COVID-19 Primary Care bulletin

15 May 2020

COVID-19: today's round-up for primary care

Dear colleagues,

Thank you to everyone who joined our regular webinar yesterday, please do continue to send in your questions, examples of good practice and comments so we can look to respond to these in future webinars on an on-going basis.

The majority of areas now have a clinical lead for their care homes. However, we know there are still some questions about this, and we wanted to specifically clarify the role of the clinical lead. The clinical lead is not medically responsible and accountable for the care of individual care home residents. Medical responsibility and accountability for the care of individual care home residents remains with their registered GP – and there may be residents with different registered GPs within a care home. We do not expect residents to be re-registered.

A reimbursement mechanism for general practice will be established to help practices meet the additional costs of COVID-19 related activity which cannot be met from existing practice resources. Reimbursement will be managed through clinical commissioning groups (CCGs), on the basis of national guidance.

There are other ways the NHS and government are also supporting care homes, so it truly is a system response. This includes NHS testing of all patients prior to discharge to care homes; CCG directors of nursing assisting local authorities with training in infection prevention and control; improvements in care support including remote monitoring, virtual wards, medicines use and end of life care; NHSmail accounts for care homes and free connection to broadband and support for care homes with indemnity and PPE.

If you still have questions about how to offer care to your residents, please do get in touch with your CCG or local NHSE team. We want to support you in delivering care to this population.

Nikki and Ed

General practice

Clarification – NHS 111 referring into general practice

Earlier this week we wrote to advise that when practices receive a referral from 111 services, including the COVID-19 Clinical Assessment Service (CCAS), that they should assume clinical responsibility for the patient. We would like to clarify that by this we mean that practices should take ownership of the patient and onward decisions about the care they require, to ensure they are not passed back to 111 services. This does not mean that GPs will be liable for the assessment and decisions made by 111 services before the patient is referred to general practice.

Community pharmacy

Resumption of Market Entry activity

NHS England and NHS Improvement and Primary Care Support England suspended market entry applications from 25 March 2020 to allow staff who work on these tasks to be redeployed to functions which have higher priority during the current Covid-19 pandemic. As part of its overall recovery plan to restore services paused during the lockdown, staff are now being returned to their Market Entry roles and resuming work to process applications.

As of 1 June 2020 it is expected that the full Market Entry function will be restored. However, it is likely that some applications may still take longer than the regulatory timescales to process as Market Entry teams work through the backlog of applications.

Coronavirus outbreak indemnity

The updated FAQs published by NHS Resolution on coronavirus outbreak indemnity include information which is relevant to community pharmacists, including those returning to the profession to help with the response to the coronavirus pandemic. Please refer to question 11 in the FAQs for full details on how indemnity insurance and cover may be applied.

Dentistry

The most recent guidance letter and standard operating procedure for oral health professionals is available on our website.

Optometry

The most recent guidance letter for optical staff is available on our website.

Community Care

Supporting compassionate visiting arrangements for those receiving care at the end of life

Guidance focused on supporting compassionate visiting arrangements for those receiving care at the end of life was published this week. It provides advice on how visiting at the end of life can be facilitated across a range of settings including healthcare inpatient settings (including mental health and learning disability), care homes, hospices and at home. Please note that this guidance does not specify the length of visit that can be allowed as this depends on the individual circumstances and should be determined on local, case by case basis. Please direct any queries to england.covid-eolc@nhs.net.

Additional information

Access to British Sign Language (BSL) interpreters

BSL Health Access delivers immediate, on demand access to British Sign Language (BSL) interpreters for communication with Deaf people in all health settings, including pharmacy, opticians, general practice and dentists, free of charge during the current coronavirus situation. Access to BSL interpreters will take place through two methods: Video Relay Services (VRS) – when a BSL interpreter relays information over a telephone call between a BSL user and the hearing person receiving or making the call; and Video Remote Interpreting (VRI) - where a remote interpreter is used to facilitate communication with a Deaf and hearing person in the same location.

Helping NHS staff get the essentials they need

NHSX have been working with retailers to introduce and scale-up initiatives aimed at health and social care staff so they have access to essential supplies, such as food and medicines. The offers include Morrisons who are providing free-delivery on its foodbox service for NHS staff - these grocery boxes contain a selection of everyday food and essential household items and each box contains enough to feed two adults for a week, and Iceland who have introduced priority access to dedicated shopping slots and deliveries for social care and NHS staff. More information on staff offers is available on the NHS England and NHS Improvement web page.

Health and wellbeing survey
We would like to understand the current wellbeing of the primary care workforce, and invite you to take part in a survey undertaken by the Institute for Employment Studies to support this. The survey will take no longer that five minutes to complete and will contribute to our ongoing response to support your wellbeing.

Dates for your diary 

• Tuesday 19 May, 5-6pm - Remote working across primary care. Looking at remote working from different perspectives - GP, sessional GP, Nursing, CCG and more. Presenters include Dr Paul Atkinson, Helen Crowther RN, Dr Damian Williams 
• Wednesday 20 May, 7-8pm - Community pharmacy webinar with Keith Ridge and Ed Waller
• Thursday 21 May, 5-6pm - GP Webinar with Nikki and Ed (submit your questions in advance)
• Tuesday 26 May, 5-6pm - Update on Direct Booking into General Practice from NHS 111 & CCAS via GP connect. Presenters include Dr Phil Koczan, GP and Digital Clinical Champion and Michelle McDermott, GP Connect Lead

Nikki and Ed's link of the day

Accessible communication – advice for healthcare professionals