The BMA and RCGP have listed services practices can pause and work that must continue in updated workload prioritisation advice for general practice. The guidance is aimed at helping practices to focus on the vaccination campaign in the coming weeks.
The college and the BMA said that a 'definitive list' of services that can be postponed in general practices was not possible - and that there was 'no one-size-fits-all' solution for the profession as a whole.
However, the guidance sets out a list of services that must be maintained and offers a number of potential services that could be suspended as practices divert their attention to the vaccination campaign.
Work to continue
- Services for acutely unwell patients
- Contraception appointments
- Childhood and flu immunisations
- Medication problems that require a GPs' input
- Cancer or suspected cancer
- Palliative care
- Wound management
- Acute visits to housebound patients and care homes
- Management of long-term conditions in high-risk patients (the guidance suggests who these patients might be)
- Mental healthcare monitoring for those with serious mental illness or a long term illness and care for those believed to be at high risk.
- Cervical smears
- Essential injections
- Essential paperwork
- Med3 certification after period of self certification (this has been extended to 28 days temporarily by the Department for Work and Pensions - see below).
Work that could be paused
- Non-urgent screening such as health checks
- Data collection requests
- Blood monitoring for lower-risk conditions
- Vitamin B12 injections
- Routine care for those with long-term conditions not considered to be at high risk
- Non-essential procedures
- Minor surgery (apart from skin cancer excision)
- Non-urgent investigations that will not impact on treatment
Vaccination in children
The Joint Committee on Vaccinations and Immunisations (JCVI) has recommended that children aged 5 to 11 years in a clinical risk group (as defined in the Green Book), or who are a household contact of someone who is immunosuppressed should be offered two 10 micrograms doses of the Pfizer vaccine. There should be eight weeks between the first and second doses and the minimum interval between any vaccine dose and recent COVID-19 infection should be four weeks.
It will issue further advice on vaccination for other children aged 5 to 11 after considering more data. Meanwhile the JCVI has also recommended that 12- to 15-year-olds should receive a booster dose of the Pfizer vaccine at least three months after their second dose (or third dose if they are immunosuppressed).
GP practices have been reminded to report a COVID-19 outbreak if 'two or more' staff test positive, as the NHS seeks to maintain services in the face of an Omicron surge.
In an update sent to primary care providers, NHS England reminded practices of the 'requirement and importance of reporting COVID-19 outbreaks'.
The update said an outbreak 'is defined two or more confirmed cased of COVID-19 among individuals associated within a specific setting' - and warned that prompt reporting was vital to guarantee 'continuity of primary care services and to enable commissioners to provide timely support'.
'Primary care providers should inform their commissioner as soon as they consider that delivery of the full contracted service may be compromised by staff absence due to the outbreak,' the update warned - adding that commissioners will 'work with the contractor to put business continuity arrangements in place and to maintain access to services for patients'.
NHS England has updated guidance around the provision of new treatments for COVID-19 in the community. It includes details of a new neutralising monoclonal antibody (nMAB) treatment sotrovimab (Xevudy), which became available for use from 20 December. A new directory of the COVID Medicine Delivery Units, where patients can be referred to be prescribed the treatments is also available.
All of the guidance related to community-based treatment can be found here.
From 17 December until 26 January 2022 the Department for Work and Pensions is changing the rules around fit notes. Self-certification to access statutory sick pay will be extended from 7 to 28 days and there will be no requirement for a fit note to access other benefits. NHS England said this should significantly reduce the number of fit note requests practices receive.
Guidance on this is here.
Friends and Family Test
The suspension of the requirement that practices report to commissioners about Friends and Family Test returns has been extended until 31 March 2022.
COVID-19 guidance tracker
Don't forget that our COVID-19 GP guidance tracker provides a list of guidance relevant to GP practices in an easy-to-search format. The tracker is regularly updated and you can find it here.