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Somerset LMC Weekly Update Friday 17th December 2021

Date sent: Friday 17 December 2021

Sent to all Somerset GPs and Practice Managers          This and previous updates are available here

NATIONAL CALL TO ACTION: Practices are encouraged to continue to use care navigation and triage to help provide patients with timely advice and care from the right healthcare professional in a way that is matched to their needs. Online systems can support triage and provide an additional option for patients to access their practice remotely, which may help free up the telephone for non-digital users. Primary care will always be there for their patients, and we need to make sure people do not delay in coming forward with health concerns and we get the balance right. We know you will use your clinical judgement and strike the right balance and work as PCNs and with your local pharmacies to do what is right for your populations…Shared decision making remains important - use your clinical judgement, supported by triage processes, as to when patients should be asked to attend the practice in person and when remote care would be more appropriate – tailoring the approach to the person, their circumstances and needs, and balancing this against the risk of exposure to COVID-19.”
NHS Bulletin this week.

The LMC knows that many Somerset practices are struggling with unprecedented patient demand with pre-existing staffing problems made worse by Covid and the associated restrictions. We know because you tell us. We also know that, despite all this, general practice here is performing among the best in England as the CCG acknowledges.

And then, suddenly, Sunday saw the national “Call to Action” to put only urgent same day and cancer consultations ahead of Covid booster jabs. It was notable how the prime minister went out of his way to praise general practice. Better late than never but a shame to have not much defended (to say the very least) a key part of the NHS you suddenly need to rely on?

Somerset general practice has responded magnificently - already taking on more housebound patients for example - but facts must be faced: practices in Opel 3 and 4, for instance, cannot be expected to drop everything and concentrate on Covid boosters. This would simply not be safe as recognised in the NHSB extract. We believe that the CCG understands this but we also know that colleagues in primary care are often their own harshest critics and so are feeling upset at being unable to do any more.

Booster jabs are vital but it makes no sense for already exhausted teams to work through days off and holidays no matter how much they might want to show willing. Individuals in such practices of course might want to sign up with 100-Fold on their days off but we do not see how those practices can do any more.

Similarly, we are by no means convinced that NHSEI nationally understands the Call to Action will not be without adverse consequences: there will be a new backlog to be dealt with in January perhaps by an even more diminished workforce.

England may expect that every one will do their duty - but when you are burned out, you can’t. You can only do what you can. Remember that you are only human.

UPDATE ON PROOF OF VACCINATION FOR 12-16s: From Monday fully vaccinated patients age 12 and upwards can request proof of vaccination via 119 or the internet and a paper copy will be posted which conforms to the standards for the EU covid pass. There will be a QR for each vaccine valid (for some reason only) for 30 days. The digital route via the NHS app is not yet open to 12-15s.
NHS Covid Pass
Get your NHS Covid Pass letter
There is no date yet for the provision of paper recovery certificates which is expected under the EU scheme the UK joined last month but other work is taking priority.

TRAVEL - CONFIRMATION OF RECOVERY STATUS FROM COVID: The Foreign & Commonwealth Office website has now changed the wording for Poland. References to GPs have been removed after it was raised at the weekly vaccine IT call with the BMA GPC. It now states: "The UK does not issue COVID-19 certificates of recovery for children under the age of 16. In this case, you must present alternative evidence to demonstrate recovery from COVID-19.”

GPs & PRACTICE STAFF NO LONGER NEED TO ISOLATE AFTER CLOSE CONTACT WITH A PROVEN OR SUSPECTED OMICRON CASE: The UKHSA updated its guidance for healthcare professionals on Wednesday to remove the isolation requirement for contacts with a case of a proven or suspected Omicron variant. It has been replaced with a negative PCR and then daily LFT antigen tests for ten days – with isolation only on testing positive or developing symptoms – for those who are fully vaccinated.

VACCINE REQUIREMENTS IN PRACTICES: The LMC have been receiving queries about the government requirements in reference to the vaccine status of staff, we have commissioned Porter Dodson to create a suite of documents to help managers with these discussions.
These will include;

  1. Guidance note on Govt requirements and how to manage them.
  2. Draft letters in conjunction with process set out in guidance pack.
  3. Contagious diseases policy – covering not only COVID but any other, similar pandemic in the future.
  4. Online Q&A seminar (dates to be confirmed).
  5. Updated staff handbook and contract.  

We hope these will be available to distribute early in the New Year.  The LMC expects that a national solution will be forthcoming to this “problem” which has been caused by legislation to make vaccination mandatory for NHS staff passed by the House of Commons this week. We understand however that HR matters often have a long lead time and therefore decided to undertake this work on behalf of practices.

NEW TO PARTNERSHIP PAYMENT SCHEME EXTENDED: NHS England has announced that the New to Partnership Payment Scheme (N2PP) will be extended into the 2022/23 financial year and they have now removed the requirement to apply within six months of commencing a partnership role.  New to Partnership Payment Scheme .

LARC: ‘If you are a practice who is suspending your LARC provision to step up your COVID response, Somerset Wide Integrated Sexual Health Service (SWISH) is happy to work with the practice to pick up patients. To enable the most effective pathway please make a referral to the service. Please do not just tell the patient to call the service. SWISH Services Professional Enquiry Form .
You may wish to offer a bridging method i.e. Progestogen Only Pill if appropriate or direct patients to obtain over the counter from pharmacy while waiting for a LARC appointment’.

PATIENTS WITH CALL BLOCKERS ON TELEPHONES: (Adapted from Devon Doctors) More people are using a variety of call blockers on both landlines and mobiles preventing contact from withheld numbers including many [practice] phones. What is more some people don’t know they have switched the option on.  There is no consistency in what happens when you call and there may be no message saying the number doesn’t accept calls from withheld numbers: it may just ring constantly; go to voicemail; appear to be engaged or say, “this number is not available as dialled.” Dialling 1470 before the number may work but all this is another reason it is important to record ALL failed calls with the time and a brief note like “number engaged” or “unavailable at this time” in the medical record.

TRAINEE NURSE ASSOCIATE PROGRAMME: The next Trainee Nurse Associate programme at the University Centre Somerset (UCS) Taunton will be March / April 2022.  All EOI and for more information please contact Education Facilitator, Somerset Training Hub.  

STUDENT NURSES & TRAINING NURSING ASSOCIATE PLACEMENTS IN PRACTICE OR PCNs: There is a one off placement incentive payment available for GP practices or PCNs who commit and sign up to offering Student Nurses and Trainee Nursing Associate (TNA) placements in 2022. Please complete the survey here  if you will support student nurse and TNA placements going forward. 

AND FINALLY…a study published this week “Depression, anxiety & happiness in dog owners…during the COVID-19 pandemic in the United States” concluded that dog owners felt “more loved and less depressed” than those without dogs. Isn’t it amazing what science can teach us?

Kind regards


Jill Hellens

Executive Director
Somerset LMC
Crown Medical Centre, Venture Way, Taunton, TA2 8QY

Tel: (01823) 331 428            
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