Update for Primary Care Clinical Team 26 January 2023

 Public health and NHS topics discussed at our clinical meeting today at Dr Curran and Partners in Clapham, London.

1. Infectious diseases update

After high rates of infectious diseases such as Covid-19, influenza and Streptococcus A towards the end of 2022, we are seeing signs of falls in all these infections. This should help the NHS locally and nationally. However, Covid-19 remains a threat and it is very likely we will experience periods during 2023 when Covid-19 infections are high. 

a. Covid-19 statistics

b. Hospital admission rates in England: Covid-19 and influenza

c. Weekly scarlet fever notifications in England

2. New JCVI recommendations on Covid-19 vaccine boosters

The JCVI has recommended that Covid-19 booster vaccinations should be offered in the Spring and Autumn this year for selected groups of patients at high risk. In the Spring, this is likely to be similar to the programme in 2022 (i.e. the very elderly and immunocompromised). In the Autumn, it is likely to be similar to this Autumn’s programme but further details are awaited on eligibility. It is also likely that primary Covid-19 vaccinations will be stopped for people under 50 years not in a high-risk group. We need to encourage our unvaccinated patients in this group to come forwards for vaccination before this happens.

See https://www.gov.uk/government/publications/covid-19-vaccination-programme-for-2023-jcvi-interim-advice-8-november-2022/jcvi-statement-on-the-covid-19-vaccination-programme-for-2023-8-november-2022 for further details

 3. Vaccination in pregnancy

Recent research from my department has shown a low uptake of flu vaccination in pregnant women. Rates are also low for other vaccines such as Covid-19 and Pertussis. We need to consider how we improve vaccine uptake in this group.

See https://bjgp.org/content/early/2023/01/23/BJGP.2022.0078

 4. Practice vaccination programme

We need to think how we improve vaccine uptake in our patients as Lambeth is doing particularly badly for all vaccines. It may be possible to get some academic support to improve our delivery and uptake of NHS vaccines.

5. NHS pressures

Discussion about NHS primary care pressures and how the NHS GP contract could be modified. For example, an increase in activity-based funding or changes to the NHS to implement “core” (free) and “add-on” (payable) services. This would be controversial and risk increasing health inequalities.