Welcome to Bridge End Surgery
Email from North Durham CCG MO team on 16th September 2021
Following a number of queries around the recently released COVID-19 vaccination guidance we wanted to update you regarding the eligible cohorts for vaccination (as of time this email is sent!!).
The Phase 1 and 2 Enhanced specification has been updated on the 14th September to enable the vaccination of some recently announced cohorts, however the PGDs and national protocol have not been updated yet in some cases – this is expected to be updated sometime next week and we will circulate when available.
You may therefore vaccinate the following cohorts if you have an appropriate legal mechanism in place to do so;
- Immunosuppressed patients with a third dose
NHSE have stated that national searches are expected by the end of the month, but local searches can be done in advance of this. The PGD and national protocols for both AZ and Pfizer have NOT yet been updated for a third dose so patients will need to have this dose under PSD or undertaken by a prescriber.
Please note for those aged 18 years and over, JCVI advises a preference for mRNA vaccines for the third primary dose, with the option of the AstraZeneca vaccine for individuals who have received this vaccine previously where this would facilitate delivery. Under 18s should receive Pfizer unless contraindicated.
Recording on Pinnacle - Despite this being a third dose of the PRIMARY course, NHSE have confirmed that this dose is to be recorded on Outcomes4Health as a 'booster' dose.
If any of these patients are eligible for their flu vaccine these can be undertaken at the same time in line with MHRA guidance published yesterday.
- 12–15-year-olds at clinical risk and household contacts of immunosuppressed patients
Previously (August 2021), JCVI advised that children with severe neuro-disabilities, Down’s Syndrome, underlying conditions resulting in immunosuppression, profound and multiple learning disabilities (PMLD), severe learning disabilities or who are on the learning disability register, should be offered COVID-19 vaccination. It also suggested 12-15 year old household contacts of immunosuppressed patients should be vaccinated. These are all covered under the Pfizer PGD or national protocol and will need 2 doses.
The phase 1 and 2 specification has now been updated to cover vaccination of the additional clinical risk groups announced on 3rd September, however the PGD and national protocol have NOT been updated therefore these patients will need to be vaccinated under PSD or undertaken by a prescriber and will need 2 doses.
The list of eligible at-risk children now covers the following patients:
- Chronic respiratory disease: Includes those with poorly controlled asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, cystic fibrosis, ciliary dyskinesias and bronchopulmonary dysplasia.
- Chronic heart conditions: Haemodynamically significant congenital and acquired heart disease, or milder heart disease with other co-morbidity. Chronic conditions of the kidney, liver or digestive system: Includes those associated with congenital malformations of the organs, metabolic disorders and neoplasms, and conditions such severe gastrooesophageal reflux that may predispose to respiratory infection.
- Chronic neurological disease (NB some may be covered under original criteria): Includes those with: 36 neuro-disability and/or neuromuscular disease including cerebral palsy, autism, epilepsy and muscular dystrophy hereditary and degenerative disease of the nervous system or muscles, or other conditions associated with hypoventilation severe or profound and multiple learning disabilities (PMLD), Down’s syndrome, or those on the learning disability register, neoplasm of the brain
- Endocrine disorders: Includes diabetes mellitus, Addison’s and hypopituitary syndrome.
- Immunosuppression (NB most will be covered under original criteria): Immunosuppression due to disease or treatment, including: those undergoing chemotherapy or radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients genetic disorders affecting the immune system (for example, deficiencies of IRAK-4 or NEMO, complement disorder, SCID) those with haematological malignancy, including leukaemia and lymphoma those receiving immunosuppressive or immunomodulating biological therapy those treated with or likely to be treated with high or moderate dose corticosteroids those receiving any dose of non-biological oral immune modulating drugs – for example, methotrexate, azathioprine, 6-mercaptopurine or mycophenolate those with auto-immune diseases who may require long term immunosuppressive treatments
- Asplenia or dysfunction of the spleen: Includes hereditary spherocytosis, homozygous sickle cell disease and thalassemia major.
- Serious genetic abnormalities that affect a number of systems: Includes mitochondrial disease and chromosomal abnormalities.
As highlighted in the NHSE bulletin yesterday, the Phase 3 enhanced specification for PCNs has NOT YET been updated, therefore please do not start administering booster doses, as you are not covered by your indemnity.
The spec and the PGDs and national protocol are expected to be updated by next week. As soon as they are available we will circulate. We are aware that there are also issues with the consent forms that are available for the care homes as they do not cover third doses (either for primary course for immunosuppressed patients or booster doses) – we have flagged this with the regional team for escalation.
Vaccination of all of this age group is being managed by the 0-19 Nursing Team from Harrogate and District Foundation Trust, and will include visits to all senior schools within County Durham. Once vaccination dates have been confirmed with schools we will share the programme dates with practices, along with confirmation of plans for home-schooled children.
Neither the phase 1 and 2 or the phase 3 spec, or the PGDs and national protocols have been updated to allow the vaccination of healthy 12-15-year olds in the LVS sites at present. Therefore, please DO NOT vaccinate this age group at present UNLESS they are eligible as a high risk patient or a household contact as specified above as you will not be covered by indemnity. It may also lead to increased workload for you and others as parents/children try to get their vaccine faster than their planned school visit.
We hope that this information clarifies some key points, please get in touch with the team if you have any queries
The MO team.
We are currently working with the CCG and other practices to plan for all of the above work in a safe manner for all concerned as this is a complicated matter that is frequently changing.
National Shortage of blood sample bottles
We have been advised by NHS England that all primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing. Examples of clinically urgent testing include:
- Bloods that are required to facilitate a two week wait referral
- Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of condition
- Bloods that if taken could avoid a hospital admission or prevent an onward referral
- Those with suspected sepsis or conditions with a risk of death or disability
we are unfortunately going to have to cancel appointments in the coming days and would ask you bear with us during this national shortage.
We are conscious that some patients registered at Bridge End Surgery may be affected by current events in Afghanistan. Bridge End Surgery is accredited by the Royal College of General Practitioners as one which specialises in the care of military veterans and their families. All the team have been trained in the care of military veterans and their families. If recent events have affected you and you wish to seek help, please come forward.
We are still open and here for you and are continuing to provide services as we have been doing throughout the COVID-19 pandemic and are prioritising delivering care and services based on clinical needs. If you need medical advice or treatment, first please ring us on 01913883236 or complete an online enquiry here.
When you phone or go online, you will be asked to provide some information about your healthcare need. This will help the practice team assess the most appropriate way to provide your care, which may include a face-to-face consultation and ensure it is provided by the most appropriate person.
Face-to-face appointments are available to all patients, where there is a clinical need and these will be assessed by the GP when they phone you. If needed, you will be asked to come to see them the same day.
Online consultation requests for non-urgent help can be made at any time. They will be responded to as soon as possible, usually within two working days. Alternatively, visit the local pharmacy for clinical advice on minor health concerns.
For urgent issues or out of hours, you can also call the NHS on 111 or go online to seek NHS advice 111.nhs.uk
If you are planning to travel, proof of your COVID-19 vaccination status is available on the NHS app, which is also valuable for accessing your health records and ordering repeat prescriptions. For further information use this link https://digital.nhs.uk/services/nhs-app/nhs-app-guidance-for-gp-practices/nhs-covid-pass
Alternatively, call the NHS helpline on 119 and ask for a letter to be posted to you. This must be at least five days after you’ve completed your course of the vaccine, the letter may take up to five days to reach you. GP Practices are unable to provide certificates.
Appointments are being delivered face-to-face, by telephone, or using video calls and messaging to your mobile or computer – the practice team will assess what is most appropriate for you and if you have a preference you can discuss this with them.
We have had to take the unprecedented step of closing the surgery doors, except those who have been asked by a GP or nurse to come to the surgery. Those patients need to use the buzzer and a receptionist will be with you. If you do not have an appointment please do not be offended if we refuse you access, this is for your safety and ours.
If you need to order a prescription, please use online services, such as the NHS App or leave a request in our post box – you will be refused access to the building to make these requests.
We also have a box to leave any samples you have been asked to provide. The booking of appointments online has also been suspended in line with NHS guidance.
Data for Planning and Research update
A letter was sent to practices on Monday from Jo Churchill, the Minister for Primary Care and Health Promotion, outlining the criteria that will strengthen security for the GP data collection programme.
It sets out the tests that must be met for the GP data collection to proceed and means a move away from the fixed start date of 1 September. The letter can be read here.
COVID 19 VACCINATION CLINICS (19 August 2021 10:00)
We are still operating out of Fellrose Surgery, 2, Craghead Road, Pelton Fell, Chester-le-Street, DH2 2NH for weekend vaccinations, contact us if you want booking in
Information is changing regularly and we will try to update this page as often as possible because our phones lines are extremely busy dealing with routine work and in trying to book patients in for covid vaccinations.
Our labs have received numerous requests across the County for Covid-19 antibody testing in patients post Covid-19 vaccination, this antibody test has not been set up or validated to test for response to the vaccine and so currently, there is no local provision to test for antibody response to the Covid-19 vaccine.
Patient queries about vaccination records
A service is being established to support people in England with specific queries about their COVID-19 vaccination records. This service is expected to go live in August and we will provide more information when available. In the meantime, you can find answers and support for common data queries on the NHS Digital website.
Currently there is not a central mechanism for capturing details of overseas COVID-19 vaccines, and only vaccines delivered in the UK can be accepted as evidence for UK COVID certification/ the NHS COVID Pass.
Through this website we hope to improve our services to all our patients and enable you to find the information required at the click of a mouse. You can order repeat prescriptions online, download registration forms, change your name and address, provide feedback using the Friends and Family Survey Test and much more.
Keeping You Informed
You can find out information about medical conditions and diseases through our patient information leaflets as well as keep up to date with all the latest practice news and developments.
Like many other surgeries, we stopped doing requests by phone some years ago for safety reasons as many medicines sound the same and have difficult names to pronounce which can lead to mistakes being made. There are several ways to order medication, either online, post, via several local pharmacies or by dropping the request slip into the box in the surgery reception.
Our building has suitable access for disabled patients. All the patient areas including the waiting room, the consulting rooms and the toilets, have wheelchair access. If you require one, there is a wheelchair available at reception. There are designated disabled parking spaces in the car park.
Please ensure if you use the car park and have to block other vehicles you leave your name and number plate with the Reception staff.
Out of Hours Emergency Care
If you need to out of hours emergency care then NHS Choices offers a search facility for A&E and Urgent Care Centres, so please click here for details.
Welcome to our new online consulting tools and you can contact us about a medical, administrative or prescription issue by clicking either of the logos
Answer a few short questions and we will get back to you within 2 working days.
Please do not use this online form for urgent or emergency requests. The submitted forms will only be read during office hours he forms will not be read on the weekends (Saturdays and Sundays) or on bank holidays. They will not be read Monday-Friday between the hours of 1800 - 0900. Please contact 111 during out of hours or 999 if this is an emergency.
or try using a self help version
We were inspected by CQC on 22 March 2015 and the findings can be accessed on the CQC website.
We have a number of extremely useful pages for military veterans now that we have become accredited view here
Carer Friendly Employer Award - County Durham
(Site updated 16/09/2021)