Newsletter January 2022
BEST Events – Held @ Shaw Lane Sports Club, Barnsley
For further information the BEST Portal Website can be accessed at http://best.barnsleycc.nhs.uk/
Shared care and Amber-G guidelines can be found at the following link: http://best.barnsleyccg.nhs.uk/clinical-support/medicines/shared-care-guidelines/ An overview of Shared Care guidelines, including the Principles of Shared Care is available to read here.
Prescribers (including secondary care clinicians) are encouraged to report any problems they experience with shared care or other medicines related issue, particularly where guidelines are not being complied with, to the following email address: BarnsleyAPCReport@nhs.net.
With secondary care opening up activity and undertaking remote consultations, it has been reported that there has been increased pressure in primary care to undertake things they wouldn’t normally. Due to this, the APC reporting has been temporarily expanded to capture any issues and these can be fed into the APC. The hospitals need this information so that issues can be addressed.
Practices can now report any interface issues they have, as much as possible, via Barnsley LMC, which will then be submitted to the hospitals.
A list of Prescribing Guidelines is available to view here.
The Barnsley Area Joint Formulary is available to view here.
Medicines Management monthly Newsletters are available to view here.
Covid-19 and Vaccination Programme Status in SYB
As we are seeing nationally, rates of Covid in SYB are exceptionally high – the highest that they have been throughout the pandemic.
Across the ages, the highest transmission rates remain in the under-18’s (which also includes a high number of the Delta variant) but this gap has been narrowed significantly due to the spread of the Omicron variant.
Unfortunately, there are early signs of stacking (passing of the Covid virus between older and more vulnerable groups within the same household) as reflected in increases in cases for the over-65’s.
With schools having returned this week and resuming their heightened Covid testing procedures, the case rates are expected to continue rising sharply.
This coincides with the announcement that from 11th January in England, people who receive a positive Covid result from a lateral flow device (LFD) test will not be required to take an additional confirmatory polymerase chain reaction (PCR) test as well – but will be required to self-isolate immediately.
SYB’s Covid vaccine booster programme has gone extremely well with over 773,000 boosters/third doses delivered so far (5th January 2022).
Before Christmas this was 54 per cent but this has since risen to 77 per cent which is fantastic news and a very promising figure which is likely to rise again in the next few weeks. This was an anticipated drop in demand in the run-up to Christmas and the New Year, and we are pleased to see the vaccination programme appears to be in high demand once more.
Following the recent announcement of the NHS’ national Level 4 Incident (20th December), SYB’s Health and Care Management Team (HCMT) met this week to discuss potential scenarios in relation to expected (ongoing) increases in workforce abstraction rates.
With the current abstraction rates ranging between 7-15% across our acute and mental health trust organisations, the scenario planning discussions build on the learning from previous Covid surges and will consider changes to non-urgent elective care surgery, mutual aid arrangements, safe discharge of more patients and enhancing remote care provisions.
Abstraction – rather than absences – is in reference to the numbers of staff who are unable to perform their frontline roles due to sickness, caring responsibilities, undertaking Covid-isolation requirements or unable to do their work effectively from home.
There is also forecasting work taking place around the potential drop in eligible NHS workforce as the Vaccination as a Condition of Deployment (VCOD) approaches its deadline (2nd February 2022) however so far the uptake data looks encouraging (over 94 per cent).
One of the key aims over the next few weeks will be to protect our most vulnerable age groups (particularly those in care homes) from Covid infections; there have been more outbreaks in these settings and many of these sites are enacting their Outbreak Management Plans accordingly.
Besides Covid vaccinations, the use of effective new antiviral treatments will also play a significant role in reducing hospitalisations, severe illness and deaths among those identified as being of the highest risk from Covid.
We are closely enacting the national guidance to step-up the deployment of new Covid antiviral and monoclonal antibody treatments through specially designated COVID medicines delivery units (CMDUs).
On 24th December, NHS England and NHS Improvement (NHS E/I) released new operational planning guidance 2022/23 outlining 10 clear priorities for health and care systems to enact over the next two years.
Key elements of this guidance include reinforcing and strengthening our workforce, enhancing our access and capacity across primary care networks (PCN’s) and continuing with transformation to reduce health inequalities through data and analytics.
It’s also noteworthy that Covid response and treatment (including vaccination) is also firmly embedded within these priorities aligning this more closely with business-as-usual activities.
Fundamentally, these plans are all set against the proposed Integrated Care Board (ICB) formation – which although subject to the Health and Care Bill passage – provides both stability and assurances of the direction of travel for health and care systems in their future operational planning.
Please see the attached document “COVID-19 workload prioritisation guide for general practice during the accelerated booster vaccination campaign (England)” for your information.
As announced in the above guidance document, there will now be a three-month delay on the proposed implementation of integrated care systems (ICS’) which will now be effective from 1st July 2022.
This step in the ICB development is due to the mounting pressures surrounding the national Covid response.
Our current pace and trajectory will not change much as we are already in a very strong position to proceed with key aspects of the ICB development. The recruitment process for the recently advertised South Yorkshire ICB leadership vacancies, the pre-agreed financial arrangements with our five Clinical Commissioning Groups (CCG’s) and the agreed boundary decision for Bassetlaw (moving into Nottingham and Nottinghamshire ICS) in April 2022 will continue as planned.
During the extended interim period with our CCG’s, we will continue to work together collaboratively as we have done throughout this transition journey so far.
NHS England’s bid to discharge more patients early from hospitals to free up beds could have a destabilising effect on GP practices, the BMA has warned.
NHS England said last month that discharge and care in the community should be stepped up to ease pressure on acute services amid rising Omicron cases.
Preparing the NHS
In a letter to practices, it set out a new priority to ‘maximise capacity across acute and community settings, enabling the maximum number of people to be discharged safely and quickly and supporting people in their own homes’.
But the BMA’s GP Committee has written to NHS England to express its concerns about the move amid a lack of capacity in practices to deal with additional patients in the community.
In the letter, sent to NHS England national medical director Professor Stephen Powis on Christmas Eve, GPC England chair Dr Farah Jameel added that community settings are ‘ill-equipped to cope with this sudden excess and unfamiliar care needs’.
Respiratory Clinical Assessment Service Hubs
This document supports systems to plan for a likely rise in respiratory infections, for example, COVID-19, respiratory syncytial virus (RSV), influenza and other infections this winter.
Network Contract Directed Enhanced Service Specification
NHS England published a revised Network Contract directed enhanced service (DES) specification with updated contract guidance and Investment and Impact Fund (IIF) implementation guidance.
Priorities and Operational Planning Guidance
NHS England has published the 2022/23 priorities and operational planning guidance which sets out the priorities for the year ahead.
Community Rollout of COVID Treatments
Deploying new COVID antiviral and monoclonal antibody treatments through COVID medicines delivery units (CMDUs) is a priority to reduce hospitalisation for highest risk patients.
Doctor Magazine – Increasing Pressures of GPs
The Doctor magazine is producing a feature – potentially a series of features – for upcoming issues of the magazine looking at the increasing pressures GPs are facing and the impact this is having on the profession and patient care. Peter Blackburn – the magazine’s senior journalist – would like to speak to GPs who have made the decision to leave the profession, doctors who have given up sessions or taken early retirement, GP partners who have stepped back from partnership or staff who have been involved in handing contracts back. Peter would also like to speak to GPs who may be able to share personal experiences which would help demonstrate to the public, national NHS bodies and the Government the severe impact that working pressures are having on the wellbeing and working and personal lives of doctors and, ultimately, the communities GPs serve. The feature will be used to lobby those who hold sway over doctors’ lives and raise awareness of. If you are interested in speaking to Peter – or can recommend a colleague/former colleague who may be able to speak about these issues please contact email@example.com
LMC Buying Group
Barnsley LMC has been a member of the LMC Buying Groups Federation since 2013. This means that practices can access the discounts the Buying Group has negotiated on a wide range of products and services. If you’re not sure what the Buying Group is all about then this short video explains what they do: https://www.youtube.com/watch?v=FekMwFI5ILg.
By registering with the Buying Group: www.lmcbuyinggroups.co.uk/members/, you can view all the suppliers’ pricing, contact details and request quotes. The Buying Group also offers any member practice a free cost analysis which demonstrates how much money your practice could save just by swapping to buying group suppliers. Tel: 0115 979 6910 Email: firstname.lastname@example.org Website: www.lmcbuyinggroups.co.uk