COVID-19 Primary Care bulletin

16 April 2020

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

Dear primary care colleagues,

Thank you to those who joined our webinar earlier this evening, we hope it was useful and that we managed to answer some of your questions. Please do join us again for next week’s webinar, details of which are included below.

Nikki and Ed

General practice

Shielding patients

Thank you for all your help in identifying and supporting the people who are at greatest clinical risk of severe illness from coronavirus. We know that we have asked a lot of you during the last few weeks and are grateful for the efforts that you have gone to in helping to protect those who at greatest risk during this time.

As you are aware, a number of people have self-identified as being at highest clinical risk and registered on the government’s website. Government have asked us to pass you the patients who did this before 29 March for review. These will be provided to you via tasks in your IT system from 17 April and completed by 24 April. We ask that you complete your reviews where possible by 28 April so the data extraction (starting every Tuesday evening) can be completed and patients offered the support they need.

Referrals to secondary care

In the current context it is important that clear, consistent processes exist to ensure safe handling of emergent, urgent and routine referrals from primary care. At present this requires agreement between partners at a local level.

NHS guidance will be published shortly advising secondary care to accept and hold clinical responsibility for GP referrals. Therefore, GPs should continue to refer patients to secondary care using the usual pathways and to base judgments around urgency of need on usual clinical thresholds (taking into consideration need for non face to face consultations, likely delays in recommencement of routine elective activity, and communicating likely delays to patients at point of referral).

GPs should continue to use specialist advice and guidance where available to inform management of patients whose care remains within primary care including those who are awaiting review in secondary care when appropriate. Colleagues should work collaboratively across primary and secondary care to ensure this advice and guidance is provided in a timely fashion to ensure safe care is delivered, taking into account the exceptional pressures which exist across the whole system.

GP retention scheme

NHS England and NHS Improvement previously lifted the restrictions on the maximum number of in-hour sessions retained GPs can conduct so they can contribute to the COVID-19 response. This relaxation on the maximum number of in-hour sessions will now be extended until further notice.

Regarding retained GPs due for their scheme annual review, CCGs will now be able to:

• agree with retained GPs, who are due for a scheme annual review before the end of September 2020, to defer their annual review until a later date
• consider granting retained GPs, who are approaching the end of the scheme (e.g. those in their final three months of the scheme), with a scheme extension until the end of September 2020.

Retained GPs are encouraged to contact their HEE local scheme leads if they require any support at any stage.

Community pharmacy

Shielded patient flag

We have already shared details with you of the new alert that has been made available to community pharmacy for the people on the Shielded Patient List. This alert is currently accessible via the SCRa (web application) but will also be accessible via SCR 1-click solutions from tomorrow, Friday 17 April. The alert states whether someone is vulnerable because they are at risk of severe illness if they catch COVID-19. The list of people for whom this alert is set is held within the NHS Spine and will be regularly updated.

Community pharmacy staff who already have access to the SCRa via 1-click will have access to these flags. Each time a patient’s record is opened, an alert will pop-up for people referenced on this list. SCR 1-click is available via the following systems: Cegedim Pharmacy Manager, PharmOutcomes and Sonar Informatics.

Access to the alert will support the identification of patients that must be supported by the Medicines Delivery service announced last Friday 10 April.

Dentistry 

The most recent guidance letter and standard operating procedure for oral health professionals was published yesterday.

Optometry

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

Additional information

Government support

The government have launched a new website for patients to use in finding out what help they can get if affected by coronavirus. This service is available to all patients who are seeking advice and guidance on the topics such as:

• feeling unsafe
• going in to work
• paying bills or being unemployed
• getting food
• having somewhere to live
• mental health and wellbeing

Covid-19 adult social care action plan

The government have published the adult social care action plan on how they will support the adult social care sector in England throughout the coronavirus outbreak.

NHS Volunteer Responders

Professionals working across primary care are encouraged to take advantage of the NHS Volunteer Responders programme to refer patients who are considered to be vulnerable and at risk.

Guidance for health professionals on how to refer is available. All NHS healthcare staff - and local government staff, who need to use their gov.uk email addresses -  can make requests via the NHS Volunteer Responders referrers’ portal or by calling 0808 196 3382. Read more about how the referrals work here.

Dates for your diary 

17 April, 12.30pm: GP connect appointment management - EMIS

Digital First webinars on practical steps that practices should take to establish a total triage model:

• 17 April, 2-3pm: remote total triage using Sense.ly
• 20 April, 11.30am-12.30pm: remote total triage using Doctorlink
• 21 April, 12.30-1pm: COVID19 Digital Nurse Network
• 23 April, 4.30-5pm: using accuRx throughout COVID19 for video consultations

22 April, 7-8pm: Community pharmacy webinar with Keith Ridge and Ed Waller

23 April, 5-6pm: Primary care webinar with Nikki Kanani and Ed Waller

Nikki and Ed's Link of the Day

Resuscitation Council Statement on PHE PPE Guidance