COVID-19: 30th December round-up for primary care
Today we have seen two major decisions that will shape and expand the COVID vaccination programme. This notification should be read alongside this system letter setting out changes to second dose vaccine scheduling and an expansion of first dose delivery. This note also reflects MHRA’s approval of a new Astra Zeneca vaccine.
Following a review of clinical evidence and the latest public health data, the JCVI and the Department of Health and Social Care have also published updated guidance for the NHS on the dose interval for the second dose of the Pfizer/BioNTech vaccine. It recommends the second dose of the Pfizer/BioNtech vaccine should now be scheduled for after three weeks but before 12 weeks after the first dose, and that the second dose no longer needs to be held in storage.
They recognise that this will mean we need to reschedule second doses for most of our current first dose recipients booked from next week (Monday 4 January 2021), but for the reasons set out today by JCVI and the Chief Medical Officers, doing so should substantially improve individual and population-level protection against COVID-19 over the next 3 months.
We understand that this will be a significant job for general practice at a busy time and we are grateful for your support in ensuring that we can offer protection to many more people because of this development.
To recognise that a delayed second dose will also delay payment to an unreasonable extent under the terms of the current Enhanced Service, we will agree with the British Medical Association (BMA) an amendment to offer payment for each dose instead. We are exploring ways to support rebooking of this cohort, recognising the complexity.
Today the MHRA has also approved for use the Astra Zeneca vaccine. This is another great step forward in the fight against coronavirus. Once we have further details, we will be outlining the logistics for the dissemination of this vaccine from next week and describing how it can be used.
While the delivery model for the new vaccine will predominantly be through local vaccination sites (LVSs) and vaccine centres, the first supplies will initially be used in hospital hubs to ensure safety, before being more widely rolled out. This new vaccine opens up the possibility of reaching smaller care homes and the housebound 80+ cohort in a more manageable way, and the initial delivery of this needs to be targeted in this way.
We have asked all local COVID vaccination services to prioritise wherever possible care home residents and care home staff to ensure this priority group are vaccinated against the coronavirus as quickly as possible.
Local systems should be working to ensure that all healthcare workers falling into the JCVI priority cohort, including those in primary care, are able to access the vaccine from a local vaccination site or hospital hub as appropriate.
We appreciate the additional time and resources needed to deliver the vaccine in a care home setting, especially at such a busy time of the year. Therefore, we are providing an additional supplement of £10 per dose on top of the item of service fee for all vaccines delivered in a care home setting.
The supplement is applicable where the first dose was delivered before the end of January 2021.
The LVS SOP will be updated shortly to reflect the addition of Astra Zeneca and the change to the second dose.
We know today’s announcements offer new hope but equally we appreciate the further challenges they create on the ground in trying to deliver a vaccination programme at pace. We will continue to support you as best we can in an ever-changing environment.
We will also provide further advice about additional measures to ensure GP practices and PCNs are able to prioritise the vaccination programme appropriately, including removing unnecessary contractual burdens.
We will be hosting a webinar on Tuesday 5 January 2021, 5-6pm to provide further updates on the COVID-19 vaccine roll out. A link to join the MS Teams Live event can be found on FutureNHS.
Local Enhanced Service for Community Pharmacy Vaccination
We have had a great response from community pharmacy teams to deliver the vaccination and look forward to seeing the first pharmacy local vaccination services. We wrote to those pharmacy contractors who applied as part of the designation process on 18 December, published the Local Enhanced Service for Community Pharmacy and have now written to the designated sites rolling out the vaccine. To support community pharmacy on the vaccine rollout, we held a webinar on 23 December 2020. The slides and recording can be viewed on FutureNHS.
Home delivery of medicines and appliances during the COVID-19 outbreak
Following government’s announcement of further Tier 4 arrangements on 23 December 2020, the Community Pharmacy Home Delivery Service and the Dispensing Doctor Home Delivery Service will be commissioned from 26 December 2020 to 18 January 2021 for clinically extremely vulnerable (CEV) patients living in the particular Tier 4 areas.
Reminder to order lateral flow tests
Primary Care Support England (PCSE) has now sent direct invitations to all primary care contractors to place their orders for lateral flow tests onto the portal.
If primary care contractors (medical, dental, optometry and community pharmacy) have not yet placed their order, they should log onto the portal and complete their order as soon as possible, and by COP Wednesday 30 December to receive deliveries from early January.
Contractors who have not been able to place an order before the deadline will still be able to go onto the portal and order tests. However, deliveries of orders placed after the deadline may take place at a later date.
Each organisation should order one box for each patient-facing member of staff, for example if there are 10 patient-facing members of staff delivering NHS services within an organisation, the order should be for only 10 boxes of test kits.
SOPs and FAQs on lateral flow testing in primary care are available for further information.
COVID-19: 31st December round-up for primary care
As 2020 comes to an end we are at a critical point in the pandemic and it is therefore imperative that we prioritise the first doses of vaccine for as many people as possible on the priority list.
This will protect the greatest number of at-risk people overall in the shortest possible time and will have the greatest impact on reducing mortality, severe disease and hospitalisations and in protecting the NHS and equivalent health services.
Today the UK Chief Medical Officers have published a letter clearly outlining their support for this strategy.
Additionally, the JCVI and PHE have published details on the effectiveness of a single dose of either the Pfizer/BioNTech or Oxford/AstraZeneca vaccine.
We recognise that the request to re-schedule second appointments is operationally very difficult, especially at short notice. We have written to CCGs to outline a package of support to help you do this.
We have made an additional £1,000 available to the first wave PCNs to support with administrative costs in rescheduling appointments and free support is also available from a CSU, via your CCG who have stood up a call centre which can be used to contact patients to reschedule vaccinations.
A patient letter and script have been produced to support you in these challenging conversations. We will do all we can to support public messaging.
We will be hosting a webinar on Tuesday 5 January 2021, 5-6pm to provide further updates on the COVID-19 vaccine roll out. A link to join the MS Teams Live event can be found on FutureNHS.
As difficult as it is, we must act at speed if we are to beat this pandemic which is running rampant in our communities and we believe the public will understand and thank us for this decisive action. We look forward to working with you in 2021.
Webinar: Tuesday 5 January 2021, 5-6pm
Nikki Kanani and Ed Waller provide further updates on the COVID-19 vaccine roll out. A link to join the MS Teams Live event can be found on FutureNHS.
