Page last updated: 16 April, 2021, 2:23pm

Primary Care E-bulletin (Issue 134) – 16 April 2021

Welcome to the latest edition of our e-briefing to support GP practices across mid and south Essex.

If you think these e-briefings could be improved, please let us know how by sharing your feedback.

Previous bulletins can be found on the MSE healthcare professional website.

There is also a search function (located top-right of the website) to make it easy to find what you’re looking for.

Support with day to day issues

GP VIIT Advice

In the wake of recent press coverage concerning rare thromboses in patients who have received the Oxford-AstraZeneca vaccine, Mid and South Essex Hospitals have seen a large number of referrals of patients with headache following vaccine administration. Following guidance produced by the Expert Haematology Panel of the British Haematology Society, a clinical pathway has been produced jointly by the Royal College of Emergency Medicine, the Society for Acute Medicine, and the Royal College of Physicians.

Regarding cerebral venous thrombosis, points to consider include:

  • Cerebral venous thrombosis is rare. 
  • Headache is the most common presenting symptom.  
  • Onset may be sudden (“thunderclap”) or progressive. 
  • Typically worse with Valsalva or recumbency. 
  • Vomiting, visual problems and papilloedema may be present. 
  • Focal signs, seizures, confusion or coma should prompt urgent imaging. 

Headache that is new onset (no previous episodes) which is persistent, not improved with analgesia and either worse on Valsalva or associated with papilloedema raises suspicion or cerebral venous thrombosis. 

Vaccine associated thrombosis occurs 4-28 days post vaccine. 

If a patient presents with a headache suspicious of cerebral sinus thrombosis, with onset 4-28 days following administration of the Oxford-AstraZeneca vaccine, a full blood count should be taken. If platelet count is not reduced (i.e. count is >150 x 109/L), then Vaccine induced Thrombosis and Thrombocytopenia is excluded. Headache should be investigated and managed in accordance with standard pathways/practice. If platelet count is <150 x 109/L, or same day blood test is unavailable, refer to secondary care for further evaluation.

Suspected Deep Vein Thrombosis or Pulmonary Embolism should be assessed by Wells score +/- D-dimer according to standard pathways.

Click here for pathway.

More first dose vaccination appointments available for health and care staff 

Further first dose appointments have been opened up for health and care staff this week via shift partner (covid.shiftpartner.com). The additional appointments have been made available following recent changes to the national booking service. Slots are available this week at The Lodge in Wickford (Wednesday through to Sunday), Chelmsford City Racecourse (Wednesday, Friday and Saturday) and The Cliffs Pavilion (Saturday).

Please note these are for the AstraZeneca vaccine - in line with national guidance, please only book if you are aged 30 and above. NHS staff should use their personal email address, not their nhs.net address, to sign up if they are not already registered on the shift partner system. 


COVID-19 vaccinations for people with Severe Mental Illness: New videos

NHSE has developed a series of short videos on COVID-vaccinations for people with Severe Mental Illness including a guide for GPs and teams to support people:

COVID-19 vaccinations: Supporting gypsies and travellers

Friends, Families and Travellers have produced a range of materials to support staff working in health and care settings to support Gypsy and Traveller people access the Covid-19 vaccine:

https://www.gypsy-traveller.org/health/fft-launch-materials-to-support-gypsies-roma-and-travellers-access-the-covid-19-vaccine/

Network Contract Directed Enhanced Service – Standardised GP Appointment Categories – 2021/22

As you are more than aware, the COVID pandemic delayed the publication of NHS England GP-AD guidance.

This has now been published and is available online (NHS England » Network Contract Directed Enhanced Service – Standardised GP Appointment Categories – 2021/22)

To kick off this piece of work, a number of short demos have been recorded to cover how best to carry out the national mapping exercise:

  • EMIS WEB: Howbeck Healthcare along with Cheshire & Merseyside Health & Care Partnership have very kindly developed training videos and given permission for all organisations to access them. They can be found here: GP Appointments Data (GPAD) | HowbeckHow2
  • TPP SystmOne: three training videos, showing users how they can delete redundant slots, amend slot type settings and how to complete slot mapping in line with national guidance are available. They can be found here: GP Appointment Data (GPAD) | TPP

NHS Digital are also hosting a number of webinars to supplement these materials.

More information and a registration link can be found here

Pathology First: new phone number and survey

Pathology First has introduced a second telephone number for GPs to use when requesting same day or urgent phlebotomy appointments for patients.  

It is:  07825863156. The older number, 07387105567, continues to be in use.   These two numbers are for GPs only and are for same day or urgent tests when there is a clinical need. 

Primary Care Pathology First User Survey 

  1. This takes about 4 mins to complete. 
  2. It closes on 26th April
  3. The aim is to feedback the results by 24th May

https://www.surveymonkey.com/r/PathologyFirstsurvey

Education and training

Invitation to attend: National ‘Blood Pressure @home - Steps to success’ webinar

WHAT: ‘Blood Pressure @home: Steps to success’ webinar

WHEN: 20 April  2.30pm - 4.30pm,

WHO:  Dr.Shahed Ahmad, National Clinical Director for Cardiovascular Disease Prevention

DETAIL:  A walk-through of the practicalities of the Blood Pressure @home Standard Operating Procedure, followed by examples of how GPs and local areas have targeted specific vulnerable patient cohorts. This session is aimed at GP practice and Primary Care Network business managers and clinical directors, and Clinical Commissioning Group cardiovascular disease prevention colleagues or similar roles.

HOW: Please click the below to sign up for the webinar:

https://www.events.england.nhs.uk/events/blood-pressure-home-steps-to-success-webinar

Surviving Emotions: A Safe Space to Talk

The East of England Leadership & Lifelong Learning Academy in collaboration with Carter & Corson, have announced a series of 2 hour virtual masterclasses created for leaders working in challenging, constantly evolving systems – who still need to care for the people in their team and find ways to care for themselves.  The dates of the events are as follows:

To attend one of these events, please visit the Leadership Academy

For information

COVID Ambassador role

This is an exciting opportunity to support general practice’s with establishing and maintaining appropriate infection control and prevention levels in light of the ongoing COVID-19 pandemic.

The Ambassador role will act as external support to GP practices within each CCG locality to ensure the highest infection prevention standard are followed and minimise the risk of outbreaks and service closures.

For more information on this role, please contact [email protected]. The deadline for submitting an expression of interest is 25 April 2021.

Click here for more information.

Bowel Cancer Awareness Month

April is Bowel Cancer Awareness Month. For information about how your practice can support this awareness campaign please click here.

In our short video ‘ABCD of Bowel Cancer – Know the symptoms’, Dr Deepak Kumar talks about the ABCD of symptoms and what to look out for. Click here to view the video.

For cancer information for your websites, please visit:

Cancer Information: PCN/GP practice websites

NHS Primary Care COVID-19 Bulletin

Click here to access NHS England’s latest primary care COVID-19 bulletins.

For the latest advice and guidance around coronavirus for clinicians, please visit the NHS England website.