Primary care bulletin - 4 December 2024

Central flu procurement and supply – call for provider engagement

The NHS England Vaccination Strategy set an ambition to improve the efficiency and responsiveness of vaccine supply. As part of this, the aim is to explore the potential costs and benefits of centralising the procurement and supply of adult flu vaccine.

NHS England want to hear from providers of the adult flu vaccination service about the current procurement model and how this supports delivery of the flu programme. Providers are invited to complete a questionnaire which takes 15-20 minutes and is anonymous. The deadline for completion is close of play on Tuesday 17 December 2024. Thank you in advance for taking the time to provide feedback.

Influenza season 2024/25: Use of antiviral medicines

Prescribers working in primary care may now prescribe, and community pharmacists may now supply antiviral medicines (oseltamivir and zanamivir) for the prophylaxis and treatment of influenza at NHS expense. This is in accordance with NICE guidance, and Schedule 2 to the National Health Service (General Medical Services Contracts (Prescription of drugs etc) Regulations 2004), commonly known as the Grey List or Selected List Scheme (SLS).

Antiviral medicines may be prescribed for patients in clinical at-risk groups as well as anyone at risk of severe illness and/or complications from influenza if not treated.

It is important that:

People start taking oseltamivir within 48 hours of onset of symptoms
For zanamivir, treatment should begin within 48 hours of onset of symptoms for adults and within 36 hours of onset of symptoms for children who are 5 years old or over
Children over 12 months and adults who are not able to swallow capsules can be prescribed oral oseltamivir suspension
Prescribing for children under 12 months: Oseltamivir is indicated in children including full term neonates who present with symptoms typical of influenza, when influenza virus is circulating in the community. Efficacy has been demonstrated when treatment is initiated within two days of first onset of symptoms.

Click here to see the alert in full.

The Record a Vaccination Service (RAVS) technical issue

Following extensive ongoing national investigation into the RAVS technical issue, we are pleased to be able to advise practices that the seasonal flu payments do not appear to be affected by the issue. We are therefore able to approve the seasonal flu payments.

The national teams continue to work on resolving the technical issue for Pertussis and RSV pregnant women vaccination data and so practices will still need to check these returns to ensure that the CQRS extractions do not include any vaccinations that were given by other healthcare providers.

The NHS England London Regional Team recognise the inconvenience to practices and thank you for your continued patience and support in checking these smaller payment claims.
As any further information is made available we will circulate to practices.

Please email any queries to england.londonimms@nhs.net.

Continuation of autumn winter 2024 - COVID-19 campaign to 31 January 2025 and vaccine supply process

As part of the ongoing efforts to improve vaccination uptake, please note that Autumn Winter 2024 - COVID-19 campaign will continue to 31 January 2025.

What does this mean?

COVID-19 vaccinations for all cohorts, including outreach services will continue to 31 January 2025
As the National Booking Service will be closing on 20 December 2024, all the vaccinations after 20 December 2024 will based on walk-in activity (or if a site is operating a local booking system)
Eligible patients can access walk-in finder website (find a walk-in COVID-19 vaccination site) for their COVID-19 vaccination at a pharmacy site
119 service will continue to 31 January 2025 for queries and signposting.

COVID-19 vaccine supply after 20 December 2024

To support ongoing vaccination and outreach activity, COVID-19 vaccine supply will be available to sites until 31 January 2025 via ICB Exception Process ONLY (as TDM replenishment process will only operate until Friday 13 December 2024)
Sites will be required to submit the exception request to ICB (nhsnwl.immunisations@nhs.net) before 10am each day
To reduce vaccine waste, exception requests will be reviewed thoroughly to ensure the need for additional vaccines is justified (with review of VVE trend, how much vaccine is wasted, delivery estate in the vicinity etc.) and also if all the reporting compliances are met (stock, waste, VVEs)
At first, the re-supply (if required) will be via the mutual aid process to reduce vaccine waste. Exception request to region will only be submitted if mutual aid support is not feasible
Sites will also be expected to consolidate walk-in demand in order to reduce waste.

National Booking Service closure

The National Booking Service will be closing on 20 December 2024. The current system Q-Flow (the appointment management system that interacts with the National Booking Service) is being replaced in 2025. Further details will be shared once confirmed.

North west London delivery infrastructure

The NHS North West London website will remain up-to-date with infrastructure details at borough level:

https://www.nwlondonicb.nhs.uk/your-health-services/Covid-19/where-get-your-vaccine

Flu continue to 31 March 2025

Flu pharmacy finder will continue to 31 March 2025.

Find a pharmacy that offers free flu vaccination
All school should have had a visit by 13 December 2024. Mop up clinics may be required in the new year. Flu vaccinations continue to 31 March 2025.

Closure of Imperial's Neurosurgery Advice & Guidance (A&G) Service

The service has now closed. Please read this letter for further details.

The REST is KIDNEYS podcast. New name same passion

The REST is KIDNEYS makes kidney disease management easy

The REST is KIDNEYS is for primary care clinicians

The REST is KIDNEYS is NICE consistent short and sweet.

Welcome to The REST is KIDNEYS brought to you by North West London NHS kidney care team

Episode 6: Sweet urine, good times never seemed so good! SGLT2 inhibitor are a game-changer in kidney care! They transform CKD treatment slowing disease progression, delay or prevent dialysis, and reduces cardiovascular risk, for people with or without diabetes. Learn more with Prof Jeremy Levy and Dr Andrew Frankel.

Follow here: The Rest is Kidneys. We are also on Instagram and Linkedin.

The podcast has successfully reached the top 20 UK medical podcasts and is now aiming to reach the top 10. We need your help! You can support by sharing the podcast with your networks and teams and social media!

Last week we have also reached international charts, in the medical podcast category: number 5 in Ireland, number 22 in Netherlands and number 30 in Saudi Arabia!

Virtual buddy befriending service

Sense, a disability charity, offer a nationwide service dedicated to helping disabled people make friends remotely.

Social prescribers and others are welcome to signpost patients as appropriate.

Find out more here.

UK Disability History Month - Keeping Well (for staff)

The 14 November to 20 December 2024 marks UK Disability History Month. This year’s theme is ‘Disability, Livelihood and Employment’, an opportunity to raise awareness and understanding of the barriers disabled people face in the workplace, such as accessibility and discrimination.

The 2023 Staff Survey revealed that 25% of NHS staff have a long-term condition or disability.

Keeping Well has a dedicated webpage with resources, support and information for staff with disabilities, including advice around support in the workplace.

You can contact us for free, confidential support by:

Telephone: 0300 123 1705

Email: keepingwell.nwl@nhs.net

Complete a self-referral form

Education and training

Final dates released for polypharmacy action learning set workshops

Cohort twenty-two - 22 January, 5 and 26 February 2025.

The National Polypharmacy Programme exclusively invites our NW Londin prescribers to join the Action Learning Set (ALS). The programme aims to build GP and prescribing health care professionals’ confidence in, and understanding of, the complex issue surrounding and stopping inappropriate medicines safely. Delegates need to attend all three sessions. The ALS with also help PCNs deliver the medicines optimisation elements of the new Directed Enhanced Services contract and contributes to the QoF

To learn more about the Polypharmacy ALS please click here to register.

We are also looking for prescribers to register their interest in sessions in 2025 and 2026.

By registering their interest prescribers will be offered priority places.

Feel free to circulate this invite to other colleagues who may be interested.

For further information and/or to get involved with the ICHP polypharmacy programme please contact amar.singh@imperialcollegehealthpartners.com

ICHP masterclass - polypharmacy as a chronic condition: Clinical and ethical approaches in primary care and mental Health

Dr Waseem Jerjes, GP Partner, Hammersmith and Fulham Partnership, and Imperial College Health Partners, invite you to attend this upcoming polypharmacy on Wednesday 15 January 2025, 12 - 2pm.

The session will focus on strategies for deprescribing in primary care and addressing mental health polypharmacy. The aims of this masterclass include redefining polypharmacy and exploring its implications in primary care, with a focus on the ethical and psychological elements of deprescribing, including shared-decision making. It will also address the challenges of evidence-based strategies managing mental health polypharmacy while emphasising the role of personalised medicine and a multidisciplinary approach in enhancing patient outcomes.

Please bring along any questions for discussion.

Please click here to register for the session.

Feel free to circulate this invite to other colleagues who may be interested.

For further information and/or to get involved with the ICHP polypharmacy programme please contact Amar Singh.