COVID-19 Primary Care bulletin

15 April 2020

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

Dear primary care colleagues,

We will be hosting the next general practice webinar tomorrow at 5pm, we hope you can join us via this link on MS Teams. This will be an opportunity for you to ask your questions which, between us, we will do our upmost to answer them during the session. We will be joined by Professor Mike Holmes, Vice Chair of the Royal College of General Practitioners (RCGP) and Heather Simpson, Primary Care Networks Programme Lead who will share the work they are doing on the wellbeing support offer for staff across Primary Care. During the hour’s webinar, we will also hear from Sam Sherrington, nurse and Head of Stakeholder and Cultural Transformation, and Karen Storey, Primary Care Nursing Lead who will be talking about nursing in the community and primary care.

A dedicated page has been set up on our website about how health and social care services can access personal protective equipment (PPE). This information is aimed at providing clear advice to primary care, hospices, social care, home care providers and trusts about the arrangements for ordering and receiving essential items of PPE.

We hope many of you can physically and mentally switch off this evening and enjoy the last of today’s sunshine. If you are struggling, please do remember that there is support for you. Please use the NHS Health and Wellbeing Support button at the bottom of this bulletin for information and how to access support.

Nikki and Ed

Dentistry 

The latest dental letter from Sara Hurley, Chief Dental Officer has been published today alongside the standard operating procedure.

General practice

Total triage and remote consultation

We’re grateful to everyone across general practice who has been making great progress in moving towards a total triage approach using online consultations, and also enabling video consultation to support remote management of patients. The latest data shows there has been an impressive uptake in response to COVID-19 with 84% of practices now offering video consultations (with a further 15% in the process of implementing or procuring a video solution) and 49% of practices offering online consultations (with a further 45% in the process of implementing or procuring a solution). These measures are helping to reduce avoidable footfall in practices, protect both patients and staff from the risks of infection, and enable practices to manage work more efficiently.

Practices are reminded that as per our letter of 27 March, all practices should be remotely triaging all patient contacts. To support this, all practices must have an online consultation system in place that supports total triage. While total triage can be done over the phone, this is less efficient and risks patients being unable to contact the practice if phone lines are busy. Commissioners and practices are asked to ensure all practices have an online consultation system in place by the end of April 2020 at the latest. It is also essential that all practices have a video consultation system in place to support remote management of patients. This should be in place by 17 April 2020.

Commissioners who still need to procure an online or video consolation system should contact the Commercial Procurement Hub for support. Both online consultation and video consultation systems will be centrally funded for general practice, and there is funded implementation support available to help with the roll out and effective use of these tools. Please contact your NHS England and NHS Improvement regional team or the NHSX Implementation Team to access this implementation resource.

Community pharmacy

Acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of COVID-19 (RPS2001)

In response to the public health emergency posed by COVID-19, we have established a rapid policy development process to aid clinicians in offering best care and advice to patients with or at risk of COVID-19. This document sets out the clinical policy for the acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of COVID-19. The chronic use of NSAIDs is outside of the scope of this policy with a separate review to take place. NICE has also produced a rapid evidence summary.

Next community pharmacy webinar

Details of the next webinar with Keith Ridge, Chief Pharmaceutical Officer and Ed Waller, Director for Primary Care Strategy and NHS Contracts will be held on 22 April at 7pm. Link to join can be found below in 'Dates for your diary'.

Optometry

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

Community health services

Community health services standard operating procedure – now available

The new Community Health Services Standard Operating Procedure (SOP) supports community services to respond to COVID-19. It includes a range of resources, information and guidance for teams on developing operating responses for home visits and in healthcare settings, virtual triage and assessments. It also includes information on supporting the most vulnerable including people with dementia and children and young people. The SOP should be used in conjunction with the discharge guidance and Prioritisation within Community Services guidance and will be updated on an ongoing basis.

Public campaigns

New ‘Looking out for each other’ campaign

As part of the Government’s response to managing the impact of coronavirus, this campaign is to inform those who are well and not at risk as well as the things that they can do to help support their friends and neighbours.

The Looking Out For Each Other assets explain how people can help friends, family and neighbours in isolation safely directing to gov.uk/safehelp for more information. The assets explain that if you are well, you should only leave the house for one of four reasons, including to provide care or to help a vulnerable person. They also tell you what actions you should take to help vulnerable people safely.

Additional information

NHS Volunteer Responders: open to referrals from all areas of primary care

We have published guidance for health professionals about the NHS Volunteer Responders programme and how to refer patients for support who are considered to be vulnerable and at risk.

Anyone working in primary care – GPs and their teams, dentists and their teams, primary care nurses and pharmacists and so on - can make the referral, by using their nhs.net address. You can refer people who are at very high risk from coronavirus where no local support is available, for example if they have been asked to self-isolate and ‘shield’, if they are over 70 and have underlying health conditions, or if they are self-isolating and you consider them to be especially vulnerable. You can continue to use your local schemes where they exist and please speak to your patients if in doubt about whether they require support.

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

Advanced care planning guidance

We have developed guidance and a template for advanced care planning in the context of coronavirus (COVID-19).

Dates for your diary 

General practice

Thursday 16 April 5-6pm: primary care webinar with Nikki Kanani and Ed Waller

Community pharmacy

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

Digital

Digital First Primary Care team webinars on practical steps that practices should take to establish a total triage model.

• Thursday 16 April, 4.40-5pm: COVID-19 giving your patients access to online services remotely
• Friday 17 April, 2-3pm: remote total triage using Sense.ly

These GP Connect Appointment Management webinars will look at the steps required to enable NHS111 appointment booking to support the COVID response. You can register for any of these here.

• Thursday 16 April, 2.30pm: TPP
• Friday 17 April, 12.30pm: EMIS 

Nikki and Ed's Link of the Day

Fair Health in the Time of Covid-19