COVID-19 Primary Care bulletin

2 June 2020

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

Dear colleagues,

You will have seen that on 31 May 2020, the Government has updated its guidance for people who are clinically extremely vulnerable to COVID-19 and have been advised to shield. The update from Government comes into effect from 1 June 2020. In summary the changes are:

• The advice for people identified as clinically extremely vulnerable is that they should continue to shield until at least the 30 June but from 1 June, they can spend a short period of time outdoors each day with members of their household, still maintaining 2 metre distance from others.
• If the shielded person lives alone, the Government is advising they can meet one other person from a different household, maintaining strict social distancing. The advice is that this be the same person each time.
• Important aspects of Government’s policy and guidance remain the same. Apart from going outside once per day, a shielded person should continue to avoid all non-essential face to face contact. This means they should still not go shopping or to pharmacies.
• The support for shielded people remains in place and unchanged.

The Government has also confirmed that it will be reviewing shielding guidance alongside wider changes to social distancing, including plans to write to those on the shielding patients list with information about next steps on shielding after the next review on 15 June 2020. 

Nikki and Ed

Dentistry

Legionella and Pseudomonas risks

There is the risk of legionella and pseudomonas proliferation in little used water systems, that can lead to disease transmission through aerosol from taps and showers.

This is particularly likely where rooms or buildings have remained dormant. This is especially the case when ambient temperatures are above 20 degrees, as has been the case in the United Kingdom over recent months.

Please make yourself aware of Health and Safety Executive guidance on this issue and Department of Health and Social Care's HTM 04-01 Safe Water Management in Healthcare Premises – Part B Operational Management guidance. These links provide information on your duties and how to manage legionella and pseudomonas proliferation through: temperature controls; flushing outlets; and chlorination of systems.

Please pay particular attention to how to bring little used outlets back into use without causing harm to yourself or others. 

General Practice

GP Standard Operating Procedure published

The latest GP Standard Operating Procedure was published last week. If you haven’t already, we recommend that you take some time to read through the document which includes important updates and information.

Principles of safe video consulting in general practice during COVID-19

New guidance aimed at NHS general practice staff who are consulting via video with patients at home has been published. Supported by the Royal College of General Practitioners and other key stakeholders as part of the guideline development group, it includes the key principles for safely assessing patients using a video consultation. The guidance is split into two sections; the first section covers general information for staff such as information governance, medico-legal and consent. Section two outlines guidance for remote examinations including intimate examination and a practical step-by-step guide to starting a remote video consultation.  

Personal Protective Equipment (PPE) portal access

Throughout May and June 2020, Department of Health and Social Care has been inviting GPs and small social care providers (both residential and domiciliary) to register and order with the PPE portal, in order to help meet their emergency PPE needs, supplementing the default wholesale supply route.

Please ensure that all providers of these types regularly check their email accounts registered with the Care Quality Commission (CQC) / Medicines and Healthcare products Regulatory Agency (MHRA) in order to ensure that the email invitation is received and actioned.

Community pharmacy

COVID-19 - Uplift to pharmacy contractors’ payment on 1 June 2020

To mitigate cash flow issues due to COVID-19, in April and May pharmacy contractors received an uplift to their advance payment totalling £300 million. On 28 May a further uplift to their advance payment totalling £50 million was announced. This will be made on 1 June 2020. Further information is available on the NHS Business Services Authority website.

Flexible access to essential digital tools for community pharmacy teams

Community pharmacists and pharmacy technicians will be able to access the core national digital tools including the Shielded Patient Flag (SPF), Summary Care Record (SCR), the Electronic Prescription Service (EPS) and the Patient Demographic Service (PDS) from any community pharmacy in England by Friday 5 June 2020.

Temporary smartcard positions have been created by NHS Digital that will provide additional flexibility to approximately 19,000 pharmacists and over 3,500 pharmacy technicians for an initial 12 months during the COVID-19 pandemic. The new position has already been granted to existing locum pharmacists and pharmacy technicians to ensure consistent access to SCR from wherever they are working. This work is being done centrally, with no action required by individuals.

Summary Care Record (SCR) additional information and COVID-19 codes

Under new COVID-19 policy arrangements, over 21 million patient SCRs have so far been enriched to include additional information. This does not include patients who have previously informed the NHS that they do not want an SCR or additional information to be shared.  There will also be a temporary change to include COVID-19 specific codes on SCRs. Users of the SCR application and SCR 1-click will be made aware of specific, suspected and confirmed COVID-19 information by a message box displayed within the SCR.

Working in care homes during Covid19: new training resource

The Royal Pharmaceutical Society (RPS) has today published a training resource to support pharmacists and pharmacy technicians newly deployed to care home settings during the COVID-19 pandemic to deliver safe and effective patient care with confidence. This practical guide has been developed to enable pharmacy professionals provide a baseline level of patient care covering four key areas of practice: clinical reviews, medicines supply, structured medication reviews, and medicines information.

The COVID-19 care homes training resource provides step-by-step instructions for upskilling. It includes a self-assessment knowledge and capability guide, targeted learning using a range of resources and worked case studies which show how to apply your knowledge in practice. It also provides tools for reflection, peer support and feedback.

Access to RPS COVID-19 learning resources is free during the pandemic for the entire pharmacy profession, through registering on www.rpharms.com or using RPS membership details.

Optometry

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

Additional information

Dispensing Doctors – payments related to COVID 19

Processes are now in place to ensure that Dispensing Doctors receive payments for the following:

1. The mandatory element of the Pandemic Delivery Service
2. The actual delivery of medicines
3. The £300 towards the cost of screens

Element one will be paid automatically. The period 9 April - 31 May will be paid along with June 2020 dispensing payments. Thereafter payment will be made on a monthly basis for as long as the service is commissioned.

A claim form will need to be submitted for element two. Claims for the period 9 April – 31 May can be submitted along with the FP34D at the end of June 2020.

Subsequently claims should be made at the end of the month for which they relate. Claims should only submitted for eligible patients.

Element three will be paid automatically as a one-off payment. The payment will be along with June 2020 dispensing payments.

The NHS is here for you and your family - new primary care communications materials

We have added further communications materials to the Campaign Resource Centre to support the public message that the NHS is here for people and their families. Please do use these materials through your web and social media channels.

Dates for your diary 

Wednesday 3 June 2020, 12.30-1.30pm: NHSX CNIO Natasha Philips, and NHSX Digital Nurse Network's Ann Gregpory and Helen Crowther are presenting at the Best in Practice webinar on Digital Nursing. Clinical Nurse Advisors and Leaders of the Digital Nurse Network, Ann Gregory RN and Helen Crowther RN joined by Dr Natasha Phillips RN, CNIO at NHSX. This session will look at key aspects of digital nursing, during covid and beyond. Nurses across the country are driving transformational change and adapting rapidly to new ways of working. Join in a discussion on how we deliver care, engage with patients and connect with other services during the crisis and what we hope to continue after.

Thursday 4 June, 12-1.30pm: Achieving diversity in the digital response during and beyond COVID-19. Presenters include Kevin Holton Head of Experience of Care and Equalities and Health Inequalities (NHS England and NHS Improvement), Ijeoma Azodo, Associate Director Clinical Health Service Design (NES Digital Service Scotland) and Emma Stone, Director of Design, Research and Communications (Good Things Foundation).

Thursday 4 June, 5-6pm - GP Webinar with Nikki Kanani and Ed Waller