Government budget 2021
The Chancellor Rishi Sunak gave his budget speech on 3 March. We were disappointed that no significant funding announcements for the NHS were made. This was a missed opportunity to announce extra support for the NHS and its workforce in this difficult time. Read the BMA briefing and analysis on key announcements.
The Chancellor also outlined the freezing of the lifetime allowance for pensions – in a move that will disproportionately affect doctors. This comes as a new BMA survey, responded to by more than 7,000 doctors, reveals that 72% of doctors would be likely to leave the NHS earlier and 61% would be likely to work fewer hours or part-time if the freezing of the lifetime allowance was put in place. Read more here
Letter to Chancellor about funding in general practice
In a joint letter with the RCGP to the Chancellor, we said that the funding currently available is spread very thinly and urged the Government to use the Budget to invest in general practice. The letter also said: “While vaccination of the first nine priority cohorts is not expected to be completed until at least Easter and the Government’s aim is now to vaccinate every adult over the age of 18 by the end of July, the clinical director funding and the £150 million/£30m per month Covid Capacity Fund are currently only available up to the end of March, and are spread very thinly for multiple purposes.” This was reported by Pulse.
Government evidence to DDRB (UK)
The Government and Department of Health and Social Care has published their evidence to the DDRB, which suggests a pay uplift of 1% for those within the remit. Responding to this, the Chair of Council, Dr Chaand Nagpaul said, “This is a total dereliction of the Government’s moral duty and obligation to a workforce that is keeping the NHS on its feet and patients alive.” The full statement can be read here.
The BMA has already submitted it’s evidence to the DDRB, including for UK salaried GPs, all GPs in NI, Scotland and Wales. We have not made a submission for GP partners in England and there as there is already a practice funding agreement in place for England which enables a pay uplift of 2.1%.
COVID-19 vaccination programme (England)
Vaccinating cohort 7 and Phase 2 of vaccination programme
This week, people aged 60-64 (JCVI cohort 7) are being invited to book an appointment to receive a COVID vaccination. Practice groups should though continue to focus on vaccinating patients in the bigger cohort 6 group. People are being invited to be vaccinated in order of risk, which increases with age. JCVI has also published a statement advising that during Phase 2 of the COVID-19 vaccination programme will be age-based, and proceeding once those in the current cohorts 1-9 have been offered vaccinations, to next invite all those aged 40 to 49 years, followed by all those aged 30 to 39 years, and then finally all those aged 18 to 29 years.
Vaccination deployment
NHSE/I has published a letter setting out the next steps and key priorities for vaccine deployment plans for weeks beginning 8 and 15 March. These include actions for immediate review, such as ensuring maximum penetration and uptake within the JCVI cohorts, second dose planning and delivery and preparations for vaccination in line with increased supply. All future second dose deliveries will be made 11 weeks after the corresponding first dose, and so practices should now start to book second dose appointments when making first dose bookings.
The letter confirms that from 11 March, vaccine supply will increase substantially and be sustained at a higher level for several weeks. Therefore, from the week of 15 March vaccination sites are being asked to deliver around twice the level of the limited vaccine supply available this week and next.
Improving social staff vaccination rates
NHSE/I has also published a letter about improving social care staff vaccination rates and completion of outstanding first dose vaccinations in older adult care, which asks care providers to work with local partners to ensure social care staff vaccination rates increase further. The letter confirms that the £10 supplement in addition to the Item of Service fee for vaccinations administered to residents and/or staff in older adult care home settings has been extended beyond the end of January. This means that any first doses administered in February onwards will also attract the supplement, as will corresponding second doses.
NHS number and COVID vaccinations
NHSE/I has this week sent a reminder to vaccination sites, that no patient, including NHS staff, require an NHS number or GP registration to receive a vaccination and should never be denied one on this basis, either in person when presenting for a vaccine, or through design of booking systems. Vaccination sites are being asked to ensure this is not the case within their organisation.
If a patient has not been issued with an NHS number, then providers should vaccinate now, record locally via a paper system and ensure that the vaccination event is recorded on Pinnacle at a later date. NHSE/I is working to agree a longer-term solution, but providers should not wait for this before vaccinating. Providers will be advised once a solution is in place so they can transfer the vaccination record on to Pinnacle and be paid for these vaccinations in the next payment period.
Read our guidance on the COVID-19 vaccination programme which includes information about what is expected of practices and the support available to enable practices to prioritise vaccine delivery.
Vaccine dose data
This week, we are celebrating another milestone - over 20 million people in the UK have received their first dose of the COVID-19 vaccine, and the latest data report shows that as of 5 March nearly 19 million doses have been given in England.
Health Secretary’s message of thanks to GPs on pandemic effort
We are pleased to see that the Secretary of State for Health and Social Care, Matt Hancock MP, has again expressed his thanks to all those in general practice (via the RCGP website) who have been involved in the COVID vaccination programme and who have continued to deliver dedicated care throughout the pandemic.
Recruiting and maintaining your vaccination workforce
The BMA, NHSE/I and the RCGP have developed the Vaccination workforce top tips guide for use by practices, PCNs and LMCs. This can be used in conjunction with the BMA’s own online guidance for former NHS doctors willing to support the vaccination workforce and recruiting retired and former NHS doctors back into fully licenced clinical practice.
Please note that, although there are national initiatives to bring back staff (NHS England and Improvement) and recruit the vaccination programme workforce (NHS Professionals), willing former NHS GPs and doctors of any age can also approach local practices / PCNs / LMCs directly to offer their services. This can either be as fully licensed doctors, which requires going through the formal return to practise process, or as registered healthcare practitioners or clinical supervisors in the vaccination workforce. For any questions, queries or concerns about bringing staff back into the workforce, please do contact the BMA for advice and support in undertaking recruitment or overcoming any issues you may encounter.
Flu vaccination orders and reimbursement
We are aware that prior to the publication of the flu letter for the 2021/22 programme, some practices had already placed orders for QIVe vaccines for their 18-64 year old cohort, and are now struggling to change their orders to QIVc as set out in the flu letter. NHS England and NHS Improvement have now confirmed that, given that QIVe is still recommended for the 18-64 at risk cohort, practices should feel confident that they will be reimbursed for any QIVe administered to this group over the 21/22 season if unable to change their orders. If any LMCs become aware of difficulties with reimbursement then please contact info.lmcqueries@bma.org.uk
NHSBSA has also published information for practices administering flu vaccines, about claiming for reimbursement, completing end of season 2020/21 flu vaccine declaration, and guidance around NHSBSA’s post payment verification process.
Contract webinar 2021/22 recordings (England)
The recordings of the recent GP contract 2021/22 update webinars are now available on the BMA website, including question and answer sessions.
Amended QOF SFE 2020/21 (England)
The Department of Health and Social Care has now published the amended QOF SFE for 2020/21. The QOF guidance will be published next week.
Welsh GMS Contract - Relaxation of Access standards
Following a sustained campaign over a number of months, GPC Wales met with Welsh Government officials last week and negotiated a relaxation relating to the Welsh GMS contract in-hours Access standards. (The Access Standard domain is part of the Quality Assurance and Improvement Framework [QAIF], and incentivises practices to meet the Access Standards set by the Minister for Health & Social Services)
GPC Wales received confirmation this week that the Access standards call answering target will be paid at last year’s achievement, and the whole system will be rolled over until April 2022. Read more in this email sent to Welsh GPs and in a statement by Chair of GPC Wales, Phil White.
Northern Ireland’s plan for exiting lockdown
The Northern Ireland’s pathway for exiting lockdown has now been published. In response to this, BMANI has warned that the approach should be co-ordinated between north and south and Tom Black, Chair of NI BMA Council, cautioned divergence between Dublin and Belfast could ravage Border areas as people flock from one side to the other. He said: “They should co-ordinate non-essential retail and should definitely co-ordinate hospitality and personal services, because there would be concerns people will move across the Border to venues that are open”. NIGPC chair, Dr Alan Stout, was interviewed on the Nolan Show (40:38) about the NI exit plan for lockdown, and comments from this interview were subsequently picked up by the Belfast Telegraph.
LMC Secretaries conference 2021
I was pleased to attend the LMC Secretaries Conference, held virtually yesterday, where I gave an update on the importance of a 4-nation united profession. We received updates from the Cameron Fund and GPDF, heard a range of perspectives of the impact of COVID-19 on General Practice in the UK, and a presentation on how LMCs can engage with the integrated care agenda. Thanks to all those who organised the conference.
New to Partnership Payment - Physician Associates
As of 1 March, the New to Partnership Payment Scheme has been expanded to include Physician Associates. Although there is currently a delay in launching the regulation of this profession, the additional scheme criteria in place is that for those on the Physician Associate Voluntary Register at the time of application, registration with their professional body will be required at a later date once this is in place. In line with the current eligible professions, applications to the scheme can be made via the online portal.
The guidance has been updated, and more information including FAQs is available on the Future NHS platform (GP career support hub).
This addition brings this group of healthcare workers in to the scheme alongside others who are nationally regulated. However we also believe that many practices want to and would benefit from making their practice manager a partner in the practice, and so we continue to push for practice managers to be involved in this scheme.
Remote fit notes - please remember to sign them
DWP has asked us to remind GPs that as per previously agreed guidance they will accept fit notes that are printed, signed, scanned and be mailed to patients. This advice has also been given to employers, who should also be accepting signed, scanned and emailed fit notes. However, DWP is receiving a significant number of unsigned fit notes which they cannot accept and this results in inconvenience for both patients and GPs. We would therefore remind GPs that fit notes must be signed.
Read more in the Service Provision section of the COVID-19 toolkit for practices.
Senior female GPs Leadership webinar
In celebration of International Women's Day on Monday 8 March, we are pleased to present senior female GP leaders, talking about their leadership and career journeys, in a webinar to be held 7– 8.30pm on Thursday 25 March.
A lack of females in senior medical leadership positions is recognised as one of the underlying factors contributing to the gender pay gap, and this latest webinar forms part of a series of work from the GPC education, training and workforce policy group.
There will be advice, insights and inspirational stories shared to help guide and motivate the future leaders of tomorrow of all genders, as well as an opportunity to submit questions as part of the Q&A panel discussion. Speakers include:
Dr Samira Anane (GPC Education, Training & Workforce Policy Lead)
Dr Nikki Kanani (Medical Director for Primary Care, NHS England and NHS Improvement)
Dr Helena McKeown (Chair of the Representative Body of the BMA)
Dr Farah Jameel (GPC England Executive Team, GPC Negotiator and Chair Camden LMC)
Dr Margaret Ikpoh (RCGP Council, Associate Director of Primary Care Hull Medical School)
Dr Katie Bramall-Stainer (CEO Cambridgeshire LMCs, BMA Deputy Chair UK LMC Conference, BMA Council member)
Click here to sign up
Please submit advance questions to Cscott@bma.org.uk
GP Retention Scheme webinar
You can now view a video of our recent GP Retention Scheme webinar, where you will learn about how the GP Retention Scheme works for both employees and employers, and tackles some common misconceptions about the scheme. Access a recording of the webinar here
GPC UK regional elections
The voting period is open for seats to GPC UK in the following regions:
The nomination period for the Durham/Cleveland region has reopened until 12pm Friday 19 March.
To submit your nomination please visit https://elections.bma.org.uk/
If you have any queries regarding the election process, please contact elections@bma.org.uk.
Read more on the BMA website
Please share as widely as possible through your networks where applicable
Media
Pulse reported on the Government’s plans for a COVID-19 revaccination campaign, to which I commented: ‘If it was found necessary as we understand more about Covid and the requirement to provide protection to our patients, then it’s quite possible that we may need further boosters in the future and general practice would be the best place to deliver that.
BMA Northern Ireland Council Chair Tom Black was interviewed in the News Letter about the need for a near-elimination strategy to tackle the pandemic and in the Belfast Telegraph about the contrasting vaccine programmes between Northern Ireland and the Republic of Ireland. He was also interviewed on the RTÉ Radio One News at One about the vaccine roll-out in Northern Ireland. NIGPC chair Alan Stout took part in a panel discussion on BBC Radio Ulster Talk Back about the Covid vaccination programme.
Responding to the Welsh Government’s announcement that the introduction of a target for GP practices to answer 90% of phone calls within two minutes has been delayed, BMA Cymru Wales said it was "pleased" the target had been "rolled over for another year due to concerns raised about the impact of the pandemic". White, chair of GPC Wales said: "Given the unprecedented pressures on general practice and the wider NHS - including delivering the largest vaccination campaign in history - now is not the time to introduce major contractual changes. This was reported by the BBC
Read the latest GP bulletin here
