GPC England's LMC Update: 21 January 2022
GPC England meeting update
GPC England met today, 20 January 2022. Zoe Greaves (GPC England speaker) opened the meeting by welcoming Farah Jameel, in her second meeting as GPC England chair, and introduced the new Executive Team members Kieran Sharrock (Deputy Chair), Dean Eggitt (Executive Officer), and Richard Van Mellaerts (Executive Officer) who were appointed in December 2021.
GPCE heard updates from:
· The GPCE chair and the new executive team members
· The Sessional GPs Committee chair, Ben Molyneux
· GP Trainees Committee chair, Euan Strachan-Orr
Lena Levy, Head of BMA’s Public Health & Healthcare Delivery team, provided an update on mandatory vaccinations and confirmed BMA wide guidance has been published this week. FAQs for GP practices will also be published shortly.
The Committee also received an introduction from the BMA President Professor Neena Modi who gave an update on the President’s project.
There were also updates on proposed next steps following the results of last year’s indicative ballot on industrial action, work on setting GPCE England’s new strategic priorities and from the BMA Strategic Communications Team on the ongoing national GP Campaign.
The Committee received an oral update from Devina Maru, FMLM National Medical Director’s Clinical Fellow, Medical Woman’s Federation Representative to GPC, on the future of General Practice. Members then divided into breakout groups to discuss how the Committee could contribute to the development of a policy document on the future of general practice.
In the afternoon the Committee debated a motion on proposed changes to the BMA Conflicts of Interest policy.
The Committee then debated the GPC UK review proposal paper following opening remarks from the GPCE chair and a brief introduction from the chair of the review task and finish group, Mark Sanford-Wood. It was noted that all four national GPCs would be discussing this in their January meetings, with the Sessional GPs and GP Trainees committees, who do not have scheduled meetings this month, reviewing the proposals and feeding back electronically. A further debate and vote on the proposals will take place at the next GPC UK meeting on 24th March, with an aim to have the new GPC UK function and remit in place for the 2022/23 session.
Mandatory vaccinations FAQs for GPs and practices
Given the impact the requirement for COVID vaccinations as a condition of employment in the health and social care sector will have for GPs and practices as contractors, providers and employers, we are developing a set of FAQswhich will address redeployment, termination and implications for practices, which will include answers to:
What does mandatory vaccination mean in reality for employed staff, partners as workers, and practices as employers?
Who decides whether unvaccinated individuals are redeployed or terminated and how (for both employees and partners)?
Are there legal obligations when going through redeployment (eg pay protection, changing terms and conditions)?
Are there protections against termination for both salaried staff and partners?
What happens if there are several staff in the practice who are vaccine hesitant – viability of practice, impact of service provision, impact on remaining workforce etc?
This will be published next week and will sit alongside wider BMA guidance published earlier this week. Both sets of guidance should be read in conjunction with each other.
We will add to the guidance as more questions are asked and more information becomes available.
NHSE/I has also released guidance for employers.
Extension of free PPE to the health and care sector
The government has extended the central, free provision of all items of COVID-19 PPE to the health and care sector, including primary care, by up to one year to March 2023 or until the infection prevention and control (IPC) guidance on PPE usage for COVID-19 is either withdrawn or significantly amended.
The recently updated UK Health Security Agency guidance on infection control states that “an FFP3 respirator (or equivalent), must be worn by staff when caring for patients with a suspected or confirmed infection spread by the airborne route (during the infectious period)”.
The Department of Health and Social Care (DHSC) has advised in its response to the consultation on provision of PPE to the health and social care sector, that practices can use the DHSC PPE portal to access PPE free of charge.
NHSE/I has confirmed that this includes FFP3 respirators, and that CCGs have been informed that where risk assessments have shown it to be necessary that fit-testing should also be provided by the CCG.
Face coverings in practice premises
On 19 January the Prime Minister announced that face masks will no longer be mandated, though people are still advised to wear coverings in enclosed or crowded spaces and when meeting strangers.
IPC guidance for health settings has not changed and states "Universal masking with face coverings or surgical masks (Type II or IIR) to prevent the transmission of SARS-CoV-2 and other respiratory infectious agents in health and care settings, as a source control measure, should continue to be applied for all staff, patients, and visitors"
Furthermore, practices should carry out risk assessments of their environments and assess what level of respiratory protective equipment should be worn by different groups in various settings. Health and Safety law makes it your responsibility to protect staff and other patients based upon these risk assessments, thus making mask wearing a legal requirement if your risk assessment suggests masks should be worn.
If challenged by patients not wanting to wear a mask you can advise the about the IPC guidance and your risk assessments and inform the patient that "the law imposes on me the duty to expect you to wear a mask, and on you the duty to wear one in these premises"
Download our poster about using face coverings in practices.
Access all our patient resources for practices on our Support Your Surgery page
Guidance on COVID-19 Infection Prevention and Control for GP practices
Last week we published guidance for GP practices on COVID-19 Infection Prevention and Control, to help practices reduce the risk and pressures on their staff. The guidance also includes a template letter to CCGs requesting support with getting RPE supply.
The BMA Occupational Medicine Committee is also drafting guidance for workplaces to advise that employers should carry out risk assessments and provide mitigations to reduce risk of contracting COVID. This guidance will be published in full shortly.
COVID-19 self-isolation can end after 5 full days following 2 negative LFD tests
From Monday 17 January, people with COVID-19 in England can end their self-isolation after 5 days, as long as they test negative on day 5 and day 6 with LFD tests. The health service is experiencing disruption from widespread absences due to the rapid spread of Omicron but healthcare workers do not want to risk infecting colleagues and patients - many of whom are clinically vulnerable. So they can only return to work safely after a shorter period of isolation and two negative lateral flow tests if they have access to high-grade masks, and many are finding that this is still not the case.
Read the BMA statement
Read the NHSE/I guidance on isolation for NHS staff
COVID-19 vaccinations programme
Vaccinating 12-17 year olds at risk
NHSE/I has published operational guidance following JCVI advice on booster vaccination of eligible 12 - 17 year oldsand household contacts of immunosuppressed people. Vaccinations sites can now begin to invite eligible 12-17 year olds for their booster vaccinations.
Extending the post-thaw expiry date of specific batches of Comirnaty® (30 microgram/dose)
After discussions with Pfizer Inc. and the Medicines and Healthcare products Regulatory Agency (MHRA), certain post-thaw expiry dates of unpunctured and undamaged Comirnaty (30mcg/dose) vials in batches detailed in this NHSE/I letter may be extended from 31 days to 45 days.
Updated PGD and National Protocol for Spikevax (Moderna)
An updated PGD and National Protocol for Spikevax (formerly COVID-19 Vaccine Moderna) V05.00 have now been published.
Global vaccine equity
The BMA is a leading voice calling for urgent action to ensure an equitable distribution of vaccines globally. This is not only a moral imperative – as we have seen all too clearly with the emergence of the Omicron variant, failure to achieve high levels of vaccine coverage anywhere puts lives at risk everywhere.
We have twice written to the Prime Minister urging the UK to lead by example and do more to help poorer countries vaccinate their populations and we published a joint statement with other unions and royal colleges in Decemberexpressing our deep concern at the ongoing inequity in access to COVID-19 vaccines globally.
We are also supporting the #VaccinatetheWorld campaign launched by a group of grassroots health care professionals, including one of our GP members, Dr David Attwood, and senior leaders as a New Year’s resolution for the UK. The campaign calls on doctors and the public to sign a petition and write a letter to their MPs (template provided). If you have a few moment, please consider supporting this important action.
National Standards of Healthcare Cleanliness 2021
Members and practices have been asking if the implementation of the National Standard of Healthcare Cleanliness is mandatory in Primary Care. NHSEI have confirmed that, while contractors must have regard to NHSEI guidance, it is not a mandatory requirement.
CQC acknowledge in their advice on Infection prevention and control in General Practice that it will continue to regulate in line with its own regulations and the existing Code of Practice.
Medicines Supply Tool
The Department of Health and Social Care and NHSE/I have now launched an online Medicines Supply Tool, which provides up to date information about medicine supply issues. To access the Medicines Supply Tool you will need to register with the SPS (Specialist Pharmacy Service) website.
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Pressures in general practice
Dr Farah Jameel, Chair of GPC England, appeared on a special ITV Tonight episode 'When can I see my GP?' last week, which examined why patients are struggling to get GP appointments, the impact this is having on the wider NHS and what the solution might be. Dr Farah Jameel said: "It's a perfect storm. People are tired, working long hours, managing a whole variety of complexity and illness and not seeing an end in sight. We don't feel valued and so the workforce is leaving."
Pulse reported that COVID pressures are forcing GPs to provide urgent-only services in two areas and featured a BMA survey which revealed that almost 70% of GPs have seen staff shortages affect patient care. Dr Jameel commented that: “These survey findings highlight the sheer scale of impact that the latest surge in COVID-19 infections has had on practices, the workforce and their very ability to provide patients with the care they need.”
CQC report into ethnic minority-led GP practices’ experiences of CQC regulation
Responding to the publication of the CQC’s research into ethnic minority-led GP practices’ experiences of CQC regulation, Dr Jameel, said: "It is an important piece of work that underlines and recognises not only the poor experiences of, and challenges faced by, ethnic minority GPs during inspection processes, but also wider systemic factors that disproportionately impact this valuable group of doctors and their patients. These are all areas the BMA has been consistently raising for years.” This was reported by in Pulse, GP Online Management in Practice and London News Today.
Read the latest GP bulletin (England) here