GP Bulletin Thursday 25th November 2021

GP Bulletin Thursday 25th November 2021

The GP Confederation Bulletins will routinely now be issued on Tuesdays and Thursdays.  The Thursday edition of the bulletin each week will focus on contract news and information.  Additional bulletins may be issued on other days with vaccination information from the PCNs.

1. DAS/Oximetry@Home Service – Closed today (25th November 2021)

Please note that the DAS has unexpectedly had to be closed today.

We ae sorry that our staffing cover for today has fallen through and so there is no DAS service today. Normal service will resume tomorrow.

2. NEL CCG – LIS/LES Income Protection Letter

NEL CCG emailed all practices on 17th November 2021 advising that the temporary income protection arrangements for LIS/LES will be extended until 31st March 2022. We are now working with the CCG and LMC to review how we will handle this at a City & Hackney level.  We will update practices as soon as we are able, but we hope that practices will continue to do the right thing for their patients.

Please note that this income protection letter covers the CCG Commissioned services only.  Therefore, payments for the following contracts will be based on 2021/22 performance and activity:

  • NHS Health Checks – London Borough of Hackney (LBH)
  • Sexual & Reproductive Health – London Borough of Hackney (LBH)
  • Teledermatology – Homerton University Hospital (HUH)

Please also note that QoF is not being stood down in 2021-2022 and achievement via the local contracts (SMI Health Checks and LTC) will help the practice achieve their QoF.

letter – income protection (Nov)

3. Text Messages to Patients Re. COVID19 Vaccination Offer – Urgent Action Required by Practices Today

Dear Practice Managers

As part of a major push across NEL and London this weekend to promote the COVID-19 vaccine offer ahead of the festive period, there is an urgent ask by the PCNs and the CCG for practices to action the following by COP TODAY:

Send the following 2 text messages to ALL patients on a practice’s register:

  • Text Message 1:

Covid rates in City & Hackney are rising. Most patients who are seriously ill in hospital with Covid aren’t fully vaccinated. It’s not too late to protect yourself and your family this Christmas. Anyone aged 12 or over can book their first and, if eligible, second or booster jabs online:

  • Text Message 2:

Questions about the vaccine? Find out more at our Q&A events

4. Flu Vaccines given by District Nurses and the Roving Home Visiting Vaccination Service (RHVVS) – Important Information

The District nurses are continuing to vaccinate patients on their lists and the RHVVS nurses are continuing to visit your housebound patients to administer the flu vaccine.

How we communicate with practices about patients who have received the flu vaccine and what we need practices to do

Data from the District Nurses

We are sending an email to your practice flu lead, or where we do not have this, to your practice generic email address with a spreadsheet detailing which of your patients have had a flu vaccine, the batch number and the date of the vaccine.

The spreadsheet also provides details from the DNs about patients who have declined, who have not been contactable or, occasionally, who are not on the DN caseload. Please look out for these emails and act on their content by coding those patients who have been vaccinated, coding the decliners if you are satisfied that they are indeed decliners and completing any other necessary actions for those with whom the DNs were not able to make contact.

Data from RHVVS Nurses

The RHVVS nurses use the same system as that used by Extended Access and Wound Care – the consultation is entered on EMIS Community (via the Adult Immunisation Template) and a notification letter is sent via workflow to your EMIS WEB. Please look out for these notification letters and act on them immediately. By tracing in the codes to your EMIS WEB, your patients are coded as having been vaccinated and are thus removed from the recall searches. If the codes are not transferred over to the EMIS WEB record, these patients continue to show on the recall searches as needing to have the flu vaccine. It takes time then for the team to go over all the data and unnecessary contact is made to patients who have already been vaccinated. The same message applies to the coding of patients seen and vaccinated by the DNs. Please be sure to code these on EMIS WEB as soon as you receive the information.

If you have any questions about any of this, please email

5. Vaccination Update from the Office of the PCNs’ Vaccination Team

Requests for Medical exemptions to COVID 19 Vaccination from Health and Social Care staff or members of the public

 There have been several queries on this subject coming through to the PCN Clinical leads and the response is as follows:

The official guidance is as follows:

“The possible reasons for exemptions are limited. Examples that might be reasons for a medical exemption are:

  • people receiving end of life care where vaccination is not in the person’s best interests
  • people with learning disabilities or autistic individuals, or people with a combination of impairments where vaccination cannot be provided through reasonable adjustments
  • a person with severe allergies to all currently available vaccines
  • those who have had an adverse reaction to the first dose (for example, myocarditis)

Other medical conditions could also allow you to get a medical exemption.

Short-term exemptions will also be available for those with short-term medical conditions and as an option that some pregnant women may choose to take.

Pregnant women can alternatively use MAT B1 certificates to show their COVID status, if they choose to use a medical exemption. Pregnant women do not need to apply for a medical exemption NHS COVID Pass if they have a MAT B1 certificate. For pregnant women the exemption will expire 16 weeks post-partum. This will allow them to become fully vaccinated after birth.”

Please note that this guidance is not to suggest that vaccination during pregnancy is harmful. In fact, there have been cases of pregnant people dying from COVID-19 infection and we know that the vaccine protects against serious infection and death.  The guidance to allow short-term exemption is designed to respect the choice a pregnant individual may make, but please endorse the vaccine and outline that the evidence supports vaccination during pregnancy.

You can see that as is currently stated there is room for interpretation- if you are unsure you could ask the patient’s specialist for advice on whether a medical exemption is valid- for example, a patient whose mental health may deteriorate if not granted an exemption.

The decision to endorse or support an application for exemption rests entirely between the GP/Specialist Clinician/Midwife and the patient and is effectively the endorsement of the medical exemption that the patient has applied for.

Please note that exemption guidance is subject to change, we will communicate with you if any of the above guidance change, or you can view the latest updates here.

6. Sexual Health – Sexual Health London Signposting Codes

When signposting patients to the online Sexual Health London service (where patients can order an STI test kit to be delivered to their home), clinicians should give patients the specific URL linked to their practice (for example: instead of the generic URL (

This will enable the Confederation to provide you with data on the number of your patients who have accessed the service as a result of your signposting.

Please share your practice specific URL listed in the attached spreadsheet with your staff.

City & Hackney GP Practices – Sexual Health London signposting codes

7. NHS Health Checks – Request for Examples of Invitation Letters/Texts

A Health Inequalities Behavioural Insights project will be delivered at scale across NEL in the new year.  NHS Health Checks will be the focus for this project.  As part of the preparatory work, we have been asked by London Borough of Hackney for examples of text messages and letters that practices send out to patients when inviting them to attend for an NHS HC.

We appreciate that practices are really busy and this request will not be a high priority for you, however, we would be very appreciative of any information you are able to send us.

Please email with copies of your letters and text messages so that we can collate them.

8. Changing the GP Confed Articles of Association to appoint a Lay Chair – URGENT – 8 more votes in favour needed!

As you are aware we have already agreed to allow the GP Confederation to appoint a Lay Chairperson as we could not find a GP to take on this role. Caroline Millar has confirmed that she would be willing to take on this role. We are now doing the formal legal bit to enact this.

We need at least 30 practices (75%) to vote in favour.  We have received 22 votes in favour to date. Please would the following practices respond by Friday 26th Nov 2021:

  • Barretts Grove
  • Brooke Road
  • Somerford Grove
  • Stamford Hill
  • Gadhvi
  • Healy
  • Rosewood
  • Clapton
  • Athena
  • Kingsmead
  • Elsdale
  • Dalston
  • Beechwood
  • London Fields
  • Queensbridge
  • De Beauvoir

If you agree with the resolution, please put an resolution then please put an “X” in the “For” box.  If you do not agree, please put an “X” in the “Against” box.  Please return your vote to the Confed generic email address (

Notice of Resolution

Also attached are a copy of the Articles of Association amended to reflect this change. If the Resolution carries, we will adopt these and inform Companies House.

20210916 Articles of Association (version 8 in tc)

If you have any queries about this, please contact Laura ( Otherwise, we look forward to receiving your completed vote.