General practices in London have been asked to ‘stand down’ routine care over the next two weeks in a bid to free up time to deliver Covid vaccinations.
Commissioners have told a CCG in the capital to ‘focus on urgent care’, including support for care homes.
This comes nearly a week after NHS England said it will provide advice ‘over the coming weeks’ around the removal of ‘unnecessary contractual burdens’ as part of ‘additional measures’ to help GPs across the country prioritise Covid vaccinations.
A letter at the start of December said: ‘While urgent care will [still] need to be provided across general practice, for the days on which the vaccine is being delivered from these sites, this programme will be the top priority.’
And the BMA also advised practices to ‘re-prioritise’ and postpone routine activities such as ‘non-essential health checks and reviews’ to make way for the vaccination programme last month.
But now practices in London have been asked to ‘focus on urgent care’ and ‘stand down’ any non-essential activity for a two-week period, ending on 15 January.
A letter sent to practices by NHS North Central London CCG on Wednesday, seen by Nursing in Practice‘s sister publication Pulse, said that the measures would start today due to rising ‘pressure’ facing GPs.
It said practices should ‘focus on urgent care including care home support, serious acute illness and deterioration in long-term conditions’ and ensure ‘essential’ drug monitoring, childhood immunisations and support for mental health, learning disability and autism (MHLDA) patients being seen in primary care.
Practices should also prioritise supporting digitally-excluded or extremely clinically vulnerable patients ‘with appointments’, ensure they are offering one appointment per 500 patients to NHS 111 direct booking and ‘protect Covid and flu vaccination capacity’, it added.
The letter added: ‘Practices are asked to stand down non-essential work to the same time period to enable the prioritisation of the work above.
‘[However], where capacity exists and you are not involved with system support to manage the Covid surge or the vaccination programme, the expectation is that your usual practice should continue.’
The prioritisation measures – which are to be reviewed for extension beyond 15 January next week – are in place ‘across London’ and will be accompanied by London-wide patient communications, the letter said.
A spokesperson for Londonwide LMCs told Pulse that the four other London commissioners are yet to announce a specific launch date for the measures.
The letter added that practices should ‘consider releasing allied healthcare professionals that are currently not supporting vaccine programmes or delivering practice based urgent care’ to support rapid response teams, community nursing teams and step-down beds.
Londonwide LMCs deputy CEO Dr Lisa Harrod-Rothwell told Pulse that clinical prioritisation is ‘essential’ to maintaining safe services and ‘keeping practice doors open’.
She added: ‘London’s GPs and practice teams are working flat out to keep services as safe and accessible as possible during the Covid-19 pandemic.
‘As with the first peak in cases, they will be switching to focussing on essential services due to the unprecedented volume of patients seeking care, stringent infection control measures and the impact of illness and isolation requirements on workforce availability.’
However, she stressed that London practices are still open and those who are seriously ill or worried they might be ‘should not delay seeking help’.
Meanwhile, in a letter sent to practices last week, NHS England said its aim is to vaccinate at-risk groups ‘as fast as supply makes possible’.
The letter said: ‘We will 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.’
Kent LMC medical secretary Dr John Allingham told Pulse that while lots of unnecessary activity has already been reduced, there is a ‘raft of things’ NHS England could still do to give GPs ‘breathing space.’
He called for a ‘moratorium’ on unnecessary paperwork such as sick notes, and a full suspension of CQC inspections and all appraisal activity for 12 months.
He said: ‘Send CQC away on holiday for 12 months and forget about your appraisal e-portfolio completely. There are lots of things they could do just to give us breathing space.
‘What would really be handy is if we could pretty much just do emergencies only and that bit of the chronic disease management that really needs to be done – perhaps some of the diabetes and COPD stuff.’
The letter added that NHS England will also ‘continue to build capacity’ by launching additional vaccination services ‘over the coming weeks’, with NHS Professionals and St John’s Ambulance supporting local vaccinator recruitment.
It reiterated that GPs will receive an extra £10 for every Covid vaccine dose they give to care home residents or staff, on top of the £12.58 item-of-service fee, due to the ‘additional time and resources’ needed for care home delivery.
It comes as GPs are to start delivering the ‘bulk’ of existing Oxford/AstraZeneca vaccine doses from this week – after its launch in hospitals yesterday – following MHRA authorisation for the vaccine’s use in the UK.