COVID-19 Primary Care bulletin

9 June 2020

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

Dear colleagues,

On Friday 5 June, Health and Social Care Secretary Matt Hancock announced that from 15 June 2020 all staff in hospitals should wear face masks and all visitors and outpatients should wear face coverings. We are clarifying what changes would be appropriate for staff and patients in primary care settings. We will share further information shortly. In the meantime please continue to follow the Public Health guidance on the use of personal protective equipment (PPE).

We have received a number of inquires for GPs about what it means for patient who  decide not to proceed with medical hospital procedures during COVID-19 and whether they would be discharged back to general practice. We published Referral to treatment (RTT) measurement and COVID-19 on 24 March providing advice that: ‘If a patient cancels, rearranges or postpones their appointment, this has no effect on the RTT clock, which should continue to tick. Patients should not be discharged back to their GP simply because they have cancelled or rearranged appointments; this should always be a clinical decision, based on the individual patient’s best clinical interest.’

Today marks What Matters To You Day, an opportunity to encourage colleagues to ask this question so people get care and support that’s right for them. Whilst some activities have been scaled down this year, this question is as important now as ever before, and our Personalised Care team are inviting you and your colleagues to share your examples of putting What Matters To You into action, using the hashtags #WMTY20 and #PersonalisedCare on Twitter, or follow @Pers_Care to see what others are sharing.

Nikki and Ed

Dentistry

Resources for dental practices

As dental practices begin to open to see patients, we have produced a poster for practices to use in their entrances. These will soon be available to download on Public Health England’s Campaign Resource Centre.

General Practice

GP Standard Operating Procedure updated: Staff risk assessments

Following feedback from GP practice colleagues and representatives, we have revised the current GP SOP v3 section about staff at increased risk from COVID-19 and risk assessments as follows:

• The government has issued guidance on shielding for people defined on medical grounds as extremely clinically vulnerable from COVID-19. Staff who fall into these categories should not see patients face to face; this takes precedence over any other risk assessments.
• All other staff including BAME staff and people identified as clinically vulnerable who are asked to apply stringent social distancing should be risk assessed to consider if they should see patients face to face. The Faculty of Occupational Medicine has published the Risk Reduction Framework for NHS staff (including BAME staff) who are at risk of COVID-19 infection. NHS Employers has also published guidance on risk assessments for staff.  Staff may be referred to an occupational health professional for further advice and support (contact your commissioner for details of your local occupational health service if not known). 

This has been updated in the published GP SOP which can be found on our website.

Guidance for general practice ordering personal protective equipment

All GP practices can register on the new online personal protective equipment (PPE) portal for ordering emergency PPE from a central inventory. This is to supplement (not replace) the wholesale supply route that already operates.

The Department of Health and Social Care (DHSC) developed the portal in partnership with eBay UK, NHS Supply Chain, the Army, Clipper and Royal Mail. Throughout May and June 2020, DHSC has been emailing GP practices, inviting them to register with the PPE portal. The emails should be coming from PPE Dedicated Supply Channel - ppe.dedicated.supply.channel@notifications.service.gov.uk. Please ensure that you are regularly checking your email accounts registered with the CQC/MHRA in order to ensure that the invite is received and actioned.

Current order limits mean GP practices can order one combined pack, containing 50 IIR masks, 200 aprons and 400 gloves (200 pairs), per week or up to this amount of separate items. These limits may change over time.  Orders through the portal should arrive within 48 hours if placed before 1pm. Orders placed after 1pm will be subject to an additional 24-hours.

If providers have any queries, please contact our customer services on 0800 876 6802.

Collecting your examples of innovation

COVID-19 has changed healthcare delivery in England. New and innovative ways of working have been rapidly developed across the NHS. As we move into the next phase of our response to COVID-19, we want to ensure the beneficial changes are captured and, where possible and appropriate, sustained as the NHS continues to evolve in the coming months and years. We hope to be able to take promising examples of innovation and test them further, to fully understand the benefits. Further information on this piece of work, and a short webform to submit your examples by Thursday 25 June, is at ipsos.uk/COVIDinnovation. Please contact england.capturinginnovation@nhs.net if you have any questions not addressed by the information on the link. We look forward to receiving your examples.

Clinical negligence indemnity arrangements during the COVID-19 pandemic

NHS Resolution has published guidance in relation to its indemnity schemes and claims management during the COVID-19 pandemic. General practice specific guidance aims to clarify how the management of claims interactions between general practice indemnity beneficiaries and NHS Resolution will proceed during the pandemic.  It also provides answers the most common questions regarding Clinical Negligence Scheme for General Practice (CNSGP) indemnity cover under COVID-19 working arrangements.

Cervical screening update

To support GP practices to respond to the impact of the COVID-19 pandemic, the intervals at which invitation and reminder letters are issued for the NHS Cervical Screening Programme were extended. As a result, invitations have been issued 12 weeks (rather than the usual 4 weeks) after Prior Notification Lists were sent to GP practices and reminder letters have been sent 30 weeks after the initial invite, rather than the usual 18 weeks.  Intervals for invitation and reminder letters have now begun to return to normal.  Therefore, you should expect to start receiving more requests for appointments and should ensure that appointments are offered to women who are eligible and due to be screened. If practices need any advice, please talk to your NHS England and NHS Improvement regional public health team. Further guidance is available on FutureNHS. 

Community pharmacy

Specialist Pharmacy Service’s monthly webinars

The Specialist Pharmacy Service’s (SPS) Medicines Use and Safety Team host regular webinars at 1pm for an hour. 

Pre-registration for each event is required. Future webinars include:       

• Wednesday 10 June - Helping people to manage end-of-life medications at home
• Wednesday 17 June - Resources to support pharmacy teams working in care homes
• Thursday 25 June - Remote Consultations in Care Homes

SPS also run a Care Home Resource Hub to support pharmacy teams working into care homes in response to increased pressure from the COVID-19 pandemic.

Community health services

COVID-19 aftercare guidance

Guidance has been published about the aftercare needs of inpatients recovering from COVID-19. The document is designed to support local primary care and community health services as they work with partners to develop recovery/rehabilitation services for patients after they have been discharged following an acute episode of COVID-19.

Optometry

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

Additional information

Homeless Health in London

Across London, the NHS, local authorities and voluntary sector organisations have come together to house, protect and support the health of homeless people with and at risk of COVID-19. A written case study on this work, led by the Healthy London Partnership (HLP). A podcast covering the how-to of the work and the outcome so far, with insight from London’s Homeless Health Operations Director and HLP Prevention Director, Jemma Gilbert. The HLP has a full set of resources available to support organisations in their response to homeless health in COVID-19.

NHS Health at Home campaign – new messaging and assets

The NHS Health at Home campaign signposts the public to the information they need to access NHS services online from home. The second phase of this campaign has been updated to align with new government guidance and complements the NHS ‘Help Us Help You’ campaign by signposting to online provisions of NHS services. As well as general assets for those with health concerns, ordering repeat prescriptions and video consolations, specific assets are now available for some long-term illnesses/vulnerable groups such as those with diabetes or asthma and pregnant people and new parents.

Resources including a toolkit, social media assets (including graphics and animations) email signatures and website graphics are available on the Public Health England Campaign Resource Centre. Please share this information with your networks and stakeholders.

Dates for your diary 

Wednesday 10 June, 1-2pm - Digital Nurse Network webinar focus on Carer's week

Join the Digital Nurse Network's weekly Wednesday webinar from 1-2pm. Nurses Helen Crowther and Ann Gregory will be focusing on the role of nurses in supporting care homes during COVID-19. Discussion will include weekly care home virtual check-ins and proxy access. Book your place now.

Wednesday 10 June, 5-6pm - Digital Primary Care webinar focus on care homes 

Dr Matt Hoghton and Alison Taylor will be discussing the role of GPs in delivering virtual check-ins and proxy access, drawing upon his personal experiences as a GP. Find our more and ask your questions by joining them. Book your place now.

Thursday 11 June, 4.30pm - Webinar on supporting Digitally Excluded Communities: how to support patients with getting online

Join NHSX for a 30 minute webinar on how we can better support patients to get online. This webinar is part of our series to support Digitally Excluded Communities. Aimed primarily at GP practice staff the webinar explores how general practice can make the most of their digital services during the COVID-19 pandemic to protect your staff and patients. The webinar consists of a 10 minute presentation with 20 minutes Q&A panel. Digital nurse champion Ann Gregory will be sharing the digital transformation work she has been doing at her GP practice which cares for patients from one of the most deprived areas of the UK. Find out more and register.

Nikki and Ed's link of the day

How older people can have a successful video GP appointment