In a letter to GPs and commissioners, NHS bosses said that imminent changes to the GP contract would mean that the April bank holidays (10 and 13 April) would be identified ‘as normal working days’.
It said that surgeries could also be asked to work through the May bank holidays (8 and 25 May), but this would be confirmed in April.
NHS bosses explained that the measures, which are to be adopted by the rest of the health service, would allow the NHS to 'manage demand together'.
The letter, co-written by NHS England primary care medical director Dr Nikki Kanani, said: 'We need your help to be prepared and aligned with the rest of the NHS,which will be treating these as ordinary working days and cancelling staff annual leave to ensure services are able to be maintained. To enable this, changes to the GP contract coming imminently mean the April dates will now be identified as normal working days for GP practices.'
NHS 111 alogorithm
The letter, dated 27 March, also sets out the basic system for how NHS 111 and primary care will work during the pandemic, ahead of an updated standard operating procedure for general practice that will be published shortly.
It revealed that a new 'consistent algorithm' would be used by NHS 111 to stream patients into different groups, with the aim of minimising the number of people contacting GP practices for advice.
Symptomatic patients needing further assistance but not hopsital treatment, Cohort 2a, will be passed onto a new Covid Clinical Assessment Service (CCAS) that will be partly staffed by retired doctors who have come back to work during the pandemic.
In the event that a Cohort 2a patient does not need hospital treatment, they will be offered a face-to-face primary care assessment, or their GP could be asked to proactively manage them via telephone monitoring.
Practices are also asked to ensure nominal appointment slots are always available to allow the National COVID-19 Response Service to ‘book’ patients into a work list. Practices will be able to decide how to give the appropriate care to the patient, which may involve referral to a 'hot hub' depending on local referral pathways.
The letter adds that 'swift changes to regulations are expected to give statutory force' to the new processes.
GPs have also been asked to identify any additional patients that should be added to the group of patients most vulnerable to COVID-19 that require 'shielding'. Practices should have already received a list of patients who have been sent a letter from the government advising them to shield themselves, but there may be other patients on their list that need to receive similar advice.
Practices will be expected to ensure these patients have up-to-date care plans, which should be done remotely, that they are able to receive their medicines and speak to any individuals who have concerns about their pre-existing conditions.
The letter also confirms that practices should still accept registration forms from new patients which have been sent online or by post. Previous rules stated that patients had to bring a signed application or medical card into a practice.
Meanwhile, a ban on the use of fax machines that was due to come into force on 1 April as part of the new GP contract has been temporarily lifted, with practices able to use the technology as a ‘last resort of communication’.
The letter also confirms that the new online system that allows patients to access 'isolation notes' for their employers if they are required to self isolate for 14 days is now up and running. Patients can access this service via NHS 111 here: https://111.nhs.uk/covid-19.
NHS bosses also confirmed that items such as personal protective equipment (PPE) and IT equipment will be provided free of cost and they are working with CCGs to enable secure remote working options for GPs and practice staff, including social prescribing link workers.
Amid reports of shortages of basic PPE, GPs have been forced to buy their own protective equipment during the pandemic. However, the letter says that National Supply Disruption Response is now able to issue ‘pre-packed kits’ with a minimum of 100 type IIR facemasks,100 aprons and 100 pairs of gloves within 72 hours. Practices are advised to call the helpline on 0800 915 9964 to order kits.