COVID-19 Primary Care bulletin

27 April 2020

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

Dear primary care colleagues,

Over the weekend you may have seen media coverage of the new NHS campaign - Help us to help you – with the aim to encourage the public to seek care when needed. As you may have noticed in your own area, the coronavirus pandemic has resulted in a decrease in people accessing NHS services, including primary care, for a range of conditions that are not related to coronavirus.

This appears to be impacting: adults and children attending at A&E departments for urgent and emergency medical issues, including serious conditions such as stroke and heart attacks; cancer patients attending their ongoing treatments; and expectant mothers attending for regular scans.

The new public information campaign includes digital adverts, posters and social media featuring NHS staff to encourage people to contact their GP or the 111 service if they have urgent care needs – or 999 in emergencies - and to attend hospital if they are told they should. Campaign assets are available on Public Health England's Campaign Resource Centre for NHS comms teams and partner organisations to use.

Tomorrow morning at 11am we will be holding a minute silence for the NHS staff who have died from coronavirus. Please do join in if you can.

Nikki and Ed

General practice 

Patients advised to shield

Thank you for your ongoing support to identify patients who should be advised to shield as they are at highest clinical risk from COVID-19. The updates you are providing are ensuring that the patients you identify are added to the Shielded Patient List so that they can receive shielding advice, and additional support should they need it.

Patients have been added to the Shielded Patient List in three ways:

1. Practices have been sent a list of centrally identified patients by NHS Digital and are being asked to review the notes to check the codes are correct.
2. GPs can use their discretion to add a small number of further patients who they feel are at particularly high risk and would benefit from shielding.
3. Secondary care consultants are adding additional patients who they feel need to shield. GPs should not need to remove these from the list but if there are any concerns, the patient should ask their consultant.

Practices have also been sent a list of patients who have self-registered. GPs are reviewing this list and adding patients who meet shielding criteria.

The Chief Medical Officer has now confirmed that renal dialysis patients should be advised to shield. Where they have not already done so, Renal units will get in touch with patients, send them a letter and add them to the Shielded Patient List via the regular trust submissions to NHS Digital. GPs are asked to note this update, but no further action is required at this point. 

Following the latest GP Extraction Services (GPES) last week, a small group of new patients have been identified by the national algorithm. As with others who have been identified nationally, these patients will be sent letters and text messages this week and a flag will be added to their GP records soon. Please contact these patients as you have those previously identified.

On an ongoing basis, there will be a small number of patients who need to be added to the list as they become sick. Those who have time-bound conditions (e.g. patients receiving chemotherapy) may need to be removed from the list. Clinical decisions should continue to be taken based on the criteria set by the Chief Medical Officer and following a conversation with the patient. There should no automated processes to complement or supplement individual clinical identification other than that used by NHS Digital.

Support is available from local authorities, NHS Volunteer Responders and charities for anyone who needs it, whether they are on the Shielded Patient List or not. 

RCGP e-learning resource

RCGP has produced an e-learning resource about shielding vulnerable patients from COVID-19. The module discusses the details of who needs to shield and what GPs need to do next.

Community pharmacy

Accessing medicines for detainees released during COVID-19

This recently published guide is to support probation and youth offending teams and other teams supporting people released from custody on accessing medicines and pharmacy services during the COVID-19 outbreak.

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.

Dates for your diary 

Upcoming webinars

• 28 April, 12.30-1pm: giving your patients access to online services remotely 
• 30 April, 4.30-5pm: Video Consultations: using accuRx throughout COVID-19 for EMIS and SystmOne practices
• 30 April, 5-6pm: primary care webinar with Nikki and Ed with a focus on an extended Question and Answer session 
• 7 May, 11am: homeless health webinar

Nikki and Ed's Link of the Day

PICS Statement: Increased number of reported cases of novel presentation of multi-system inflammatory disease