from people living with diabetes

Potential ID Fraud 8/10/2020

Please find attached (3) a new fraud alert. It relates to an individual attempting to gain employment within the health sector.

Place-based Settings and C)VID-19 - Message to GP practices Place-based Settings and C)VID-19 - Message to GP practices 8/10/2020

There has been some concern around behaviour from staff working across GP practices including gathering round computer monitors to look at test results (not social distancing correctly) and not maintaining social distancing in break rooms.  This is a polite reminder that all staff should be adhering to the social distancing guidelines in place.

Car Sharing 

You should try not to share a vehicle with those outside your household or support bubble. If you need to do this, try to: 

  • share the transport with the same people each time
  • keep to small groups of up to 6 peopleat any one time
  • open windows for ventilation
  • travel side by side or behind other people, rather than facing them, where seating arrangements allow
  • face away from each other
  • consider seating arrangements to maximise distance between people in the vehicle
  • clean your car between journeys using standard cleaning products - make sure you clean door handles and other areas that people may touch
  • ask the driver and passengers to wear a face covering 

NHS Diabetes Prevention Programme and Glucose monitoring 8/10/2020

The NHS Diabetes Programme has published and disseminated a letter outlining the recent updates to the Healthier You NHS Diabetes Prevention Programme for people with Type 2 diabetes and Type 1 diabetes glucose monitoring. It includes details on the new self-referral model into Healthier You, an update on Flash uptake and plans to provide continuous glucose monitoring (CGM) for pregnant women. 

Clinical validation of surgical waiting lists framework and supporting tools 8/10/2020

On 18 September 2020, we wrote to systems explaining what is required for the clinical prioritisation of surgical waiting lists. We have now published the clinical validation of surgical waiting lists framework and supporting tools, designed to support systems to clinically validate their waiting lists and establish patient’s wishes regarding treatment. This project is centred around making the best mutually agreed decisions with patients regarding their treatment and is not an exercise to reduce numbers on waiting lists.

The priority is to contact all patients on an admitted pathway by 23 October 2020 to establish their wishes about their preferred next steps. The patient’s GP practice will be notified of the outcomes of discussions regarding their procedure.

Update on NHS Diabetes Prevention Programme, CGM and Flash 8/10/2020

Please find the attached (2) update from the NHS Diabetes Programme Team.

Diabetes UK ‘Let’s talk about Feet’ Webinar 8/10/2020

Please find details attached (1) of this forthcoming Diabetes UK  event that may be of interest to you.  The event is due to take place on Tuesday 20 October 2020 8.00pm – 9.30pm

NHSX free patient information videos 5/10/2020

As part of its plans to support staff through the pandemic, NHSX has secured a licence for NHS clinicians to access a library of over 600 health and care videos for patient information completely free of charge until the end of the year. The videos have been written by NHS clinicians and developed to work within care pathways. They have been professionally produced by Health and Care Innovations (HCI) for use by patients and have been independently, clinically assured by various NHS trusts across the UK. An online resource hub, including specialty webinars, is also available to NHS clinicians and includes guidance on how to access the videos by clinical specialism or pathway, and how they can be made available to patients as part of the patient journey. 

COVID-19 app guidance to staff   5/10/2020

Please see attached information (attachment 6) for ‘people working healthcare’ document relating to the use of NHS COVID-19 App, produced by the Department of Health and Social Care.

Flu Fund   5/10/2020

NHS England & Improvement have made available additional monies to local systems and primary care providers to cover reasonable additional costs (over and above the usual fee structures) associated with this year’s extended flu programme.  This is in recognition of the fact that considering social distancing, some flu providers may need to adopt alternative delivery models. For further information please see attached the ‘ 20-09-24 claim process for flu fund v.6 - General Practice’ document, see attachment 5.

For ease please find below items that practices are able to claim for and items that are not covered under this fund.   

What can GP practices claim for?

  • additional venue hires and associated costs (signage, external temporary shelters)
  • additional fridges/mobile cold storage.

To claim for any of the above costs practices will need to submit an invoice to the Primary Care Inbox: barnsleyccg.primarycare@nhs.net  for authorisation.

Claims will not be authorised for costs that are already funded via other routes.  Therefore the funding will NOT cover:

  • additional staff costs;
  • routine vaccination consumables i.e. syringes, disposal of sharps;
  • PPE;
  • communications and advertising.

COVID-19 General Practice support Fund 5/10/2020

The Covid-19 General Practice Support Fund has been reduced and therefore going forwards there will higher levels of scrutiny for Covid-19 claims and the items that practices are able to claim for.

The CCG would like to inform practices that they are no longer able to claim additional PPE through the CCG.  

The route for practices to claim PPE is through the Online Portal and any additional PPE that is sourced by practices will not be reimbursed by the CCG.

COVID-19 Outbreak Management Plan for Primary Care, Community Pharmacy and Optometry practices   5/10/2020

Please find attached a copy of the Outbreak Management SOP for Primary Care (attachment 1a) together with a flowchart poster (attachment 1b)

This document has been developed by the CCG in collaboration with BMBC/PHE and NHSE/I and includes the following:

  • Key Guidance
  • Practice planning
  • Symptoms of Covid-19
  • What to do if a staff member becomes unwell with Covid-19 symptoms at home
  • What to do if someone becomes unwell with Covid-19 symptoms in a health setting
  • How to get a test
  • What to do if there is a confirmed case of COVID-19
  • Close contacts
  • What to do in the event of an outbreak
  • Confidentiality
  • Contact details

Please note: As COVID-19 is a rapidly evolving situation; guidance may change at short notice. Please check the latest date and version of this guidance here or contact the CCG Primary Care team.

New and holistic medication reviews for thousands of patients as new guidance rolls out  5/10/2020

New NHS guidance that comes into effect today, will help primary care networks (PCNs) offer thousands of patients a holistic review of their medication, to help them stay healthy and remain independent.

The guidance supports PCN clinical pharmacy teams with implementation of the structured medication review (SMR) and optimisation service requirements in the Network Contract Directed Enhanced Service Specification in 2020/21.

PCNs are asked to proactively consider all aspects of the guidance when planning, implementing and delivering the service. It outlines how each PCN will identify and prioritise patients who would benefit from a SMR, including those:

  • in care homes
  • with complex and problematic polypharmacy, specifically those on 10 or more medications
  • on medicines commonly associated with medication errors
  • with severe frailty, who are particularly isolated or housebound or who have had recent hospital admissions and/or falls
  • using potentially addictive pain management medication

We recently published a PCN clinical pharmacist case study from Nipa Patel who has over 20 years’ experience of working in community pharmacy, general practice and clinical commissioning groups (CCGS). This case study describes how care is being delivered in SASSE Network 2 PCN, as well as how SMRs are already being implemented.

COVID-19 conversations training video and supporting information  5/10/2020

Please see the link below to a short, 10 minute training video produced by the Public Health Team to support people to share some simple messages in their everyday conversation with families, friends and work colleagues that will help to stop the spread of the virus and keep us all safe and well.

You can find this training video, along with the additional information on our website. 

Please help us to share these messages through any communications mechanisms and conversations you may have by sharing the web link widely.

Gateway C webinar on lung cancer Vs Covid to primary care 7 October 7pm  5/10/2020

Lung Cancer vs COVID-19 Webinar 7/10 @7PM

Overview: In this webinar, our key speakers will explore lung cancer referrals and diagnosis during COVID-19.

Audience: This webinar is suitable for primary care professionals across NHS England.

Key speakers:

  • Dr Matthew Evison, Consultant Chest Physician and Director of the Lung Pathway Board
  • Dr Seamus Grundy, Consultant Respiratory Physician
  • Dr Sarah Taylor, Cancer Research UK GP and GatewayC GP Lead

Register here: https://bit.ly/3c3Akgt

GatewayC’s webinar page: https://www.gatewayc.org.uk/free-webinars/

CPD Lipid Management - New Advances in Primary Care – Tuesday 6 October  5/10/2020

Everything you need to know to understand more about LIPIDS and their management in Primary Care, for further information and registration details see attachment 4.

Primary Care Issues & Answers Live 2020 – New realities – new Solutions  5/10/2020

Free unmissable sessions in three highly interactive broadcasts with CPD points, for further information and registration details see attachment 3.

NHS Reset: a new direction for health and care  1/10/2020

A new report by the NHS Confederation (of which NHSCC is part) has identified five factors our members believe will help to fundamentally reset the way health and care is planned, commissioned and delivered. The report reflects members’ views and sets out a possible direction for the NHS and a future which should lead to improving health for individuals, families and communities. Download the report.

The report has had extensive coverage today including on the BBC and the Guardian, among others. The NHS Confederation's chief executive Danny Mortimer appeared on BBC Breakfast and Times Radio this morning. 

The NHS Confederation has also published an accompanying report, “Health inequalities: time to act, which looks specifically at how this issue must be addressed, as the global events during the pandemic have exposed the need for urgent and sustained action.

Webinars 1/10/2020

Thursday 8 October, 12pm - 1:30pm. New PCN care coordinators webinar

8 - 9 October. UK Annual Social Prescribing Link Worker Day Awards and Conference. A virtual awards ceremony and conference is set to mark the day.

Tuesday 13 October, 11am – 12pm. Building back from COVID-19: Involving citizens in the next phase of pandemic response

This webinar will look at ‘dialogue and deliberation’ as a crucial way to support recovery planning and ICS development. Focusing on an example of ‘deliberative engagement’ used across London to engage residents to help shape policy, this webinar will focus on why citizen engagement is crucial to Covid-19 recovery and how ICSs could benefit from adopting the same approach. Speakers include:

  • Mike Cooke, North Central London Integrated Care System [CHAIR]
  • Vin Diwakar, Medical Director, London Region
  • Amy Darlington, Imperial College Health Partners
  • Michelle Mackie, Ipsos Mori

12 – 13 NovemberPCRMM Virtual Conference 2020

NHS Confederation’s PCN Network resources 1/10/2020

The NHS Confederation’s PCN Network has produced a number of resources and good practice that may be useful for PCNs. These include:

Network DES 2020/21 service requirements and supporting guidance 1/10/2020

On 17 September NHS England & NHS Improvement published an updated Network Contract DES SpecificationNetwork Contract DES Guidance and Investment and Impact Fund implementation guidance.  The changes were summarised in this covering letter.  These changes supplement existing guidance on Enhanced Health in Care Homes and Early Cancer Diagnosis service to support primary care networks with delivery of the DES service requirements.

These three delayed Primary Care Network Directed Enhanced Service (DES) service requirements apply from October 2020.   Guidance is available on the NHS website:

FAQs are available but should you have any additional questions, please contact NHSE GP Contracts team via email england.gpcontracts@nhs.net.

Letter to GP practices about GP contract changes 1/10/2020

Please see the Letter to GP practices about GP contract changes (attachment 2)

This will be added to our website shortly here:  https://www.england.nhs.uk/gp/investment/gp-contract/ and linked to from here: https://www.england.nhs.uk/coronavirus/publication/preparedness-letters-for-general-practice/

PCN Early Diagnosis DES & National Cancer Diagnosis Audit (NCDA) Reports - NOTICE FROM CCG AND PCN 1/10/2020

From October 2020 , as you know the new early diagnosis cancer specification for PCNs will become mandatory. In collaboration with Cancer Research UK the PCN Network have produced a briefing for PCNs summarising the requirements, the challenges, as well as practical advice, top tips and a case study. This joint briefing, prepared by Cancer Research UK and the PCN Network, aims to give an overview of the early diagnosis of cancer PCN specification and how it fits with the QOF quality improvement domain.

We have received confirmation from Cancer Research UK (Yorkshire and Humber) that the National Cancer Diagnosis Audit (NCDA) Reports will be available this week for all Practices that took part in the audit. This means participating Practices will receive a tailored Practice level report which looks at data relating to patients diagnosed with cancer within an individual Practice. This report will go a long way to help Practices identify areas of focus, highlight good practice and support quality improvement plans, as well as the delivery of both QOF and PCN DES. As part of the offer, a CRUK Facilitator will be conducting a follow-up process to provide additional support to Practices on how to use this information. Please note, due to the high level of completion, support will only be provided collectively at a neighbourhood level to those Practices that need additional support. We will aim to work in close partnership with the CRUK Facilitator over the coming weeks to facilitate this process. Further details will be shared with Practices in due course.

Flu Vaccination Letter Template for Practices 1/10/2020

The letter template for children aged 2 and 3 years.  GP practices can use this template to invite parents and guardians to get their child vaccinated at the local surgery.

COVID-19 Outbreak Management Plan for Primary Care, Community Pharmacy and Optometry practices   1/10/2020

Please find attached a copy of the Outbreak Management SOP for Primary Care (attachment 1) and attachment 1a

This document has been developed by the CCG in collaboration with BMBC/PHE and NHSE/I and includes the following:

  • Key Guidance
  • Practice planning
  • Symptoms of Covid-19
  • What to do if a staff member becomes unwell with Covid-19 symptoms at home
  • What to do if someone becomes unwell with Covid-19 symptoms in a health setting
  • How to get a test
  • What to do if there is a confirmed case of COVID-19
  • Close contacts
  • What to do in the event of an outbreak
  • Confidentiality
  • Contact details

Please note: As COVID-19 is a rapidly evolving situation; guidance may change at short notice. Please check the latest date and version of this guidance here or contact the CCG Primary Care team.

NEW - WEBINAR & CPD NOW AVAILABLE ON-DEMAND: DEMYSTIFYING INSULIN   1/10/2020

Module 1: Type 2 Diabetes – The Essentials of Insulin – Now available on demand here  and don’t forget to complete the CPD programme to download your CPD certificate here!*

NEXT IN THE SERIES – register here

Module 2: Making the most of Insulin 

Simple guide to initiating and titrating insulin
Tuesday 13th October 2020  19:00-20:00 hours

Module 3: Maximising benefit: Minimising risk
Reducing the risk of hypos and a guide to the skills you need and where to find them
Tuesday 27th October 2020 19:00-20:00 hours

A further step toward an alternative route into nursing  1/10/2020

Health Education England’s (HEE) Blended Learning Nursing Degree, an innovative national programme to train nurses of the future, has moved to the next stage.

Using a mix of technologies to study with important practice experience, this degree will provide opportunities to more people who have the right aptitude and values but need to study flexibly, pursue a career in nursing.

At a collaborative event last week/month [25/9/2020] a partnership of seven universities, HEE and others discussed the next steps to delivery of the programme, while beginning to build a network for knowledge sharing and best practice.  Universities are working towards the first students starting their courses from early 2021.

Cellulitis Pathway Community  28/9/2020

This is a reminder to GPs about the first dose IV Cellulitis pathway to avoid a hospital admission, this should be the first course of action for cellulitis treatment in the community should IVs be required.  See attachment 1a and attachment 1b

Flu modelling tool for practices - Training Session - Friday, 25 September at 3.30pm 24/9/2020

A flu modelling tool is now available for use by Practices and PCNs to help with operational planning of flu clinics. This has been discussed at the North East and Yorkshire Vaccination Board, and with CCG Flu Leads, and we would like to encourage all practices to use this.

The CCG flu groups and ICS Boards would have the potential to review the outcomes of the tool to highlight emerging issues around capacity and plans across the geography, and therefore share learning and offer support where it is needed.

Attached (3) is a User Guide with instructions on access and how to use, and a training session has been set up for this Friday 25 September at 3.30pm. We are also hoping that there will be a video guide which practices will be able to use following these initial training sessions.

Details for joining the training session are attached. For log in details, or any technical difficulties, please email jack.pickard@carnallfarrar.com

Shielding Patients – Updated Comms 24/9/2020

We’re aware of some confusion regarding the current status of shielding guidance.  Specifically, queries from the public about whether shielding guidance is currently in place in their area are increasing.

To confirm:

  • People who were identified as clinically extremely vulnerable (CEV) to coronavirus were advised to ‘shield’ during the first wave of the pandemic.
  • Shielding advice was lifted in most parts of the country on 1st August 2020.  The means the vast majority of people considered CEV are no longer being advised to shield.
  • There are two specific exceptions to this in Leicester City and North East Blackburn. Shielding advice is still in place in these areas but will be lifted from 5th October. 
  • Therefore, unless Government policy changes again, from 5th October no-one in England will be advised to shield.
  • Areas that are subject to local lockdown restrictions are not automatically subject to shielding guidance; the decision to introduce shielding advice is currently made on a case by case basis by the UK Deputy Chief Medical Officer (DCMO) alongside the local Director of Public Health (DPH).
  • If shielding guidance is re-introduced in a particular area, people considered clinically extremely vulnerable, as well as local health system colleagues, will be informed of the changes.

COVID PCR swab testing for staff - reminder  24/9/2020

  • The advice is to keep trying on the online portal as slots are added intermittently at different times of the day and we have been informed that capacity has now increased
  • The local testing unit at County Way and the roaming mobile unit will no longer accept people for swabbing without an appointment and the individual must have symptoms.
  • If you are unable to access a test for a member of staff (or household contacts) with symptoms via the portal or 119, then please contact the Primary Care Team as temporary arrangements have been made to access urgent testing at County Way between 7-8pm, should they be needed.
  • If practices have any issues or queries regarding staff testing and/or self-isolation then please contact the CCG Primary Care Team 

COVID-19: Reviewing High Risk (Shielding) Patients  24/9/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  

The latest update to the SPL in EMIS Web is SPL23 - this was originally released to affected GP organisations on 18th September 2020, but due to an error was incorrectly named. This was corrected on 21st September. Your SPL23 reports may show either date.

Remember not every practice will receive lists of affected patients every week.

SPL23 includes both patient additions and patient subtractions; both have been identified centrally by NHS Digital and NHS England, and will be contacted by them – practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate or low risk instead.

In addition, practices are encouraged to continue to add patients to the list themselves, where indicated

How are these patients identified in my system?

SPL23 updates may include up to two new lists of patients, added to the folder titled ‘EMIS Health: COVID-19 searches’ within your local Population Reporting folders (not in the EMIS Library). They will not create any lists where there are no patients to populate those - as this process matures, the amount of patients identified obviously decreases. Therefore it is possible your practice may only have one of the lists described below, or may not receive either of these lists, in which case you have no affected patients in this cohort.

  • The list of new SPL23 additions is titled either ‘Shielding patients identified centrally, added 18th September 2020 (SPL23)’ or ‘Shielding patients identified centrally, added 21st September 2020 (SPL23)’.
  • The list of SPL23 subtractions is titled either 'Patients removed from SPL 18th September 2020 (SPL23)' or 'Patients removed from SPL 21st September 2020 (SPL23)'.
  • These lists will be in the following location in your EMIS Web system:
    EMIS Ball > Reporting > Population Reporting > *your practice name* > EMIS Health: COVID-19 searches

 The SystmOne (TPP) searches can be found in the COVID folder:

- LOT 21 High Risk COVID-19 code added 18/09/20 without a more recent Low Risk or Moderate Risk code

- LOT 21 High Risk COVID-19 code added 18/09/20 WITH a more recent low/moderate code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

Additional Shielded Patients List update from NHS Digital

We have received the following update from NHS Digital in relation to the 'Additional SPL patients for review August 2020' list which we originally informed you about on 11th August. Because of discrepancies in that cohort, not every EMIS Web GP organisation received that list.

Hospital Deductions of Patients

A small number of requests by hospital Trusts to remove patients from the NHS SPL were not correctly processed by NHS Digital. These have been passed to general practice during August for review using a technical method known as an intra-systems task to ensure that the latest clinical information is used in the decision making. Once GPs have reviewed, the patients will be removed from the NHS SPL by them adding a low or moderate risk code.

Missing Risk Status in GP Records

In mid-August NHS Digital became aware of circa 65,000 patient records in general practice where the patient was on the NHS Shielded Patient List but there was not a similar entry on their GP record, for example if added by the national algorithm. The patients had been advised they were high risk and other organisations, including the Government service, were aware. The issue will be resolved by adding the information to the GP record, with the work scheduled to complete by Friday 25 September latest.

Deductions from the SPL arising from the CMO rule set

In mid-August NHS Digital became aware of circa 23,000 patients’ records which have been removed from the NHS Shielded Patient List as they no longer meet the requirements of the national methodology but were not removed at the request of a clinician. During September national deductions letters will be sent to those patients by NHS Digital to inform them that they have been removed from the list. A small number of patients have been reinstated on the list by GPs following their removal

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Medicines Management For Information

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm

UCL Partners: Long-term condition support 24/9/2020

This site contains tools and resources designed to enable primary care teams to continue to effectively manage patients with long-term conditions.

The pack includes:

  • Search and risk stratification tools - That can be used with EMIS (and SystmOne to follow), accompanied by user guidance.
  • Education and training resources - Including protocols, guidance, videos and virtual training sessions to upskill the breadth of primary care team members to proactively support patients.
  • Digital tools - A selection of a clinically appraised digital tools to support patient activation and self-management in the home setting.

https://uclpartners.com/long-term-condition-support/ 

Advice & Guidance: guide for general practice  21/9/2020

Advice & Guidance (A&G) services provide GPs with continued access to specialist advice on investigations, interventions and potential referrals. This helps manage non-urgent patients in the most appropriate setting.  A short guide is now available which sets out practical advice for general practice teams to get the most from A&G services, including:

  • how A&G can support the safe and effective delivery of care alongside COVID-19 activity;
  • where general practice teams can learn more about making an A&G request; and
  • how general practice can support system partners in implementing A&G services in their area.

Further information is available on the Elective Care Community of Practice. Please email ECDC-manager@future.nhs.uk for access to this platform. Support is also available on the Advice and Guidance toolkit for the NHS e-Referral Service (e-RS) 

Network Contract Directed Enhanced Service - Contract specification 2020/21 - PCN Requirements and Entitlements – Updated 17 September 2020  21/9/2020

Key additions are highlighted in the document (attachment 3) and relate to:

  • The nursing associate and trainee nursing associate (TNA) roles that have now been included in the Additional Roles Reimbursement Scheme
  • Investment and Impact Fund (IIF) (see attachment 4 - IFF Implementation Guidance) 

 Cold Chain Guidance  21/9/2020

Public Health England has been notified that there has been several cold chain incidents involving the flu vaccine in primary care across Yorkshire and Humber.   

Please see the attached Cold Chain guidance for information and to reiterate the importance of cold chain to Practices delivering flu vaccinations, particularly during Flu season when the vaccines are limited.

For action: Workforce data collection reminder  21/9/2020

Understanding the current workforce is essential for planning and will support the future development of primary care. It is also a requirement as part of the GP Contract and Network DES that practices and PCNs submit regular workforce information.

The next reporting deadline is 30 September 2020; you will need to check that you have updated your records on National Workforce Reporting System (NWRS). For practices, this should include any locums or subcontracted capacity. For PCNs, this should include all staff funded through the Additional Roles Reimbursement Scheme (ARRS), whether employed by the PCN or by another body (e.g. social prescribing link workers are often employed in the voluntary sector).

From October 2020, the practice reporting requirement will be changing from quarterly to monthly with the next extraction on 31 October. It would be beneficial for practices to update workforce information as changes occur, to keep the records up to date. More information on how to register and use the NWRS is here.

Urgent action: Smartcard renewal issue affecting EPS prescribers  21/9/2020

Due to a recent smartcard renewal issue, some Electronic Prescription Service (EPS) prescribers need to self-renew their smartcards urgently.

Prescribers who renewed their smartcard or were issued with a new one between 2-4 September 2020 must self-renew their smartcard before issuing any further EPS prescriptions.  Smartcards that are not renewed by 4 October 2020 will expire. For further support with this, please contact your local Registration Authority.

Practices may be contacted by pharmacies unable to dispense affected prescriptions and should cancel the original EPS prescription and issue a replacement.

New: NHS Covid-19 App – displaying a QR code poster, who does it apply to? 21/9/2020

On Friday the Government announced that certain venues, including venues run by local authorities, will now be legally required to display NHS QR posters in their venues by 24 September as part of the NHS Covid-19 App.

We have reviewed the venues and services listed in the legislation and it does not appear to include NHS only services/buildings.

However, there are some GP practices and pharmacy services which operate in buildings of mixed use, which may include local authority services and other publically accessible services. The other services within these building will need their own NHS QR code poster.

We are waiting for the final guidance for all, including those sharing a building, to come out today and we will circulate this tomorrow.

Flu – communications campaign 21/9/2020

To help support the flu vaccination programme the national flu campaign will start over the next week. To kick that off and to celebrate all the hard work practices, pharmacies and colleagues are doing, we’ll be issuing a press release to announce that this is likely to be Barnsley biggest flu vaccination year in history.

This will be the start of more local promotion over the coming weeks as we focus on some of those groups where take up is often lower. If you have a great news story about your flu programme please get in touch.

Primary Care Respiratory Academy Service (PCRA) Development Roundtable  21/9/2020

The Primary Care Respiratory Academy, are delighted to invite you to accept one of our limited places at the PCRA Digital Roadshow roundtable discussion.

Led by specialist GPs and commissioners from PCRS-UK, this in-depth online discussion will feature a multi-disciplinary group of delegates from primary care and other providers in order to discuss the latest challenges affecting service provision and share experiences from across your region.

Register here

How it works:
Hosted over zoom, the session will take place over 2.5hours from 6.00-8.30pm and will bring together an intimate group of your multi-disciplinary peers to debate key challenges and discuss how to overcome current and future obstacles.
 
Topics of discussion include key subjects like the lessons learnt during the Covid-19 pandemic for service transformation, planning for winter, ensuring our patients with respiratory disease are winter ready” and the challenges facing new PCNs faced in these challenging times.
 
Delegates will also be able to gain free access to a series of on-demand clinical education videos focussed on asthma, COPD, lung cancer and ILD.
 
This is your chance to participate and guide the agenda to suit your needs and share any learnings from your service with others.
 
The agenda for each roundtable consists of three universal questions:

  • What does ‘RESET’ look like for respiratory pathways?
  • How do we ensure system resilience?
  • How do we promote prevention and reduce acute episodic care?

Which roundtable should I join?
The roundtables have been divided into regions, to focus on the challenges and pathways in your geographic location. If you are not available for your region, feel free to join another date.

  • Greater London (East) Thurs 1 October
  • Midlands and East of England Thurs 8 October
  • North of England Thurs 15 October
  • South of England Thurs 12 November
  • Wales & Northern Ireland Thurs 19 November
  • Greater London (West) Thurs 26 November

Register here

Third Phase of NHS Response to COVID-19 - Clinical Prioritisation & Validation of Elective Waiting Lists  21/9/2020

Please can practices cascade the attached letter, from NHS England and Improvement regarding Clinical Prioritisation of Elective Waiting Lists as appropriate.

Protect yourself, your family and our patients from Flu this winter  21/9/2020

Please can practices cascade the attached letter, from NHS England and Improvement to all NHS frontline workers.

BEST and PCN Event Cover 17/9/2020

This is a gentle reminder to add a message on your telephone systems to advise patients to call NHS 111 if they require non-emergency medical help when your practice is closed for BEST and PCN events. This is only needs to be put in place if you arrange to have cover for these events via Michelle Thompson.

Covid Testing for Asymptomatic Staff Visiting Care Homes  17/9/2020

  • Any professional (health and social care) attending a care home on at least two visit per week and most of the weeks in a year, to see one or more residents.

Using the above criteria it is anticipated that general practice staff will not need testing, but please contact the Primary Care Team if any practices feel they have staff that would need meet the criteria and would require regular testing.

Please note:

  • Visiting staff are tested as part of care home weekly staff testing and be counted in the numbers for the care home they spend most time in. If a staff member attends multiple homes it would be the one where they spend most time that they would have their swab.
  • Health and social care professionals attending care homes in a professional capacity who are NOT displaying COVID-19 symptoms should not be denied access because they have not had a COVID test.

COVID-19 Guidance for the remobilisation of services within Health and care settings: Infection prevention and control recommendation  17/9/2020

The IPC guidance has been updated to reflect the focus on restoration of services and to help health and care providers to assess how settings can be classified by risk with appropriate infection prevention and control measures. There is no change to the IPC measures for high and medium risk pathways. Full guidance can be found here. Quick reference guides are attached:

The IPC principles in the document apply to all health settings* (including the independent/private sector) and are underpinned by the best available evidence.

This guidance supersedes the COVID-19 UK IPC guidance (18 June 2020).

Key messages:

Patients/Individuals treatment, care and support to be managed in 3 COVID-19 pathways:

  • High risk: There is no change in recommendations for IPC or for the use of PPE by staff when managing patients/individuals who have, or are likely to have, COVID-19
  • Medium risk: This includes patients/individuals who have no symptoms of COVID-19 but do not have a COVID-19 SARS- CoV-2 PCR test result.
  • Low risk: Patients/individuals with no symptoms and a negative COVID-19 SARS- CoV-2 PCR test who have self-isolated prior to admission for example following NICE guidance

Sessional use of single use personal protective equipment (PPE) items has been minimised and only applies to extended use of facemasks for healthcare workers.

The use of face masks (for staff) or face coverings1 (England and Scotland) is recommended in addition to social distancing and hand hygiene for staff, patients/individuals and visitors in both clinical and non-clinical areas to further reduce the risk of transmission.

Physical distancing of 2 metres is considered standard practice in all health and care settings.

Patients/individuals on a low risk pathway require Standard Infection Prevention Control Precautions for surgery or procedures.

A range of creative assets to support local services are available (in digital and design formats) on the Campaign Resource Centre. The below list includes existing assets (including government) as a reminder of what is available to support your organisational communications.

Social media or internal assets should be accompanied by explanatory text appropriate to the service.

 Key highlights reference guide                       

  • Care pathways – overarching
  • Coronavirus facility warnings                            
  • Social distancing    
  • Reducing risk                                                   
  • Staying safe at work
  • Face masks (staff)  
  • Face coverings (outpatients and visitors)

This guidance supersedes the COVID-19 UK IPC guidance (18 June 2020).

Don’t be a Contact!  17/9/2020

With infection rates rising practices may want to consider revisiting their work place risk assessment to ensure that, if a member of staff develops symptoms, colleagues do not become contacts:

The definition of a contact is any of the following without appropriate PPE:

  • Direct face-to-face contact (e.g. talking) for any length of time

Or

  • Being within 1m for 1 minute or longer

Or

  • Being within 2m for 15 minutes or longer

Further information regarding workplace assessment, including templates, can be found on HSE website here: https://www.hse.gov.uk/coronavirus/working-safely/index.htm

The Infection Prevention Control (IPC) Specialist nurses at BHNFT are available for advice and can be contacted on 01226 432825 (Monday-Friday 8-5) or email bdg-tr.infectioncontrol@nhs.net

To stop the spread of the virus remember: Hands. Face. Space.

Wash your hands regularly, use a face covering when social distancing is not possible and try to keep your distance from those not in your household. Regularly clean ‘touch point’ and communal areas in the surgery, e.g. telephones, reception areas.

If you have COVID symptoms, you must isolate immediately for 10 days whilst you try to get a test (don’t wait for a test or a test result before doing so).  The main symptoms of coronavirus are a high temperature, a new, continuous cough and a loss or change to your sense of smell or taste.

If you don’t have symptoms, don’t get a test (unless you have been asked to get tested by a doctor or a public health professional or by your local council).

You may be advised to self-isolate if you have been in contact with a confirmed case but you should only get a test if you have symptoms.  If you are identified as a contact of a positive case you must isolate for the full 14 days (even if for some reason you got a negative test during that period).

Social media assets available to promote access to primary care 14/9/2020

Social media resources advising patients about how GP, dental and community pharmacy services are operating are now available to download from the Campaign Resource Centre.

Patient information videos for clinical use to support NHS staff through COVID pressures 14/9/2020

Please see the attached Access to general practice comms toolkit – sept 2020.pdf and C0765_Access to GP practices_letter 14 September 2020.pdf.

As part of the response to COVID-19, NHSX has secured a national licence for NHS clinicians to access a video library of over 600 health and care videos free of charge. The videos have been written by NHS clinicians and developed to work within care pathways.

They have been professionally produced by Health and Care Innovations (HCI) for use by patients and have been independently, clinically assured by various NHS trusts. An online resource hub, including specialty webinars, is also available to NHS clinicians and includes guidance on how to access the videos by clinical specialism or pathway, and how they can be made available to patients as part of the patient journey. The videos have been developed and written by NHS clinicians to use within a wide range of care pathways including maternity, physiotherapy, rheumatology and podiatry.

Quality and Outcomes Framework (QOF) updated 14/9/2020

NHSE have updated the QOF 2020/21. This is effective immediately and the Statement of Financial Entitlement will be amended shortly to reflect this. As outlined in NHSE’s letter of 4 September, the Dispensary Services Quality Scheme (DSQS) which was reinstated on 1 August has also been updated.

Know your numbers week - the UK's biggest blood pressure testing and awareness event  14/9/2020

High blood pressure is the number one risk factor for cardiovascular disease (CVD) worldwide. Those who wait longer than 6 weeks with raised blood pressure have increasing risk of MI or stroke and this is worst for those with the highest pressures.

This week is ‘Know your numbers week’ and Blood Pressure UK is recommending patients check their own blood pressure. GPs and practice nurses can use this information to help manage their patients. Please consider using your practice websites and text-based systems to encourage people with hypertension to self-monitor and send in their readings. Especially consider reaching out to those you believe to be most as risk of cardiovascular event and ensuring that you have an up to date reading and treatment plan.

My Type 1 Diabetes 14/9/2020

My Type 1 diabetes are offering an online session to learn more about the platform and the benefits it can bring to people with type 1 diabetes living in your region. The session will take place on Wednesday the 23rd September at 11am over Microsoft Teams and will cover:

  • A review of the information website
  • Tour of the Understanding and Living with T1D eLearning courses
  • Tour of the insulin pump eLearning courses
  • Q&A
  • How to access the platform as a healthcare professional

If you would like to attend the online session more information can be found here: www.mytype1diabetes.nhs.uk and you can join the meeting here: Join Microsoft Teams Meeting

How to communicate better with people with hearing loss 14/9/2020

COVID-19 poses a unique challenge for health and social care professionals when talking to someone with hearing loss. Here are some important tips to help you communicate effectively.

COVID-19: Reviewing High Risk (Shielding) Patients 14/9/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  This latest SPL update is referred to as SPL22.

​As with previous updates, SPL22 include both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL22 additions:

The approved high-risk code will be added to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL22 subtractions:

Patients identified as being subtracted from the SPL will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally,added 11th September 2020 (SPL22)

- EMIS HEALTH: COVID-19 SEARCHES/Patients removed from SPL 11th September 2020 (SPL22)​

 The SystmOne (TPP) search can be found in the COVID folder:

- LOT 20 High Risk COVID-19 code added 11/09/20 without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

BBS IT Newsletter 10/9/2020

Please see attached (5) the BBS IT Newsletter for information.

Practice Declaration Forms 10/9/2020

This is a reminder to practices that have not already done so, to return a signed copy of the attached practice declaration form and return back to Rachel Barraclough at: rachel.barraclough@nhs.net  as soon as possible.

COVID-19 general practice support fund – deadline 15 September 2020  10/9/2020

The Government have released a COVID-19 general practice support fund to assist with the legitimate additional costs of the response borne by GP practices. NHSE have confirmed details of the fund in a letter which can be accessed here. 

Having reviewed the letter the CCG has already reimbursed practices for the majority of items listed. With the exception of reimbursements for staffing costs which can be found in Annex A of the letter; points 14 -17 and 22.

CQRS Reminder - Early Approval for September Payments 10/9/2020

Please be aware that from Friday 18 to the 22 September inclusive, CQRS will be offline to accommodate system enhancements.

This is a reminder for all GP Practices and Commissioners that achievement will need to be declared and financially approved before midday on Friday 18 September.

If payment declarations are not approved before the 18 September, the next opportunity will be from the 23 September when CQRS is available. These payment declarations will be sent from CQRS to PCSE Online on the 28 September to enable payments to progress.

Once the system enhancements to CQRS have been completed, from the 23 September you will be asked to log in to CQRS as given in the attached (3) guidance. 

New Patient Registrations / Practice Lists 10/9/2020

This is a polite reminder to all practices that, as patient lists are open, new patients should be registered as stated in your GMS/PMS/APMS contract.  No practices should be advising patients that they are unable to register them unless they do not live within the practice’s catchment area. 

Annual Health Check Webinar 22 September 2020 10/9/2020

Please see attached (1) details of a webinar on LD Health Checks on 22 September 2020.

GP Fellowship Scheme 10/9/2020

Please find attached (4) a letter to practices regarding the GP Fellowship programme.

For further information regarding the national programme please click on the following link: https://www.england.nhs.uk/gp/the-best-place-to-work/gp-fellowship-programme/

We would also be grateful if you could forward this email to any eligible salaried GPs or Partners and ask them to register their interest via the form link below

https://forms.gle/LgDhRB2GZ2AXAe5AA

Please do not hesitate to contact Amanda Barrett  amanda.barrett28@googlemail.com or Robert Eastman robert.a.eastman@gmail.com if you require any further information regarding the programme

UPCOMING WEBINARS   7/9/2020

  • Tuesday 8 September, 11.30am - 12.45pm - Building back from COVID-19: tackling health inequality in partnership  The second in a series of NHSEI Integrated Care webinars - run in collaboration with SCIE - will look at tackling health inequalities in partnershiphow systems can work together and plan for action at both system and place level.
  • Thursday 17 September, 5pm – 6.30pm. A focus on primary care networks  This webinar will be the first in a series focusing on primary care networks and the priorities and opportunities for them in the coming months and years. Join Nikki Kanani, Ed Waller and special guest speakers for this online interactive event designed to support PCNs on their development journey. To attend please ensure you register in advance.

COVID-19 general practice support fund – deadline 15 September 2020 7/9/2020

The Government have released a COVID-19 general practice support fund to assist with the legitimate additional costs of the response borne by GP practices. NHSE have confirmed details of the fund in a letter which can be accessed here. 

Having reviewed the letter the CCG has already reimbursed practices for the majority of items listed. With the exception of reimbursements for staffing costs which can be found in Annex A of the letter; points 14 -17 and 22.   For ease these are;

“Backfill for COVID-19 related absences between 23 March – 31 July

  1. Practices will be able to seek approval from their commissioner for reimbursement for retrospective backfill costs for COVID-19 related absences between 23 March and 31 July 2020 (eg, COVID-19 related sickness absences or absences as a result of staff shielding where staff were not able to work remotely), where:
  • It was necessary to secure backfill to maintain capacity and it has not been possible to cover the absence from existing capacity across the practice or wider system, eg across the Primary Care Network (PCN).
  • Practices are paying or have paid employees full pay, irrespective of the terms of their contract of employment.

 

  1. Where commissioner approval is given:
  • Backfill for GP absence as a result of COVID-19 can be claimed from day one to day fourteen of absence, in line with the rates set out below. After two weeks, any ongoing claims will need to be made under the Statement of Financial Entitlement provisions.2
  • Backfill for non-GP practice-based staff related absence as a result of COVID-19 can be claimed from day one of absence in line with the rates set out below, for the length of the absence (up until end of July).
  1. The rates that can be claimed are set out in paragraph 22.

 

  1. From 1 August 2020, the usual contractual and legal position will again apply.”

 

And

 

Rates of reimbursement for staffing costs

  1. The following sets out reimbursement rates for staffing costs – if approved by the local commissioner:
  2. GP partners Partners can claim a maximum of two additional sessions per week (Monday-Sunday) up to a maximum of £289 per 4-hour session, plus applicable employer National Insurance and pension costs. This reimbursement rate is based on average partner earnings.
  3. Salaried GPs – permanent contracts of employment Practices can seek reimbursement for backfill to cover COVID-19 related absences or additional capacity in line with the individual’s contractual hourly and overtime rates as paid to them in the February 2020 payroll, plus applicable employer National Insurance and pensions costs. To claim at this rate, the individual must be employed on a permanent basis and their contract must have been in place before 1 March 2020. The commissioner may ask for evidence of the existing contractual arrangements, for example evidence from the February 2020 payroll.

iii. Salaried GPs – temporary contracts of employment Practices may wish to temporarily engage additional salaried GPs at this current time. If approved by the local commissioners, practices may claim reimbursement for backfill to cover COVID-19 related absences or additional capacity at the rates of £200 a session (£400 per day); or £250 per session for OOHs (plus applicable employer National Insurance and pensions costs only). The commissioner may ask for evidence of hours worked.

  1. Locum GPs

 

Practices may seek reimbursement for backfill to cover COVID-19 related absences or additional capacity needs of £200 a session (£400 per day); or £250 per session for OOHs eg, bank holidays (plus applicable employer National Insurance and pensions costs only).

  1. Other practice staff members of the workforce Practices can seek reimbursement for additional capacity from existing practice staff members or from temporary staff members for backfill to cover COVID-19 related absences or additional capacity needs – if it is not possible to meet resource needs through existing resources within the PCN and local health economy. If approved, claims for existing practice staff would be reimbursed at current rates of pay only under their contractual arrangements. We would expect claims for temporary staff members to be in line with the practices’ existing contractual rates of pay for the role. Practices may be required to provide evidence to support claims.”

 PLEASE NOTE THE DEADLINE DATE IS 15 SEPTEMBER 2020

To claim for the above costs practices will need to complete the attached invoice template and Annex B of NHSE’s letter (Practice declaration for reimbursement claims) and submit these to the Primary Care Inbox; barnsleyccg.primarycare@nhs.net 

As schools are now returning, practices need to review children and young people on the Shielded Patients List (SPL)  7/9/2020

In their letter of 8 July 2020, the Chief Medical Officer for England and NHS Medical Director asked clinicians to review all children and young people who had been identified as clinically extremely vulnerable (CEV) to coronavirus and included on the Shielded Patient List (SPL). Children no longer considered CEV according to guidance from the Royal College of Paediatrics and Child Health (RCPCH) should be removed from the SPL following consultation with the individual and their family. The majority of these patients will be under the care of a specialist, however, there are children on the SPL that have been added by primary care and no longer need to be identified as CEV.

As schools are now returning, as soon as possible please review children you have added to the list, so that children and families are clear on what advice they should follow. So far, only a small number of children and young people have been removed from the SPL since July.  

The RCPCH guidance states that the children and young people with conditions including asthma, who are cared for just in primary care, are unlikely to be clinically extremely vulnerable. These patients should therefore be reviewed and, if appropriate, removed from the SPL as soon as possible. Please can practices communicate with the patient/their family to discuss their individual circumstances and remove the high-risk flag from records of anyone who no longer needs to be on the Shielded Patient List.

Seasonal influenza DES specification – updated  7/9/2020

The Influenza and Pneumococcal Immunisation Directed Enhanced Service specification has been amended and republished to provide for additional new cohorts of patients to be vaccinated in general practice.

The new cohorts include household contacts of those on the NHS Shielded Patient List or of immunocompromised individuals, and health and social care workers employed through Direct Payment (personal budgets) and/or Personal Health Budgets, such as Personal Assistants, to deliver domiciliary care to patients and service users. It also covers a potential cohort of 50-64 year olds later in the flu season, depending on vaccine availability.

In addition, the specification requires that practices must include within at least one written communication to eligible patients offering vaccination, a request that the patient advises the practice of their ethnicity status if they have not previously provided this information to the practice and requires the practice to record this in the patient record

Community Agreement 2020/21   7/9/2020

The agreement for medicines administration services to be provided by district or community nurses is attached (2) for information.

Flu vaccination arrangements  7/9/2020

Providers are thinking about and planning the ways in which they will deliver flu vaccinations for winter 2020/21.   Models for delivery could look different to usual as a result of the coronavirus (COVID-19) pandemic.  Information regarding Flu vaccinations can be found on the CQC website:  https://www.cqc.org.uk/guidance-providers/registration/registration-flu-vaccination-arrangements

Your COVID Recovery – helping patients to understand what to expect as part of their recovery from COVID-19 7/9/2020

 Your COVID Recovery is an NHS website designed to help people recover from the long-term effects of COVID-19 and support them to manage their recovery. It has information from rehabilitation experts about how to manage ongoing symptoms and health needs at home, and signposts to sources of support. A significant proportion of post COVID-19 patients are likely to have ongoing health problems. How quickly somebody recovers and the problems they have is likely to vary, and this website can help to answer some questions for patients. 

Evidence-based interventions (EBI) programme: list 2 engagement final review  7/9/2020

The EBI programme runs alongside the NHS England and NHS Clinical Commissioners’ programme, focused on items that should not be routinely prescribed in primary care. Both programmes follow similar principles, while one focuses on medicines and the other on interventions.

Over the last few weeks, the EBI Expert Advisory Committee have been engaging on the second list of procedures for the EBI programme as a follow up to the original guidance. The online questionnaire is now closed but we are holding a post-engagement event which is open to anyone and are encouraging patients, the public, clinicians, commissioners, providers, and anyone with an interest to join the post-engagement event on 22 September from 9am – 12pm to share any further views. Please register your interest here.

Brand NEW - The Essentials of Insulin webinar series  7/9/2020

For further information and registration details see attachment 1.

COVID-19 and professional standards activities – resumption of appraisal  7/9/2020

Medical appraisal was suspended for most doctors in March 2020, to free up clinical time to manage the COVID-19 emergency situation.

Medical Appraisal 2020, developed with partners and stakeholders, describes the restart of appraisals using a rebalanced approach that focuses on the doctor’s professional development and wellbeing, and simplifies expectations around supporting information and pre-appraisal paperwork.

This letter, sent from Professor Stephen Powis, National Medical Director to Responsible Officers and Medical Directors in England, describes the flexible approach to the incremental restoration of appraisal across all organisations in England, beginning by 1 October, with a view to resuming normal levels of activity by 1 April 2021. Further resources to describe and explain this format, including materials to support appraisers, are hosted on the Academy of Medical Royal Colleges website.

This will be added to the NHSE website https://www.england.nhs.uk/coronavirus/publication/covid-19-and-professional-standards-activities-letter-from-professor-stephen-powis/

COVID-19 general practice support fund – deadline 15 September 2020 3/9/2020

The Government have released a COVID-19 general practice support fund to assist with the legitimate additional costs of the response borne by GP practices. NHSE have confirmed details of the fund in a letter which can be accessed here.

Having reviewed the letter the CCG has already reimbursed practices for the majority of items listed. With the exception of reimbursements for staffing costs which can be found in Annex A of the letter; points 14 -17 and 22. For ease these are;

“Backfill for COVID-19 related absences between 23 March – 31 July

  1. Practices will be able to seek approval from their commissioner for reimbursement for retrospective backfill costs for COVID-19 related absences between 23 March and 31 July 2020 (eg, COVID-19 related sickness absences or absences as a result of staff shielding where staff were not able to work remotely), where:
  • It was necessary to secure backfill to maintain capacity and it has not been possible to cover the absence from existing capacity across the practice or wider system, eg across the Primary Care Network (PCN).
  • Practices are paying or have paid employees full pay, irrespective of the terms of their contract of employment.

 

  1. Where commissioner approval is given:
  • Backfill for GP absence as a result of COVID-19 can be claimed from day one to day fourteen of absence, in line with the rates set out below. After two weeks, any ongoing claims will need to be made under the Statement of Financial Entitlement provisions.2
  • Backfill for non-GP practice-based staff related absence as a result of COVID-19 can be claimed from day one of absence in line with the rates set out below, for the length of the absence (up until end of July).
  1. The rates that can be claimed are set out in paragraph 22.

 

  1. From 1 August 2020, the usual contractual and legal position will again apply.”

 And 

Rates of reimbursement for staffing costs

  1. The following sets out reimbursement rates for staffing costs – if approved by the local commissioner:
  2. GP partners Partners can claim a maximum of two additional sessions per week (Monday-Sunday) up to a maximum of £289 per 4-hour session, plus applicable employer National Insurance and pension costs. This reimbursement rate is based on average partner earnings.
  3. Salaried GPs – permanent contracts of employment Practices can seek reimbursement for backfill to cover COVID-19 related absences or additional capacity in line with the individual’s contractual hourly and overtime rates as paid to them in the February 2020 payroll, plus applicable employer National Insurance and pensions costs. To claim at this rate, the individual must be employed on a permanent basis and their contract must have been in place before 1 March 2020. The commissioner may ask for evidence of the existing contractual arrangements, for example evidence from the February 2020 payroll.

iii. Salaried GPs – temporary contracts of employment Practices may wish to temporarily engage additional salaried GPs at this current time. If approved by the local commissioners, practices may claim reimbursement for backfill to cover COVID-19 related absences or additional capacity at the rates of £200 a session (£400 per day); or £250 per session for OOHs (plus applicable employer National Insurance and pensions costs only). The commissioner may ask for evidence of hours worked.

  1. Locum GPs

Practices may seek reimbursement for backfill to cover COVID-19 related absences or additional capacity needs of £200 a session (£400 per day); or £250 per session for OOHs eg, bank holidays (plus applicable employer National Insurance and pensions costs only).

  1. Other practice staff members of the workforce Practices can seek reimbursement for additional capacity from existing practice staff members or from temporary staff members for backfill to cover COVID-19 related absences or additional capacity needs – if it is not possible to meet resource needs through existing resources within the PCN and local health economy. If approved, claims for existing practice staff would be reimbursed at current rates of pay only under their contractual arrangements. We would expect claims for temporary staff members to be in line with the practices’ existing contractual rates of pay for the role. Practices may be required to provide evidence to support claims.”

PLEASE NOTE THE DEADLINE DATE IS 15 SEPTEMBER 2020

To claim for the above costs practices will need to complete the attached invoice template (5) AND Annex B of NHSE’s letter (Practice declaration for reimbursement claims) and submit these to the Primary Care Inbox; barnsleyccg.primarycare@nhs.net 

Service Update - CQRS Notification of downtime 18 to 22 September inclusive 3/9/2020

Please see the attachment 3 communication regarding CQRS.

COVID-19: Reviewing High Risk (Shielding) Patients 3/9/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  This latest SPL update is referred to as SPL21.

​As with previous updates, SPL21 include both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL21 additions:

The approved high-risk code will be added to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL21 subtractions:

Patients identified as being subtracted from the SPL will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 2nd September 2020 (SPL21)

- EMIS HEALTH: COVID-19 SEARCHES/Patients removed from SPL 2nd September 2020 (SPL21)​

The SystmOne (TPP) search can be found in the COVID folder:

- LOT 19 High Risk COVID-19 code added 02/09/20 without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Primary Care: New Roles Webinar Series 2020 1/9/2020

The ICS is running its third webinar in a series of webinars which are designed to provide an overview of the opportunities of the new roles for primary care networks in South Yorkshire & Bassetlaw.

These webinars are supported by South Yorkshire & Bassetlaw (SYB) Integrated Care System; SYB AHP Council and Primary Care Workforce and Training Hub. They are produced in collaboration with Clinical Leads  from the relevant professions that form part of the Additional Roles Reimbursement Scheme. Please circulate to any colleagues you think will find it useful to  join.

Session 3:-

Topic: The Role of an Advanced Practice Podiatrist in Primary Care​

Presenter: Jeremy Walker, Head of Podiatry Services, Sheffield Teaching Hospitals NHS Trust

Date: Wednesday 16th September 2020

Time: 12:30 - 13:00 pm

LINK HERE FOR WEBINAR ACCESS: https://teams.microsoft.com/l/meetup-join/19%3ameeting_YjE4ZWZjODgtZjMwNy00NmU3LWI4NjEtMDQ0Mjk2ZWI0Y2Jk%40thread.v2/0?context=%7b%22Tid%22%3a%2237c354b2-85b0-47f5-b222-07b48d774ee3%22%2c%22Oid%22%3a%22c13d330b-a1b7-4cd8-ac74-648565090fe0%22%2c%22IsBroadcastMeeting%22%3atrue%7d

These webinars are recorded and will be available after the event at: https://pcwth.co.uk/​ If you have any queries please contact: 

Heather Jackson:   heather.jackson@nhs.net, Louise Berwick: Programme Manager SYB Primary Care Workforce & Training Hub louise.berwick2@nhs.net or Suzanne Bolam: South Yorkshire and Bassetlaw AHP LeadSuzanne.bolam1@nhs.net.

COVID-19: Reviewing High Risk (Shielding) Patients 1/9/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield.  This latest SPL update is referred to as SPL19 & SPL20 (this is a combined cohort, as EMIS were unable to process SPL19 when they initially received the data). 

​As with previous updates, SPL19 & SPL20 include both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.  

SPL19 & SPL20 additions:

The approved high-risk code will be added to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL19 & SPL20 subtractions:

Patients identified as being subtracted from the SPL will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 27th August 2020 (SPL19, SPL20)

- EMIS HEALTH: COVID-19 SEARCHES/Patients removed from SPL 27th August 2020 (SPL19, SPL20)

The SystmOne (TPP) search can be found in the COVID folder:

- LOT 18 High Risk COVID-19 code added 27/08/20, without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Clinical entrepreneur training programme - helping bring innovations into the NHS For information 1/9/2020

The latest round of NHS England and Improvement’s clinical entrepreneur programme is open and welcoming applications from a diverse range of clinical and non-clinical healthcare professionals. The clinical entrepreneur programme is the biggest entrepreneurial workforce development programme of its kind, aiming to provide the commercial skills, knowledge and experience needed to successfully develop and spread innovative solutions to the challenges facing the NHS. If you (or someone you know) might be interested in applying, find out more here. Contact england.cep@nhs.net if you have any questions

National Shielding Programme: Next steps  27/8/2020

Please see attachment 3 which are helpful notes, particularly the update on the development of a COVID19 risk prediction tool which should be available to GPs from November.

Upcoming Diabetes webinars  27/8/2020

Diabetes Professional Care, the DSN Forum and AstraZeneca are excited to be collaborating in producing a series of 4 live webinars which focus on best practice use of GLP-1 agonists in the management of type 2 diabetes and full training regarding how to effectively use the NEW Bydureon BCise (exenatide) device. 

Each of the 4 webinars will deliver the same educational content so that you can choose the most convenient time and date that works for you.  These CPD-accredited webinars are designed for Diabetes Specialist Nurses, Practice Nurses, GPs, Pharmacists, and other diabetes prescribers and initiators.

The Webinars can be accessed at the following link:  https://www.diabetesprofessionalcare.com/digitalhub/bcise

Upcoming webinars   24/8/2020

Thursday 3 September, 5 - 6pm - General Practice webinar. 

The next General Practice webinar with Nikki Kanani and Ed Waller will include a focus on remote consultations and include a guest speaker from National Voices. This is a closed webinar for those working in or with general practice. To attend please register in advance.

Tuesday 8 September, 11.30am - 12.45pm - Building back from COVID-19: tackling health inequality in partnership.

The second in a series of NHS England and Improvement Integrated Care webinars - run in collaboration with SCIE - will look at tackling health inequalities in partnershiphow systems can work together and plan for action at both system and place level. Further details about the webinars, and a range of other useful webinars for colleagues working in STPs and ICSs, can be found on the Integrated Care Learning Network.

Registering patients prior to their release from the secure residential estate 24/8/2020

GPs have a contractual obligation as set out in the NHS England Standard General Medical Services (GMS) Contract 2017/18 (page 64) to support with registering patients prior to their release from the secure residential estate. GP practices are asked to ensure that processes are in place to support this, with information on how to do this here.

Plans are also progressing to enable patients to register with a GP in their place of detention in the same way as they register with a community GP. This will be rolled out next year in a phased approach across England.

Update to European Health Insurance Card (EHIC) reporting process 24/8/2020

National Back Office has made some operational changes which means that the email address you would usually send any EHIC information collected at GP registration to has now changed to nhsdigital.costrecovery@nhs.net

Please ensure that when you are submitting this information to National Back Office you are using the new email address as above. Any forms sent to the old email address will not be received or processed.  If you have any questions, please contact Samantha.Pease@dhsc.gov.uk.

Video consultations – new resources  24/8/2020

To support primary care in delivering video consultations, two new resources have been published. These are visual resources, intended to support patients and staff in the use of video technology when conducting appointments.

Video consulting with your NHS is a quick step-by-step guide for patients which explains the benefits of a video consultation and provides practical guidance on how to start, have and finish a video consultation. A similar quick step-by-step guide aimed at NHS staff is also available and covers practical tips on running a video consultation. 

General Practice Quality Markers  24/8/2020

Quality Markers were published in Summer 2019 by the NHS England national team,  further information about the Quality Markers can be found here:  https://www.england.nhs.uk/publication/supporting-carers-in-general-practice-a-framework-of-quality-markers/

Kerry Knox, Leadership Support Manager to the Commitment to Carers Programme North East Yorkshire region is currently trying to understand whether GP practices are aware of the Quality Markers and if they have been implemented  and also trying to establish some baseline information about General Practice Quality Markers.         

Kerry would be grateful if practices could take the time to respond to the questions below: 

  1. Has your practice been sighted on the General Practice Quality Markers (before now)? 
  2. Has your practice implemented the General Practice Quality Markers?
  3. If yes, would you be happy to share this information with me?
  4. If no, are there any plans to implement the General Practice Quality Markers?
  5. If no, would the practice be interested in implementing the General Practice Quality Markers?

Please can practices send any responses back by Friday 28 August directly to Kerry Knox:  k.knox2@nhs.net  

For your attention - recent correspondence from PCDC  24/8/2020

Practices may have received an email from Paul Couldrey  of PCDC on Thursday last week.   Paul provides the Data Protection Officer function for GP Practices in Barnsley.  The email detailed how a number of Paul’s private facebook posts had been shared with organisations that he provided DPO support to, which in Paul’s words ‘make him appear to be hostile and racist’.   The CCG would like to assure you that we are undertaking a thorough investigation of these posts and will be liaising with Paul in order to ensure the values that we work to across the NHS are upheld in any contract that we procure.  The CCG will contact you in the near future with the outcome and any proposed steps that will be taken 

Non-sterile gowns – important information 24/8/2020

Flosteril FLO-MED-8130 non-sterile gowns do not meet minimum standards for fluid resistance. Providers are asked to check their stocks and quarantine any unused gowns. The attached alert contains images of the product packaging and the affected product Stock Keeping Units.

The attachment is dated 11 August which is when it was originally issued via the PPE supply channel.  If providers have already received the alert via another channel and acted on the instructions, then no further action is required.

New IPC guidance has been published by Public Health England  24/8/2020

As we return to this “New Normal” and enter a recovery phase in community services we wanted to let you know our current holding / recovery position. 

We know that face to face contact is very important for many of our service users and clinically essential, hence why as a service we have continued to see patients at home doing essential visits and activity including but not limited to: 

  • EOL Support Care
  • Insulin Administration
  • IV Antibiotic Administration
  • Essential Wound Care – Leg Ulcers
  • Medication Administration
  • Catheter Support and Care

As we move towards the recovery phase of the coronavirus pandemic we are now able to support more face to face appointments where it is clinically indicated, taking into account both patient and staff safety considerations. The decision to meet face to face or virtually should be taken after discussion with the patient and the MDT and be based on clinical need, taking account of both patient and staff safety which is paramount.

As part of this phased recovery District Nursing Clinics have started at a very limited and reduced capacity with the main focus of these clinics being to provide complex wound management. The clinics are limited to 1 clinic per week per neighbourhood at selected sites that have been risk assessed and approved by our internal recovery TAG. These clinics remain for non-house bound patients requiring complex wound management.

It is essential that as a neighbourhood team we work together and be creative on how best to meet patient need and understand current limitations on activity that can be undertaken.

From October 2020 we will be in a position where by we will be fully delivering all aspects of the service for housebound patients and will have returned to more or less normal within the current ever changing NHS Landscape.

Our Long Term Conditions Team are all redeployed presently within the Integrated Neighbourhood Teams supporting the increased home visiting and acuity of patients in community. Long Term Conditions Reviews are not due to be restarted up as an activity until phase 4 (Mid Oct 2020) for house bound patients only, but this is subject to change due to further outbreak management etc.

NB: If we are subject to a second wave of Coronavirus, or our area is subject to a local lockdown then we will review Local and National Guidance and face-to-face provision may be withdrawn.

Any problems or concerns please discuss within your Neighbourhoods with your linked District Nurse or Community Matron.

South West Yorkshire Partnership NHS Foundation Trust - Current Holding / Recovery Position – Barnsley Integrated Neighbourhood Teams  24/8/2020

As we return to this “New Normal” and enter a recovery phase in community services we wanted to let you know our current holding / recovery position. 

We know that face to face contact is very important for many of our service users and clinically essential, hence why as a service we have continued to see patients at home doing essential visits and activity including but not limited to: 

  • EOL Support Care
  • Insulin Administration
  • IV Antibiotic Administration
  • Essential Wound Care – Leg Ulcers
  • Medication Administration
  • Catheter Support and Care

As we move towards the recovery phase of the coronavirus pandemic we are now able to support more face to face appointments where it is clinically indicated, taking into account both patient and staff safety considerations. The decision to meet face to face or virtually should be taken after discussion with the patient and the MDT and be based on clinical need, taking account of both patient and staff safety which is paramount.

As part of this phased recovery District Nursing Clinics have started at a very limited and reduced capacity with the main focus of these clinics being to provide complex wound management. The clinics are limited to 1 clinic per week per neighbourhood at selected sites that have been risk assessed and approved by our internal recovery TAG. These clinics remain for non-house bound patients requiring complex wound management.

It is essential that as a neighbourhood team we work together and be creative on how best to meet patient need and understand current limitations on activity that can be undertaken.

From October 2020 we will be in a position where by we will be fully delivering all aspects of the service for housebound patients and will have returned to more or less normal within the current ever changing NHS Landscape.

Our Long Term Conditions Team are all redeployed presently within the Integrated Neighbourhood Teams supporting the increased home visiting and acuity of patients in community. Long Term Conditions Reviews are not due to be restarted up as an activity until phase 4 (Mid Oct 2020) for house bound patients only, but this is subject to change due to further outbreak management etc.

NB: If we are subject to a second wave of Coronavirus, or our area is subject to a local lockdown then we will review Local and National Guidance and face-to-face provision may be withdrawn.

Any problems or concerns please discuss within your Neighbourhoods with your linked District Nurse or Community Matron.

Barnsley Safeguarding webinar 26/8 – Learning Lessons of Clive 20/8/2020

A webinar has been arranged for the 26 August 2020 1.00- 3.00pm to share the learning and examine the impact on our practice in relation to the case of Clive, which we shared with you in a recent bulletin.

Learning outcomes

  • Outline the history of Clive and the circumstances of his death
  • Consider how you can embed the learning into practice
  • Identify what support you may need from your manager/organisation to embed the new ways of working

To book a free place please use POD

 https://www.barnsley.gov.uk/services/children-families-and-education/schools-and-learning/schools-workforce-development/training-and-development-online/

Any problems please contact the POD team – pod@barnsley.gov.uk

Places will be limited to 12 to allow for discussion, additional sessions will be arranged if necessary.

COVID-19 general practice support fund 20/8/2020

The Government have released a COVID-19 general practice support fund to assist with the legitimate additional costs of the response borne by GP practices. NHSE have confirmed details of the fund in a letter which can be accessed here.

Having reviewed the letter the CCG has already reimbursed practices for the majority of items listed.  With the exception of reimbursements for staffing costs which can be found in Annex A of the letter; points 14 -17 and 22. For ease these are;

“Backfill for COVID-19 related absences between 23 March – 31 July

  1. Practices will be able to seek approval from their commissioner for reimbursement for retrospective backfill costs for COVID-19 related absences between 23 March and 31 July 2020 (eg, COVID-19 related sickness absences or absences as a result of staff shielding where staff were not able to work remotely), where:
  • It was necessary to secure backfill to maintain capacity and it has not been possible to cover the absence from existing capacity across the practice or wider system, eg across the Primary Care Network (PCN).
  • Practices are paying or have paid employees full pay, irrespective of the terms of their contract of employment.

 

  1. Where commissioner approval is given:
  • Backfill for GP absence as a result of COVID-19 can be claimed from day one to day fourteen of absence, in line with the rates set out below. After two weeks, any ongoing claims will need to be made under the Statement of Financial Entitlement provisions.2
  • Backfill for non-GP practice-based staff related absence as a result of COVID-19 can be claimed from day one of absence in line with the rates set out below, for the length of the absence (up until end of July).
  1. The rates that can be claimed are set out in paragraph 22.

 

  1. From 1 August 2020, the usual contractual and legal position will again apply.”

 

And

Rates of reimbursement for staffing costs

  1. The following sets out reimbursement rates for staffing costs – if approved by the local commissioner:
  2. GP partners Partners can claim a maximum of two additional sessions per week (Monday-Sunday) up to a maximum of £289 per 4-hour session, plus applicable employer National Insurance and pension costs. This reimbursement rate is based on average partner earnings.
  3. Salaried GPs – permanent contracts of employment Practices can seek reimbursement for backfill to cover COVID-19 related absences or additional capacity in line with the individual’s contractual hourly and overtime rates as paid to them in the February 2020 payroll, plus applicable employer National Insurance and pensions costs. To claim at this rate, the individual must be employed on a permanent basis and their contract must have been in place before 1 March 2020. The commissioner may ask for evidence of the existing contractual arrangements, for example evidence from the February 2020 payroll.

iii. Salaried GPs – temporary contracts of employment Practices may wish to temporarily engage additional salaried GPs at this current time. If approved by the local commissioners, practices may claim reimbursement for backfill to cover COVID-19 related absences or additional capacity at the rates of £200 a session (£400 per day); or £250 per session for OOHs (plus applicable employer National Insurance and pensions costs only). The commissioner may ask for evidence of hours worked.

  1. Locum GPs - Practices may seek reimbursement for backfill to cover COVID-19 related absences or additional capacity needs of £200 a session (£400 per day); or £250 per session for OOHs eg, bank holidays (plus applicable employer National Insurance and pensions costs only).
  2. Other practice staff members of the workforce Practices can seek reimbursement for additional capacity from existing practice staff members or from temporary staff members for backfill to cover COVID-19 related absences or additional capacity needs – if it is not possible to meet resource needs through existing resources within the PCN and local health economy. If approved, claims for existing practice staff would be reimbursed at current rates of pay only under their contractual arrangements. We would expect claims for temporary staff members to be in line with the practices’ existing contractual rates of pay for the role. Practices may be required to provide evidence to support claims.”

To claim for the above costs practices will need to complete the attached invoice template (3a) AND Annex B (attachment 3b) of NHSE’s letter (Practice declaration for reimbursement claims) and submit these to the Primary Care Inbox: barnsleyccg.primarycare@nhs.net. 

NHS England & NHS Improvement North Regions Support Pack for GP Practices Re-starting AHCs  20/8/2020

Please find attached (2) a support pack for the LD Annual Health Checks.

Flu jab for Ages 50-64 – Wording for your Websites & Reception Teams 20/8/2020

Please find below nationally approved wording for primary care setting websites/receptionists. It is designed to clarify the position when 50-64 year olds approach requesting their flu jab.

Please note that people in the 50-64-year old age group will not be vaccinated until November and December, providing there is sufficient vaccine, and no appointments will be offered for this age group until then. This is to ensure that those who are most at risk are vaccinated first.  If you are 50-64 and you are in one of the other groups which is eligible for the flu vaccination, for example you have a health condition which puts you at risk from the flu, you will be invited earlier.

Estates planning support and guidance 17/8/2020

The GP Contract makes reference to ensuring sufficient space is available for additional staff employed under the Additional Roles Reimbursement Scheme (ARRS) in terms of estates. A number of documents offering advice and guidance to PCNs, constituent practices, and commissioners in receipt of applications for additional funding to accommodate additional staff are available on FutureNHS.

New GP practice profiles on the NHS website 17/8/2020

New NHS website profiles that better meet the needs of patients and feature improved support for mobile and tablet devices are being launched today for GP practices. The new profiles have a clean, modern design in keeping with the rest of the NHS website and meet modern accessibility standards.

Your existing profile information will be automatically copied over to the new platform and the way you update your profile has not changed. Profile editors should have received further information via email from the NHS website service desk.

This work is part of a programme to continuously improve the care and experience offered to patients through the NHS website, the UK’s largest health website for the public. New profiles will be live from Thursday 13 August.  Use the NHS website GP practice finder to find and view your new profile.

Indemnity cover for GP Trainee Nursing Associates role  17/8/2020

The range of providers who can employ Trainee Nursing Associates (TNA) has been widened to include General Practice. For clinical negligence, TNAs employed by Trusts, but on rotation in general practice will be covered under the employing Trusts membership of state schemes operated by NHS Resolution (the Clinical Negligence Scheme for Trusts (CNST) and the Liabilities to Third Parties Scheme (LTPS)). 

Like other Practice staff, TNAs employed and working in General Practice, will be covered for clinical negligence liabilities under the Clinical Negligence Scheme for General Practice (CNSGP). As in their normal course of business, General Practices should maintain adequate employers and public liability insurance.

NHS England & NHS Improvement North Regions Support Pack for GP Practices Re-starting AHCs  17/8/2020

Please find attached a support pack for the LD Annual Health Checks/

Reminder to complete review of children and young people on the Shielded Patients List (SPL) by September 17/8/2020

In our letter of 8 July we outlined the process for all children and young people currently identified as clinically extremely vulnerable to be reviewed and, where appropriate, removed from the SPL following consultation with their specialist clinician or GP. This is in line with guidance from the Royal College of Paediatrics and Child Health.

To date, while there has been a reduction in the numbers on the SPL, they have not fallen significantly. It is important that this review is completed ahead of the new school term (early September) to avoid children and young people receiving inappropriate advice in the case of new public health measures being applied in their area.

While many of these children will be under the care of specialists, who have also received instruction to review their patients, there will be a small number of children and young people who have previously been identified as clinically extremely vulnerable and who are not under the care of a specialist.  

Practices will need to identify and advise these individuals. Once a conversation with the patient/patient’s family has taken place, the patient must be removed from the SPL if deemed clinically appropriate. To do this, the high risk flag on their patient record should be changed to moderate or low risk. This patient should also be written to, to confirm they have been removed. For more detail about removing a patient from the SPL visit the NHS Digital website.

 

More accurate general practice appointment data (GPAD) 13/8/2020

What is GPAD ? NHS Digital has been collecting data from general practice appointment systems and publishing it, collated by CCG area, since 2018.

This published data provides a picture of general practice appointments. It includes details such as the number of appointments, the healthcare professional carrying them out, and where possible, the mode of delivery, e.g. face to face, or telephone.

Why is improvement needed now? During the COVID-19 emergency, practices have had to rapidly change their working patterns. This has highlighted that not all clinical interactions with patients are recorded in the appointment book.

This may result in an under-recording of the activity taking place in practices. In turn that may lead to under-reporting in the NHS Digital GPAD data publication. This is potentially giving a false picture of overall activity and workload in general practice. It is in all our interests to capture accurately the full scale of scale of activity that general practice is providing for patients.

For more information: https://www.england.nhs.uk/gp/gpad/

COVID-19 general practice support fund 13/8/2020

In the bulletin on Monday 10 August we alerted practices to the COVID-19 general practice support fund. Below we have provided further clarity regarding what practices are able to claim for:

  • Staffing costs –  practices are able to claim for any overtime costs they have incurred, or any temporary staff costs to cover absent staff. As long as backing evidence is provided.
  • PPE –  practices will continue to be reimbursed for PPE, but only where this is above normal use and is not available through clipper or the mutual aid agreement within Barnsley.
  • Webcams/Headsets/Screens – the CCG has previously agreed to fund these items and will therefore honour this agreement and pay the invoices for these items.
  • Other items – no other costs will be reimburse.

Webinar – ‘Effective Workforce Planning in Primary Care – Can we face the Future without  it?’ 13/8/2020

Skills for Health are sponsoring a webinar, the details are: 

Date/time: Wednesday, 19th August at 12:30-13:30pm

Title: Effective Workforce Planning in Primary Care – Can we face the future without it?

The webinar will provide insights into effective workforce planning opportunities in the primary care sector.

Key Learning Points:

  1. Explore why workforce planning is an immediate and urgent priority for primary care.
  2. Identify the essential principles and characteristics of effective workforce planning.
  3. Help to build confidence and knowledge that excellent workforce planning is an achievable and realistic goal.

To register for FREE please follow this link:

https://www.bigmarker.com/closerstill-media/Effective-Workforce-Planning-In-Primary-Care-Can-We-Face-The-Future-Without-It?utm_bmcr_source=barnsccg

COVID-19: Reviewing High Risk (Shielding) Patients 13/8/2020

Although the national shielding programme for high-risk (clinically extremely vulnerable) patients is currently paused as of 1st August, it is possible that either local or national advice may change, potentially at very short notice. Therefore, the national Shielded Patient List (SPL) needs to be maintained even though high-risk patients themselves are not currently being advised to shield 

Since the last update provided in the bulletin on the 30th July, there have been 2 updates to the Shielded Patient List (SPL):

  1. SPL17
  2. SPL18

As with previous updates, SPL17 & SPL18 include both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL17 & SPL18 additions:

The approved high-risk code will be added  to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL17 & SPL18 subtractions:

Patients identified as being subtracted from the SPL will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 4th August 2020 (SPL17)

- EMIS HEALTH: COVID-19 SEARCHES/Patients removed from SPL 4th August 2020 (SPL17)

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 10th August 2020 (SPL18)

EMIS HEALTH: COVID-19 SEARCHES/Patients removed from SPL 10th August 2020 (SPL18)

The SystmOne (TPP) search can be found in the COVID folder:

- LOT 16 High Risk COVID-19 code added 04/08/20, without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MM

Updated GP SOP 13/8/2020

Please see attached the updated GP SOP (1), it can also be accessed here. Any changes since v3.3 (24 June 2020) are highlighted in yellow. The sections which have been updated are:

  • 3 Case definition of COVID-19 and government guidance
  • 5 Patients at increased risk of severe illness from COVID-19
  • 6 Patients advised to shield themselves (only applicable if specifically instructed to do so)
  • 7 Safeguarding
  • 7 Symptom management and end-of-life care 

2020-21 Payment for Anticoagulation monitoring in Primary Care  10/8/2020

Practices will recall that the CCG made an upfront payment to practices in April for Anticoagulation monitoring which covered the period April - July. 

This was based on a 4 month average of 2019-20 invoices submitted to the CCG. 

Rachel Barraclough from the Primary Care team will email Practice Managers individually to ask for activity numbers for the period April to July.  Once the information is received back, a reconciliation will be carried out to determine whether practices have been under or over paid for this period.  The practice will then be notified of any further action required from them.

COVID-19 general practice support fund 10/8/2020

The Government have released a COVID-19 general practice support fund to assist with the legitimate additional costs of the response borne by GP practices. NHSE have confirmed details of the fund in a letter which can be accessed here.

Having reviewed the letter the CCG has already reimbursed practices for the majority of items listed. With the exception of reimbursements for staffing costs which can be found in Annex A of the letter; points 14 -17 and 22. For ease these are;

“Backfill for COVID-19 related absences between 23 March – 31 July

  1. Practices will be able to seek approval from their commissioner for reimbursement for retrospective backfill costs for COVID-19 related absences between 23 March and 31 July 2020 (eg, COVID-19 related sickness absences or absences as a result of staff shielding where staff were not able to work remotely), where:
  • It was necessary to secure backfill to maintain capacity and it has not been possible to cover the absence from existing capacity across the practice or wider system, eg across the Primary Care Network (PCN).
  • Practices are paying or have paid employees full pay, irrespective of the terms of their contract of employment.

 

  1. Where commissioner approval is given:
  • Backfill for GP absence as a result of COVID-19 can be claimed from day one to day fourteen of absence, in line with the rates set out below. After two weeks, any ongoing claims will need to be made under the Statement of Financial Entitlement provisions.2
  • Backfill for non-GP practice-based staff related absence as a result of COVID-19 can be claimed from day one of absence in line with the rates set out below, for the length of the absence (up until end of July).
  1. The rates that can be claimed are set out in paragraph 22.

 

  1. From 1 August 2020, the usual contractual and legal position will again apply.”

 

And

Rates of reimbursement for staffing costs

  1. The following sets out reimbursement rates for staffing costs – if approved by the local commissioner:
  2. GP partners Partners can claim a maximum of two additional sessions per week (Monday-Sunday) up to a maximum of £289 per 4-hour session, plus applicable employer National Insurance and pension costs. This reimbursement rate is based on average partner earnings.
  3. Salaried GPs – permanent contracts of employment Practices can seek reimbursement for backfill to cover COVID-19 related absences or additional capacity in line with the individual’s contractual hourly and overtime rates as paid to them in the February 2020 payroll, plus applicable employer National Insurance and pensions costs. To claim at this rate, the individual must be employed on a permanent basis and their contract must have been in place before 1 March 2020. The commissioner may ask for evidence of the existing contractual arrangements, for example evidence from the February 2020 payroll.

iii. Salaried GPs – temporary contracts of employment Practices may wish to temporarily engage additional salaried GPs at this current time. If approved by the local commissioners, practices may claim reimbursement for backfill to cover COVID-19 related absences or additional capacity at the rates of £200 a session (£400 per day); or £250 per session for OOHs (plus applicable employer National Insurance and pensions costs only). The commissioner may ask for evidence of hours worked.

  1. Locum GPs

 

Practices may seek reimbursement for backfill to cover COVID-19 related absences or additional capacity needs of £200 a session (£400 per day); or £250 per session for OOHs eg, bank holidays (plus applicable employer National Insurance and pensions costs only).

  1. Other practice staff members of the workforce Practices can seek reimbursement for additional capacity from existing practice staff members or from temporary staff members for backfill to cover COVID-19 related absences or additional capacity needs – if it is not possible to meet resource needs through existing resources within the PCN and local health economy. If approved, claims for existing practice staff would be reimbursed at current rates of pay only under their contractual arrangements. We would expect claims for temporary staff members to be in line with the practices’ existing contractual rates of pay for the role. Practices may be required to provide evidence to support claims.”

To claim for the above costs practices will need to complete the attached invoice template (3) AND Annex B of NHSE’s letter (Practice declaration for reimbursement claims) and submit these to the Primary Care Inbox; batnsleyccg.primarycare@nhs.net.

Letter for GPs: returning to a single Covid-19 hospital site for SYB 10/8/2020

Last week we sent out a letter providing further information to all GP practices about the plans in South Yorkshire and Bassetlaw for a specific COVID-19 site and COVID-19 light sites in acute hospitals.

Please see attached Q & A document (4) which answers some of the questions that you may get from patients in regards to this change.

Development opportunity 10/8/2020

SWYPFT Barnsley Community Services Recovery Work 10/8/2020

Please see attached briefing for your information, which provides an update regarding recovery work undertaken by Barnsley Community Services.

Implementing phase 3 of the NHS response to the COVID-19 pandemic 10/8/2020

Further to the letter released on the 31 July 2020 about the third phase of the NHS response to COVID-19, NHSE have published a range of supplementary materials to support implementation of the letter. This can be accessed here.

2020-21 Payment for Anticoagulation monitoring in Primary Care   6/8/2020

Practices will recall that the CCG made an upfront payment to practices in April for Anticoagulation monitoring which covered the period April - July.  

This was based on a 4 month average of 2019-20 invoices submitted to the CCG.

Rachel Barraclough from the Primary Care team will email Practice Managers individually to ask for activity numbers for the period April to July.  Once the information is received back, a reconciliation will be carried out to determine whether practices have been under or over paid for this period.  The practice will then be notified of any further action required from them.

Vague Symptoms Survey – for GP’s and Practice Staff - complete by 19 August 6/8/2020

The Vague symptoms pathway has been running as a pilot since last year.  The CCG is now evaluating this pathway’s pilot introduction and would therefore appreciate your feedback about the pathway. Please can you complete the survey at this link Vague Symptoms Pathway Pilot Evaluation Survey to help us do this.

The survey is for both GP’s and Practice staff that have used the pathway and also for those that have not used it.  We would like to hear from more than one staff member in a practice therefore the survey can be completed multiple times within a practice.  For further details about the pathway please go to this link :VS pathway details  

If you have any queries relating to this work, please contact Siobhan Lendzionowski - Lead Commissioning and Transformation Manager via email at siobhan.lendzionowski@nhs.net 

Please note that the deadline for feedback is 19 August 2020.  Thank you for your support with this evaluation.    

GPhC guidance on COVID-19 rapid antibody tests 3/8/2020

The General Pharmaceutical Council (GPhC) issued a letter to community pharmacy owners and superintendent pharmacists on 21 July to highlight its position concerning the provision and sale of COVID-19 rapid antibody tests from community pharmacies. 

It states that in the light of current public health advice, it is not appropriate for them to be sold in community pharmacies or recommended by pharmacy professionals at this point in time. 

Exciting development opportunity for potential General Practice Leaders 3/8/2020

There is an exciting development opportunity for potential General Practice Leaders within our region to work with the Primary Care Workforce and Training Hub in supporting workforce and service development plans across the Integrated Care System. The successful applicants will work with the Primary Care Workforce and Training Team or other partners in the area. These may include ICS, CCG, GP Federations or Primary Care Networks. This may involve working on service development and/or education and training initiatives. 

The fellowship programme is multi-professional with applications welcome from any clinical profession working in General Practice including; GP’s, General Practice Nurses, Advanced Nurse/Clinical Practitioners and Allied Health Practitioners including Physiotherapists and Pharmacists.

The programme will be 3 sessions per week, fixed term for 12 months. Successful applicants will additionally benefit from support from the Primary Care Workforce and Training Hub to facilitate the leadership sessions, enrolment in leadership/educational courses and mentorship / coaching throughout the post.

For further information please contact: Dr Alan Shirley Clinical Director, SYB Primary Care Workforce Training Hub alanshirley@nhs.net

https://www.jobs.nhs.uk/xi/vacancy/916129528 - MDT Fellowship posts (for General Practice Nurses, Advanced Nurse/Clinical Practitioners and Allied Health Practitioners including Physiotherapists and Pharmacists)

https://www.jobs.nhs.uk/xi/vacancy/916129505 - GP Fellowship posts

SystmOne practices: new electronic notifications for the urgent supply of medicines 3/8/2020

You can now receive electronic notifications from pharmacies about the urgent supply of medicines made as part of the NHS Community Pharmacy Consultation Service (CPCS). This informs you that a patient registered with your practice has received an urgent supply of medicine from a community pharmacy.

The notifications arrive as a workflow task and include ‘structured’ information, which means you can add the information directly to a patient’s record without having to transcribe it manually. Not all pharmacies can send the electronic notifications yet, so you should continue to check for notifications received via NHSmail, fax or post.

More information, including user guidance and training materials, is available on the NHS Digital website.

Important NHS Mail updates  3/8/2020

On Tuesday 4 August NHS Mail are making changes to way we authenticate to the system.  This may mean you need to re-input your password.

Unfortunately this won’t just affect your laptop, desktop and mobile, it could also cause issues for any devices which rely on an NHS Mail account to function. This could include scan to email and text messaging services.

Be prepared

In order to ensure you are prepared for this change can you please complete the following steps: 

  1. Identify any of your applications or devices which make use of an NHS Mail account. This may include scanning from a printer/scanner etc. and SMS for clinical systems etc.
  2. Ensure you are aware of the password for these accounts.
  3. If you do not know the password you will need to reset this using the NHS Mail self service password reset functionality where possible.
  4. Ensure any 3rd parties who support devices\applications are aware of this change and are able to support you after the change.
  5. Ensure that where passwords have to be reset that saved passwords are cleared.

How to reset forgotten NHS mail passwords

Guidance for resetting a forgotten NHS mail password or locked NHS Mail account can be found at https://support.nhs.net/knowledge-base/self-service-password-reset/ . You can also access our knowledgebase which has a number of articles around how to update your password for SMS in Clinical systems and for use with outlook. These guides will help you prepare for this change and troubleshoot any issues prior to contacting the IT service desk.

Should you have any issues that you are unable to resolve from using our knowledgebase, please log a ticket via our self service portal on the following link https://servicedesk.sheffield.nhs.uk

Supporting Learning from Deaths Reviews (LeDeR) for people with a learning disability 3/8/2020

Practices are asked to support Learning from Deaths Reviews for people with a learning disability and release case notes to reviewers as quickly as possible (ideally within a week of a request being made using the secure LeDeR web-based portal).

If preferred, a GP can have a direct discussion with a LeDeR reviewer. Click here for further information. 

Pulse oximeters for use with people at home and in care homes 3/8/2020

Pulse oximetry used under clinical supervision can help identify ‘silent hypoxia’ and rapid patient deterioration for patients with COVID-19 living at home including in care homes. 

We’ve purchased a limited supply of pulse oximeters that can be transferred to CCGs free of charge for their local areas when there is an urgent need such as increased local infection rate, existing intention to purchase pulse oximeters, or care homes with insufficient oximeters (each care home is recommended to have around one oximeter per 25 beds, depending on the type and configuration of the home and with a minimum of two per home).  

CCGs will need to provide assurance that:

  • oximeters will be used under general practice supervision
  • people at greatest risk from COVID-19 will be prioritised and supported
  • reasonable efforts will be made to safely reallocate oximeters if required, for example, because of evolving COVID-19 infection profiles and clinical pathways
  • reasonable efforts will be made to supply relevant information on oximeter use to inform future use of oximetry for COVID-19 patients.

It is recommended that primary care networks (PCNs) contact their CCG if they feel they have an urgent requirement of which their CCG is not already aware. Oximeters will be transferred to CCGs so there is no VAT liability for practices or PCNs. Guidance is available on the use of pulse oximetry to detect early deterioration of patients with COVID-19 in primary and community care settings.

Access to repeat prescriptions For Information 

During the COVID-19 pandemic many practices have adopted new ways of working and have encouraged patients to request repeat prescriptions online, where appropriate. Online ordering of repeat prescriptions has many benefits for practices and patients, but it isn’t suitable for everyone. Following some recent enquiries, we wanted to clarify that practices must still have systems in place to enable patients to request repeat prescriptions by telephone or in person.

Carer funding available to qualified GPs on the Induction and Refresher Scheme returning to practice 3/8/2020

Funding has now been agreed to provide financial help towards the cost of childcare and caring responsibilities for GPs on the NHS GP Induction and Refresher Scheme. We have reached agreement with the British Medical Association General Practice Committee (BMA GPC) that the support will also be available to those GPs with other caring responsibilities. Up to £2,000 will be available to claim for the cost of childcare for each child whilst on the scheme and those with caring responsibilities. The funding is in addition to the £3,500 per month bursary and other funding that GPs on the scheme can claim.

The funding will be available from 1 April 2020 until 31 March 2022. 

Updates to shielding guidance 3/8/2020

From 1 August, shielding advice to those who have been identified as clinically extremely vulnerable is being relaxed and the national shielding programme is being paused. The updated guidance will be published on 1 August on GOV.UK and further details will be communicated in next week’s bulletin.

Individuals considered clinically extremely vulnerable will not receive another letter from the government to confirm these changes. The relaxation of shielding measures was communicated to everyone on the Shielded Patient List (SPL) in a letter from the government on 22 June, or more recently via their shielding letter if identified as clinically extremely vulnerable since then. 

There may be exceptions to lifting the shielding guidance in parts of the country experiencing community outbreaks. Where specific local measures are in place, the local guidance should be followed. Individuals living in these areas will be informed by the government shielding service.

As per the letter to the NHS on 8 July, the Shielded Patient List will still be maintained while the shielding programme is paused, as the government may advise people to shield again if there is an increase in transmission of coronavirus in the community. Clinicians should continue to identify people who may be considered clinically extremely vulnerable based on the existing criteria and add them to the SPL. An updated template letter for notifying people identified as clinically extremely vulnerable will be distributed to practices and trusts and will be made available on the NHS Digital website.

As set out in annex 3 of the letter of 8 July practices should support the process of reviewing and, where appropriate, removing children and young people previously identified as clinically extremely vulnerable from the SPL in line with new advice from RCPCH. The actions required must take place before the start of the new school term in September 2020.

It is essential that everyone who needs to access health services is supported to do so as services are restored. Individuals who have been shielding may be particularly anxious about attending health settings, and this should be taken into account in care planning and in communications about attending appointments and visiting NHS sites.

Measures should be put in place to support safe service restoration and provide environments where the risk of infection is managed for all patients. Individuals’ care should be reviewed as necessary to identify any potential deterioration of existing conditions during shielding and need for rehabilitation or support in resuming daily activities.

Self-isolation of health and care workers from high risk countries 3/8/2020

From 31 July, registered health and care professionals travelling to the UK from high risk countries will lawfully be required to self-isolate for 14 days. They will no longer be exempt. The move will bring health and care professionals in line with the general public and further protects the NHS and social care system from the spread of coronavirus from overseas, as signs of second waves begin to show in other countries.

The regulations are laid out by the Department for Transport (DfT).  The current list of countries exempt from self-isolation measures is available on GOV UK.  Health and care professionals returning from a country which has a travel corridor to the UK will not be required to self-isolate on return.  Information on air corridors can be found here.  This amendment to the regulations will ensure consistency with wider quarantine measures and continue to protect public health.

Third phase of NHS response to COVID-19 3/8/2020

The NHS received its phase three planning letter from Sir Simon Stevens and Amanda Pritchard – both thanking and noting the tremendous efforts of staff and setting out the next – third phase of the response effective from 1 August 2020 and the task ahead of us in the coming months.

You can read the full letter attached however the three areas that the CCG will be focusing on are:

  • Accelerating the return to near-normal levels of non-COVID health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter
  • Preparation for winter demand pressures, alongside continuing vigilance in the light of further probable Covid spikes locally and possibly nationally.
  • Doing the above in a way that takes account of lessons learned during the first Covid peak; locks in beneficial changes; and explicitly tackles fundamental challenges including: support for our staff, and action on inequalities and prevention.

Subject: Important NHS Mail updates  30/7/2020

On Tuesday 4 August NHS Mail are making changes to way we authentic

ate to the system.

This may mean you need to re-input your password.

Unfortunately this won’t just affect your laptop, desktop and mobile, it could also cause issues for any devices which rely on an NHS Mail account to function. This could include scan to email and text messaging services.

Be prepared

In order to ensure you are prepared for this change can you please complete the following steps: 

  1. Identify any of your applications or devices which make use of an NHS Mail account. This may include scanning from a printer/scanner etc. and SMS for clinical systems etc.
  2. Ensure you are aware of the password for these accounts.
  3. If you do not know the password you will need to reset this using the NHS Mail self service password reset functionality where possible.
  4. Ensure any 3rd parties who support devices\applications are aware of this change and are able to support you after the change.
  5. Ensure that where passwords have to be reset that saved passwords are cleared.

How to reset forgotten NHS mail passwords

Guidance for resetting a forgotten NHS mail password or locked NHS Mail account can be found at https://support.nhs.net/knowledge-base/self-service-password-reset/ . You can also access our knowledgebase which has a number of articles around how to update your password for SMS in Clinical systems and for use with outlook. These guides will help you prepare for this change and troubleshoot any issues prior to contacting the IT service desk. 

Should you have any issues that you are unable to resolve from using our knowledgebase, please log a ticket via our self service portal on the following link https://servicedesk.sheffield.nhs.uk

Reminder: Online AF Patient Education Series 30/7/2020

This event will improve education, outcomes, and confidence for atrial fibrillation patients to manage their condition, leading to an improved quality of life.  For further details (see attachment number 4)

New: Safeguarding Adults Board newsletter – spotlight on self-neglect review 30/7/2020

The Barnsley Safeguarding Adults Board now produces a helpful newsletter (see attachment number 3) to keep you up to date with the latest guidance, training and importantly, learnings for us all from case reviews.

Safeguarding Adults Reviews (SARs) provide an opportunity to learn lessons and improve practice, when abuse or neglect is suspected to be a factor in the death or serious harm of an adult with care and support needs.

In this issue there is a safeguarding adult review into the sad death of Barnsley man Clive who died as a result of self-neglect. Thanks to his family for contributing.

Clive died alone at home weighing 6 stones in an unheated house due to worries about money.  He struggled to access payments via the DWP due to his inability to leave his home. The key learnings: Impact of bereavement; need to provide home support for adults who are “unable” to attend appointments; and the need to work together to share information and manage the risks. You can read the review learnings in full in the newsletter.

Diabetes Clinical Network Update:  July 2020  20/7/2020

This month the newsletter (see attachment number 2) contains information for those interested in diabetes care including:

  • ABCD Yorkshire & the Humber Regional Diabetes meeting, 20th October – register now
  • Association of British Clinical Diabetologists (ABCD) - a new publication: Diabetes at the Front Door, and American Diabetes Association conference reports
  • Diabetes UK Sick Day rules in various languages
  • Managing Diabetes and Supporting BAME Patients during COVID19: Webinar
  • Care home diabetes: a continuing health & social care challenge: ABCD Webinar
  • Delivering Diabetes Care during the COVID-19 Pandemic – the ‘new normal’ - guide for general practice
  • Public and patient involvement, inequalities and learning disabilities – two opportunities
  • Diabetes in pregnancy – Best Practice Guide for Diabetes Technology
  • Gestational diabetes diagnostic pathway feedback
  • Diabetes UK Clinical Champions
  • Diabetes UK Discovering Leadership
  • Utilise Time in Range through LibreView: Webinar
  • Diabetes Advice Line for those with insulin-treated diabetes
  • DSN Survey to develop a pan-European perspective on the impact of COVID-19 – all diabetes nurses requested to take part
  • Diabetes Audits – information capture can continue

COVID-19: Reviewing High Risk (Shielding) Patients 30/7/2020

The latest Shielded Patient List (SPL) data  has been processed and added to the clinical systems.This latest SPL cohort is collectively referred to as SPL16.

As with previous updates, SPL16 includes both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL16 additions:

The approved high-risk code will be added  to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL16 subtractions:

Patients identified as being subtracted from the SPL in SPL16 will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 28th July 2020 (SPL16)

- EMIS HEALTH: COVID-19 SEARCHES/ Patients removed from SPL 28th July 2020 (SPL16)

The SystmOne (TPP) search can be found in the COVID folder:

- LOT 15 High Risk COVID-19 code added 28/07/20, without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

NEW* Immunisation & Vaccination Refresher elearning & supporting webinar launched 27/7/2020

With the government announcement last week promising more than 30 million people across the UK a free flu vaccination this year, part of plans to help protect our NHS, we've worked with partners Charles Bloe Training to launch a new blended elearning and webinar Immunisation and Vaccination Refresher offer to support the sector prepare.

Developed to help tackle the challenges still currently encountered around receiving face-to-face training, our Immunisation and Vaccination Refresher Bundle has been designed to give learners access to not only our comprehensive elearning, but reinforced with a supporting webinar, delivered by online, virtual and classroom healthcare training experts Charles Bloe.

Whether you are a nurse, healthcare assistant, pharmacist, or other healthcare professional, ensure you have the up-to-date background knowledge required to vaccinate patients safely with our course covering: current issues in immunisation and vaccinations; legislation and policies; reviews on current practice for administering the vaccine; Anaphylaxis; basic life support and more...


Webinar sessions are available for:

  • Tuesday 11 August, 2020, at 14:00 and 17:30
  • Places are limited, so don’t delay and book your place here     

Primary Care: New Roles Webinar Series 2020: The Role of an Advanced Practice Dietitian in Primary Care 27/7/2020

Please join us for the first in our series of webinars designed to provide an overview of the opportunities of these new roles for primary care networks in South Yorkshire & Bassetlaw.

These webinars are supported by South Yorkshire & Bassetlaw (SYB) Integrated Care System; SYB AHP Council and Primary Care Workforce and Training Hub. They are produced in collaboration with clinical leads  from the relevant professions that form part of the Additional Roles Reimbursement Scheme. 

Session 1:

Topic:             The Role of an Advanced Practice Dietitian in Primary Care​

Presenter:      Sophie Hempsall Professional Lead Nutrition & Dietetics, Doncaster & Bassetlaw Teaching Hospitals NHS Trust 

Date:               Wednesday 29 July 2020

Time:              12:30 - 13:00

Meeting link here 

Containing and managing local COVID-19 outbreaks 27/7/2020

The government has published guidance for local authorities and local decision-makers on containing and managing COVID-19 outbreaks at a local level. This document sets out how NHS Test and Trace and the Joint Biosecurity Centre (JBC) will work with local authorities, Public Health England (PHE) and the public to contain and manage local COVID-19 outbreaks.  

New regulations came into effect on 18 July 2020 to give local and national government additional powers to stop local transmission of the virus. These will allow them to restrict local public gatherings and events, and close local businesses premises and outdoor spaces

DOAC monitoring emis template v1 27/7/2020

To support practices in the Monitoring of “High Risk” Patients being prescribed Direct Oral Anticoagulants please contact the primary care team for the emis template which some practices may find helpful in prompting the clinician to review key patient factors.

A SystmOne template is in development and will be circulated when available.

Please also note the current guidelines are under review and due to be considered at the APC meeting in August.  Any resulting changes to monitoring requirements will be circulated with an updated template if required.  

Guidance - New recommendations for primary and community health care providers in England 27/7/2020

This is the latest update on guidance on infection prevention and control (IPC) recommendations for primary and community health care providers in England.  It advises all providers of primary and community health services should ensure that measures are in place so that all settings are, where practicable, COVID-secure, using social distancing, optimal hand hygiene, frequent surface decontamination, ventilation and other measures, where appropriate.  It also advises on the use of face masks.

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/new-recommendations-for-primary-and-community-health-care-providers-in-england

NHS Workforce Virtual Conference 23/7/2020

Our virtual conference series is offering you the ability to listen, learn, and engage with some of the country's most forward-thinking and reputable policymakers and health innovators. You can enjoy live presentations, multiple content streams, networking, and an interactive event, all from the comfort of your home!

Preserving and protecting the health, safety, and wellbeing of staff is critical for NHS organisations as they respond to the COVID-19 outbreak.

It is essential that NHS organisations take every effort to support the physical and mental wellbeing of the workforce, to allow staff to stay healthy and shield themselves, colleagues, patients and families as we continue to deliver services through this challenging period.

NHS Workforce Management Virtual Conference: 11:30am - 3:00pm, September 16th, 2020, Convenzis App.

Key subjects:
• NHS Guardian initiative
• FTSU
• Diversity and inclusion
• Working from Home

Registration is open, we look forward to greeting you on the day.

Website: https://www.convenzis.co.uk/events/supporting-developing-and-valuing-staff/

We are advising ALL attendees attend the event via personal laptop or mobile device (Non-NHS Device)
We have noticed that NHS Devices are making it more difficult to view event content.
To maximise the chances of viewing content:
• Attend via a NON-NHS Device
• Attend the event via the Convenzis APP (where possible)
• Connect via your personal WI-FI (NON-NHS)
• Attend the online platform via google chrome web browser

New Patient Registrations  23/7/2020

This is a reminder to all practices that your patient list should remain open to register new patients as stated in your GMS/PMS/APMS contract.  No practices should be refusing to register patients, providing they live within the practice catchment area. 

COVID-19 tests and testing Kits – updated guidance  23/7/2020

Updated guide to COVID-19 tests and testing kits' to make it clearer how the different types of tests work, and who can use them can be found at the following link: For patients, the public and professional users: a guide to COVID-19 tests and testing kits 

The different types of tests and testing kits for COVID-19, and the specifications for manufacturers. First published 13/05/2020 updated guidance can be found at the following link:  How tests and testing kits for coronavirus (COVID-19) work

Enhanced Testing for people without symptoms who are concerned  23/7/2020

Who can have a test?

Tests can be performed at a walk-in mobile testing unit if you:

  • do not currently have symptoms of COVID-19 (coronavirus)
  • have a face covering
  • adhere to social distancing at all times including when travelling to and from the site 

The main Barnsley testing unit is based at  County Way car park.  You can drop in to get a test between 10.30am and 4pm from Saturday 11 July to Friday 31 July.

For a limited time you can also get a test as follows between 11am to 3pm:

  • Friday, 24 July: Wombwell - Station Road car park (rear of the library) S73 0BA

https://www.barnsley.gov.uk/services/health-and-wellbeing/covid-19-coronavirus-advice-and-guidance/covid-19-coronavirus-mobile-testing-units/  

Booking and registration process

To make the process as smooth as possible, a booking process is in now in place and can be carried out as follows:

  1. Find out more about how to book a test online in advance with the NHS
  2. On the day via people’s smartphone. Staff will be on hand to help people with this while they wait for a test.

Please note that advance bookings can only be made from 6pm the night before.

Booking for people with symptoms remains the same and can be accessed on the link above

COVID-19: Reviewing High Risk (Shielding) Patients 23/7/2020

The latest Shielded Patient List (SPL) data  has been processed and added to the clinical systems.This latest SPL cohort is collectively referred to as SPL15.

As with previous updates, SPL15 includes both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL15 additions:

The approved high-risk code will be added  to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL15 subtractions:

Patients identified as being subtracted from the SPL in SPL15 will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 17th July 2020 (SPL15)

- EMIS HEALTH: COVID-19 SEARCHES/ Patients removed from SPL 17th July 2020 (SPL15)

The SystmOne (TPP) search can be found in the COVID folder:

- LOT 14 High Risk COVID-19 code added 20/07/20, without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Mastering ECG's in Primary Care – 25 July 2020 20/7/2020

Yorkshire Health Practitioners Association(YHPA) are offering an educational session on Saturday 25 July 9.40 – 11.10 am via Zoom.

Please see attached information on how to register and Agenda details. 

GP IPC Training 20/7/2020

Following on from the recent bulletin item on IPC and use of PPE, including updating your workplace risk assessment, we had arranged a number of virtual sessions with the Infection Prevention and Control Specialist team at Barnsley Hospital who oversee the CCG contract to deliver support training for practices.

No further sessions have been arranged however if practices have any queries or require any support they can contact the Infection, Prevention and Control Team via email bdg-tr.infectioncontrol@nhs.net 

Barnsley, Bassetlaw and Sheffield (BBS) IT Service Newsletter and Self Service Guide  20/7/2020

Please find attached the first edition of the Barnsley, Bassetlaw and Sheffield IT Service Newsletter and the BBS IT Self Service Guide – Contact Clinical Apps.

If you have any questions, comments or feedback regarding any of the information provided, please let us know.

Clinical Applications & Data Quality Support Team, BBS IT Services, NHS Sheffield Clinical Commissioning Group, 722 Prince of Wales Road, S9 4EU

Password Resets:- https://password.sheffield.nhs.uk

Self Service Portal:- https://servicedesk.sheffield.nhs.uk

Temporary Expansion of APC Reporting  20/7/2020

Area Prescribing Committee (APC ) Reporting is a process where medicines related issues which occur across the Provider interface(s) are able to be reported and resolved. This process is additional to (does not replace) the organisational incident reporting processes.

Due to COVID 19 service changes which are happening,  it has been agreed to temporarily expand  this process to capture the wider reporting of clinical interface issues; as it a process which has clinician oversight , engagement across all Providers and is well understood by services.

Clinicians from all/any Barnsley Provider Services are now encouraged to report  problems/issues which they experience at any (local or SY&B or wider) Provider interface.

Clinicians can report issues by email to: BarnsleyAPCReport@nhs.net 

COVID-19 tests and testing Kits – updated guidance   20/7/2020

Updated guide to COVID-19 tests and testing kits' to make it clearer how the different types of tests work, and who can use them can be found at the following link: For patients, the public and professional users: a guide to COVID-19 tests and testing kits 

The different types of tests and testing kits for COVID-19, and the specifications for manufacturers. First published 13/05/2020 updated guidance can be found at the following link:  How tests and testing kits for coronavirus (COVID-19) work 

Antibody Testing for Health Care Staff 20/7/2020

Please be aware that results are taking at least 2 weeks to come back at the moment and in many cases this has been much longer.  Staff members registered GP may be able to access your result from the ICE system at their GP practice. 

Staff should also get a text to the mobile number they have provided, but there is currently a backlog of results that need sending out.   We are currently trying to address this situation with the labs as a matter of urgency. 

Please also be aware that community health care staff, such as pharmacies, dental and optometry staff, are currently being offered testing for Covid19 antibodies and the results are being shared with their registered GP via ICE.  You may have staff requesting their result – since you have not requested the test, you may need to download results directly from ICE. 

Scheduled South Yorkshire Mobile Testing Unit deployments up to 31 July 15/7/2020

 

South Yorkshire MTU deployments

Key:

Site is "locked in" and live on the national booking system.

CONFIRMED

Key:

Barnsley

Site is "locked in" and can only be changed for operational reasons.

OPS LOCKED

Doncaster

Site is tentative and subject to change.

TENTATIVE

Rotherham

Sheffield

Deployments in italics with an asterisk* are additional MTU capacity released under the Enhanced Testing Strategy

Day

Date

District

Site address

Wednesday

15-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield*

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Thursday

16-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Barnsley*

Station Road, Wombwell, Barnsley S73 0BA

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield*

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Friday

17-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Barnsley*

Station Road, Wombwell, Barnsley S73 0BA

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield*

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Saturday

18-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield*

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Sunday

19-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield*

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Monday

20-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Tuesday

21-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Wednesday

22-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Thursday

23-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Friday

24-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Saturday

25-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Sunday

26-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Rotherham*

Herringthorpe Athletics Stadium, Middle Lane South, Rotherham S65 2HR

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Monday

27-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Tuesday

28-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Wednesday

29-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Thursday

30-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

Friday

31-Jul-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

Rotherham

Bus Depot, Midland Road, Rotherham, South Yorkshire S61 1TF

Sheffield

Olympic Legacy Park Car Park off B6085, Worksop Road, S9 3TL

Doncaster

Dearne Valley Leisure Centre, Doncaster Road, Mexborough, S64 0LB

 

COVID-19: Reviewing High Risk (Shielding) Patients 15/7/2020

The latest Shielded Patient List (SPL) data has been processed and added to the clinical systems. This latest SPL cohort is collectively referred to as SPL14 (14th July).

As with previous updates, SPL14 includes both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL14 additions:

The approved high-risk code will be added  to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL14 subtractions:

Patients identified as being subtracted from the SPL in SPL14 will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 14th July 2020 (SPL14)

- EMIS HEALTH: COVID-19 SEARCHES/ Patients removed from SPL 14th July 2020 (SPL14)

 The SystmOne (TPP) search can be found in the COVID folder:

- LOT 13 High Risk COVID-19 code added 13/07/20, without a more recent Low Risk or Moderate Risk code

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

GP patient survey 2020 13/7/2020

The GP patient survey for 2020 was published yesterday (9 July 2020) and is an important indicator for how our patients feel about general practice and dental services. It is positive to see that more than 95% of patients have confidence and trust in their family doctor and thanks to hard working dental practices, nine out of 10 people were able to get an appointment when they needed one, with the vast majority reporting a positive experience with their NHS dentist.

The survey covers the period up until the end of March 2020 and the pandemic has radically altered the way our patients use primary care services, giving us a real opportunity to continue to improve access to high quality care. The full results of the survey can be accessed on the GP patient survey website.

Completion of Staff Risk assessments13/7/2020

In the NHSE letter of 24 June 2020 on the completion of staff risk assessments, a request was made to NHS employing organisations for to ensure that all risk assessments were completed for at least ‘at-risk’ staff groups within four weeks. All NHS organisations will be asked to submit returns for the following four questions:

  • Have you offered a risk assessment to all staff?
  • What % of all your staff have you risk assessed?
  • What % of risk assessments have been completed for staff who are known to be ‘at-risk’, with mitigating steps agreed where necessary?
  • What % of risk assessments have been completed for staff who are known to be from a BAME background, with mitigating steps agreed where necessary? 

If a staff member has concerns regarding risk assessment, organisations should offer assurance about confidentiality, signpost to occupational health and other support services, and reiterate that there will be no detriment to them, or their career, in the short or longer term. Primary care organisations have been contacted directly with details about the process used to collect this information this week, with deadlines for submission on 17 and 31 July 2020.  Thank you for your support with this important issue.

Second phase of general practice response to COVID-19 13/7/2020

his week NHSE published a letter on the second phase of the general practice response to COVID-19.  This letter confirms contractual arrangements from July and income protection arrangements.  Please do take time to read this letter. Some key points are:

  • We need general practice to continue its vital role in supporting high-risk patients with ongoing care needs, but also to resume as soon as possible services which may have been paused, managing pre-existing conditions and urgent demand.
  • We recognise that practices will need to re-prioritise aspects of care not related to COVID-19 and intend to modify the Quality and Outcomes Framework (QOF) requirements for 2020/21 to support this.
  • We are asking practices to resume new patient reviews, routine medication reviews, over-75 health checks and clinical reviews of frailty – but to prioritise these using their clinical judgement and a risk-based approach. The letter also describes how flexibilities under the GP contract may be reinstated to support with management of local outbreaks.

Message from Julia Burrows, Director of Public Health, Barnsley Council 13/7/2020

Updated message from Julia Burrows, Director of Public Health in Barnsley is available here.  

New guidance – key principles for intimate clinical assessments undertaken remotely children 13/7/2020

This guidance is aimed at clinicians who are consulting remotely with patients through a digital channel (e.g. online, email, text, video-link) across healthcare settings in England. 

The principles described in this guidance aim to support patients to access care in a way that meets their needs and to support clinicians to provide care in a way that is in the best interests of their patients, whilst protecting both from the risks associated with remote intimate assessments.

The production of this guidance has also lead to amendments of legal guidance from the Crown Prosecution Service on indecent and prohibited images of children.

For any problems in accessing this guidance contact england.digitalfirstprimarycare@nhs.net

Updated shielding guidance changes for children 13/7/2020

The Government shielding guidance has been slightly relaxed so that those who are shielding can meet in groups of up to 6 outdoors and to form "support bubbles", if they wish.  In addition to these changes, the guidance has been updated to reflect the Royal College of Paediatric and Child Health’s guidance on children and shielding, which the government has now endorsed. Children and young people should continue to shield until 31 July 2020.

From Saturday 1 August 2020, the guidance will then be paused so clinically extremely vulnerable people of all ages will no longer be advised to shield. We expect most children and young people will be removed from the shielded patient list following consultations with clinicians and GPs over the summer. This group will not be advised to shield if government guidance on shielding is changed in the future.

Update to GP contracts and income protection arrangements 10/7/2020

Letter dated 9th July 2020 re: Update to GP contracts and income protection arrangements can be found at:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0569-Second-phase-of-General-Practice-response-to-COVID-19--update-to-GP-contracts-and-income-protection-a.pdf

Minimising Nosocomial Infections Updated 6th July 10/7/2020

Please find attached updated letterSOP and IMARCH form relating to minimising nosocomial infections in the NHS.

Please note change to outbreak form (IMARCH) on slide 20

If you have any queries please contact Regional COVID-19 Incident Coordination Centre, North East and Yorkshire, Email: england.eprrney@nhs.net, Phone: 07702404046

Nominations to become an Elected Member of the Barnsley CCG Governing Body 10/7/2020

Please find attached letter and role descriptor requesting nominations to become an elected member of the Barnsley CCG Governing Body.

Upcoming Webinar 6/7/2020

Wednesday 8 July, 7-8pm – Risk assessment and community pharmacy webinar

Alert regarding Cardinal Health Type IIR masks 6/7/2020

You may have received an Important Customer Alert about Cardinal Health Type IIR masks on 26 June 2020. Although these masks meet the breathability, filtration and splash resistance requirements of BS EN 14683, in light of ongoing monitoring, further complaints reported and testing from the manufacturer on the masks, the MHRA recommends that all lots of this product are disposed of locally. There is a risk to staff wearing the mask if the foam strip on the mask flakes and enters their airway or mouth. There have also been complaints of the ties and/or stitching coming away from the mask. The product affected is the Type IIR Mask from the supplier Cardinal Health (NPC: BWM028, MPC: AT74535UK, applies to all lots of AT74535UK).

Any practices who are about to run out of type IIR masks due to this product quality notice should contact the supplier they originally received this product from for further stock: this could be the wholesaler or the Local Resilience Forum (LRF).  For emergency supply, providers can contact their LRF who have PPE stock available, or the NSDR.   

Practices can also register and place orders for PPE via the Portal. PPE ordered from the portal is free of charge and orders will be delivered by Royal Mail within 48 hours for orders placed before 1pm and 72 hours for orders placed after 1pm. Further information can be found on the DHSC PPE Portal guidance page. 

2020 GP Patient Survey 3/7/2020

The 2020 GP Patient Survey (GPPS) will be published at 9.30am on Thursday 9 July 2020. The survey is sent out to more than two million people, aged 16 and over, every year who are registered with GP practices across England. As in previous years, the results will cover broad information about experiences of primary care – primarily in general practice but with some questions relating to NHS primary care dental services – and monitors a wide range of experiences including ease of making appointments, waiting times, opening hours, treatment and care planning by healthcare professionals. 

The findings will be published at www.gp-patient.co.uk by Ipsos MORI.

Caring for our most vulnerable residents - so much more than a virtual ‘check in’ 3/7/2020

If you are looking for information and tools to support virtual check-ins and video consultations with care homes, you might find this blog helpful from Dr Matt Hoghton, GP and Clinical Advisor, Digital Primary Care NHSX.

EPS4 UPDATE: Practice support and prioritisation 1/7/2020

HEADSETS 1/7/2020

Surface Pro Sim Cards 1/7/2020

COVID-19: Reviewing High Risk (Shielding) Patients 1/7/2020

Public guidance - attending vaccination appointment 29/6/2020

Please find details of some text on what people can expect when attending a vaccination appointment and what we are doing to keep them safe. This can be adapted locally and used in letters and other communication with the public. The document is also available on FutureNHS at:

https://future.nhs.uk/PHCO/view?objectId=73639909 

COVID-19 waste management guidance SOP version 2 29/6/2020

The link below sets out the updated waste management approach for all healthcare facilities including primary care facilities and testing facilities in England and Wales during the COVID-19 outbreak: https://www.england.nhs.uk/coronavirus/publication/covid-19-waste-management-standard-operating-procedure/

(Updates to Version 1, published on 6 April 2020, are highlighted in yellow) 

Important Customer Alert - Type IIR Masks – Cardinal Health 29/6/2020

Please find attached Important Customer Alert ensure you:

  • Identify, stop using and immediately quarantine all lots relating to BMW028 of the Cardinal Type IIR masks. 

Clinical guidance for healthcare professionals on maintaining immunisation programmes during COVID-19 29/6/2020

https://gp.selondonccg.nhs.uk/wp-content/uploads/2020/06/GPB-200603-Technical-advice-to-HCPs-on-imms-for-COVID-19-FINAL.pdf   Version 2.2 – updated on 3rd June 2020 

Supply issues with lodoxamide, mirtazapine, imipramine, lacosamide and an update on ranitidine 29/6/2020

The table below provides a summary of the attached (1-5) MSNs:

Medicine

Out of stock until

Alternatives

(NB FP10 prescriptions must indicate that a special is required/prescribed by the GP if relevant)

MSN/2020/025-U2

Ranitidine: All formulations update to SDA/2019/005-U2

To be confirmed

Clinical advice on alternatives of oral ranitidine preparations for adults and children has been shared in the previous supply disruption alert SDA/2019/005 (U2)

UKMi have provided updated clinical advice regarding alternatives of ranitidine preparations, which can be found in the MSN.  

MSN/2020/034

Lodoxamide (Alomide) 1% eye drops

w/c 24 August 2020

Sodium cromoglycate eye drops and various antihistamine eye drops remain available.

MSN/2020/035

Mirtazapine 15mg and 45mg orodispersible tablets

End of July 2020

Unlicensed imports of mirtazapine orodispersible tablets have been sourced.

Mirtazapine 15mg, 30mg and 45mg tablets remain available.

MSN/2020/036

Imipramine 25mg tablets

Early August 2020

Imipramine 10mg tablets remain available.

Unlicensed imports of imipramine 25mg tablets have been sourced.

MSN/2020/037

Lacosamide (Vimpat) 50mg tablets

From early July until w/c 20 July

Vimpat 10mg/ml syrup remains available.

There have also been changes to the resupply dates of the medicines listed in the attached document. These MSNs were previously circulated via our commissioning routes.

* An updated MSN regarding H2-antagonists will be issued shortly.

Please be aware this communication is also being circulated separately to all Community Pharmacies in England

Please note that supply issues that have been categorised as tier 1 or 2, DHSC and the MSRG have requested that we use our commissioning routes to reach community pharmacy and GP practices. More serious supply issues are communicated via the Central Alerting System for action.

If you have any queries please contact: DHSCmedicinesupplyteam@dhsc.gov.uk 

Health and care video library available free to NHS 26/6/2020

As part of the response to COVID-19, NHSX has secured a 6 month national licence for NHS clinicians to access a health and care video library of over 600 patient information videos free of charge. The videos have been developed and written by NHS clinicians to use within a wide range of care pathways including maternity, physiotherapy, rheumatology and podiatry. The library platform and the videos have been professionally produced by Health and Care Innovations (HCI). Join the onboarding webinars (see below) to get the most out of this resource.

Social Distancing – Keeping 2mtres apart still applies for NHS 26/6/2020

You will have seen the government's announcement of the change in the guidance on social distancing. From July 4th the guidance will change from ‘Stay 2 metres apart’ to ‘Where it is possible to keep 2 metres apart people should’. It advises people to keep a social distance of ‘one metre plus’, meaning they should remain at a minimum one metre apart, while also taking physical steps to reduce the risk of transmission.

Across the NHS, staff have been working hard to restore those services that had to be paused to deal with the first COVID-19 peak, and you have been doing this within social distancing guidelines and following infection control procedures to protect patients and staff.

NHS England and NHS Improvement is working urgently to consider the implications of the change of Government guidance on the service. If any change in the guidance for health services is agreed, based on clinical advice, new guidance will be issued. Our priority will be to enable those running services to see as many patients as possible, while keeping staff and patients safe.

In the meantime, it is essential that those running and planning services maintain social distancing at 2 metres and, even if any new guidance is communicated, continue to social distance at 2 metres wherever possible. As Chris Whitty, the Government's Chief Medical Officer said  "the advice to stay at 2m when you can stay at 2m remains".

Webinars 26/6/2020

GP Standard Operating Procedure updated 26/6/2020

We have added two new sections to the GP Standard Operating Procedure and updated it with some additional information and links for ease of access – these can be identified as highlighted in the published GP SOP which can be found on our website. The updated sections are on:

  1. Outbreak management in the context of COVID-19 – with a recommendation to review business continuity plans.
  2. Suspected or diagnosed cancers, including ongoing cancer treatment – information on referral into secondary care.

Please refer to the updated SOP for further information.

Alcohol-based hand sanitiser and the risk of vehicle fires 24/6/2020

This quick share is to alert all colleagues to the potential fire risk in vehicles, caused by alcohol-based hand sanitiser.  We have received a number of reports of hand sanitiser being the cause of fires when left in vehicles in the hot weather the UK is currently experiencing.

IPC Primary Care Training 24/6/2020

Following on from the recent bulletin item on IPC and use of PPE, including updating your workplace risk assessment, we have arranged a couple of virtual sessions with the Infection Prevention and Control Specialist team at Barnsley Hospital who oversee the CCG contract to deliver support training for practices.  The initial dates have been arranged as follows: 

  • Tuesday 30 June 2020 11.30-12.30pm
  • Thursday 2 July 2020 10-11am

Both meetings will take place through Mircosoft Teams.

If you would like to join the training please send your preference of date and who will be representing your practice (we suggest no more than 2) with their email to barnsleyccg.primarycare@nhs.net and we will forward on a meeting invite.

SOP Minimising nosocomial infections in the NHS  24/6/2020

This standing operating procedure has been written by the Regional leads from NHS England and NHS Improvement and Public Health England with the support of the Regional Covid-19 Incident Team to provide local guidance to support organisations.

It describes the regional processes that are aligned to the ‘Minimising Nosocomial Infections in the NHS England and Improvement’ letter dated 9 June 2020.

We recommend that all NHS organisations and providers of NHS funded care follow this process as part of the national incident requirements to protect staff and ensure timely reporting and management of outbreaks and staff absence.  See attached information.

Covid-19 antibody testing - indemnity arrangements 24/6/2020

We understand there has been some concern regarding the indemnity arrangements that apply for primary care staff who undertake antibody testing on other NHS workers. To ensure that indemnity is not a barrier to the NHS supporting the Government’s antibody testing programme, we are able to confirm that where you are not covered for this activity under your existing indemnity/insurance arrangements, the Clinical Negligence Scheme for Coronavirus (CNSC) will provide clinical negligence indemnity cover. This cover is for primary care staff who take blood samples from any NHS primary care contractor’s staff, including colleagues, or other NHS employees for the purpose of a Covid-19 antibody test. A FAQ covering this topic is also published on the CNSC FAQ pages of NHS Resolution’s website.

COVID-19: Reviewing High Risk (Shielding) Patients 24/6/2020

The latest Shielded Patient List (SPL) data  has been processed and added to the clinical systems. This latest SPL cohort is collectively referred to as SPL11 (22nd June).

As with previous updates, SPL11 includes both patient additions and patient subtractions. New additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England; practices do not need to contact these patients unless clinical review indicates that they should be considered as either moderate- or low-risk instead.

SPL11 additions:

The approved high-risk code will be added  to any patient identified as an SPL addition in this update (this is so that GP systems are in-sync with the national SPL), this may be backdated to reflect the date that the patient was identified as being in the high-risk category

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL11 subtractions:

Patients identified as being subtracted from the SPL in SPL11 will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital. 

Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 22nd June 2020 (SPL11)

- EMIS HEALTH: COVID-19 SEARCHES/ Patients removed from SPL 22nd June 2020 (SPL11)

The SystmOne (TPP) search can be found in the COVID folder:

- LOT 9 High Risk COVID-19 code added 22/06/20, without a more recent Low Risk or Moderate Risk code 

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

 If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Shielding Letter and Shielding Patient Letter 24/6/2020

Please see attached Shielded Patient letters that have been circulated to practices by NHSE. Letter 1 Letter 2

Barnsley launches virtual COVID-19 Book of remembrance 22/6/2020

Barnsley has launched a virtual book of remembrance that recognises the impact of Covid 19 on individuals and communities as well as the incredible contributions people have made during the pandemic. It will create a lasting memory for the people of the Borough.

From Thursday 18 June, people are invited to leave messages that remember and pay respect to friends, family and loved ones who have lost their lives during the pandemic, as well as ones that recognise, commend and appreciate those who have worked tirelessly to support local communities.

Messages can include a name, memory, photograph, drawing or poem to honour or share thanks.

Head over to the BMBC website for more information.

Scams 22/6/2020 

You may have started to see or hear about scams outside of work which are popping up relating to coronavirus.  Here’s more information on current scams and what to do about them. It’s scam awareness fortnight and you can read more about the things Barnsley Trading Standards are seeing across Barnsley.

Coaching support for all non-clinical and clinical primary care staff 22/6/2020

Would it be helpful for you to talk to someone who can help you process the experiences you are facing, develop coping skills and importantly, develop practical strategies to manage the situation, so you can carry on with your work and your life? Book your session at a time to suit you. Sessions are available 7 days a week, either by video or telephone. More information about the #LookingAfterYouToo coaching support.

Mobile and broadband enhancements for frontline NHS staff 22/6/2020

To support colleagues in unprecedented changes to working environments, major network providers have agreed to provide personal mobile data and broadband enhancements to identified frontline NHS staff, who are existing customers, throughout the response to the COVID-19 pandemic.

To find out about the offers and see if you are eligible visit the dedicated website.

Many offers are available through self-serve processes provided by individual network providers. Eligible staff can access other offers by nominating themselves to their CCG HR Director. HR Directors are responsible for validating and submitting requests to ensure eligible staff are prioritised for enhancements.

NHS Practitioner Health 22/6/2020

The last few weeks have taken a toll on many of us working across the NHS and now is the time to consider your own mental health and wellbeing. For doctors and dentists in England, NHS Practitioner Health is able to offer free mental health treatment and support, access to a network of clinicians and therapists as well as prescribing and inpatient care in a confidential service. Access is via self-referral and the service can see and treat mental health and addiction issues at any level. All other NHS staff can access a range of free wellbeing resources via the service, including online reflective spaces and webinars plus signposting to free offers of therapy and support.

Webinars hosted by Thrombosis UK 22/6/2020

As the UK manages the Covid-19 pandemic and face to face educational meetings are currently not possible to hold, Thrombosis UK, a registered charity, has initiated and hosted a range of free, health care professional educational webinars focusing on the management of thrombosis in patients with a confirmed diagnoses of, or suspected of having, COVID-19, and also considering those who may be at increased risk of blood clots.

The webinars are led by leading experts in this field and have received CPD accreditation form the Royal College of Pathologists.

Problem areas in thromboprophylaxis and COVID-19

Thursday 2nd July, 16:00-17:00 BST

Registration FOC: https://thrombosisuk.org/findevent/hcp-events.php

1 CPD credit

As the UK manages the Covid-19 pandemic, this webinar will consider the natural history of COVID-19 and COVID pneumonia and the evidence available to inform decision making in the role of:

  1. extended thromboprophylaxis following discharge from hospital for COVID-19,
  2. what considerations should be given when managing unwell COVID-19 patients in the community and care homes and
  3. guidance on identifying COVID-19 positive patients who are at high risk of VTE.

Existing guidance, practice and emerging evidence will all be considered through presentations and discussion with opportunity to pose questions.

How should General Practice consider respiratory issues in a time of COVID-19?

Thursday 7th July 2020, 19:30-20:30

Registration FOC: https://thrombosisuk.org/findevent/hcp-events.php

1 CPD credit awarded

Hosted by Primary Care Cardiovascular Society & Thrombosis UK, the webinar is open to all healthcare and allied professionals but will be of particular interest to those working in General Practice and the community, including care homes, and managing patients with a diagnosis or suspected history of COVID-19.

 The live webinar will consider new challenges for primary care practitioners in the management of COVID-19 positive patients presenting with respiratory issues.

This webinar will consider:

  1. What is the pathway and action for primary care managing acute but not hospitalised thrombosis and patients late presenting with breathlessness?
  2. Guidance on investigating and managing respiratory issues in a patient when acutely unwell with COVID-19.
  3. Considerations for the management of asymptomatic / mildly unwell COVID-19 positive patients with a previous history of thrombosis.
  4. General management of respiratory issues during recovery from COVID-19.

COVID-19 Plasma Appeal: New campaign launches next week 22/6/2020

From Monday 22 June the NHS is launching an urgent appeal for COVID-19 plasma donors. The key messages are:
 
➡️The NHS needs more COVID-19 convalescent plasma donors.
➡️Plasma donation is safe, easy, and could save lives.
➡️If you've had coronavirus, you can donate at Bradford or Leeds donor centres.
 
Find out more at www.nhsbt.nhs.uk
 
In our region, NHS Blood and Transplant will be collecting plasma at donor centres at Bradford and Leeds city centre.

NHS Complaints process 22/6/2020

On 26 March 2020, NHS England wrote to NHS organisations explaining that, subject to local determination, you may pause the complaints process. Unless circumstances change significantly, we are not planning to extend the pause into July.  We would also be grateful if you could begin planning for resumption in normal service.

Primary care network workforce data 22/6/2020

Data about your primary care network (PCN) workforce is essential to planning, recruiting and training staff. This is now taken from the National Workforce Reporting System (NWRS) by NHS Digital with the next extraction due at the end of this month.

Please ensure you are registered on NWRS and have updated your workforce records before 30 June. We recognise the time pressures you are under, but accurate information will ultimately support the future development of PCNs, practices, and staff. This is essential for all roles within your PCN, including social prescribing link workers, community pharmacists and other members of the multi-disciplinary team. Guidance is available here.

Management of patients with musculoskeletal and rheumatic conditions 22/6/2020

The British Society for Rheumatology and other partners have published Management of patients with musculoskeletal and rheumatic conditions who are on corticosteroids, require initiation of oral/IV corticosteroids or a corticosteroid injection.

This guidance relates to musculoskeletal (MSK) service provision across primary, community and secondary care and is applicable to adults and children. The use of steroid medication is one of the management options for a range of MSK conditions and in particular rheumatic conditions, and this guidance aims to assist decisions on the use of such medication during the pandemic.

The guidance supersedes the specialist guidance - Management of Patients with Musculoskeletal and Rheumatic Conditions on Corticosteroids - published as part of NHS England and NHS Improvement’s phase one response to COVID-19 pandemic.

Collecting your examples of innovation 19/6/2020

NHSE are collating examples of new and innovative ways of working in general practice and community pharmacy, so that we can ensure beneficial changes are captured and, where appropriate, sustained. We would like to learn from you, and the communities you care for, about the innovations that have emerged in response to COVID-19, and understand which of these should be kept and protected in the months and years to come.

Submit your examples by Thursday 25 June at ipsos.uk/COVIDinnovation. Please contact the team if you have any questions.

Take part in the NHS 72 anniversary 19/6/2020

On July 5th, it will be 72 years since the NHS began.

During the last few months, the NHS has been through the greatest test in its lifetime. And we will continue to deal with the many challenges brought about by the Covid-19 pandemic for the foreseeable future.

Every single one of you has worked so hard to ensure that our organisation coped and continues to cope with the additional pressures we have faced. We want to use this opportunity to thank you once again for all that you are doing.

As an NHS we have experienced many difficult times during these months, including the loss of much loved colleagues. So this year, as we remember all those we have lost, the way we mark our anniversary will have a different feel to years gone by. 

Every week of the pandemic, we have seen the communities we are here to serve show their love and appreciation for the NHS and carers. And so many have done their bit during the difficult weeks of lockdown.

So we want to use our 72nd anniversary as an opportunity to say thank you back. To thank them for helping us to help them. Across the country the NHS  has partnered with Together which is a coalition that everyone is invited to join, from community groups to some of the UK’s best known organisations. The aim is to bring people together and bridge divides, to help build a kinder, closer and more connected country.

There are lots of things advertised on the Together website as well as creative ways to get involved in the run up to, and over that weekend.

Of course we want to get involved here in Barnsley too. If your practice is getting involved we’d love to share your photos or videos on social media. There will also be another feature in Barnsley Chronicle that weekend from the NHS. Send any of your plans or photos over to Kirsty at the CCG in the run up or tag us in on Facebook @nhsbarnsleyccg. Barnsley Chronicle and We Are Barnsley are also working with us on Facebook so they would love your photos too. 

Cyber Attack – British Red Cross 19/6/2020

We have been informed that British Red Cross have been subject to a cyber-attack and as such we are being advised not to open any emails from them at the current time 

Self Care Forum Coronavirus Innovations Award 15/6/2020

Every year the Self Care Forum invites submission of examples of good practice and innovation during Self Care Week - this year they will be celebrating good self care practice for coronavirus initiatives. Winners will be given a £500 bursary and highlighted as a true innovator at a time when we need to find inspirational ways to support and protect people against one of the deadliest viruses this country has faced in decades. If you have implemented an initiative that has made a difference to individuals and the local community then get in touch. This invitation is open to everyone and the closing date for admissions is 31 July 2020. Find out more and submit.

Collecting your examples of innovation  15/6/2020

NHS England are collating examples of new and innovative ways of working in general practice and community pharmacy, so that we can ensure beneficial changes are captured and, where appropriate, sustained. We would like to learn from you, and the communities you care for, about the innovations that have emerged in response to COVID-19, and understand which of these should be kept and protected in the months and years to come. Submit your examples by Thursday 25 June at ipsos.uk/COVIDinnovation. Please contact the team if you have any questions.

Webinars 15/6/2020

Wednesday24 June, 18:00 - The coronavirus pandemic – Diabetes (CPD webinar)

Understanding the increased vulnerability of patients with Type 1 and Type 2 diabetes during the coronavirus pandemic

  • What is the mechanism driving this increased risk?
  • Why is it important to maintain glycaemic control? 
  • Practical tips and guidance for primary care

Register now >

Wednesday 17 June, 1.30-2pm - Digitally Excluded Communities - how to support your patients with getting online 

Thursday 18 June, 5-6pm  GP webinar with Nikki and Ed

GP Practice Questionnaire 15/6/2020

Please could Practice Managers follow the link below to complete a short questionnaire in regards to the services that are currently being delivered in your GP practice. We would appreciate if you could complete this and submit your response by 5pm Friday 19 June 2020.

https://www.surveymonkey.co.uk/r/LT22XZL

This questionnaire has been devised to help the CCG ascertain which services are currently being delivered by GP practices across Barnsley and aims to help us establish a baseline.

At the start of Covid-19 the RCGP provided guidelines for GP practices recommending a number of services that they aim to continue to deliver as a minimum. To create the questionnaire we have used the RCGP recommendations.   

We would like to take this opportunity to thank GP practices for all they have done throughout this global pandemic, we appreciate how hard practices have worked and how quickly they have adapted to the changes that have been requested. 

Pulse Oximetry and remote monitoring (C0445) 15/6/2020

In Friday’s bulletin we shared published guidance setting out principles to support the remote monitoring, using pulse oximetry, of patients with confirmed or possible COVID-19 in the community, focused on primary care.

There is now clear evidence that patients most at risk of poor outcomes are best identified by oxygen levels. The use of oximetry to monitor and identify ‘silent hypoxia’ and rapid patient deterioration at home is recommended for this group.

The principles we have set out will inform the work already ongoing in many practices and community teams using oximetry to support remote monitoring, and support these services being expanded to a wider cohort as needed. 

GMS/PMS Equalisation 12/6/2020

In Summer 2013 NHS England commenced a review of the funding of PMS practices due to the significant variation in approach to these contracts both in terms of the financial resources invested and the additional objectives included in contracts.  In 2019/20 the CCG continued with the work towards the GMS/PMS equalisation and this Committee approved the approach recommended to continue with the reconciliation.

For 2020/21 the CCG continues with the equalisation between GMS/PMS contracts and will be applying an uplift to all PMS practices.  An email will be sent out next week to individual PMS practices with details of their uplift.

MS Teams recording 12/6/2020

Please can practices be aware that any recordings made via MS Teams are stored on MS Streams which is accessible to any user of Teams and as such it is strongly advised not to record meetings where there is any possibility of confidential or sensitive matters being discussed. 

Local guidance for the Reuse of Medicines in care homes and hospice 12/6/2020

The Reuse of medicines guidance for Care Homes and Hospices has been approved for local use.  The attached guidance details the process to be followed by care homes and hospices if there is a shortage of specific medicines.  The Medicines Management Team will be contacting care homes to discuss the guidance and to answer any questions that may arise over the next few weeks. In the meantime, if there are any queries relating to this or other care home medicine related queries then please contact barnccg.mrsenquiries@nhs.net

Clinical negligence indemnity arrangements during the COVID-19 pandemic 10/6/2020

NHS Resolution has published guidance in relation to its indemnity schemes and claims management during the COVID-19 pandemic. General practice specific guidance aims to clarify how the management of claims interactions between general practice indemnity beneficiaries and NHS Resolution will proceed during the pandemic.  It also provides answers the most common questions regarding Clinical Negligence Scheme for General Practice (CNSGP) indemnity cover under COVID-19 working arrangements.

Upcoming Webinars 10/6/2020

  • Wednesday 10 June, 5-6pm - Digital Primary Care webinar focus on care homes 
    Dr Matt Hoghton and Alison Taylor will be discussing the role of GPs in delivering virtual check-ins and proxy access, drawing upon his personal experiences as a GP. Find our more and ask your questions by joining them. Book your place now.
  • Thursday 11 June, 4.30pm - Webinar on supporting Digitally Excluded Communities: how to support patients with getting online

Join NHSX for a 30 minute webinar on how we can better support patients to get online. This webinar is part of our series to support Digitally Excluded Communities. Aimed primarily at GP practice staff the webinar explores how general practice can make the most of their digital services during the COVID-19 pandemic to protect your staff and patients. The webinar consists of a 10 minute presentation with 20 minutes Q&A panel. Digital nurse champion Ann Gregory will be sharing the digital transformation work she has been doing at her GP practice which cares for patients from one of the most deprived areas of the UK. Find out more and register.

COVID-19 aftercare guidance 10/6/2020

Guidance has been published about the aftercare needs of inpatients recovering from COVID-19. The document is designed to support local primary care and community health services as they work with partners to develop recovery/rehabilitation services for patients after they have been discharged following an acute episode of COVID-19.

GP Standard Operating Procedure updated: Staff risk assessments  10/6/2020

Following feedback from GP practice colleagues and representatives, NHSE have revised the current GP SOP v3 section about staff at increased risk from COVID-19 and risk assessments as follows:

This has been updated in the published GP SOP which can be found here.

Quality and Outcomes Framework 8/6/2020

The CCG have supported NHS England and have now finalised payments for QOF 2019-20. Practices should receive their payment by end June. We are awaiting plans from NHSE for QOF 2020-21 and will advise practices when we have any further information.

Email re: NHS Mail Password 8/6/2020

We are aware that an email was sent out from Feedback@nhs.net over the weekend requesting that users reset their NHS Mail password. Please can we advise of the following:-  

  • We have confirmed this is a legitimate email which was sent by NHS Digital to all accounts associated to a CCG or GP practice.
  • You should follow the guidance given by following the instructions below

Login to https://portal.nhs.net/

·         Choose 'Profile' from the top left of your screen 
·         Click on the 'Change Password' button on the right.
·         Password complexity should match the following guidance. Please note we believe that on screen it may say 8 characters this should be 10

New passwords will be valid for 365 days instead of the current 90-day expiry and must meet the following criteria:

Minimum length – 10 characters without requiring a mix of character types

Health and safety risk assessments for your staff 8/6/2020

Earlier last week NHS England and NHS Confederation announced the creation of a new centre to investigate the impact of race and ethnicity on people’s health. The NHS Race and Health Observatory has been created in response to the concerns regarding the impact of the COVID-19 virus on people from black, Asian and ethnic minority (BAME) backgrounds and will identify and tackle the specific health challenges facing them. You may have also seen the Public Health England COVID-19: review of disparities in risks and outcomes which looks at the factors impacting outcomes of COVID-19 including race.

To support the health and safety risk assessments you will be carrying out for your staff, the local clinical forum has shared a risk assessment tool (attached - SAAD Score), produced by primary care colleagues in another area.

The risk assessment tool is a supporting tool for conversations with your staff. It doesn’t replace anything and is intended as guidance. Further support on carrying out risk assessments and risk reduction is available on the NHS Employers website which was updated last week. https://www.nhsemployers.org/covid19/health-safety-and-wellbeing/risk-assessments-for-staff

Upcoming Webinairs 8/6/2020

New CPD accredited webinar: DATE: Tuesday, 9th June TIME: 18.00 hours BST

Effective care of patients with asthma or COPD in primary care is vital. During this pandemic there are important practical issues we need to address.

  • How can these issues be addressed and what guidance has been created? 
  • What do you need to do and how can you do it?
  • What is the current advice for patients? 

Presenter: Beverley BostockAsthma Lead, Association of Respiratory Nurse Specialists
Policy Forum Member, Primary Care Respiratory Society, Editor-in-Chief, BJPCN 

COVID-19: Reviewing High Risk (Shielding) Patients 8/6/2020

Despite changes announced by the government, the weekly Shielded Patient List (SPL) process continues, and as of 3rd June, the practice systems have been updated with the latest weekly Shielded Patient List (SPL) data. This latest cohort of SPL additions and subtractions is collectively referred to as SPL9.​

SPL9 additions:

As with previous updates, new additions have been identified centrally by NHS Digital and NHS England, and these patients will have been contacted by NHS England this week via a central letter.

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

SPL9 subtractions:

Patients identified as being subtracted from the SPL in SPL9 will be coded with the appropriate moderate-risk or low-risk code according to the data received from NHS Digital, and therefore will no longer be included in the results of ‘Patients at high risk of complications from COVID-19 infection’ search. Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.
The EMIS web searches can be found (if you have any patients to populate them) in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the two new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added  3rd June 2020 (SPL9)

- EMIS HEALTH: COVID-19 SEARCHES/ Patients removed from SPL 3rd June 2020 (SPL9)

The SystmOne (TPP) search can be found in the folder:

- LOT 7 High Risk COVID-19 code added 03/06/20, without a more recent Low Risk or Moderate Risk code

This most recent upload has introduced 'subtractions' for a very small number of patients who have been deemed to NOT meet the High Risk criteria by Secondary Care clinicians. These patients have had a Low or Moderate Risk code added automatically to their records in the most recent SPL download. 

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

Temporary changes to the need for patient consent to maximise use of the electronic repeat dispensing (eRD) system 5/6/2020

letter to GPs and community pharmacists to formally notify you of temporary changes to the need for patient consent to maximise use of the electronic repeat dispensing (eRD) system. 

#LookingAfterYouToo: individual coaching support for primary care staff 5/6/2020

Recognising the challenges currently facing frontline primary care staff, both clinical and non-clinical, the #LookingAfterYouToo individual coaching support service was launched on 24 April, to provide staff with opportunities to process experiences, develop coping skills, deal with difficult conversations and develop strategies for self-management in difficult circumstances.

Our baseline survey suggests that the need for this service is as strong as ever as the challenges for primary care staff continue, so we’d like your help in getting the message out so as many people as possible can benefit. Download a poster to display in your place of work and share this offer among your colleagues.

Book your session at a time to suit you. Sessions are available 7 days a week, by video or telephone.

The Rapid Deployment of Online and Video Consultations across London 5/6/2020

The challenges presented by COVID-19 have seen an acceleration of transformation projects in general practice, particularly the use of technology and a move to a digital infrastructure. This podcast from London, brings a clinical, project and programme perspective on a successful transition to online and video consultations as well as the NHS App.

Public Health Update: New Campaign Resources 5/6/2020

Please find below links to a range of materials available to support the HM Government NHS Test and trace Service

A suite of these campaign resources are now available on the Campaign Resource Centre

Posters
Social Media Resources
Additional Social Content
Digital Screens
Ruth May Video

There are additional resources available to supporting wider coronavirus messaging:

Stay Alert to Stay Safe

  • Posters using icons to denote hand hygiene and other key stay alert messages. 
  • Alternative resources including easy read, large print and British Sign Language. 

Return to School

Symptoms 

Alternative resources including easy read, large print and British Sign Language.

Webinars 5/6/2020

Tuesday 9 June, 18:00 - The coronavirus pandemic - Asthma & COPD (CPD webinar)

Effective care of patients with asthma or COPD in primary care is vital. During this pandemic there are important practical issues we need to address.
How can these issues be addressed and what guidance has been created? 
What do you need to do and how can you do it?
What is the current advice for patients? 

Register now >

Wednesday 10 June, 1-2pm - Digital Nurse Network webinar focus on Carer's week

Join the Digital Nurse Network's weekly Wednesday webinar from 1-2pm. Nurses Helen Crowther and Ann Gregory will be focusing on the role of nurses in supporting care homes during COVID-19. Discussion will include weekly care home virtual check-ins and proxy access. Book your place now.

Wednesday 10 June, 5-6pm - Digital Primary Care webinar focus on care homes 

Dr Matt Hoghton and Alison Taylor will be discussing the role of GPs in delivering virtual check-ins and proxy access, drawing upon his personal experiences as a GP. Find our more and ask your questions by joining them. Book your place now.

Thursday 11 June, 4.30pm - Webinar on supporting Digitally Excluded Communities: how to support patients with getting online

Join NHSX for a 30 minute webinar on how we can better support patients to get online. This webinar is part of our series to support Digitally Excluded Communities. Aimed primarily at GP practice staff the webinar explores how general practice can make the most of their digital services during the COVID-19 pandemic to protect your staff and patients. The webinar consists of a 10 minute presentation with 20 minutes Q&A panel. Digital nurse champion Ann Gregory will be sharing the digital transformation work she has been doing at her GP practice which cares for patients from one of the most deprived areas of the UK. Find out more and register.

COVID-19 Webinar Series - Primary Care Nursing – Issues and Answers

Watch on-demand >

COVID-19 National Testing: Flowing results to GP records 5/6/2020

PCR swab testing is now routinely available to members of the public by visiting nhs.uk/coronavirus or calling 119.

Test results will soon be sent to GP records. Within the next two weeks, when a patient receives their test result from the national COVID-19 PCR swab testing, this will also be sent to GP systems and appear in the patient’s record as a laboratory test result. Results from tests previously undertaken through the same route will also shortly be sent to GP systems – with the exception of a small number of cases where there was insufficient information to identify the patient’s NHS number.

The test results will have the Requesting GP as G9999981 and Requesting GP Surname of COVIDpillar2; this will ensure they are clearly distinguishable from other test results. Bulk upload of test results into GP records will take place without any manual patient by patient process. GP practices will shortly receive further guidance by their own system supplier about how this will work in their own system of choice, as well as details on how results will be filed in the system.

There will be no action required from the practice on receipt of these results. In particular:

  • There will be no need to communicate results to patients, as these will have already been sent to them by text and email;
  • No clinical action will be necessary, as patients will have also received links to national guidance in their text and email, such as requirements on isolation or what to do if symptoms worsen;
  • The results will not need to be notified to Public Health England under the notifiable diseases requirements, as this will have already been done.

Results from the test will be communicated as one of the following three options: negative, positive or unclear. They will appear in patients’ records as “SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) RNA (ribonucleic acid) detection result negative / positive / unknown”. When a result is “unknown” it means this was unclear and the patient will be advised to be tested again through the original route they use to request a test.

Council ECC including "Shielding" Questions in their calls to Shielded People 5/6/2020

 The Councils Emergency Contact Centre when undertaking contact calls to vulnerable patients who are shielding will now be asking some additional "shielding"questions and returning information through to GP practices. Please find attached the "script " for the additional questions they will be using and further background about this work with recommendations regarding coding and action. The MMT will be liaising with practices regarding the information being received and will be seeking feedback from practices on the development of this work and the usefulness of the information in practices prioritising "follow up" of and support to their shielded patients. ​

Shielding/High Risk  "Follow Up" Clinical System ( S1 & EMIS )Templates 5/6/2020

Please find attached copies of locally developed System 1 and EMIS template(s) which are now available for use within GP practice systems. These templates are recommended for use by staff to support undertaking  contact calls to shielding, high risk or isolating patients. It is hoped that by  adopting use of this template will standardise COVID clinical coding across GP practice systems.​

The new template is called “Barnsley: Covid-19 Questionnaire (v1.0)”.

S1

The S1 template has been published centrally to the “Barnsley” category and you should now be able to amend and add this to your clinical trees if required. You can also launch the new template by pressing the F12 key whilst in a patients’ record and searching for the template this way.

EMIS Web

The template is in the attached zip file along with the usual importing instructions. The new template can be launched from within a consultation using the “Run Template” button, or by clicking the green “Add” button and selecting “Data using template”

NHS Support for Patients who are Shielding 5/6/2020

Please see the attached letter which includes confirmation of the governments updated advice for shielding patients and maintenance of the shielding list.

Please also see link below which provides further support and documentation

https://www.england.nhs.uk/coronavirus/publication/guidance-and-updates-for-gps-at-risk-patients/ 

Free NHS Staff Car Parking – Local Authority Car Parks 3/6/2020

Did you know that local councils are offering free car parking in their off-street car parks to all NHS staff members, health or social care workers, and NHS Volunteer Responders during the COVID-19 emergency response.

The attached pass can be used as evidence that a motorist is on official duty, giving them access to free council car parking as outlined. Please note, this does not apply to privately owned car parks.

Add NHS Barnsley CCG as the issuing workplace on your pass. Please note that NHS organisations are asked to keep a record of the Vehicle Registration Numbers (VRNs) of workers using the concession in case of instances of fraud or misuse.

Barnsley Council’s guidance on parking is available on their website. 

There’s a digital copy which allows a user to fill in the fields with a computer before printing, or an easy to print version.  The link to the guidance is here  https://www.gov.uk/government/publications/covid-19-health-care-and-volunteer-workers-parking-pass-and-concessions/covid-19-health-care-and-volunteer-workers-parking-pass-and-concessions

Practice Website and NHS Website Profile 3/6/2020

This is a gentle reminder to practices to ensure your practice website and NHS website profile is updated with any changes, in particular any changes to services and branch closures due to COVID-19, many patients and partners will be reliant on the online information provided. 

If you require any support or guidance on how this is done, please do not hesitate to get in touch with the Primary Care Team who will be happy to assist you with this. 

Dispensing Doctors – payments related to COVID 19 3/6/2020

Processes are now in place to ensure that Dispensing Doctors receive payments for the following:

  1. The mandatory element of the Pandemic Delivery Service
  2. The actual delivery of medicines
  3. The £300 towards the cost of screens

Element one will be paid automatically. The period 9 April - 31 May will be paid along with June 2020 dispensing payments. Thereafter payment will be made on a monthly basis for as long as the service is commissioned. 

claim form will need to be submitted for element two. Claims for the period 9 April – 31 May can be submitted along with the FP34D at the end of June 2020.

Subsequently claims should be made at the end of the month for which they relate. Claims should only submitted for eligible patients.

Element three will be paid automatically as a one-off payment. The payment will be along with June 2020 dispensing payments. 

IT Service Desk - Portal Access 1/6/2020

As a reminder, all staff can now report faults and issues via the new IT service desk portal but you will need to set up your access.  Attached are some guides for password reset and BSS Self Service but for ease of reference below are step-by-step actions below which you may find easier: 

  1. Access the portal                                             https://servicedesk.sheffield.nhs.uk
  2. Username is INSPIRE\                                   followed by your windows logon username (what you use to logon to PC)
  3. Password is your windows password             (again the password you use to logon to PC)

Please contact the IT service desk on 0114 305 1030 if you encounter any difficulties.

Upcoming Webinars 1/6/2020

Thursday 4 June 5 – 6 pm - GP Webinar with Nikki Kanani and Ed Waller

MHRA updates 1/6/2020

Guidance has been produced by MHRA for members of the public, patients, professionals and industry around the COVID-19 tests and testing kits. This includes information on how they work, the different types of tests and the specifications manufacturers need to follow. 

They have updated the following sections: 'for patients, the public and professional users' and 'for industry and manufacturers' with new information on temporarily stopping the sale of COVID-19 antibody tests for members of the public until the regulatory and safety concerns are resolved. 

Sources of information on shielding 1/6/2020

Please see attached updated guidance for your information, detailing for patients and clinicians the range of sources from which they can obtain information for shielded patients.

Principles of safe video consulting in general practice 1/6/2020

Please find attached new guidance on the Principles of safe video consulting in general practice during COVID-19.

Guidance and Standard Operating Procedures - General Practice in the Context of (COVID-19), Version 3 1/6/2020

Please find attached Version 3 of the SOP which has been updated to reflect current guidance and provides additional clarity throughout the document with links to pertinent information, for example:

  • The Key Principles for General Practice (section 2.1) regarding access to routine care and referrals; and appointment planning
  • A guidance for staff section (section 2.3)  
  • The Managing Patients with symptoms of COVID-19 guidance and flowchart (section 2.4).
  • Considerations for General Practice in the Context of COVID-19 (section 2.7) including patient registration, identifying patients at deterioration from other conditions, speciality referral pathways, self cert and fit notes, mental health, marginalised groups, care homes and advance planning 

This can also be located at the link below https://www.england.nhs.uk/coronavirus/publication/managing-coronavirus-covid-19-in-general-practice-sop/

New social media campaign 29/5/2020

A new social media campaign promoting the work of community pharmacies and how they are supporting patients and the public to keep safe and get the advice and medicines they need during the Covid pandemic will be taking place across this and next week. Keep a look out for the activity on NHS social media channels and share and retweet to support the campaign. In addition, updated social media assets for community pharmacy during the pandemic can be found on the Campaign Resource Centre.

Risk assessments for BAME and other staff 29/5/2020

NHS Employers have published guidance on risk assessment, particularly for at risk and vulnerable groups within the workforce. This includes staff returning to work for the NHS, and existing team members who are potentially more at risk due to their race and ethnicity, age, weight, underlying health conditions, disability, or pregnancy. NHS Employers have taken an inclusive approach and have described that the guidance is applicable, with appropriate local adaptations, in all healthcare settings. 

Digital Solution survey 29/5/2020

Over the last 5-6 weeks primary care has rolled out, at scale, a range of digital technologies. Many of these were planned but their roll out accelerated.  It would be helpful to understand which of these have been valuable additions, which might need refinement before they become mainstream, and which have not worked.

The aim of this programme across the Region has been to implement digital solutions that 1) improve patient care; 2) make the system more efficient; 3) improve the working life of the workforce.

Together with the Academic Health Science Networks (AHSN NENC & Y&H AHSN), the NEY Region are keen to gain a rapid insight into evaluation requirements, so we gain local intelligence on the digital solutions implemented over recent weeks. It is important that we can determine whether or not the aims listed above have been achieved, where more needs to be done, and where there are gaps.  

We would therefore be grateful if you could help us define the questions we need to ask in an evaluation by completing the survey via this link: https://www.smartsurvey.co.uk/s/WV7XLM/. This should only take 5-8 minutes to complete. It is in 3 sections (Online Consultations, Video Consultations and SMS messaging) – please fill in all or as many sections as you feel able. Whilst the survey won’t close and there isn’t an official deadline, if you could look to complete it no later than Friday 12th June that will help the AHSNs start to analyse the results. 

We are very grateful for your support with this. We are also planning a process to ask patients about their experiences in parallel which will complement the feedback from practices.

Risk assessment and planning for reopening primary care/LIFT buildings 29/5/2020

With the expectation that services will start to recommence all routine work in the near future, all practices are asked to ensure they have reviewed their premises in light of the government’s request for social distancing and also hand hygiene.  Practices can find latest guidance for primary care on infection prevention and control here.  Please also note that practices in LIFT buildings are being asked by CHP for their plans to ensure compliance especially in and across shared areas and services.

Upcoming Webinars 29/5/2020

Thursday 4 June 5 – 6 pm - GP Webinar with Nikki Kanani and Ed Waller 

Mobile Testing 29/5/2020

Please find below latest notification of dates for the Mobile Testing Unit (This is PVR swabbing for patients with symptoms of Covid19):-

Date

District

Site address

Confirmed

Saturday

30-May-20

Sheffield

Meadowhall Overflow Car Park, Alsing Road, Sheffield, S9 1EQ

CONFIRMED

Sunday

31-May-20

Sheffield

Meadowhall Overflow Car Park, Alsing Road, Sheffield, S9 1EQ

OPS LOCKED

Monday

01-Jun-20

Sheffield

Meadowhall Overflow Car Park, Alsing Road, Sheffield, S9 1EQ

TENTATIVE

Tuesday

02-Jun-20

Sheffield

Meadowhall Overflow Car Park, Alsing Road, Sheffield, S9 1EQ

TENTATIVE

Wednesday

03-Jun-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

TENTATIVE

Thursday

04-Jun-20

Rotherham

AESSEAL Stadium, New York Way, Rotherham, S60 1FJ

TENTATIVE

Friday

05-Jun-20

Rotherham

AESSEAL Stadium, New York Way, Rotherham, S60 1FJ

TENTATIVE

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

TENTATIVE

Saturday

06-Jun-20

Barnsley

Barnsley County Way Car Park, County Way, Barnsley, S70 2JW

TENTATIVE

Key:

 

Site is "locked in" and live on the national booking system.

CONFIRMED

 

Site is "locked in" and can only be changed for operational reasons.

OPS LOCKED

 

Site is tentative and subject to change.

TENTATIVE

 

Site has been requested from DHSC.

REQUESTED

 

 

Urgent access telephone advice line to provide GP’s with urgent advice and guidance on the care of patients in care home settings 29/5/2020

As part the work across Barnsley to ensure that residents in care homes continue to receive high quality care and support and that healthcare teams are able to access appropriate advice and guidance discussions have been taking place regarding how geriatrician input can be provided.  As a first step, it has been agreed that Barnsley Hospital will provide an urgent access telephone advice line to provide GP’s with urgent advice and guidance on the care of patients in care home settings.  Details, including how to access this support, are included within the attached document. 

COVID-19: Reviewing individuals who have self-identified as vulnerable 29/5/2020

The NHS program to identify and flag patients most at risk of complications from COVID-19 (those who should be shielding) is continuing, and as of 26th May, the practice systems have been updated with the latest weekly Shielded Patient List (SPL) data, which as of last weeks’ update now includes patient subtractions (those who are being removed from the SPL) as well as new additions to the list. This latest cohort of SPL additions and subtractions is collectively referred to as SPL8.​

For patients who have been added: 

As with previous updates, new additions have been identified centrally by NHS Digital and NHS England, and these patients will be contacted by NHS England this week via a central letter.
Please note, the government is currently advising patients on the SPL to shield until 30th June, subject to ongoing review.

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

As well as the usual SPL additions and subtractions, NHS Digital have this week identified a group of patients who were flagged by NHS Secondary Care Trusts for addition to the national SPL between 1st – 18th April 2020, but due to a processing delay were not included in the SPL cohorts given to us and flagged in your EMIS Web system during that period. NHS Digital have stated that this delay has only affected a small proportion of patients, all of whom have now received a shielding letter from their secondary care organisation and have been added to the national SPL.

The date that the patient was originally identified as needing to shield will be included in additional text alongside the code that we add to the care record. Please clinically assess these patients alongside any other patients identified in as SPL8 additions. PLEASE NOTE THIS IS LIKELY TO BE A SIGNIFICANT NUMBER OF PATIENTS AND IT IS IMPORTANT THAT THIS LIST IS REVIEWED

The EMIS web searches can be found in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the following folder to locate the 2 new searches:

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 26th May 2020 (SPL8)

- EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 27th May (April Trust Additions)

The SystmOne (TPP) searches can be found in the folder:

- LOT 6 High Risk COVID-19 code added 26/05/20, without a more recent Low Risk or Moderate Risk code

- Delayed SPL patients: High Risk COVID-19 code added 27/05/20, without a more recent Low Risk or Moderate Risk code".

For patients who have been subtracted (removed):

Patients identified as being subtracted from the SPL in SPL8 have been coded with the appropriate moderate-risk or low-risk code according to the data we have received from NHS Digital, and therefore will no longer be included in the results of our ‘Patients at high risk of complications from COVID-19 infection’ search. Practices do not need to contact any patient identified as being subtracted from the SPL in this update; it is the responsibility of the consultant removing the patient to make contact and inform the patient of this decision. Similarly, if you recode a patient as moderate- or low-risk then it is your responsibility to inform them.

The EMIS web search can be found in the folder:

EMIS HEALTH: COVID-19 SEARCHES/Patients removed from SPL 26th May 2020 (SPL8)

SystmOne/TPP have not yet published a search

For our VISION practice, we have previously contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

NHS Digital have provided a standard letter to be used when contacting patients that have been recoded as either moderate- or low-risk, and are therefore removing from the national SPL; this letter as been made available on the practice systems and can be found;

- Emis Web:  Template Manager > Document Templates > EMIS Library > COVID 19 > COVID-19 Removal from SPL notification’ 

- SystmOne: New word letter templates > COVID-19 SPL deduction letter

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT

National campaign focuses on Primary Care on 27/5/2020 

You may have heard of the #HelpUsHelpYou campaign to promote to the public that the NHS was still open for business. The campaign was created to help give people permission to access NHS services and reassuring them that they won’t be a burden on the NHS. On 28 May 2020, the NHS will be running a primary care focus day with activity on social media channels, case studies and blogs. Please do join in using #HelpUsHelpYou and share your examples on your social media pages. 

Public Health Update: New Campaign Resources 27/5/2020

HM Government has created a new campaign, Stay Alert To Stay Safe in line with the new advice, explaining the actions we all need to take to support the Government's strategy.

A suite of these campaign resources are now available on the Campaign Resource Centre.  

Materials to communicate the symptoms of coronavirus and what to do if you have any. These materials reflect the addition of changes to sense of smell and/or taste (anosmia):

Posters (including print friendly)
Social Media Resources 
Digital Screens

There are additional resources available to supporting wider coronavirus messaging:

Webinar - RCGP and AHSN Network: Primary care in care homes during COVID-19 27/5/2020

This webinar delivered on Wednesday 27 May 3:00 - 4:00pm shares examples of current good practice and collaboration between primary care and care homes, including resources to support virtual ward rounds.

  • RCGP ‘top tips’ for GPs caring for care homes
  • Providing person-centred care in times of COVID-19 
  • COVID-19 virtual wards
  • Resources to support virtual ward rounds

It will be recorded and shared afterwards.

This is the second in a series jointly organised by the Royal College of General Practitioners and the AHSN Network. You can watch the first webinar here: COVID-19: Patient assessment and the role of physiology and oximetry.

Coronavirus outbreak indemnity 15/5/2020

The updated FAQs published by NHS Resolution on coronavirus outbreak indemnity include information which is relevant to community pharmacists, including those returning to the profession to help with the response to the coronavirus pandemic. Please refer to question 11 in the FAQs for full details on how indemnity insurance and cover may be applied.

Examples of good practice 15/5/2020

The General Pharmaceutical Council has identified over 60 examples of how pharmacies are meeting their professional standards during the COVID-19 pandemic. Read the examples on the Knowledge Hub.

Dying Matters Awareness Week 15/5/2020

It’s Dying Matter Awareness Week and the focus this year is all about listening. As health professionals we are often faced with the issue of death and dying. It goes without saying that this is a difficult time for many of us at the moment, especially if you have experienced the loss of a patient or indeed a loved one. It is so important that we feel able to support our patients with their concerns and listen when they need us. But it is equally important that we too feel able to share our own experiences of death and dying, and be heard, The Dying Matters website offers a range of resources and information on how to support patients with death and dying and advice on how to open up conversations. Follow the hashtag #DyingToBeHeard this week for more updates. The NHS Staff Support Line is also available.

#LookingAfterYouToo: individual coaching support for primary care staff 15/5/2020

This coaching offer has generated considerable interest since launch on 24 April, with 570 bookings and 190 coaching sessions having taken place by 11 May. 

Feedback has been overwhelmingly positive, with almost all respondents saying that they had felt listened to and that the session had enabled them to move forward.

Dr Mike Holmes, Vice-Chair of RCGP and leader of their wellbeing group, has worked with us to co-create this offer and has created a vlog.

A reminder that this coaching service is open to ALL frontline primary care workforce, clinical and non-clinical and whether directly employed by the NHS or working on an NHS contract. To find out more and book a 1:1 coaching session at a time and in a way that suits you, go to the Look After You Too webpage.

Coronavirus Dementia Information 15/5/2020

Please find attached a one page information sheet for people living with dementia, their carers, families and staff.  

Webinar - Digital Primary Care: Remote Working in Primary Care 15/5/2020 

Tuesday 19th May 5:00 - 6:00pm 

The session will cover the remote working guidance produced by the Digital Primary Care team. We will also look at the reality of remote working from a number of different practice perspectives such as GP, Nursing, sessional GPs, CCG, the wider team working in PCNs and administrative staff.

Register here

Clarification – NHS 111 referring into general practice 15/5/2020

Earlier this week we wrote to advise that when practices receive a referral from 111 services, including the COVID-19 Clinical Assessment Service (CCAS), that they should assume clinical responsibility for the patient. We would like to clarify that by this we mean that practices should take ownership of the patient and onward decisions about the care they require, to ensure they are not passed back to 111 services. This does not mean that GPs will be liable for the assessment and decisions made by 111 services before the patient is referred to general practice.

Post COVID-19 Elective Care Recovery 15/5/2020

The regional Hospital Care Cell has developed some good practice guidance on the management of elective waiting lists in collaboration with the Elective Care Intensive Support Team to help secondary care providers manage referrals, waiting lists and clinical review processes.  

As we are now in the second phase of the NHS response to COVID19, GPs have been advised to make two week cancer, urgent and routine referrals to secondary care as normal using advice and guidance options where appropriate.  Prior to this, some GPs may have restricted referrals into secondary care. 

To minimise the risk of patients being lost in the system, we are now advising secondary care to accept all referrals from primary care.  We fully appreciate that patients might have to wait to be seen by a clinician or allocated a first outpatient appointment, but it is safer for referrals to be ‘held’ within secondary care rather than primary care. 

Urgent access telephone advice line to provide GP’s with urgent advice and guidance on the care of patients in care home settings 15/5/2020

As part the work across Barnsley to ensure that residents in care homes continue to receive high quality care and support and that healthcare teams are able to access appropriate advice and guidance discussions have been taking place regarding how geriatrician input can be provided.  As a first step, it has been agreed that Barnsley Hospital will provide an urgent access telephone advice line to provide GP’s with urgent advice and guidance on the care of patients in care home settings.  Details, including how to access this support, are included within the attached document. 

Please note that this service is specifically for advice and guidance in relation to care home residents only.

Examples of good practice 13/5/2020

The General Pharmaceutical Council has identified over 60 examples of how pharmacies are meeting their professional standards during the COVID-19 pandemic. Read the examples on the Knowledge Hub

North East and Yorkshire Region COVID-19 (Coronavirus) Daily Operational Brief 13/5/2020

Please find attached the North East and Yorkshire region operations brief. It aims to clarify the confusion around goggles and the Tiger googles recall situation. 

COVID-19: Reviewing individuals who have self-identified as vulnerable (update Tuesday 12th May) 13/5/2020

The latest update to the national Shielded Patient List (SPL), based on Hospital Episode Statistics (HES) and GP Extraction Service (GPES) data, has identified a small number of additional patients who will be advised to shield via a centrally generated letter and text message. This latest update to the SPL is referred to as SPL6 (the previous update on 6th May being SPL5). 

These patients have been identified centrally by NHS England and NHS Digital. Because these patients have been identified centrally, these patients have already been added to the national SPL. They will be contacted by NHS England this week via a central letter (this process should be complete by Thursday 14th May) . Please note, the government is currently advising patients on the SPL to shield until 30th June, subject to ongoing review. 

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL..

The EMIS web search can be found in the folder:

  • EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection
  • This has updated the previous search and so to identify new patients, practices should then go to the same folder where the self-referring patients search was included. This is:
  • EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 12th May 2020

(Please note; If your practice does not have any new patients to consider in this latest cohort, then this list will not be created in your system.) 

The SystmOne (TPP) searches can be found in the folder:

System Wide/COVID19 AT RISK/LOT 4 HIGH RISK COVID-19 code added 12/05/20 

For our VISION practice, we have contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news. 

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022​ 

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT 

Upcoming Webinars 11/5/2020

Tuesday 12 May 2-4pm - COVID-19 & BME: A conversation with the expertsThis webinar will focus on the very apparent and disproportionate effects that the Coronavirus (COVID-19) outbreak has had amongst BME staff, patients and communities. For any further queries, please contact england.WRES@nhs.net.

Wednesday 13 May 1.30-2.30pm - Starting out as a social prescribing link worker. This webinar aims to help new link workers understand the basics of their social prescribing link worker roles within PCNs.

Thursday 14 May 5-6pm GP webinar with Nikki and Ed

Webinar: Heart Failure and COVID-19 - What you NEED TO KNOW 11/5/2020

NEW CPD ACCREDITED WEBINAR, DATE: Thursday 18th May, TIME: 18.00 hours BST

  • Practical evidence-based guidance
  • Who to treat, how to treat and when to treat? 
  • How can we practically deliver care during the pandemic?

Presenter: Professor Ahmet Fuat, GP, GP Appraiser & GPSI Cardiology Darlington, Honorary Professor of Primary Care Cardiology, Durham University
CVD Clinical Adviser RCGP
CATCH UP: Our on-demand webinars in the COVID-19 Need to Know series are available now 

Latest COVID 19 Barnsley Intelligence and Data 11/5/2020

Please find attached ‘covid19 intelligence update DAILY 200507’ which is a summary of the Barnsley position on COVID 19. It summarises the local position across our local health and care providers as well as information on new cases and an update around the peak. This data is shared for information only to ensure that Primary Care are informed of the latest data and intelligence for managing COVID 19 in Barnsley. 

Stay Alert to Stay Safe Resources 11/5/2020

Materials to communicate the “Alert” phase of the Covid-19 campaign are now available on the Campaign Resource Centre.

Resources available include:

  • Social Media Resources
  • Web banners

 Example below (please don’t copy this version – download them from the resource centre)

Example 

NHS 111 referring into general practice and COVID-19 tests 11/5/2020

We are aware that general practice is currently receiving referrals from a number of routes, including from new services. One such new service is the COVID-19 Clinical Assessment Service (CCAS) which is linked to NHS 111 and which provides further assessment for patients before giving a final disposition, to ensure that patients aren’t referred to their general practice unnecessarily. If a practice receives a referral from 111 services, whether from the national CCAS or from a local service, then the practice should assume clinical responsibility for the patient. The CCAS provides a clinical assessment, usually by a GP, and therefore the patient must not be re-directed back to 111 as this could result in delay of urgent clinical care.

Additionally, it is useful for practices to be aware that patients should not be directed to NHS 111 to co-ordinate testing for COVID-19. Information about testing can be found here https://www.gov.uk/apply-coronavirus-test 

COVID-19: Reviewing individuals who have self-identified as vulnerable 11/5/2020

The NHS program to identify and flag patients most at risk of complications from COVID-19 (those who should be shielding) is continuing, and on the 6th May an additional list of patients has been identified centrally by the NHS using national algorithms and hospital data. 

Because these patients have been identified centrally, they have already been added to the national Shielded Patients List (SPL) and contacted by NHS England via a central letter (this process should have been completed by Thursday 7th May). Please note, the government is currently advising patients on the SPL to shield until 30th June, subject to ongoing review.

These patients should be clinically reviewed and, if you disagree with the high-risk assessment, they should be coded with either the approved moderate- or low-risk codes - this should only be done alongside discussion with the patient. This action will remove them from the SPL.

The EMIS web search can be found in the folder:

EMIS HEALTH Library: SNOMED Searches: EMIS Clinical Utilities/COVID-19 Patient Management/Patients at high risk of complications from COVID-19 infection

This has updated the previous search and so to identify new patients, practices should then go to the same folder where the self referring patients search was included. This is:

EMIS HEALTH: COVID-19 SEARCHES/Shielding patients identified centrally, added 6th May 2020

The SystmOne (TPP) searches can be found in the folder:

System Wide/COVI19 AT RISK/LOT 3 HIGH RISK COVID-19 code added 05/05/20 

For our VISION practice, we have contacted the system provider and been informed that the information will be available as soon as possible  and to refer to the Vision front screen blog feed, the Knowledge Base, and the Coronavirus landing page for the latest news.

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

For any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT 

COVID19 - RIDDOR Reporting 11/5/2020

The issue of RIDDOR reporting has been raised a few times.  Please see the guidance below from HSE legal team and the HSE web link.

In summary you must only make a report under RIDDOR (The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013) when: 

  • an unintended incident at work has led to someone’s possible or actual exposure to coronavirus. This must be reported as a dangerous occurrence.
  • a worker has been diagnosed as having COVID 19 and there is reasonable evidence that it was caused by exposure at work. This must be reported as a case of disease.
  • a worker dies as a result of occupational exposure to coronavirus.

https://www.hse.gov.uk/news/riddor-reporting-coronavirus.htm

Direct booking in primary care using NHS 111 or CCAS via GP Connect 7/5/2020

The attached word document, Current position for both NHS 111 and CCAS booking covers:

  • SOP – one list is the preferred setup however you can chose to keep two lists – YAS NHS 111 will book a slot and make the patient aware that their practice will contact them
  • National Data Sharing – practices required to open up appointments to ALL 111 providers (please see attached list)
  • Key changes in configuration per supplier – telephone appointments, set Reserve to ensure the correct organisations can view appointments

For ease this is broken down into:

  • General updates – items within this section are applicable to all practices regardless of their clinical system
  • TPP SystmOne – these are specific items that are applicable only to TPP SystmOne practices
  • EMIS Web – these are specific items that are applicable only to EMIS Web practices

Please note in SY&B  we know uptake of these appointments is low so if there can be a reasonable allocation for both appointments identified initially, with an expectation that this is scaled up if demand requires.

Also please note: Following the webinar which was held on 5 May, you can now access the guidance, slides and recording of the webinar by signing up to the Digital Primary Care workspace on the Future NHS platform. Anyone who signed up to the webinar will receive an invitation to the workspace via email. 

Coronavirus (COVID-19): verifying death in times of emergency 7/5/2020

This guidance is designed to clarify existing practice for the verification of death outside of hospitals and to provide a framework for safe verification of death in this coronavirus (COVID-19) emergency period. It’s for all cases outside hospital when verification of death may be completed by people who have been trained to do so in line with their employer’s policies, including medical practitioners, registered nurses or paramedics. It’s also to be exercised by other non-medical professionals, usually and normally independent of family members, who are verifying death using remote clinical support. 

Safeguarding in Barnsley during COVID-19 Urgent reminder 7/5/2020

In order to support Primary Care over the coming weeks in relation to their safeguarding requirements the CCG Safeguarding Team will take over key functions on behalf of the GP’s from 20 April 2020 (for an initial period of up to 3 months).

Please see attached documents:

Please direct any queries to Angela Fawcett, Designated Nurse Safeguarding Children, on 07887 530291, qualityteam.safehaven@nhs.net 

Priority medicines for palliative and end of life care during a pandemic  6/5/2020

In order to manage additional demand for end of life medicines, and ensure safe, equitable and compassionate care for patients, we have worked with the Association of Palliative Medicines, Royal College of GPs, Hospice UK and the Association of Supportive and Palliative Care Pharmacy to publish Priority medicines for palliative and end of life care during a pandemic. This clinical guidance for essential end of life medicines, which sets out the first and second choices for these medicines, will enable the NHS to conserve supplies, switch to alternative drugs when required and minimise waste. This is also being used to guide the purchasing of medicines for the UK. It aims to support healthcare professionals working in palliative and end of life care, including GPs and pharmacists, across hospital, community, social care and hospice settings to work together in managing additional demand for end of life medicines due to COVID-19. This should be read alongside the recently published DHSC standard operating procedure on how to run a safe and effective medicines reuse scheme in a care home or hospice during the coronavirus outbreak.

Staying in hotels: Reminder on how to book 6/5/2020

We’ve had a reminder from NHS England that if staff need to book a hotel, the central booking line is there for these bookings.

We’ve attached the national guidance again for reference. Where an organisation believes they may be getting a better rate from a hotel, they can raise this with the booking agency and they will contact the relevant hotel. It should be noted that the figures quoted on the guidance are maximum rates, not target rates. 

The strong preference is for organisations to go through this direct route for a number of reasons;

  • The billing will be centralised and this means that organisations will not have to put in separate claims
  • If organisations have to put in central claims, this may take time for claims to be processed, will add to finance teams work load and there may be instances where claims may need to be queried
  • By billing directly, they can track spend, making subsequent claims for funds related to covid work to DHSC (and HM Treasury) more reliable and will ensure that the NHS can correctly request for funding – if organisations get a slightly cheaper hotel offer and there are delays in sending in costs, this will make it more difficult for them to provide relevant data to DHSC
  • They have instances where staff have been booked in to inappropriate accommodation for a number of reasons – if bookings are made centrally they can make appropriate arrangements
  • A number of departments, including DHSC, have agreed to use central booking systems through the CCS framework where rates are guaranteed – some hotels/groups have required minimum guaranteed occupation and by going through a centralised route, they are able to maximise the hotels across an area to ensure that they can properly support staff and negotiate better rates across a number of hotels, also supporting a wider range of commercial organisations – if you go direct, they lose this opportunity to greater potential overall cost 

GP webinars 6/5/2020

The regular NHSE general practice webinar will run this Thursday from 5-6:30pm with extra time for a Q&A. Please do send in any questions you have in advance using this online form. You can also use this form to submit examples of good practice so that they can share learning with others.

COVID-19 and CV Management Series – Online Learning Bites 6/5/2020

We want to let you know that the fifth and sixth learning bites are now up on the PCCS website. Please click here to view.

Learning bite 5 – Practical considerations around the diagnosis and management of patients with heart failure during the COVID-19 crisis.  

Learning bite 6 – COVID-19 in primary care; risks for patients with cardiovascular disease. 

An update on Shielding Patients for Primary Care 6/5/2020

The latest update of the Shielded Patient List, based on the NHS Digital GP Extraction Service, has identified a small number of patients who will be advised to shield via a centrally generated letter and text message.  Flags will be added to the GP records for these patients along with patients identified by hospital clinicians this week.  The addition of flags and distribution of central letters is expected to be complete by Thursday 7 May.  You may also receive information relating to this from your system supplier.

Any patients you locally identified as clinically extremely vulnerable prior to 28 April should now be recognised by the Government support website.  Thank you for informing all of these patients, using the standard letter previously provided.  If you have not done so, please ensure that you write to these patients as soon as possible.  Please use the attached updated version of the letter.  This contains the same information but confirms that the Government is currently advising people who are clinically extremely vulnerable to shield until 30 June, subject to ongoing review.  People who you have identified locally and added to the registry will be sent text messages later this week and contacted early next week by the Government support service call centre if they have not yet registered online or by phone.  It is therefore important that you have contacted them to confirm that they have been identified as clinically extremely vulnerable. 

We are aware that some people who believe they have registered for support on the website have not received it. NHSE have fed this back to the Government service and are working with them to resolve issues with the website and call centre. Please advise people to re-register ensuring they have entered the correct NHS number on the website and their name and address as used in their NHS records. 

We have received a number of queries about the length of time patients should shield for. Government is currently advising people to shield until at least the 30 June (irrespective of when the letter from the NHS was received) and is regularly monitoring this position.  Further information about shielding will be published in due course by Government and individuals currently shielding notified.  

As a reminder, the websites below may contain helpful information about these patients / process:

Please note: A similar email to this has been sent to hospital clinicians asking them, if they have not already done so, to review their patient lists and identify anyone who should be added to the clinically highest risk registry and advised to shield. We have asked them to speak to any such patients, and to send them a copy of the standard NHS letter, as well as to notify the patient’s GP that they have been added to the list, and to submit a list of additional patients to NHS Digital.

Remote caring for registered patients stranded abroad 5/5/2020

We are aware that in some areas, a message may have been circulated that indicated, where a GP Practice is providing remote care, advice or support to its registered patients that are stranded abroad, that this would not be covered by the Clinical Negligence Scheme for General Practice (CNSGP).  We would like to clarify CNSGP cover will apply in these circumstances as long as the GP is providing NHS primary medical services under one of the standard NHS general practice contracts (GMS, PMS, APMS) for England to a patient registered in England.  Location in this context is not important as even though the patient is abroad the GP would be providing their services as part of the health service in England.

The NHS Confederation published  a briefing summarising some of the key issues in the letter from NHSEI outlining a second phase of the response to COVID-19, with a focus on where this differs from previous guidance.

New Birth Registrations 5/5/2020

 We are aware that all Borough Birth Registrations have been closed and therefore parents are presenting to register their babies without a birth certificate. We would like to remind GP Practice that the registration of babies in a timely manner is business critical and a safeguarding requirement.  It is not a requirement for the parent(s) to provide, or the practice to have sight of the birth certificate in order to register the baby.  Please ensure that babies are registered with family and given names.  If the parents have not yet chosen a given name(s) ‘Baby’ should only be entered in exceptional circumstances and followed up an updated as soon as possible with given name(s). 

Paediatric multisystem inflammatory syndrome  5/5/2020

The Royal College of Paediatrics and Child Health have published guidance on paediatric multisystem inflammatory syndrome temporally associated with COVID-19. Most children are asymptomatic or exhibit mild symptoms from COVID-19 infection. However, a small number have recently been identified who develop a significant systemic inflammatory response. This document for clinicians, which has been developed after expert review of the cases, includes a case definition and approach to clinical management. 

Upcoming webinars 4/5/2020

6 May, 7-8pm: Community Pharmacy webinar with Keith Ridge and Ed Waller

Market Entry 4/5/2020

Further to the statement on suspension of market entry activity in the letter from Keith Ridge and Ed Waller dated 31 March 2020, NHS England and Improvement and Primary Care Support England (PCSE) are working to progress applications where there is a pressing reason for doing so. PCSE has contacted applicants to advise them on what to do if they wish to ask for their application to be progressed. Where a decision has been made and notified to the applicant and interested parties then the usual timescales apply. For more information please see the PSNC website.

Amendments to the Misuse of Drugs Regulations (MDR) 2001 Regulations 4/5/2020

Amendments to the MDR 2001 Regulations were laid on 29 April. These enable the Secretary of State to make an announcement at a time of pandemic that would then, following that announcement, permit the following for NHS services:

  • The supply of schedule 2 and 3 CDs under a Serious Shortage Protocol (HMR Regulation 226A).
  • The emergency supply of Schedule 2 and 3 CDs during a pandemic (HMR Regulation 226).
  • The ability of a pharmacist to change the interval on an instalment prescription in consultation with the prescriber (HMR Regulation 15).

There is no change in practice until the flexibility introduced by the legislation is activated by an announcement from the Department of Health and Social Care. 

Upcoming webinars 4/5/2020

To catch up on previous webinars visit Future NHS 

Primary care wellbeing survey 4/5/2020

We would like to understand the current wellbeing of the primary care workforce, and invite you to take part in a short survey undertaken by the Institute for Employment Studies to support this and to support the wider evaluation of the #lookingafteryoutoo  Primary care coaching offer. The survey will take no longer that 5 minutes to complete and will contribute to our ongoing response to support your wellbeing.

Letter from Cancer Research UK (CRUK ) 4/5/2020

CRUK have prepared a resource pack to assist practices in optimising your safety netting processes, while managing the corona virus risks. 

Along with this pack they are asking if practices, or the PCN, would benefit from a tailored-on line session on safety netting guidance, to reflect current challenges with remote consultation and patient confidence in presenting to primary care. The sessions can be adapted to be on line with the numbers of staff and time available. Please see attached the letter and safety netting guidance’s and flow chart. For further details contact Rachel Ball; CRUK Facilitator Manager, Tel: 07789174906  or Email Rachel.ball@cancer.org.uk

Notification of COVID-19 4/5/2020

COVID-19 is a notifiable disease; guidance on reporting notifiable diseases is available on the GOV.UK website. Suspected COVID-19 cases should be notified by general practice. Test confirmed cases will be notified by the laboratory. The GOV.UK website provides guidance on which cases should be reported to local health protection teams. 

Area Prescribing Committee 4/5/2020

The memo from the March meeting can be accessed via the following link: https://www.barnsleyccg.nhs.uk/APCMemoMarch2020.pdf 

Care for our care home residents 4/5/2020

Following the letter published this week outlining the second phase of NHS response to COVID-19, we will continue to share information in the coming days on how this will impact primary care services. 

In particular, NHS England have published a lettersee attached, asking primary care and community health services to help provide the best possible care for our care home residents at this difficult time. 

NHS England would like CCGs, working with primary care and community providers to ensure:

  • timely access to clinical advice for care home staff and residents;
  • proactive support for people living in care homes; and
  • care home residents with suspected or confirmed COVID-19 are supported through remote monitoring – and face to face assessment where clinically appropriate – by a multidisciplinary team.

We will shortly share details of webinars and further support offers to enable all areas to offer this if they do not already.

Age -related Paediatric Creatinine reference ranges 1/5/2020

The attached communication from Dr M Turzyniecka; Consultant Chemical Pathologist-  is about the provision of the age-related reference ranges for creatinine in children. This was put together in response to a clinical query and approved by paediatricians at both hospitals. 

Barnsley Hospital Outpatients Framework 1/5/2020

Please find attached ‘Barnsley Hospital COVID Outpatients Framework’, the intention of the document is to clarify the framework that BHNFT are currently working with, provide details of capacity in specialties and give assurance that all referrals are clinically reviewed. 

We will continue to work with the Trust as new guidance emerges and activity levels change to ensure that routine activity can be reintroduced as soon as possible.

We would like to thank primary care for their efforts over the last few weeks to conservatively manage patients within primary care, only referring urgent patients and maximising the use of Advice and Guidance during these challenging times. You are contributing to the system wide effort to create capacity to provide the vital care required for patients with Covid-19.  

Definition of Online Consultation in general practice – April 2020 30/4/2020

As part of the Covid19 response, it is key for practices to offer an online consultation system that supports total triage. There have been discussions around texting and video consultations as a possible solution; based on the definition of online consultation, a practice would not be in compliance with providing patients with an online solution although these tools do form part of the communication process with the patient. This is just one part of moving towards the digital first primary care vision so further digitisation and integration of services should be expected over time.

An Online Consultation system is a system that enables patients to contact their general practice online in a structured way, regarding the wide range of queries, requests and issues that patients usually need support with from their practice, e.g. administrative requests, clinical queries or condition management. The system will support the practice to triage these incoming contacts from patients, including the ability to flag urgent requests, to easily signpost patients to the most appropriate service, to distribute requests to team members and to include data in the patient record with minimal manual burden.

 The system will include: 

  • Capability for a patient to make a request to (their registered) general practice online. There should be capability for the practice to support non-digital users to go through the same process to make their request; either over the phone or in-person, as well as for parents/nominated proxy to submit an online consultation on behalf of the patient. The process should capture relevant information about the patient’s request, symptoms or issue via a structured format
  • The request must either go through a validated automated triage process or arrive at the practice such that the practice can then easily sort and triage the requests, and then pass them to an appropriate member of the team to respond to.  
  • The data submitted by the patient must be presented to the practice in a way that is easy for the practice to review, respond to and transfer into the patient record with minimal manual burden.
  • Ideally there would be a two way digital engagement channel that enables the practice to securely respond to the patient via the same online system. However, some systems do not support this and so practices use other tools to respond to the request (e.g. text, phone, video)
  • The system must include signposting to validated self-care advice (e.g. nhs.uk)
  • The system must enable capture of outcome data to support service improvement

 Online Consultations by 30th April

A recent update from National NHSE team noted ‘Commissioners and practices are asked to ensure all practices have an online consultation system in place by the end of April 2020 at the latest’.  

Please note - shielding letters 30/4/2020

The Government is currently advising people to shield until at least the 30 June (irrespective of when the letter from the NHS was received) and is regularly monitoring this position. Further information about shielding will be published in due course by Government and individuals currently shielding notified.

Guidance on shielding is available here 

Upcoming webinars 30/4/2020

Second phase of NHS response to COVID-19 30/4/2020

Simon Stevens, NHS Chief Executive and Amanda Pritchard, NHS Chief Operating Officer have published a letter today outlining the second phase of NHS response to COVID-19. Please do take time to read this letter. The key points for primary care are:

  • Ensure patients have clear information on how to access primary care services and are confident about making appointments (virtual or if appropriate, face-to-face) for current concerns.
  • Complete work on implementing digital and video consultations, so that all patients and practices can benefit.
  • Given the reduction of face-to-face visits, stratify and proactively contact their high-risk patients with ongoing care needs, to ensure appropriate ongoing care and support plans are delivered through multidisciplinary teams. In 8 particular, proactively contact all those in the ‘shielding’ cohort of patients who are clinically extremely vulnerable to COVID-19, ensure they know how to access care, are receiving their medications, and provide safe home visiting wherever clinically necessary.
  • To further support care homes, the NHS will bring forward a package of support to care homes drawing on key components of the Enhanced Care in Care Homes service and delivered as collaboration between community and general practice teams. This should include a weekly virtual ‘care home round’ of residents needing clinical support.
  • Make two-week wait cancer, urgent and routine referrals to secondary care as normal, using ‘advice and guidance’ options where appropriate.
  • Deliver as much routine and preventative work as can be provided safely including vaccinations immunisations, and screening. 

Mental health online training 29/4/2020

My name is Rich Snaith and I am working as part of the workforce development initiative being run by Humankind charity and Barnsley Metropolitan Borough Council.

I have a commitment to deliver training in mental health early intervention for low level mental/emotional resilience grounded in early support and building community resilience.  This mental health early intervention course will help you recognise the common low level mental health issues that can affect people and will help you decide on the appropriate action to take to assist in their recovery. This course will help you improve your own personal mental health and increase your awareness of the people around you.

During these unprecedented times, we have moved the mental health training online, and I would like to invite you to take part in our Zoom online training sessions. All you need is internet connection and a PC with a webcam, speakers and a mic. Each session lasts around 90 minutes and you will also receive a certificate of attendance on completion.

I am looking to hold the web sessions on Tuesdays and Thursdays at 10:00 and then again at 14:00, however I can offer more conveniently timed  sessions for groups of people (4 or above) please mention this when you enquire.

So please contact me by e-mail and I will set up a time and send you an invite for the training session : richard.snaith@humankindcharity.org.uk

Managing Conflict: Dealing with Angry and Abusive Patients 28/4/2020

The Royal Pharmaceutical Society in collaboration with The Mental Wellness Academy and Pharmacy Support have produced guidance on dealing with angry and abusive patients. NHS England and NHS Improvement will be launching a community pharmacy PR campaign next week to support access to medicines for the public during the COVID-19 pandemic.

Upcoming Webinars 28/4/2020

  • 29 April, 1.30-2.30pm - COVID-19: Patient Assessment the role of physiology and oximetry

The assessment of patients who are unwell with COVID-19 or other causes presents a significant challenge for GPs and clinicians working in Primary Care. The Royal College of General Practitioners (RCGP) and the AHSN Network are holding a joint webinar looking at the role of oximetry and other physiology in that assessment. The webinar will be led by RCGP Honorary Secretary and COVID Lead Dr Jonathan Leach, with Dr Alison Tavaré, Primary Care Clinical Lead at West of England AHSN, and Dr Simon Stockley, RCGP Lead for Acute Deterioration and Sepsis. They will cover the importance of oximetry in COVID-19, clinical judgement and physiology in patient assessment, and the role of the National Early Warning Score NEWS2 in General Practice.

The webinar will be held on Wednesday 29 April, 1.30-2.30pm and you can register here. The webinar will be recorded and shared afterwards.

Helping you manage your own health and wellbeing whilst looking after others 28/4/2020

Develop new skills and discover new ways to improve your experience of work with short 10- to 20-minute guides developed by experts that are available via the www.people.nhs.uk website

Register and sign in to:

  • Save your progress when working through guides and easily find your place next time
  • Contribute to conversations and share your experiences of the topics

Spotlight on Team Resilience Guide 28/4/2020

We know that together, we are stronger. The relationships that we build between each other and our wider teams will mean we are more likely to come out of the current crisis more resilient than when we started.

Team resilience is your team’s ability to withstand and overcome adversity in a way that enables everyone to continue to perform during and after a crisis and to support each other and to stay well. It helps your team to plan for, manage and recover from challenges that test your ability to work well together and deliver care to your patients.

There are three strategies for dealing with team adversity, pressure and stress:

  • Reducing
  • Responding
  • Reflect and Renew

This guide is designed to take you through these stages by sharing helpful advice, questions, and tools.

Hypertension Learning Bites 28/4/2020

The fifth learning bite in our CV Management Series is now live on the website Please click here to view ‘Practical considerations around the diagnosis and management of patients with heart failure, during the COVID-19 crisis’.

Help Us To Help You Campaign 28/4/2020

Domestic Abuse Campaign 28/4/2020The Home Office is running a domestic abuse campaign, raising awareness of the support and advice currently available. They are grateful for all the support received so far from the NHS stakeholders. Further information and online campaign assets are available here

Patients Advised to Shield 28/4/2020

Thank you for your ongoing support to identify patients who should be advised to shield as they are at highest clinical risk from COVID-19. Patients have been added to the Shielded Patient List in three ways:

  1. Practices have been sent a list of centrally identified patients by NHS Digital and are being asked to review the notes to check the codes are correct.
  2. GPs can use their discretion to add a small number of further patients who they feel are at particularly high risk and would benefit from shielding.
  3. Secondary care consultants are adding additional patients who they feel need to shield. GPs should not need to remove these from the list but if there are any concerns, the patient should ask their consultant.

Practices have also been sent a list of patients who have self-registered. GPs are reviewing this list and adding patients who meet shielding criteria.

The Chief Medical Officer has now confirmed that renal dialysis patients should be advised to shield. Where they have not already done so, Renal units will get in touch with patients, send them a letter and add them to the Shielded Patient List via the regular trust submissions to NHS Digital. GPs are asked to note this update, but no further action is required at this point. 

Following the latest GP Extraction Services (GPES) last week, a small group of new patients have been identified by the national algorithm. As with others who have been identified nationally, these patients will be sent letters and text messages this week and a flag will be added to their GP records soon. Please contact these patients as you have those previously identified.

On an ongoing basis, there will be a small number of patients who need to be added to the list as they become sick. Those who have time-bound conditions (e.g. patients receiving chemotherapy) may need to be removed from the list. Clinical decisions should continue to be taken based on the criteria set by the Chief Medical Officer and following a conversation with the patient. There should no automated processes to complement or supplement individual clinical identification other than that used by NHS Digital.

Support is available from local authorities, NHS Volunteer Responders and charities for anyone who needs it, whether they are on the Shielded Patient List or not. 

RCGP has produced an e-learning resource about shielding vulnerable patients from COVID-19. The module discusses the details of who needs to shield and what GPs need to do next.

Searches, Reports and Other Clinical System Tools 28/4/2020

A number of clinical system reports and other tools have been released by 3rd party suppliers free of charge for use in General Practice. Please see attached and below for further information.

Ardens

A number of resources have been made available to all SystmOne users nationally for free as open access, including:

  • COVID-19 template for risk assessment, remote & face-face consultations, pneumonia, social assessment, and future care planning (with auto-upload to the Summary Care Record)
  • Paediatric Remote Consultation template for the risk assessment & management of paediatric patients during remote consultations
  • Death documentation template including death verification and coroner referral pages
  • Cremation Form 4 that auto-populates with relevant information

https://support.ardens.org.uk/support/solutions/articles/31000154927-coronavirus-covid-19-open-access-on-systmone

EMIS WEB users who are not Ardens customers are offered an EMIS COVID-19 Template for free.

PRIMIS

PRIMIS has developed stand-alone system searches for both EMIS WEB and SystmOne which can be accessed here.  These will help practices identify patients who have certain key long term conditions which may result in complications and hence increased risk of hospitalisation if they do contract COVID-19.  These searches can be downloaded and imported into your GP clinical system FREE OF CHARGE:

  • Asthma - Patients who use 12 or more short acting relievers in a year are known to be at higher risk of hospital admission and death from asthma. As it is not possible to tell the number of inhalers issued in these simple searches, searches for both six issues a year and 12 issues a year have been included.
  • COPD

1a) Patients with COPD with a history of pneumonia 
1b) Patients with COPD on ICS with no clear evidence of beneficial responsiveness* to ICS.

  • High risk GI bleed patients - The patients in these searches are potentially at risk of a GI bleed and therefore it can help to reduce demand on secondary care
  • Medication safety - The patients in these searches have conditions in which NSAID are potentially harmful.

The CCG’s Clinical Application, Data Quality and Training Team have also produced reports to assist practices with their Shielded Patient Lists:

CCG Clinical Applications Data Quality Team Reports (Guide attached)

  • Category B  - Shielded Patient List (SPL) reports have been provided and broken down into 2 groups to help practices:
  1. Identification of patients who have been coded nationally or locally, or both.
  2. Identification of patients on the SPL who may need an easy read letter/additional support, i.e. Patients with Learning Disabilities; Dementia; Autism or other communication problems, etc.
  • Category C – patients who may be at greater risk of complications from COVID-19 (flu risk group with special risk conditions).
  • Category A - patients who are over 70 or have an underlying health condition (broadly the Seasonal Flu at risk group which you may wish to add the moderate risk code to). 

What is the risk classification criteria?

  • High-risk patients - This specific group of patients is defined in the CMO letter and are also called ‘very high risk’, ‘vulnerable’ or ‘shielded’ patients. SNOMED code: 1300561000000107 - High risk category for developing complication from COVID-19 infection
  • Moderate-risk patients – This includes other 'At-risk' patients who are normally included in your flu reports or identified by the practice for other reasons.  SNOMED code: 1300571000000100 - Moderate risk category for developing complication from COVID-19 infection
  • Low-risk patients – This includes all other patients.  SNOMED code: 1300591000000101 - Low risk category for developing complication from COVID-19 infection

Note: To remove a patient from the High risk group, either a ‘moderate’ or ‘low’ risk code must be added after the date the high risk code was added (this will update the counts overnight) DO NOT REMOVE THE HIGH RISK CODE.

If you have any questions or queries or require assistance with these reports, please let us know by logging a call via the IT Self Service portal   https://servicedesk.sheffield.nhs.uk .

The Digital Nurse Network will discuss the role of Remote Working at Health at Home during COVID-19 28/4/2020

The next Digital Nurse Network webinar will take place on 30 April 2020 from 1-2pm. Our Clinical Nurse Advisors Helen Crowther and Ann Gregory will be discussing #remoteworking and the role of the network during #COVID19. Nicola Fulton will also give an overview of the Health at Home campaign and how it can positively impact nurses and their patients. Register here.

Death Management Process Cell - verification of life extinct process update 28/4/2020

This attached notice confirms:

  • The Coroners guidance and directions for verification and certification of deaths- until the temporary measures brought in by the Coronavirus Act 2020 are revoked or further guidance is issued
  • The  additional people who can verify the fact of death – but only if they are ‘suitably trained’  
  • For  verification purposes, that it is not acceptable for a doctor to talk through, either by phone or video, verification of the fact of death with an untrained person
  • For certification of death -  For signing the MCCD  a Doctor can see the patient after death but not via video- as the Coronavirus Act 2020 did not provide this extension - so it is not permitted by law to do this by video. 

Kawasaki Disease and Covid-19 28/4/2020

The following information has been shared in relation to children presenting with unusual symptoms. Abdominal pain and gastrointestinal symptoms have been a common feature, as has cardiac inflammation.

The cases have common overlapping features of toxic shock syndrome and atypical Kawasaki Disease with blood parameters consistent with severe COVID-19 in children. This has been observed in children with a confirmed PCR positive SARS-COV-2 infection, as well as with children who are PCR negative.

Prof Simon Kenny, NHS national clinical director for children and young people, said: “Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to Covid-19, but it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast.

“The advice to parents remains the same: if you are worried about your child for whatever reason, contact NHS 111 or your family doctor for urgent advice, or 999 in an emergency, and if a professional tells you to go to hospital, please go to hospital.”

Please do refer patients as a matter of urgency if you encounter any children presenting with these three types of symptoms. 

The Paediatric Intensive Care Society has also issued a statement which can be viewed here https://picsociety.uk/news/pics-statement-regarding-novel-presentation-of-multi-system-inflammatory-disease/ 

Change to shielded patient wording in SCR 27/4/2020

Further to the successful implementation of the Shielded Patient Flag for community pharmacy (accessible via the SCR application and SCR 1-click solutions) access is now being extended to all users of the SCR application to support access for healthcare professionals in other settings, including hospitals and out of hours services.

As a result of this extended access the wording of the alert has been amended to the following: “This person has been advised to consider shielding. This information may support you to manage this patient but should not be used in isolation as an assessment of risk. Patient management decisions should always be made drawing on the widest range of information sources.”

NHS Staff Feedback Hub 27/4/2020

NHS England and NHS Improvement has launched an online feedback hub so that its leaders can listen and respond to the needs and experiences of the NHS workforce at this unprecedented time.  

The hub is private and anonymous.  It asks participating NHS staff to share how they are feeling, what more can be done to support them, and how the NHS can adjust its communications as part of the COVID-19 response.  

It is being run by without charge by Ipsos MORI, the independent research organisation, and is open to anyone working in the NHS.  Ipsos MORI will be donating £100 every week to a charity chosen by the community as a thank you for members.

Ruth May (Chief Nursing Officer) and Stephen Powis (National Medical Director) say: “We really appreciate the time and effort it will take to tell us what you are feeling and thinking, but we assure you that we will be listening. These are unprecedented times, and so it’s even more important that our staff in the NHS remain at the heart of what we do. Please know that we’ll be listening to your views as they come through to us, and we will respond to what you tell us as we go along. Thank you once again for giving up your time to help us get it right.”

We would like to hear from people working in every type of role within the NHS, so please share the attached invitation with your colleagues and networks.  If you have any questions please contact us at england.insight-queries@nhs.net.

Click here to learn more and to register to join the hub.  Please use the attached posted to share the information with your NHS colleagues.

Latest COVID 19 Barnsley Intelligence and Data 27/4/2020

Please find attached ‘GP briefing 200424’ which is a summary of the Barnsley position on COVID 19. It summarises the local position across our local health and care providers as well as information on new cases and an update around the peak. This data is shared for information only to ensure that Primary Care are informed of the latest data and intelligence for managing COVID 19 in Barnsley. We will continue to share a weekly position update. 

Updated and additional protocols on temporary consolidation of under-16 paediatric emergency surgery at SCH - for ED and surgical teams 27/4/2020

Please share the updated protocols with clinical colleagues and replace any older versions.

New Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) form  27/4/2020

Please find attached the new DNACPR form. The only change to this new form is that the Regional Review Date has been updated from January 2020 to January 2023. 

Regular primary care webinars 24/4/2020

  • Coaching support webinars

24 April, 3pm: Coaching support launch webinar

  • Digital First webinars

24 April, 11-12pm: HETT: The prolific digitalisation of primary care in response to COVID-19

28 April, 12:30-1pm: giving your patients access to online services remotely 

People living with HIV 24/4/2020

It has come to our attention that some people living with HIV have received Shielding letters where they might not be required. This is a National problem relating to the way that HIV is coded, although there will of course be those with co-morbidities that require shielding on other grounds. We have sent a communication to all of our patients summarising the advice of the British HIV association and THT which is as follows:

BHIVA and THT have suggested that people with HIV and one or more of the following conditions should be categorised at highest clinical risk and consideration made of adding them to the list for shielding

    1. People with a CD4 count less than 50 cells/microL
    2. People with an opportunistic illness in the last 6 months
    3. People with significant multi-morbidity*

The attached document has further details of this advice.

People with well controlled HIV (on treatment with a CD4 count >200 ) do not appear to be at increased risk of C19 and, if infected, there is no evidence to suggest that the disease course will be more severe. Disease course may be more severe for those not on treatment, or with a CD4 count <200.

If you require any advice on whether or not a patient requires shielding based on their HIV infection, please feel free to contact Spectrum Community Health CIC on 0800 055 6442

You should flag any patients you identify as high risk by adding the SNOMED CT code to their patient record:

1300561000000107 - High risk category for developing complication from coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 infection (finding)

You should write to your patients if you have identified them as needing to shield. The letter is proof of the need to shield. 

Known issues with the shielded patient list

We are aware of the following issues.

Stable HIV

Patients with stable HIV and no other conditions have not been specifically been allocated to the shielded patient list. We are aware that despite this they are being identified as high risk. This is likely because the code of “immunosuppressed” is used on their record and this is being used to add an entry. See above.

Splenectomy patients 24/4/2020

There have been mixed messages about whether patients who have had a splenectomy should be included on the shielded patients list (SPL). We can confirm that splenectomy patients should be included in the Shielded Patient List. These patients were identified in the central searches carried out by NHS Digital and were contacted by letter by NHS England and NHS Improvement to recommend that they follow shielding advice. Any patient with splenectomy who has been taken off the SPL should be contacted to inform them of this error. NHS Digital will be able to identify these patients centrally from 29 April 2020 and will write to practices with this information. 

Update on shielding 24/4/2020

The majority of the work to establish the Shielded Patient List is near completion. Thank you to everyone who has and continues to help with this process.

As records and coding have been updated, a further 79k individuals have been flagged to be at highest clinical risk nationally. Letters and text messages are now being sent to this group – starting on 24 April. You can find further information about the national algorithm on NHS Digital’s website.

Where you have not already done so, we are requesting that all practices make sure that they have contacted all the people on their patient list who are shielding as a follow-up to the letter. These conversations should: (a) discuss what shielding means, (b) describe any changes to their ongoing care and treatment, Including home visiting wherever this is clinically needed*(c) confirm they have an arrangement in place for receiving their medications and (d) check that they are aware of the government support offer.

We asked you to review a specific list of people who self-declared as clinically extremely vulnerable before 28 March which should have been provided as a task within your IT system (to be complete by COP 28 April).  Going forward, please review any new patients that contact you self-declaring to be clinically extremely vulnerable, adding any that – in your clinical opinion – meet the criteria to the list. 

Nationally, we are setting up an Expert Group chaired by Dr Raj Patel to consider what future support we should be providing to people who are, and will be, shielding.

* If the patient needs face-to-face assessment, they should be seen on a home visit, and not brought into general practice premises unless a designated site has been set up for such purposes. A designated site should be one in which patients with symptoms of COVID-19 are not seen. If a GP surgery is not seeing patients with symptoms of COVID-19, then a room in the surgery would be an option. Home visits remain the preferred option where capacity allows to protect the health of shielded patients.

Sickle cell trait

The code for sickle cell disease has been used on the patient’s record rather than sickle cell trait. This has meant patients have been over identified.

Peripheral Vascular disease (PVD)

We have received reports that PVD is being picked up. PVD is not on any of the inclusion criteria. This cannot be explained without further specific investigation. We will provide updates as other issues are identified.

Other issues have also been raised locally. Patients can be removed from the list by adding a “low” or “moderate” risk of complications from COVID-19 flag.

  • Moderate risk category for developing complication from COVID-19 infection
    Concept ID: 1300571000000100
    Description ID: 2601371000000114 
  • Low risk category for developing complication from COVID-19 infection
    Concept ID: 1300591000000101
    Description ID: 2601431000000117

Further information can be found here: https://digital.nhs.uk/coronavirus/shielded-patient-list/guidance-for-general-practice, including a FAQ document: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/20200403-Clinician-FAQs-v_FINAL.pdf

Staff testing for COVID-19 24/4/2020

Following Pauline Philip DBE, National Director for Emergency and Elective Care and Sarah-Jane Marsh, National CEO lead for NHS Staff Testing, letter of 12 April, contractors have been sent details on how their staff can access testing.  This has been sent in an email sent by the NHS Business Services Authority to the NHSmail shared mailbox of each community pharmacy in England. The email contained a link to an invitation template for employees needing testing. Pharmacy contractors or their employees should not publish or share this invitation or the link to the CQC online portal, beyond employees who require testing. 

Barnsley CCG Staff Wellbeing Guide 23/4/2020

During this coronavirus pandemic, colleagues are dealing with stress, change and uncertainty to a level many of us have not experienced before. 

This wellbeing pack (based on an original version and format created by Bradford Council) provides a resource of support and tips to help colleagues deal with their own mental and physical wellbeing, and to help colleagues, team members, friends and family.  This was originally pulled together to support Barnsley CCG staff and some of the content is CCG specific e.g. access to the Workplace Wellness Service.  However, we were keen to share this colleagues working across primary care as much of the content and links will hopefully prove beneficial too.      

Ramadan 22/4/2020

  • The Chief People’s Officer launched a staff health and wellbeing package last week that included guidance on COVID-19 and Ramadan. This was produced by the NHS Islamic Network in collaboration with the British Islamic Medical Association, that represents over 3,000 Muslim clinicians across the UK. It can be accessed here.
  • The NHS has issued a reminder to those who observe Ramadan to avoid social gatherings because of the risk of coronavirus. A press notice was issued yesterday containing key messages about social distancing and shielding vulnerable people.

Standard Operating Procedure for GPNs, HCA’s, NA’s Visits to Shielded Patients 22/4/2020

As we move through these difficult times as Practices, we need to identify the best method of supporting patients who need our help whilst helping our staff to remain safe.  BHF after discussion with Clinical Directors, Barnsley CCG and Practices would like to support a consistent approach to undertaking bloods in Primary Care.

BHF and a number of other Barnsley GP Practices are utilising both HCA and Practice Nurse capacity to visit patients at their own home to complete bloods, this is for both Shielded and housebound patients.

We recognise home visits for HCAs in particular is something out of the norm, however we will need to work differently over the coming months to ensure we actively support the patient population. 

In speaking to our staff and from feedback across Barnsley, although there may be some reservations about travelling to a patient’s home, with the right PPE and guidance staff are willing to work in this new way.

BHF have created a Standard Operating Procedure (SOP) (attached) for our staff to use, to ensure constancy across Barnsley we are asking all Practices to adopt this approach.

There have been a few questions asked of this approach, these questions and answers are outlined below:

  • DoesHCAs/Practice Nurses indemnity cover them for this work?
    • Yes, the national indemnity scheme provides coverage for HCAs working in this capacity.
  • What car insurance is required?
    • All staff traveling by car as part of their role will need car insurance that covers them for business use.
  • Will staff be able to claim mileage?
    • Yes, Barnsley CCG has agreed to pay HCA/Practice Nurse mileage, at the HMRC rate, if they are travelling to undertake home visits for shielded or housebound patients requiring bloods.
  • WhatPPE do staff need?
    • Please follow the latest Primary Care PPE guidance.

NHS Volunteer Responders 21/4/2020

Following yesterday’s bulletin, please now see the correct links below.

Professionals working across primary care are encouraged to take advantage of the NHS Volunteer Responders programme to refer patients who are considered to be vulnerable and at risk.

Guidance for health professionals on how to refer is available. All NHS healthcare staff - and local government staff, who need to use their gov.uk email addresses -  can make requests via the NHS Volunteer Responders referrers’ portal or by calling 0808 196 3382. Read more about how the referrals work here.

COVID-19: Reviewing individuals who have self-identified as vulnerable 21/4/2020

A number of patients have been able to self-identify as clinically extremely vulnerable via the Cabinet Office website. The names of individuals who registered on the website prior to 29 March but have not been identified through the central process, is now available on the practice systems.

As per the NHS England CAS alert dated 9th April (task 4),  practices are now required to review these patients to determine their appropriate Covid-19 risk category and flag them as high, medium or low risk as appropriate. For any of these patients you flag as high risk, you will need to send them a copy of the patient letter giving them advice on shielding.

The EMIS web search can be found in the folder:

EMIS HEALTH: COVID-19 SEARCHES/Self-referring patients still to be risk assessed

The SystmOne (TPP) searches can be found in the folder:

System Wide/COVI19 AT RISK/Self declared/Self declared high risk patients without high risk codes

For our VISION practice, we have contacted the system provider and will be in contact with the practice regarding the search availability

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022

If you have any queries please contact Victoria.holmes3@nhs.net, Senior Prescribing Support Technician, MMT 

Gestational diabetes during COVID-19  21/4/2020

RCOG have issued amended guidelines on screening for gestational diabetes during COVID-19. In line with those guidelines, antenatal services at Barnsley and Rotherham replaced OGTT testing for GDM with glucose and HbA1c measurements at 12 and 28weeks (as required) for those who have not already been diagnosed with diabetes.

In order to minimise the confusion the current HbA1c auto-comments may cause, as of 20.04.20, they are now replaced for all pregnant patients (based on antenatal/midwifery locations) with the following auto-comment:

“Please refer to the local/RCOG guidance  when reviewing and interpreting HbA1c and glucose results in pregnancy during coronavirus pandemic”.

The same comment is also now appended to all glucose results from those patients.

https://www.rcog.org.uk/globalassets/documents/guidelines/2020-03-30-guidance-for-maternal-medicine-in-the-evolving-coronavirus-covid-19-pandemic.pdf

Shielding patients - guidance for GPs 21/4/2020

We know that general practice is dealing with queries from patients who require support over and above the care and treatment they are receiving for their medical condition. Included in this slide deck (also attached) on the FutureNHS portal is information, provided by the Government and the NHS, to support you in answering queries from patients in both the shielded and non-shielded groups who may require additional support during the COVID-19 outbreak.

PHE Campaign Resource 20/4/2020

New resources for pharmacies were added to the PHE Campaign Resource Centre on 10 April and are available for download here, these include versions optimised for printing locally on site.

A package of resources is being posted to all community pharmacies via the Royal Mail which will start to go out on Friday 18 April and will be received end of w/c 21 April. All pharmacies will receive: A ‘Do not enter if you have symptoms of coronavirus’ poster; A ‘Keep a safe distance’ poster, reminding people to keep 2 metres apart; and a ‘We may be closed to the public during certain times’ poster with white space for them to add their opening hours.

Digital resources for pharmacies are being developed and include a digital screen and social media assets in the national look and feel used for coronavirus public facing marketing messages. These will be available during w/c 21 April.

We will be launching a national public facing PR campaign using the digital resources with the help of media medics and pharmacists to get message out to consumers on social media and also to trade media. We plan to launch this at the beginning of May.

Regular primary care webinars 20/4/2020

23 April, 5-6pm: Primary care webinar with Nikki Kanani and Ed Waller

NHS Volunteer Responders 20/4/2020

Professionals working across primary care are encouraged to take advantage of the NHS Volunteer Responders programme to refer patients who are considered to be vulnerable and at risk.

Guidance for health professionals on how to refer is available. All NHS healthcare staff - and local government staff, who need to use their gov.uk email addresses -  can make requests via the NHS Volunteer Responders referrers’ portal or by calling 0808 196 3382. Read more about how the referrals work here.

Coaching support  20/4/2020

Some of you may have heard in yesterday’s general practice webinar that an individual coaching support offer will be made available by the end of next week to the frontline primary care workforce, both clinical and non-clinical, to proactively support staff through Covid-19 and beyond.  The aim is that this will provide staff with opportunities to process experiences, develop coping skills, deal with difficult conversations and develop strategies for self-management in difficult circumstances.

This service is being developed in collaboration with the Royal College of General Practitioners and will complement the wider range of health and wellbeing resources that was launched last week at www.people.nhs.uk.  Primary care staff will be able to easily register via an online platform at www.people.nhs.uk and book individual coaching from an experienced coach in a way and at a time of day that suits them. 

launch webinar is taking place next Friday 24 April 3pm to share specific details about the service.

In the meantime, if you are a member of the primary care workforce we would love your views on the service before it is finalised and launched.  Please join a webinar next Monday 20 April at 5pm to see what we’re proposing to offer and to help us decide on a name! For any information, please contact kate.tattershall@nhs.net.

Electronic Prescribing  20/4/2020

Could practices please postpone switching on EPS4 until we have more information. The medicines management team will be attending training this week so that they are able to support practices. A managed roll-out across Barnsley, with resources and training where required, will be developed as soon as possible. We do not want to delay roll-out we just want to ensure that practices have prepared their staff, set up it up correctly and have at the very least completed the GP practice readiness checklist prior to switch on

Medical Certificate of Cause of Death forms 20/4/2020

The Register Office have reported that they are receiving a number of MCCD forms filled in incorrectly, which means they are having to contact the Coroner’s Office or having to come back to the GP. As you can imagine the Register Office and the Coroner’s office are working to full capacity and doing their best to keep the flow going as efficiently as possible. The Coroner has also raised the issue regarding the amount of enquiries going through to them, which is taking up their valuable resource time.  If you have a query regarding the completion of a MCCD  please contact the Registrar below in the first instance, and they will be able to provide you with guidance and support.   

Barnsley Registrations Services at Juliecooke@barnsley.gov.uk  

Please also see attached Coronavirus Act – excess death provisions: information and guidance for medical practitioners 31 March 2020

The Register Office have also asked that we share some example MCCD forms to assist doctors/nurses with completion:    

NE & Yorkshire Daily Summary of key data and trends  20/4/2020

Please find attached key data and trends for Saturday 18th and Sunday 19th April 2020

Shielding patients 17/4/2020

Thank you for all your help in identifying and supporting the people who are at greatest clinical risk of severe illness from coronavirus. We know that we have asked a lot of you during the last few weeks and are grateful for the efforts that you have gone to in helping to protect those who at greatest risk during this time.

As you are aware, a number of people have self-identified as being at highest clinical risk and registered on the government’s website. Government have asked us to pass you the patients who did this before 29 March for review. These will be provided to you via tasks in your IT system from 17 April and completed by 24 April. We ask that you complete your reviews where possible by 28 April so the data extraction (starting every Tuesday evening) can be completed and patients offered the support they need.

Government support 17/4/2020

The government have launched a new website for patients to use in finding out what help they can get if affected by coronavirus. This service is available to all patients who are seeking advice and guidance on the topics such as:

  • feeling unsafe
  • going in to work
  • paying bills or being unemployed
  • getting food
  • having somewhere to live
  • mental health and wellbeing

GP Retention Scheme 17/4/2020

NHS England and NHS Improvement previously lifted the restrictions on the maximum number of in-hour sessions retained GPs can conduct so they can contribute to the COVID-19 response. This relaxation on the maximum number of in-hour sessions will now be extended until further notice.

Regarding retained GPs due for their scheme annual review, CCGs will now be able to:

  • agree with retained GPs, who are due for a scheme annual review before the end of September 2020, to defer their annual review until a later date
  • consider granting retained GPs, who are approaching the end of the scheme (e.g. those in their final three months of the scheme), with a scheme extension until the end of September 2020.

Retained GPs are encouraged to contact their HEE local scheme leads if they require any support at any stage

Good Friday and Easter Monday Reimbursement 17/4/2020

Please find attached revised template for claims relating to reimbursable costs for Easter working. Please accept our apologise as guidance received initially stated that costs for all associated staff working would be paid either on actual costs to a maximum of £250 per session, but this is incorrect and has now being corrected to ensure all associated staff costs are fully reimbursed based on individual  contracts of employment.

Where practices do not have terms and conditions in place for staff contracts the time is paid with a day in lieu to staff. Double time should be claimed from the CCG to cover the backfill for when staff take the leave

New ‘Looking out for each other’ campaign 16/4/2020

As part of the Government’s response to managing the impact of coronavirus, this campaign is to inform those who are well and not at risk as well as the things that they can do to help support their friends and neighbours.

The Looking Out For Each Other assets explain how people can help friends, family and neighbours in isolation safely directing to gov.uk/safehelp for more information. The assets explain that if you are well, you should only leave the house for one of four reasons, including to provide care or to help a vulnerable person. They also tell you what actions you should take to help vulnerable people safely.

Advanced care planning guidance 16/4/2020

NHSE has developed guidance and a template for advanced care planning in the context of coronavirus (COVID-19).

Good Friday and Easter Monday Reimbursement 16/4/2020

Practices can seek reimbursement for additional staffing costs incurred on Good Friday and Easter Monday, in line with the respective rates as set out below. That includes:

  • Sessional GPs: up to a maximum of £250 a session or £500 per day;
  • Overtime for salaried GPs in line with the individual’s contractual arrangements;
  • Additional capacity from GP Partners to recognise up to two additional sessions on each of Good Friday and Easter Monday at a rate of £289 per session plus applicable employer National Insurance and pension costs;
  • Overtime for non-GP practice staff in line with the individual’s contractual arrangements.

Please find attached a revised invoice template to be completed for your practice. In order for these to be paid as soon as possible it would be appreciated if the completed invoices be submitted to SBS in the usual way by Wednesday 22 April 2020.

Telephony Headsets 15/4/2020

We would like to thank practices for responding to us in regards to telephony headsets, we now recognise that it is not possible to provide blanket headsets for all practices as the type of headsets required is dependent upon the telephone system in place.

However, we are happy for practices to source their own headsets for priority users i.e. clinicians completing telephone triage, and to invoice the CCG for these.

New campaign resources 15/4/2020

Materials for NHS healthcare settings were recently updated to include:

  • Updated ‘Do not enter’ posters for healthcare settings including GP and pharmacies (for those with symptoms of coronavirus)

  • New Safe distance posters for use in Hospitals and other NHS settings to remind patients to keep a safe distance of 2 metres

  • New GP access poster for practices – promoting online and phone consultations for non-COVID-19 related issues

  • New Pharmacy opening times poster – for use when pharmacy may be closed to the public during normal opening hours

All downloadable here

Identifying Patients at risk 15/4/2020

Following on from the NHS England letter to review patients on the high risk system searches (9th April 2020 - https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103022​), COVID-19 pathway on NHS pathways (Eclipse Live) has identified ADDITIONAL patients within your practice that may also fall into the high risk category.

I have attached instructions on how to identify these patients on the secure NHS pathways website. If you would prefer for the MMT member working in your practice to supply you with the list(s) please contact Vicki Holmes on email victoria.holmes3@nhs.net and a request will be sent for them to be urgently sent to you.

It is recommended that the first list of patients "All Government Groups Not Received Letter" should be reviewed by close of play Friday 17th April.

Following completion of the first list, the second list of patients, "Category B & C combined not received letter", are advised to be reviewed as soon as reasonably possible. Please contact Vicki Holmes if you have any questions on: victoria.holmes3@nhs.net.

Preparedness letter for general practice 15/4/2020

The latest guidance letter for general practice was published yesterday and contains updates on changes to the GP Contract Regulations, NHS immunisations and child health surveillance as well as details on other guidance that has recently been published.

Assaults on Emergency Workers Act 2018 15/4/2020

The Royal Pharmaceutical Society has welcomed confirmation that all pharmacists and pharmacy team members are covered by the provisions of the Assaults on Emergency Workers Act 2018. This was confirmed to the RPS by the Department of Health and Social Care (DHSC) this week.

The legislation which applies to England and Wales enables judges to apply more severe sentences to those found guilty of any physical attacks on emergency or healthcare workers. 

Right to Work Verification for Returning Doctors 14/4/2020

Thank you to all the practices who have helped returning GPs to complete their right to work verification so far, your support is greatly appreciated.

Whilst many returning GPs will choose to do their return to work verification virtually, if returning doctors do approach your practice team for help with this, we would be very grateful if teams could:

  • check the documents presented and satisfy themselves that they are consistent with the appearance of the individual,
  • take a photocopy or a scanned copy of each of the documents presented,
  • complete the identification checklist which can be found here along with further information about the process, and
  • send scanned copies of the verified documents and the checklist to the GP’s employer at COVID19.CAS@nhs.net from your organisation’s NHS.net account, or another encrypted account if this is not possible.

Good Friday and Easter Monday Reimbursement 14/4/2020 

Practices can seek reimbursement for additional staffing costs incurred on Good Friday and Easter Monday, in line with the respective rates as set out below. That includes:

  • Sessional GPs: up to a maximum of £250 a session or £500 per day;
  • Overtime for salaried GPs in line with the individual’s contractual arrangements;
  • Additional capacity from GP Partners to recognise up to two additional sessions on each of Good Friday and Easter Monday at a rate of £289 per session plus applicable employer National Insurance and pension costs;
  • Overtime for non-GP practice staff in line with the individual’s contractual arrangements.

Please find attached an invoice template to be completed for your practice. In order for these to be paid as soon as possible it would be appreciated if the completed invoices be submitted to SBS in the usual way by Wednesday  22nd April 2020.

Webinar: using remote triaging and online consultations in managing COVID-19 using Engage Health 14/4/2020

In response to Covid-19 all practices should move to a total triage model and utilise remote consultations wherever possible (online, phone and video) to protect patients and staff and minimise the risk of infection. Total triage means that every patient contacting the practice is first triaged before making an appointment.

Practices are able to use doctorlink to do total triage and accuRx for video.

This one hour webinar will look at practical steps general practice should take to establish a total triage model using Engage Health.

  1. Go to https://nhsiq.webex.com/nhsiq/k2/j.php?MTID=ta58506539838fecb46fafc1c742a1319
    2. Enter your name and email address (or registration ID).
    3. Enter the session password: M4r7mHgGeq6
    4. Click "Join Now".
    5. Follow the instructions that appear on your screen. 

Primary Care Testing Guidance and Process 14/4/2020

National Plans have been outlined on widening testing of COVID-19 for NHS staff and household members including primary care staff. We expect further guidance on this in the coming days as we step up the level of testing capacity across the health and care sector. 

One of the biggest areas of concern for all Practice staff in Barnsley has been the perceived lack of testing following the onset of COVID19 symptoms. Following detailed conversations with SWYPFT, Barnsley Hospital and Barnsley CCG, Barnsley Healthcare Federation are now able to offer testing for Primary Care. 

The numbers of tests that can be processed within a day are limited, and we therefore want to maximise the number of people we can test at the most appropriate time. We have review national and regional guidance/best practice to formulate the best way of ensuring we are testing as many people as we can and at the same time ensuring we get the most accurate results, helping people to return to work safely.

The attached guidance sets out the criteria and process for requesting testing, which will be completed by Barnsley Hospital with the help of both BHF and Barnsley CCG staff.

We can accept referrals for testing from today 14th April 2020.

 Please take time to read through the guidance so you are similar with the process we will be following.

 We are also aware that there are also regional plans to increase testing, which we will share guidance on as and when it becomes available.

EOLC Symptom management 14/4/2020

Please find 2 documents attached:

  1. A short summary of advice and hints for talking about EOL issues in the COVID emergency written by a local GP and palliative care doctor - it is sympathetic to the current context and informed by current experiences on the ground - PLEASE READ 
  2. Further communication skills principles for EOL /ACP including a prompt document for use in telephone consultations, with links to online video resources via e-Learning for Health which is very useful.

Please remember you can ALSO seek support from Specialist Palliative Care 24/7.

For Community Specialist Palliative Care (SPC)Team advice between 09:15-16:45 ring 01226 645280 on weekdays), on 01226 644575 weekend and bank holidays, and at other times (after 16:45 and before 09:15) or at any time for medical advice ring Hospice 01226 244244. For Barnsley Hospital SPC Team advice between 09:00-17:00 ring 01226 434921. 

EPS Phase 4 – EMIS and TPP 14/4/2020

NHS Digital have been rolling out EPS Phase 4. Currently only TPP had full Roll out approval and was only able to enable practises on TPP. However, EMIS have now got Full roll out approval and practices can switch on Phase 4 through the resource Centre. More information can be found on the NHS digital website:

https://digital.nhs.uk/services/electronic-prescription-service/phase-4/clinical-commissioning-group-information#implementing-phase-4

Due to the rapid response of COVID-19 in Primary care, practises can switch on EPS Phase 4 directly through the system supplier.

Information about Phase 4

Phase 4 allows the use of EPS for patients without a pharmacy and/or DAC (Dispensing Appliance Contractor) nomination in their GP record. Essentially meaning that for those patients who don’t have a pharmacy or DAC nomination, their prescriptions can still be signed & sent electronically, remotely with spine connectivity or from the practice. The patient would then attend any pharmacy in England presenting identification and enabling the pharmacy to draw their prescription down from the spine.

Psychological Wellbeing in Healthcare Workers in response to COVID-19 9/4/2020

An e-learning resource on Psychological Wellbeing in Healthcare Workers in response to COVID-19 has been developed, this can be accessed here: https://www.nottingham.ac.uk/toolkits/play_22794

Supporting the wellbeing of NHS staff and students will be critical during the pandemic - psychological impacts will undoubtedly occur and may be long-lasting so we are keen to do anything to help with this. 

This package is relevant to all healthcare staff and healthcare students. It contains information, advice and tips from experts in the field and signposting around: 

Psychologically safe work environments, communication, social stigma, accessing social support, self-care strategies, rest, shift-work and sleep, and managing emotions during the pandemic. 

Scams and frauds 9/4/2020

A helpful guide to scams and frauds has been published, which outlines some of the things to be aware of during this time. This is a resources for staff and may answer any questions you may have had.  Please also be aware that there is a whole range of fake news and messages circulating in relation to the pandemic. The message is please refer only to trusted sources and don’t share anything onwards.  If you have any questions you can always check out with colleagues.  Thank you for flagging them when you have had concerns.

Patient Registration / Practice Lists 9/4/2020

A polite reminder that despite the difficulties practices are facing in regards to the Covid-19 pandemic, all practice lists should remain open and practices should continue to register patients if necessary.

Good Friday and Easter Monday reimbursement rates 9/4/2020 

Practices can seek reimbursement for additional staffing costs incurred on Good Friday and Easter Monday, in line with the respective rates as set out below. That includes:

  • Sessional GPs: up to a maximum of £250 a session or £500 per day;
  • Overtime for salaried GPs in line with the individuals contractual arrangements;
  • Additional capacity from GP Partners to recognise up to two additional sessions on each of Good Friday and Easter Monday at a rate of £289 per session plus applicable employer National Insurance and pension costs;
  • Overtime for non-GP practice staff in line with the individuals contractual arrangements.

 An invoice template will be provided on Tuesday.

URGENT UPDATE: Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 9/4/2020

Further to previous communication on flagging patients defined as extremely vulnerable to COVID-19 (3rd April), EMIS are now issuing further advice as an interim solution for flagging patients at high-risk as defined by the CMO guidelines.  (See attached)

Updated - Cancer support services response to COVID 19 9/4/2020

Through the LWABC programme the Cancer Alliance continue to work closely with local cancer support organisations to support the huge numbers of people during and beyond their cancer treatment. Current provision: Cancer Support Workers are working to deliver a support service out of the Well building. They will contact all patients on the books at the Well and work with the clinical teams to provide support to all their patients. All face to face support has stopped, however they will contact by phone. We will contact all patients past, present or future who may need us. The contact will be low level wellbeing support and not clinical but patients will be directed where possible.

See attached guidance and daily brief from SYB ICS cancer alliance team.

Maintaining Standards and Quality of Care in Pressurised Circumstances  9/4/2020

Please see the letter from Professor Stephen Powis, National Medical Director, and Ruth May, Chief Nursing Officer, NHS England.

https://www.england.nhs.uk/coronavirus/publication/maintaining-standards-pressurised-circumstances/

The letter includes guidance in regard to encouraging vulnerable patients to discuss their wishes and concerns. The British Medical Association, Care Provider Alliance, Care Quality Commission, and the Royal College of General Practice have recently issued a statement (https://www.rcgp.org.uk/about-us/news/2020/april/joint-statement-on-advance-care-planning.aspx) on the role of general practitioners which provides an excellent basis for the approach required, not just in general practice but throughout the health and care system. 

The key principle is that each person is an individual whose needs and preferences must be taken account of individually. By contrast blanket policies are inappropriate whether due to medical condition, disability, or age. This is particularly important in regard to ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) orders, which should only ever be made on an individual basis and in consultation with the individual or their family.

The appropriate use of the clinical frailty scale and the use of DNACPR which should be read in conjunction with this letter.

Assessing / Managing COVID-19 9/4/2020

Please find attached a useful summary of the new national guidance following the advice that the Roth score should NOT be part of clinical assessment of COVID-19 suspects/patients.

Webinar 8/4/2020

We will be hosting a COVID-19 webinar for community pharmacists and pharmacy technicians on Wednesday 8 April. Join Keith Ridge Chief Pharmaceutical Officer, from 7pm via MS Teams bit.ly/3bOqSwq.

 

Movement of Employees 8/4/2020

The Royal Pharmaceutical Society and the General Pharmaceutical Council have produced a letter for community pharmacists in support of the legitimate movement of pharmacy employees between their home and place of work.

Mental Wellbeing Webinars 8/4/2020

There are FREE webinars designed to help NHS frontline staff and IAPT professionals, focusing on mental wellbeing in light of COVID-19. You can join these webinars LIVE or each one will be downloadable once they have taken place.

  • Staff Wellbeing – Thursday 16th April 2020, 2pm-3pm

Register here for Staff Wellbeing: IAPT Service Support in COVID-19 >>

  • Physical activity in isolation – Friday 24th April 2020, 12pm-1pm

Register here for Physical Activity in Isolation: IAPT Service Support in COVID-19 >>

Please also see attached document which includes links to further information and registration.

QOF Aspiration Payment  8/4/2020

We are writing to advise of a change to the year-end collection schedule for QOF 2019/20. TPP, Microtest and Vision are extracting as planned between 1 and 3 April. EMIS have rescheduled the extract window for their practices due to undertaking urgent Covid-19 related work.

Consequently, QOF calculations for all practices will be placed on hold and practices will not be able to view their QOF achievement data until 23 April, as calculations can only take place once the data has been received from all the GP system suppliers. Access to some CQRS reports will be temporarily disabled on 20-21 April 2020 to allow calculations to complete uninterrupted.

However, we do not anticipate a delay to GP practices payments. The changes to year end validation processes for 2019/20, published on the NHS Digital website here, mean that we can process the payment files as planned with achievement payments being made from May 2020.

Aspiration payments in April 2020 will be the same as March 2020 and will be updated from May 2020 if necessary.

The table below provides an overview of the amended schedule:

  1. Extraction window for TPP, Microtest and Vision practices

Wednesday 1 April to Friday 3 April

  1. Extraction window for EMIS practices

Saturday 18 April and Sunday 19 April

  1. Achievement and Aspiration calculations for all practices

Monday 20 and Tuesday 21 April  

  1. Analysis work undertaken by NHS Digital to compare 19/20 and 18/19 achievement and identify practices with significant differences in performance to be flagged to commissioners

Wednesday 22 April

  1. Achievement data available to view in CQRS for all practices and automatic approval of data for practices who have not been flagged to commissioners

Thursday 23 April

  1. Submission of automatically approved payment files to NHAIS

Friday 24 April

Switching warfarin patients to DOACs' guidance 7/4/2020

Please see attached guidance for switching warfarin patients to DOAC’s.

Revised Standard Operating Procedure for general practice 06.04.2020 V2.1  7/4/2020

The updated GP standard operating procedures (SOP) that we shared yesterday (6.4.2020) has been updated and can be found here: standard operating procedures. All content changes since the previous version are highlighted in yellow. Going forward we will try to highlight the differences between an updated and current SOP.

Please note that two key links have been updated:

We also wanted to clarify the situation for face to face assessment for shielded patients. If possible, a dedicated home visiting team for shielded patients should be set up, with staff who are not seeing patients with symptoms of COVID-19. Where this is not possible, shielded patients should be seen either in designated sites or by routine home visits, depending on the local model. Infection prevention and control guidance, including appropriate use of PPE should be followed at all times.

We apologise for any confusion these updates may cause.

Tripartite Indemnity Letter 6/4/2020

The Coronavirus Act 2020 provides the Secretary of State for Health and Social Care with powers to provide indemnity for clinical negligence liabilities arising from NHS activities carried out for the purposes of dealing with, or in consequence of, the coronavirus outbreak, where there is no existing indemnity arrangement in place. The additional indemnity provided by the Coronavirus Act 2020 covers NHS services commissioned from non-NHS providers. These arrangements will therefore include healthcare professionals and others from the independent sector, working as part of the coronavirus response, where there is no existing indemnity arrangement in place.

See the letter re tripartite indemnity here.

Funding for General Practice 6/4/2020

Please find attached letter

Telephonony Headsets 6/4/2020

The CCG have available a limited supply of telephony headsets for practices. Please can you inform the Primary Care team if you would like any headsets and, if so, what your minimum requirement would be. Please respond by CoP Wednesday 8th April tobarnsleyccg.primarycare@nhs.net

Macmillan Cancer Support 6/4/2020

We’re doing everything we can to support people living with cancer right now and have updated our dedicated coronavirus information pages with a wide range of support. This includes information on how to deal with social isolation, how to access financial support, end of life care and how coronavirus may impact on a patient’s cancer treatment. There are also now pages specifically for professionals, covering resilience and how to look after your mental wellbeing.

The Macmillan Learn Zone will also be providing additional information and learning resources. If you’re not already signed up, create an account here.  

Call the Macmillan Cancer Support Line for free 7 days a week 9am-5pm 0800 808 00 00.

Stay connected from the safety of your own home - join our Online Community, talk to people who know what you're going through and ask our experts your questions.

Macmillan iHOPE (Help Overcoming Problems Effectively) Online Course for people living with or after a cancer diagnosis 6/4/2020

Macmillan are offering an online peer group support self management course which is particularly relevant at the moment. The course helps to build resilience, rediscover strengths and increase your ability to cope through their programme called iHope (Help Overcoming Problems Effectively). It's a six week programme, involving a minimum of two hours per week, at a time to suit you, if you have access to the internet via smartphone, tablet or PC. Topics include smarter goal setting; priorities and values; living positively with fears for the future; eating well; managing stress and finding things to be thankful for. Start dates for each course are 6 April; 4 May and 1 June.

British Heart Foundation - General information for people affected by heart and circulatory diseases 6/4/2020

We know this is a particularly worrying time for people with heart and circulatory diseases. You can signpost your patients to our website bhf.org.uk/coronavirus or our heart helpline on 0300 330 3322/ hearthelpline@bhf.org.uk. The helpline is receiving a significant increase in calls but we are responding by increasing our cardiac nurse staffing capacity on the helpline and extending our hours over the coming days and weeks.

We also have an online community at HealthUnlocked, which is a safe online space for people to connect with others affected by heart and circulatory diseases during uncertain times. https://healthunlocked.com/bhf

Use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) 6/4/2020

Please see the attached ‘the use of do not attempt cardiopulmonary resuscitation (DNACPR)’ following rapid NICE guidance.

This letter provides clarity in relation to the use of the Clinical Frailty Scale (CFS) and the use of do not attempt cardiopulmonary resuscitation (DNACPR) with younger patients, those with a stable long term physical need, learning disability or autism.

GP information on Caring for people at highest clinical risk during Covd-19 6/4/2020

Please see attached letter re: communication and flagging of patients for shielding

(SOP)Reprioritisation of Hospital Services Due to Covid-19 6/4/2020

With effect from 6 April 2020 the services provided by the Trust will be temporarily restricted to emergency and very urgent services only which, wherever practicable, are to be provided remotely without the need for patients to attend the hospital. This document attached provides guidelines for general practice staff on the application of these temporary restrictions of service.

Updated Covid-19 - GP Standard Operating Procedure 05.04.2020 V2 6/4/2020

Please see the attached the updated GP standard operating procedure.

Practical guides on Supported self-management and Health coaching launched 3/4/2020

During the COVID-19 pandemic, we have identified practical ways to support people to continue to manage their health and wellbeing while staying at home. A range of guides have been launched to help health and care professionals to deliver supported self-management interventions that support the delivery of the Comprehensive Model for Personalised Care. The guides have been designed to improve understanding of what good supported self-management looks like, how to commission these services locally and to support the delivery of health coaching interventions which will be of particular importance to those managing new and existing conditions at home during this pandemic. Read these new guides on Supported self-management and Health coaching.

Radiotherapy at Weston Park Hospital 3/4/2020

The radiotherapy department at Weston Park Hospital (WPH) is continuing as “normal”.  They are asking patients to arrive for their appointments as close to their time as possible and to come into the hospital/department alone where at all possible. Some patients may be delayed and some may have their planned treatment schedule shortened according to national guidelines. If any patients are unsure what may apply to them then they can contact WPH. The open evenings held on the second Tuesday of every month are cancelled for the foreseeable future but the Information and Support team are available to answer any questions from patients, relatives or HCPs by telephone or email. It will be available Monday-Friday 8.30-5.00. Contact details for patients: 0114 2265282,sth.rtinfo@nhs.net  (new easier address which we are phasing in) or sht-tr.RTInfo@nhs.net  (old email we are phasing out!).

Support for People with Cancer 3/4/2020

BHNFT Cancer Support Workers are working to deliver a support service out of the Well Centre. Two of the support workers will base themselves within the Well Centre building. They will contact all patients on the books at the Well and work with the clinical teams to provide support to all their patients. All face to face support has stopped at the Well Centre however they will contact individuals by phone. The Well Centre Tel:  01226 733019 http://www.thewellforwellbeing.org.uk/

Principles for maintaining the National Immunisation Programme during the COVID-19 Pandemic 3/4/2020

The UK advice is that childhood vaccination, should continue during this time. The Royal College of General Practitioners has also issued guidance that immunisations should continue regardless of the scale of the virus outbreak. The attached document ‘Covid-19 immunisation’, updated 02.04.2020, provides top tips for maintaining the National Immunisation Programme during the COVID-19 Pandemic. This and further information can be found on RCN website: Immunisation

Please also find attached Y&H (SYB) SIT Update - WC 30 March which has specific advice:

  • COVID-19 -  For Action
  • Vaccine update, March 2020, Issue 306 –  For Information
  • Pneumoccal infant programme – Errors following the schedule change –  For Action

High risk patients 3/4/2020

A series of public-facing FAQs has been produced which aim to answer as many of questions raised off the back of the national high risk patient letters. There will also be refreshed guidance for practices and clinicians about this process which we will send on to you when available.

Also note that Gov.uk has updated its vulnerable people guidance with additional translations.

Bank holiday preparations/ Barnsley Chronicle 2/4/2020

As per the guidance contained in the GP Preparedness documenthttps://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/gp-preparedness-update-letter-27-march-2020-.pdf , practices and the wider NHS will continue to be under ever-increasing pressure over the coming weeks, including through Easter (10 and 13 April) and, looking forward, to May bank holidays (8 and 25 May). Changes to the GP contract coming imminently, mean the April dates will now be identified as normal working days for GP practices, so that we can manage demand together.

We have received a number of queries relating to the Bank Holiday working and are looking into these and hope to provide further clarity in the next couple of days.   

We have issued the following information in tomorrow’s Barnsley Chronicle ahead of next week. We’ve tried to keep the wording as general as possible. The information will sit alongside an article talking about the fantastic job practices are doing and explaining how GP and pharmacies have been changing and adapting over the past couple of weeks.

GP practices will be open for telephone appointments on Friday 10th and Monday 13th April during their usual hours.

Evening telephone appointments available at IHeart Barnsley. Call 01226 242419

between 4:00pm – 6:00pm Monday to Friday and 8:00am – 9:30am during weekends.

Thank you for your patience as phone lines may be busier at certain times of the day.

Check back next week for pharmacy opening times.

If you need urgent advice outside of these hours continue to call NHS 111.

Covid-19 At Risk Patient Letter - for use within clinical systems 2/4/2020

The NHS England “at risk patient letter” has been amended by the clinical application support team for use within the clinical systems. There is also a “at risk patient letter (easy read)” version of this, but unfortunately due to the size of the file this cannot be imported into the clinical systems. Original copies of the letter can be found here, or via the link https://www.england.nhs.uk/coronavirus/publication/guidance-and-updates-for-gps-at-risk-patients/.

SystmOne - The standard letter has been amended and published centrally – it is called “Covid-19 High risk letter to patients” and is within a new folder called “Covid 19”.

EMIS Web - The EMIS Web version of the standard letter is in the attached zip file along with the usual importing instructions.

InPS Vision - The original Word versions are attached.

NHS England, NHS Digital and the clinical system suppliers are still working together on the reports and information required to identify the list of at risk and vulnerable patients. The advice from NHS Digital remains that practices should not take any action on this list at the moment. Further information and guidance can be found on your clinical system suppliers noticeboard or support centre.

If you have any questions or queries relating to using or importing the letters, please contact the team via the self-service portal link below or via sheffieldccg.bss@nhs.net. If you have any other questions or queries regarding the Coronavirus/Covid-19, please contact Primary Care team, CCG.

Coronavirus Act – excess death provisions: information and guidance for medical practitioners 2/4/2020

The Coronavirus Act of Parliament gained Royal Assent on 25 March 2020, and the commencement order for the clauses relating to death certification and cremation forms was signed on 26 March 2020. Guidance and information on these clauses are set out in this document, along with previous COVID-19 advice issued on 10 March, included for completeness. This document covers:

  1. Medical certificate of cause of death
  2. Registration
  3. Coroners
  4. Burial
  5. Cremation

Palliative and EOLC Symptom management 1/4/2020

 Please find attached the COVID-19 palliative and EOLC symptom management and guidance.

Coroner Office Guidance 1/4/2020

Please see attached clear guidance from the coroner’s office in relation to the new death certification and cremation form requirements. 

NHS Employers Covid-19 Guidance for NHS Workforce 1/4/2020

The third part of COVID-19 guidance for NHS workforce leaders is now available, offering guidance on staff terms and conditions during the COVID-19  pandemic.

The guidance deals with the workforce and HR issues that are likely to arise during the current pandemic and is intended to supplement your local plans and help you enact them.
Part three of the guidance covers:

  • recording on ESR
  • self-isolation
  • sickness absence
  • other forms of absence, such as carer's leave, special leave, bereavement
  • annual leave 
  • additional work to support the emergency
  • returning to work in the NHS
  • NHS Pension Scheme
  • working hours and Working Time Regulations
  • re-prioritising existing work.

Access all the guidance on NHS Employers COVID-19 web pages. 

IG: Health Service Control of Patient Info - 31/3/2020

Please see the attached; ‘Covering note for UK biobank notice’ and ‘Final Biobank COPI notice’ for guidance relating to IG for patients and patient data.

Bank holiday preparations - 31/3/2020

As per the guidance contained in the GP Preparedness document https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/gp-preparedness-update-letter-27-march-2020-.pdf , practices and the wider NHS will continue to be under ever-increasing pressure over the coming weeks, including through Easter (10 and 13 April) and, looking forward, to May bank holidays (8 and 25 May). Your help is needed to be prepared and align with the rest of the NHS, which will be treating these as ordinary working days and cancelling staff annual leave to ensure services are able to be maintained. To enable this, changes to the GP contract coming imminently, mean the April dates will now be identified as normal working days for GP practices, so that we can manage demand together. The position for the May bank holidays will be confirmed next month

Rescue Pack myth busting - 30/3/2020

We’ve seen a lot of misinformation on social media about ‘Rescue Packs’. This is across the country and not just locally. The CCG will be using the message below from the @nhsbarnsleyccg account so feel free to share it it’s helpful: 

Confusion and misinformation seems to be spreading and some people are contacting their GP practices requesting 'rescue packs' when they've not had them before. If you have asthma or another respiratory condition, continue to manage it in the usual way. Please don't contact your GP practice for a 'rescue pack' unless you've previously been prescribed one by your medical team. If you have a respiratory condition like COPD and have symptoms of #covid19, go to 111.nhs.uk/covid-19  before doing anything else.

You can help by using NHS services wisely during this time of intense pressure. Thank you! Give us a share and help spread the message.

Stay at home guidance for people with symptoms and their household - 30/3/2020

The national posters and banners identify the need for households to isolate for 14 days if a member of the family is symptomatic. However, when taken out of an individual context this can be ambiguous and confusing. Practices may want to have available the following information (e.g. at entrances to buildings) as additional guidance for the public. This is also useful in the context of staff self-isolating and when they are able to return to work according to current guidance:

Stay at home guidance for households – illustrated:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874011/Stay_at_home_guidance_diagram.pdf

Easy Read Guidance:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874281/COVID-19_easy_read.pdf

Information sources - 30/3/2020

If you are receiving a high level of correspondence from  a particular organisation and are struggling to process it all, please let us know and we will endeavour to contact the organisation and streamline this information going forwards.

Guidance for identifying vulnerable patients  30/3/2020

Please find attached BMA guidance to support practices to identify vulnerable patients for shielding.

Message from Coroner’s office: update - Coronavirus Act 2020 - 27/3/2020

As you may be aware, the Coronavirus Act 2020 came into force on 25th March 2020, but Regulation 18, 19 and 21, which cover our areas of work, have not yet come into force. These cover:

  • Reg. 18 - Registration of Deaths, Stillbirths, etc.
  • Reg. 19 - Confirmatory medical certificate not required for cremations: England and Wales
  • Reg. 21 - Modifications of requirements regarding medical certificates for cremations: Northern Ireland.

A copy of the act can be seen here - http://www.legislation.gov.uk/ukpga/2020/7/contents/enacted/data.htm

Further information will be sent once these regulations come into force but in the meantime please see the attached for further, interim information.

National Primary Care bulletin - 26/3/2020

The National Primary Care bulletin has transformed into a regular COVID-19 Primary Care Bulletin from Nikki Kanani and Ed Waller. General practice (including PCNs), dentistry, optometry, CCG and community pharmacy colleagues can sign up here.These will also be published online here.

Fraud Alert for all staff - 26/3/2020

The National Crime Agency has informed us that since COVID-19 began affecting the world, with a reduction in the manufacture of illicit drugs in countries such as China, the closure of borders and reduced movement of people and goods around the world, the supply of illicit drugs into the UK have reduced significantly and are expected to reduce further. The result of this is that street prices of illicit drugs are rising, and their quality is diminishing. In addition the illicit trade in prescription medications such as diazepam and pregabalin is increasing, with reports that street prices have already doubled.

The prognosis is that criminals will increasingly target healthcare premises to target a variety of controlled drugs and other medication to divert onto the black market, and that drug users may suffer increased harm due to their drugs being cut with other substances, with an impact on urgent care and other illicit drug related services.

One of the key messages here is that if an organisation is in possession of controlled drugs or prescription forms, these are more likely to be targeted by criminals. Organisations and their staff need to ensure they remain vigilant with their security arrangements at this difficult time.

National Primary Care bulletin - 25/3/2020

The National Primary Care bulletin has transformed into a regular COVID-19 Primary Care Bulletin from Nikki Kanani and Ed Waller. General practice (including PCNs), dentistry, optometry, CCG and community pharmacy colleagues can sign up here. These will also be published online here.

Locking Surgery doors - 24/3/2020

Practices are asked to consider on an individual basis the appropriateness of ‘locking’ front doors to their surgery. If you are restricting access to your building, by locking the door, then this will not necessarily breach your contract as long as it is clear to the public that the surgery is accessible during core/advertised opening times. Consideration will be needed as to how access to the building will be managed, ensuring social distancing guidance is maintained, e.g. avoiding 2 or more patients waiting to be allowed access to a building, a practice looking like it is shut when it is not.

Control of patient information (COPI) - 24/3/2020

Please see the attached letter and additional information regarding implementing COPI for practices to note.

Stay at home guidance for households - 24/3/2020

The national posters and banners identify the need for households to isolate for 14 days if a member of the family is symptomatic. However, when taken out of an individual context this can be ambiguous and confusing. Practices may want to have available the following information (e.g. at entrances to buildings) as additional guidance for the public. This is also useful in the context of staff self-isolating and when they are able to return to work according to current guidance:

Stay at home guidance for households illustrated: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874011/Stay_at_home_guidance_diagram.pdf 
Easy Read Guidance:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874281/COVID-19_easy_read.pdf

Version 2 of SOP for Primary Care - 24/3/2020

Version 2 of SOP for Primary Care be found  at : https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/Managing-coronavirus-COVID-19-in-general-practice-GP-SOP_19-March.pdf 

Social media posts advising patients with asthma or COPD to request ‘rescue pack’ from GP - 23/3/2020

GP practices are being approached by patients with asthma or COPD to prescribe a rescue pack following the statement made on social media. The post has since been removed and an apology provided but there are concerns that the original message is still being actioned upon.  Rescue packs are recommended for some patients with COPD:
• Those with a hospital admission in the past with an acute infective exacerbation of COPD
• Those patients who have needed two or more courses of antibiotics with steroids in the last 12 months

Asthma UK are not advising the use of rescue packs. The advice from Asthma UK remains the same as prior to the coronavirus pandemic. www.asthma.org.uk/advice/triggers/coronavirus-covid-19/  

Locking of front doors in LIFT buildings - 23/3/2020

Should practices within LIFT buildings feel they need to restrict access to the building (for example by locking inner doors), then arrangements across primary care teams in the building need to be in place to ensure doors are manned at all times during opening hours and access is given to any patients that need it.


Delivery of a pull up banner stand to your practice - 23/3/2020

A ‘Please do not enter this building’ pull up banner stand (see attached) will be delivered to each practice on Tuesday or Wednesday this week. These have been sent to main practice sites (and also include extra banners for branch sites) as well as pharmacies. If there is more than one practice per building, you may receive one or more to use across the building entrances. The stands come in a case, ready for assembly and can go by your entrances. There are a limited number of spare banners if needed.  Please drop us an email to barnsleyccg.primarycare@nhs.net if you require additional ones.  

Preparedness letter for community pharmacy - 20/3/2020

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/preparedness-letter_primary-care_community-pharmacy-19-march-2020.pdf

Interim Guidance for Primary Care - 20/3/2020

https://www.gov.uk/government/publications/wn-cov-guidance-for-primary-care/wn-cov-interim-guidance-for-primary-care

Next Steps on General Practice Response to COVID 19 - 20/3/2020

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/preparedness-letter-primary-care-19-march-2020.pdf

Provisions in the coronavirus bill - Key Items pertaining to Primary Care -Health service indemnification -Registration of deaths and still-births etc - 20/3/2020

Health service indemnification

  • powers to provide indemnity coverage for clinical negligence of health care workers and others carrying out NHS and Health and Social Care (HSC) activities connected to care, treatment or diagnostic services provided under the arrangements for responding to the covid-19 pandemic.

Registration of deaths and still-births etc

  • will simplify death certificate process and provide more flexibility in an emergency situation by enabling a doctor who may not have seen the deceased to certify the cause of death without the death being referred to the coroner.
  • will allow a family member or person who knew deceased to register without attending the register office and will also extend the list of those people who can give the relevant information to the registrar to register the death to funeral directors.

Requests for sick notes for self-isolation - 20/3/2020

Some employers are requesting sick notes for Covid related self-isolation.
NHS 111 has a link for patients to follow to get an isolation note so the GP doesn’t need to issue Med-3.
Practices may wish to adopt this process:
If patient is requesting a med-3 or an isolation note because of covid-19: Copy the following link and send to patient in an SMS for them to obtain an isolation note online (NB they do need to have been told to self-isolate by NHS111 or a health care professional)
https://111.nhs.uk/isolation-note