COVID alert levels and advice for practices and patients at risk
Following the announcement of a three-tier lockdown approach for England last week, Greater Manchester and South Yorkshire have now joined Liverpool City and Lancashire in the Tier 3 (very high) alert level. Warrington will be added next week. Read the full list of COVID alert levels in England by area here. A 17-day national "firebreak" will begin in Wales at 6pm today and a 5 tier system will be introduced in Scotland from 2 November.
We recognise that few will welcome these restrictions, but unless rising rates of transmission are curbed urgently, we will soon see an increase in patients needing care, and sadly a rise in deaths. Some hospitals have already announced that they will have to once again reduce some elective procedures, with all the implications that then brings both for patients and practices. More stringent lockdown measures are therefore necessary, and we urge everyone to take the new rules seriously. People need to have confidence that the sacrifices they are now required to make are understood by those in power and these new restrictions must be backed with more support for GP practices in those areas who will be impacted significantly.
As we reported previously, NHSE/I has confirmed that local flexibilities should be made available, to support practices to clinically prioritise capacity in these challenging times. We are in discussion with NHSEI about how they can provide clearer support to practices struggling with workload pressures as the prevalence of patients with COVID-19 increases. We are also making it clear in our public messaging that despite some media reports, whatever the current local COVID alert levels are, GP practices continue to remain open as they have done throughout the pandemic. Whilst remote consultations should be the main way in which patient care is delivered, when it is clinically necessary to see high risk patients face to face, they should be able to attend the.
Ordering additional adult flu vaccine stock (England)
As we reported last week, DHSC has written to practices to confirm the process by which they will be able to access the additional adult flu vaccine stock secured to support the expanded vaccination programme this season.
GP practices are now invited to begin ordering or pre-ordering the following vaccines:
If a GP practice has a provisional order with Sanofi for QIVe, please contact them to confirm this, before placing another order for QIVe for this cohort.
On placing an order, practices will be asked by manufacturers to verify that stock is being ordered for NHS eligible patients or frontline social care workers, where there is a genuine shortage for this cohort. Orders should only be placed where you have a shortfall in supply for existing eligible patients at this stage.
Further instruction on timing of extension of eligibility to all 50 to 64 year olds will follow and stock should not be ordered for this cohort at this stage.
Influenza immunisation FAQs (England)
NHSE/I have now produced a set of FAQs relating to the influenza immunisation programme and can be found here. They have also issued guidance on how practices and CCGs can make use of the additional £15.4m made available 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.
Pensions newsletter
The BMA’s pension committee has been at the forefront of fighting to maximise your pension benefits. Please see the first quarterly newsletter here. The newsletter provides an update you on what actions the committee is taking on a range of issues, and also provides access to educational resources, blogs and information on how to access BMA support regarding your pension.
DDRB pay award and template letter
The Sessional GPs Committee has received reports that some salaried GPs are struggling to get their 2.8% paylift, as recommended by DDRB and approved by the government, despite being entitled to it. We believe it is only fair that this uplift is awarded to all doctors, and this includes all practice-based salaried GPs. Practices are encouraged to apply this uplift across all of their employed GPs, regardless of individual contractual requirements. However, it is worth noting that there is a contractual requirement to implement this pay increase for salaried GPs employed on the model contract.
If you are a salaried GP struggling to obtain the pay increase, even after having a conversation about the matter with your practice manager, you may wish to send a formal letter. The BMA DDRB template letter can be adapted to reflect your individual circumstances. Please get in touch with the BMA if you need further assistance in this area. Read more in the Sessional GPs newsletter.
GPC Wales meeting
GPC Wales met for the first meeting of the 20/21 session yesterday, 22 October 2020 and I was pleased to be able to join them in the morning. A major focus of the meeting was a discussion about the second wave of COVID-19 and what it meant for GP practices already facing the challenges of winter pressures and flu campaign delivery. The committee unanimously supported GPC Wales’ proposals for contractual relaxation and support measures, while also unanimously voting that Welsh Government’s efforts to date were insufficient. Other items discussed included the NHS Wales flu campaign for 20/21, COVID vaccination plans, the committee’s workplan and taking forward future contractual agreements.
Circuit breaker lockdown in Wales
BMA Wales issued a press release welcoming plans for a circuit breaker lockdown in Wales, which means that a series of restrictive measures will be in place from 6pm Friday 23 October until the start of Monday 9 November 2020. Dr David Bailey, Chair BMA Cymru Wales, said: "Cases are climbing fast across Wales… It's clear that the current restrictions are not strong enough to suppress the spread of the virus. Doctors in Wales support, and are calling for as a matter of urgency, a circuit-breaker lockdown for a number of weeks. It is imperative that robust action is taken now without delay, to protect the citizens of Wales, and the Welsh NHS." Read more in the Welsh Government’s’ coronavirus firebreak FAQs here
This was reported by the BBC, BBC Radio Five and BBC Radio Wales breakfast show (at 08:37).
Dr Phil White, Chair GPC Wales, was a guest on Y Post Cyntaf on BBC Radio Wales (from 19m30s) to discuss the new ‘fire break’ lockdown for Wales.
GPC Scotland meeting
SGPC held its first meeting of session yesterday, 22 October 2020 and I was pleased to be able to join in the afternoon. Progress on delivery of the 2018 GMS contract was discussed along with work to negotiate transitionary arrangements following the end of the implementation period. The committee discussed recovery and remobilisation with a focus on general practice priorities, urgent care and enhanced COVID-19 pathway proposals, and GP IT issues, and received reports from various GPC meetings, external groups, and the GP Sessional Committee.
SGPC also heard updates on letters produced by Scottish Government including the Primary Care Improvement Fund letter, and an update on NHS Scotland Primary Care National Premises meeting, GP Wellbeing, and the SLMC Conference on 4 December. A pensions update was provided by Alan Robertson, a member of the BMA Pensions Committee who was leading on a lot of the work.
Congratulations to Andrew Cowie and Patricia Moultrie who were elected uncontested as joint deputy chairs of SGPC and to Chris Black, Iain Kennedy, John Ip, Denise Mcfarlane and Tyra Smyth were elected to the SGPC Executive for the 2020-21 session.
CQRS system supplier change (England)
NHSE/I is overseeing a programme to ensure the CQRS system supports efficient GP incentive-based payments. As part of this work NHSE/I is working with NHS CSUs to bring the running and development of the CQRS system in-house from 1 November 2020 and to introduce a new centrally funded system (CQRS Local) to support locally commissioned schemes by April 2021. These changes aim to streamline processes and reduce the administrative errors in GP payments as called for in GPCE’s Saving General Practice.
A structured transition from the existing supplier is in place to ensure the continued provision of the CQRS system from November with minimal interruption for end users. How users access and use the CQRS system is not changing and no action is required from practices or commissioners.
From 1 November the new number for the CQRS service desk will be 0330 124 4039, although the email address remains support@cqrs.co.uk
While the system itself will look and feel the same a new CQRS welcome page is now live providing direct links to the CQRS system and online training modules, guidance and news updates.
Tackling health inequality webinar
The BMA committee for medical managers is hosting a free, online panel event on Tackling health inequality, with speakers Tracie Jolliff (head of inclusive system development at NHSEI) and Roger Kline (author of The Snowy White Peaks of the NHS) on Wednesday 4 November 5.30-7pm. The event will explore why diverse leadership is essential to create an NHS that truly serves the whole country and, crucially, what steps medical managers can take to achieve this. Find out more and to book your place here
Mental health and wellbeing
The BMA continues to offer wellbeing services and confidential 24/7 counselling and peer support for all doctors and medical students, as well as their partners and dependents, on 0330 123 1245. Access the BMA’s COVID-19 wellbeing pages here.
The BMA has welcomed the NHSE/I announcement of further funding for the expanded and rapid access provision of mental health services for NHS staff in England over the winter. This is urgently required and something the BMA has been calling for to support the major challenges NHS staff are facing. At the ARM, a motion was passed expressing concern at the potential long-term impact of the pandemic and called for resources to support the profession. As we head into a second wave of the virus it is vital that staff are protected. Find out more here
Read our COVID-19 toolkit for GPs and practices, to help answer questions on a large range of topics relating to COVID-19. There is also guidance on the following topics:
COVID-19 media
On Monday I did an interview for BBC Radio York following the news that Test and Trace information could be shared with the police. GPC member Gaurav Gupta spoke to BBC Radio Kent (8.45am) on Wednesday discussing the issue of face covering exemptions.
There was extensive media coverage on NIGPC’s concerns over the flu vaccination programme shortages. NIGPC chair Alan Stout was interviewed by BBC News NI, The Nolan Show, UTV Live, BBC Newsline, News Letter. NIGPC deputy chair Frances O’Hagan appeared on BBC Talk Back (48:47).
Pulse reported on future Covid-19 vaccination campaign, and I was quoted: “While we don’t have a specific date when the vaccines will be ready, the BMA fully expects general practice to play a significant part in administering them, and practices will require significant support for what is set to be a huge immunisation campaign."’
See this week’s GP bulletin here.
Read the latest Sessional GPs newsletter here
