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GP practices to resume patient reviews and health checks immediately

by Costanza Pearce
10 July 2020

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GP practices must resume patient reviews and health checks including routine medication reviews from 1 July, NHS England has announced.

Practices must also resume the delivery of face-to-face care ‘where clinically appropriate’, NHS England said in a letter to GPs last night.

It comes as elements of QOF reporting are also being reinstated, including a ‘major expansion’ of the flu programme.

In the letter, NHS England said practices must resume routine medication reviews, new patient reviews – including on alcohol dependency – clinical reviews of frailty and health checks for those over 75 if these have been ‘deprioritised’.

These must all be reinstated from 1 July, although NHS England said practices will have to use their ‘clinical judgement’ to prioritise the ‘backlog’, it said.

Practices must offer to deliver these services face-to-face where this can be done ‘safely’ and home visits only used ‘in exceptional cases’, the letter added.

It said: ‘Where this care cannot be delivered safely face-to-face or where the patient has other medical conditions which still require them to shield or socially isolate the review could be conducted remotely, with as much of the physical review completed as is practicable in these circumstances.’

Local commissioners are also ‘encouraged’ to reintroduce local enhanced services, local incentive schemes and local pilots as part of ‘wider plans to step up routine and non-urgent services’, the letter added.

And local audit and assurance activities should also be reintroduced ‘as soon as practicable’, it said.

However, these resumed activities – as well as engagement with and review of patient participation groups – may need to be suspended locally by CCGs in ‘extreme circumstances’ such as local outbreaks, subject to approval, NHS England said.

PHE has also ‘recommended’ that practices resume the routine call for shingles vaccination programme from 1 July 2020, NHS England added.

Practices should offer the vaccine ‘on an opportunistic basis’ to patients who have turned 80 since 1 February and have not been vaccinated for shingles between now and 31 December, it said.

Payment will be managed by local commissioners and should be at the same rate as other shingles vaccines, it added.

The letter, which outlines the ‘second phase’ for the general practice ‘response to coronavirus’, further said that ‘all practices must now also deliver face to face care, where clinically appropriate’.

It said: ‘It should be clear to patients that all practice premises are open to provide care, with adjustments to the mode of delivery. 

‘No practice should be communicating to patients that their premises are closed. Nor should they be redirecting patients to other parts of the system, except where clinically assessed as appropriate.’

However, it added that digital consultations should be offered ‘as standard – unless there are good clinical reasons otherwise’.

It comes as the letter also announced that NHS England is working to ‘redesign the current process’ for GP appraisals, with the intention to ‘take a flexible approach’ to their reintroduction in light of the Covid-19 pandemic.