Classification: Official
Publication reference: PR00048

To:
ICB Chief Executives
ICB Medical Directors
Regional Directors
Regional Medical Directors
Regional Chief Nurses
Regional Directors of Commissioning
Regional Heads of Primary Care

Dear Colleague,

Following the UKHSA guidance sent out on Friday 2nd December on invasive Group A Strep, we write to you to offer further guidance on next steps.

There has been an increase in the numbers of children presenting with concerns about Group A Strep, although absolute numbers of invasive Group A Strep remain low.

This increased demand is placing pressures across 111, primary care and emergency services. Please therefore consider steps to boost in-person assessment capacity including:

• acute respiratory infection hubs (where they exist or setting these up where they do not)
• across primary care
• enhanced access hubs
• local out-of-hours services
• urgent treatment centres

As outlined in the letter to the service published 18 October 2022, systems were asked to actively consider establishing combined adult and paediatric acute respiratory infection (ARI) hubs. These aim to support the response to the current situation including creating additional capacity for paediatrics appointments. NHS England will be speaking to regional directors of commissioning imminently to
discuss ARI hubs and funding available.

Further guidance for clinicians in primary care and NHS111 services will be circulated shortly.

Yours sincerely,

Dr Amanda Doyle OBE, MRCGP
National Director Primary Care and Community Services
NHS England

Dr Kiren Collison
GP and Interim Medical Director for Primary Care
NHS England