COVID-19: 2nd February round-up for primary care
Yesterday we confirmed that the NHS has now offered the COVID-19 vaccine to every eligible care home resident across England. Local vaccination sites and community pharmacies have helped to contribute over 8 million first vaccine doses in England. This is a huge milestone and we’d like to thank all the staff that have made this possible.
Movement of vaccines
Moving the Oxford/AstraZeneca vaccine between locations across a single primary care network (PCN) grouping is encouraged if it will help minimise inequalities, maximise access and ensure timely vaccine usage. Moving vaccine within a PCN grouping is perfectly legal but the vaccine MUST be moved safely. The vaccines are not the same as flu vaccines and the Standard Operating Procedures (SOP) need to be adhered to. More information is also available in our letter of 7 January 2021.
Oxford/AstraZeneca has to be moved at 2-8 degrees in a validated cool box, as set out in the SOPs. Local NHS pharmacists are there to help and if they are unsure, will contact regional colleagues for support. See the latest position statement for the vaccination of care home residents using the AstraZeneca vaccine.
Pfizer/BioNTech is sensitive to movement and its movement is never encouraged. Movement of vaccine between PCN groupings and/or other providers is different and governed by the policy on mutual aid. This is discouraged unless absolutely necessary.
COVID-19 vaccination - national call/recall letters to Clinically Extremely Vulnerable people
The From Wednesday (3 February), people aged 18 and over in the clinically extremely vulnerable (CEV) cohort (as identified through the Shielded Patient List) will start to receive letters from the national call/recall service inviting them to book their COVID-19 vaccine at a vaccination centre or community pharmacy. The letters make it clear that people have a choice of where to get vaccinated and can choose to wait for their GP services to contact them directly, if they haven’t already, or book into a vaccination centre or community pharmacy. A copy of the letter and a PCN letter template is available in the latest letters pack on FutureNHS.
Healthcare worker vaccine uptake
Many primary care contractors will have been contacted by their CCGs or regional teams in the last few days to ask about the proportion of their front-line staff who have been given a first dose of a COVID-19 vaccine. We are very grateful for your help in providing this information, which will be important in making sure that primary care staff across the country are able to access the vaccine.
The Green Book – updates
Immunisation Against Infectious Diseases (The Green Book) is updated on a regular basis, specifically the chapter on COVID-19.
Recent changes include an emphasis that patients who are taking anticoagulants should be offered vaccination in most cases.
There is also further clarification on which children aged 12-16 years on the clinically extremely vulnerable (CEV) shielding list could be called. In brief: ‘vaccination may be considered for children with severe neuro-disabilities who tend to get recurrent respiratory tract infections and who frequently spend time in specialised residential care settings for children with complex needs.’
Confirmation has been added that the Oxford/AstraZeneca vaccine is to be authorised to those over 18 and the Pfizer/BioNTech vaccine to those over 16 years of age. Any vaccination for a patient aged less than 16 will require the authorisation of a prescriber, almost always a doctor. The Patient Group Direction or National Protocol cannot be used.
There are changes to the guidance for patients due to start immunosuppressive treatment – for example, if prior to cancer they have had therapy or a solid organ transplant they could be offered a vaccine prior to starting treatment, if clinically recommended. This includes potentially having the second dose at 3 or 4 weeks after the first.
Antimicrobials (azithromycin and doxycycline) not beneficial in the management of COVID-19 positive patients
A CAS alert has been issued by the MHRA advising that azithromycin and doxycycline should not be used in the management of confirmed or suspected COVID-19 infection within primary care, unless there are additional indications for which its use remains appropriate. General practices are asked to ensure that the local primary care team is aware.
A National Institute for Health Research supported PRINCIPLE trial found a lack of beneficial effect in patients aged over 50 who are treated with either azithromycin or doxycycline at home in the early stages of COVID-19, unless there is an additional licensed indication.
Azithromycin or doxycycline may otherwise continue to be prescribed within the licensed indications, within NICE and other associated guidelines.
Vaccine information – resources in community languages
We have produced videos of clinicians recording messages in some of the most commonly spoken languages to help ensure messages about the importance of getting a COVID-19 vaccine are clear for all.
Public Health England has also shared printable leaflets on COVID-19 vaccine information in various community languages. Download from the Campaign Resource Centre and share through your channels.
Locum pharmacy technicians urged to get COVID-19 vaccination
Locum pharmacy technicians working on the frontline across primary care are encouraged to ensure they take up the COVID-19 vaccine as soon as it is offered to them.
Chief Pharmaceutical Officer for England Keith Ridge, along with the other Chief Professional Officers has written to colleagues highlighting the importance of getting vaccinated to protect themselves, so they can be there for others.
An NHS number or GP registration is not required to receive a vaccination, nor for booking in for one. Hospital hubs, pharmacy and GP-led Local Vaccination Services are all offering COVID-19 vaccinations to eligible frontline health and social care staff.
Find my NHS number
A new service is now live to help find your NHS number. This service is for anyone living in England who has forgotten or does not know their NHS number. You can also use this service on behalf of someone else where the name, date of birth and registered home postcode is known. You can opt for the number to be sent to you by text, email or letter.
COVID-19: 5th February round-up for primary care
Thank you for your continued work delivering the COVID-19 vaccination programme across the country. Significant progress has been made in vaccinations for those in the current priority cohorts. Nikki Kanani and Ed Waller have written to local vaccination services yesterday asking that you continue to do all you can to minimise any inequalities in vaccine uptake within JCVI cohorts 1-4 between different patient groups wherever possible. This includes reminding those on your lists in cohorts 1-4 who have not yet come forward of the offer that you will welcome them making an appointment at any time.
Vaccination of housebound patients
The letter also includes information regarding the vaccination of housebound patients. Some patients will need to receive their COVID-19 vaccinations at home because they are housebound, i.e. they are unable to leave their home at all or require significant assistance to leave the house due to illness, frailty, surgery, mental ill health or nearing end of life.
We recognise the additional time and resources needed to deliver COVID vaccinations in a residential setting, in particular as this needs to happen at pace once cohorts are announced, and at the same time as delivering vaccinations at their fixed vaccination sites. In light of this, we are providing an additional supplement of £10 per visit to a housebound patient in order to administer the COVID-19 vaccinations. This supplement is on top of the £12.58 Item of Service fee. Further details are included in the letter.
Reporting COVID-19 in those who have been vaccinated
The Public Health England (PHE) Immunisation Department is conducting enhanced surveillance of COVID-19 cases in vaccinated individuals in England. Clinicians who are seeing patients face to face are encouraged to report any confirmed cases in partially or fully vaccinated individuals if they tested positive within the preceding 7 days. This provides an opportunity to get early and complete samples from these cases. Further information is available here.
Pharmacy Quality Scheme declaration window dates for February 2021
The Pharmacy Quality Scheme (PQS) declaration window opened at 9am today (Thursday 4 February) with a slight delay from it’s scheduled date of Monday 1 February. To ensure contractors have the same amount of time to submit their claims, the PQS declaration window has been extended and will now close on Monday 1 March at 11.59pm.
The date of PQS payment will not be affected. Where a contractor makes a declaration for PQS Part 2 within the new declaration window, and declares that they meet the PQS criteria, they will still receive their PQS 2 payment on 1 April.