Welcome to this week's primary care bulletin

Key points this week include:

• Shingles
• Childhood varicella vaccination programme: updated JCVI advice
• Green book update: influenza chapter 19
• Hepatitis C elimination GP champions in NW London
• LNWH GP liaison
• Updated PGD
• NHS NW London cancer bulletin
• November CYP bulletin
• Multi-factor authentication (MFA) on NHSMail accounts
• Launch of pharmacy first
• NHS type 2 diabetes path to remission programme launches
• Cold weather toolkit
• Men's health month
• Training, webinars and more

On 1 September 2023, changes were made to the shingles vaccination programme including an expansion of eligible cohorts. NHS England, London Region, has developed a communications toolkit to help practices improve uptake of the shingles vaccine. The suggested communications activities are based on best practice and evidence and have been shown to work with little or no cost to practices. 

The toolkit includes:

Vaccine programme information: eligibility, delivery, recording coverage and coding, co-administration. 
Resources for patients: web banners, posters, leaflets, stickers etc. 

A statement from the JCVI, issued on 14 November 2023, recommends that a universal varicella (chickenpox) vaccination programme should be introduced as part of the routine childhood schedule. This should be a 2-dose programme offering vaccination at 12 and 18 months of age using the combined MMRV (measles, mumps, rubella and varicella) vaccine.

The Green Book Chapter 19 (Influenza) has been updated and was published on Friday 10 November 2023

Chapter revisions include:

- updated advice on co-administration, seasonal timing of vaccination, and trivalent vaccines

- inclusion of carers and household contacts of people with immunosuppression in table 19.4 risk groups

- addition of occupational vaccination section

- updates to disease surveillance information and vaccine uptake tables.

Introducing 4 local GP’s  as our NWL Hepatitis C Elimination GP champions!

Dr Lyndsey Williams linked to LNWHT – Supporting all Harrow PCN’s, Ealing PCN’s (excluding Acton PCN) and North Brent PCN’s (Harness North, K+W Central, West and North) 

Dr Sam Gheiace linked to Imperial – Supporting South Brent PCN’s (Harness South, Kilburn Partnership and K+W South ) and Acton PCN, all Westminster PCN’s (excluding south Westminster PCN) all Hammersmith & Fulham (excluding South Fulham) all Kensington Chelsea PCN’s (excluding Brompton Health and Kensington Chelsea South)

Dr Paul O’Reilly linked to Chelsea and Westminster Hospital - Supporting all Hounslow PCN’s, Brompton Health PCN and Kensington & Chelsea South, South Fulham PCN, South Westminster PCN

Dr Pritti Vaghani linked to Hillingdon Hospital– Supporting all Hillingdon PCN’s
 
Dr Ashley Brown, Hepatology consultant Imperial is the West London Hepatitis C Operational Delivery Group lead. 

NHS England has committed to eliminating Hepatitis C before 2030. As part of the Hepatitis C Elimination Programme’s key work areas,  primary  care has been identified as a priority where a large number of people with unidentified HCV may be identified. These groups include:

• Patients that may be at risk of Hepatitis C
• Patients who have a confirmed diagnosis but no treatment record and need to be followed up
• Cases of those that may have received infected blood and /or infected blood products
• Patients with other blood borne viruses (BBV’s)

You may already know your GP champion and be working with them, but for the majority your GP champions will be reaching out to you likely in regards to patients who have a confirmed diagnosis but no treatment record using information from their local trust’s clinical lead. 
 
There will be planned Webinars supporting Hepatitis C education including introducing a new GP IT Search to support with case finding (Patient Search Identification (PSI) tool). 

EMIS practices – In the Population Reporting module, EMIS Library;- SNOMED Searches >EMIS Clinical Utilities > Third Sector Partnerships > HEP C Elimination Programme.

SystmOne practices – email hepcsearches@vipc.co.uk to request the searches

Elearning resource - Hepatitis C: Enhancing Prevention, Testing and Care. Summary of Hepatitis C: Enhancing Prevention, Testing and Care (rcgp.org.uk)

Hepatitis C GP Toolkit. The toolkit is an ‘all in one’ document covering an introduction to the virus, testing, NICE Guidelines, treatment, the National Testing Portal and more.  Developed by the Hep C U Later national programme. 

London North West University Healthcare have a new Primary Care Liaison Manager who is there to help GPs and other primary care professionals with any queries or feedback about the Trust or its services. Contact the service via email:

lnwh-tr.primarycarequeries@nhs.net

NHS England - London has published an updated PGD on its website.

The updated PGD is:

• NHSE UKHSA dTaP IPV PGD v5.00

Practices should ensure that any registered healthcare professional who is due to administer vaccinations under this PGD should be made aware of this updated version.

 If you have any queries, please contact the London Immunisations team via england.londonimms@nhs.net.

This edition of the cancer bulletin includes:

BREAST CANCER SCREENING

1. Introducing The Beauty of Support - Talking hair, culture and cancer in Black women's hairdressers. 

Pan London Cancer Alliance Research Fellows 23/24

2. Applications open for pan-London research fellowships

PRIMARY CARE CANCER EDUCATION

3.Tell us how you would like to receive Cancer Education!

4. Red Whale Cancer Education – still available!

5. FREE Cancer Education Programme

The IT team will soon be introducing Multi-factor Authentication (MFA) to make NHSMail accounts more secure and to make it more difficult for threat actors to sign into compromised NHSMail accounts.

Once MFA is enabled on your account you will need two different forms of authentication to sign into NHSMail, in addition to your email address and password. This includes an authentication app on your mobile phone, text message or phone call. This second layer of security is designed to prevent anyone but you from accessing your account, even if they know your password.

You can also set up your smartcard to authenticate your app but in order to set up your smartcard as an authenticator you would still need to set up one of the three core authenticator options first.

The IT team will be rolling MFA out to staff in a staged rollout before NHSMail implement MFA nationally on all accounts. This will allow better support to our staff with getting MFA set up and help address any issues that may occur in a more timely manner.

What are the benefits of MFA?

• Keeps any patient data in a more protected environment
• Helps you gain access to your account should you forget your password
• Helps protect the NHS' reputation.
• Provides increased protection against cyber-attacks
• Checks if an attempt is made to access your account from an unusual location or device
• If you have any questions or queries please contact the service desk at nhsnwl.servicedesk@nhs.net

We are pleased to share with you that Department of Health and Social Care (DHSC), Community Pharmacy England (CPE) and NHS England (NHSE) have agreed on the next steps for community pharmacy as part of the delivery plan for recovering access to primary care, set out in May 2023. 

The full letter has been published on the DHSC website and sets out the increasingly important clinical role of pharmacists and pharmacy technicians in offering timely access to NHS services.  

Pharmacy First will launch on 31 January 2024, subject to the appropriate digital systems being in place to support these services. This will be a new advanced service that will include 7 new clinical pathways for treating common conditions as well as urgent repeat medicines supply and referrals for a clinical consultation for minor illness, replacing the Community Pharmacist Consultation Service (CPCS). 

Pharmacy First will enable community pharmacists to offer a clinical assessment to patients and supply NHS medicines (including some prescription-only medicines under Patient Group Directions (PGDs), where clinically appropriate, to treat 7 common health conditions. 

DHSC, CPE and NHSE have also agreed that from 1 December 2023 the Pharmacy Contraception Service and Blood Pressure Check Service will be expanded. Once pharmacies are signed up, women will be able to walk into their local pharmacy to receive a clinical consultation from a pharmacist – either to be supplied contraception for the first time or to receive their next supply. Pharmacies will also deliver an additional 2.5 million blood pressure checks a year by Spring 2025. 

In both services, it will also be possible to use the wider non-registered pharmacy team members where staff have the appropriate training and are competent to deliver the service. 

Pharmacies will have access to more parts of the GP record (medications, observations, and investigations) and use a new Pharmacy First consultation record to capture the consultation which will then send automatic structured updates to the GP record and to the NHSBSA to support payments and reporting on the service. 

We will publish more details closer to the launch of the Pharmacy First service, including details of the registration and set-up fee process, clinical pathways, PGDs, and the service specification. 

The NHS type 2 diabetes path to remission programme is an evidence-based intervention programme that uses total diet replacement (TDR). It supports people recently diagnosed with type 2 diabetes to achieve significant weight loss (>15kg) and potentially attain diabetes remission (non-diabetic HbA1c results, at least six months apart, off all glucose-lowering medicines). There is no cost to participants, with all TDR (usually shakes) products funded by the NHS.

The programme allows participants to choose their preferred delivery model of either digital or in-person support. For the digital pathway, participants will not need to travel to a specific location for appointments. 

Following the recent procurement led by NHS England, Counterweight has been announced as the successful provider who will be delivering the service in North West London ICB ICS.

The service will be open for referrals starting Thursday 1 February 2024. 

For more information on the service click here

Cold weather communications toolkit is now available to download.

It is intended to provide basic health information that can be communicated during cold spells so that the right messages reach the right people at the right time. 

It contains background information, key messages, suggested social media copy, social media assets and links to useful information.

November is Movember, or Men's Health Awareness Month.

As part of the work to better understand the barriers faced by male staff in accessing wellbeing support, Keeping Well NWL commissioned a project specifically asking staff their views.

You can read more about the project’s findings and insights on the website.

Contact the service for free, confidential support via:   

• Telephone: 0300 123 1705    
• Email: keepingwell.nwl@nhs.net
• Complete a self-referral form  

Friday 1 December 2023 

Join Thrive Tribe & Dr Richard Pile in November to learn:

• How to make a referral. Get all your questions answered as Thrive Tribe explain the minimal impact to existing referral processes. 
• Why the Healthier You programme is different and how it will support your patients.
• How making a referral will benefit you, the practice and the patient. - Dr Richard Pile