COVID-19 Primary Care bulletin

18 May 2020

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

Dear colleagues,

Thank you all for providing invaluable support to care homes, as you continue to embed the three clinical elements:

• timely access to clinical advice for care home staff and residents;
• proactive support for people living in care homes; and
• care home residents with suspected or confirmed COVID-19 are supported through remote monitoring – and face to face assessment where clinically appropriate – by a multidisciplinary team.

The Government have also published an updated COVID-19: care home support package which builds on the Adult Social Care Action Plan.

This package sets out the steps that will be taken to keep people in care homes safe, and the support that will be brought together across national and local government to help care providers put this into practice. Our next regular GP webinar on Thursday will also be focused on support to care homes, so please do submit your questions about this in advance.

As we restore critical services we would like to remind practices of the importance of proactive health checks for people with a learning disability particularly during this critical time. On average men with learning disabilities die 23 years earlier than men without a learning disability and for women it’s 27 years earlier. Practices are reminded that the DES has not been suspended and that they should continue to offer this proactive service to their patients.

Healthcare Professionals should discuss with the patient (if considered to have mental capacity), their carer or their advocate the most suitable and safe way to conduct a health check. Where this can be delivered safely on a face to face basis this should continue. Where this care cannot be delivered safely face to face or where the patient has other medical conditions which require them to shield or socially isolate the review could be conducted remotely, with as much of the physical review completed as is practicable in these circumstances. Practices should use their clinical judgement and knowledge of the patient, together with the advice of family or other carers, in determining whether they would be able to participate in a remote review. Reasonable adjustments should be made to accommodate the needs of patients and carers as well as considering the capacity and capability of the GP practice whilst working in different ways. We will continue to work with a range of stakeholders to help provide further best practice advice.

We have produced a letter detailing which groups are eligible for the flu vaccination this autumn, setting out actions that can be taken now to prepare for this autumn’s vaccination campaign.It is more important than ever that we have effective plans in place for the 2020/21 flu season to protect those at risk, prevent ill-health and minimise further impact on the NHS and social care

An operating framework for urgent and planned services in hospital settings during COVID-19 has been published. Whilst this guidance is intentionally focused on hospital settings, including acute, community and mental health, many of the principles will be relevant to other healthcare settings and connecting services, including ambulance, primary and community care.

The NHS Confederation has produced a short briefing on the benefits and challenges of PCNs, to assist practices in making an informed decision. They will also be hosting a webinar on 27 May for further discussion.  

Nikki and Ed

General practice

Referring patients for COVID-19 tests 
Any patients requiring information about testing can be directed to the government website: https://www.gov.uk/apply-coronavirus-test. Patients who do not have access to or cannot use the internet can call a dedicated phone line, which can be used to order a test if no other options are available. The Coronavirus Testing Call Centre can be contacted on 0300 303 2713 between the hours of 07.00 and 23.00.  Around 98% of all Coronavirus test results are sent automatically to the individual within four days but for any that aren’t, the Call Centre can help individuals to follow up on their results. Patients should not be directed to request tests via NHS 111, as the service is not able to do this for them.

Community pharmacy

New registrations for NHS CPCS
Since  23 March 2020, pharmacies that newly registered for the NHS CPCS service via the NHS BSA portal were not being made live for the service on DOS. The registration was acknowledged but the work involved in testing the referral and processing the registration had been de-prioritised. From 1 June 2020 work to process registrations will resume and once a pharmacy registration has been processed this will be communicated.

Dentistry

First workshop held to plan the resumption of high street dental care
On the 14 of May, NHS England, the Department of Health and Social Care and the Chief Dental officer for England invited representatives of the profession, dental industry and regulators to the first of a series of workshops to plan the development of a road-map for the reopening of high street dental practices. Initial considerations focused on a graduated risk based approach to ensure appropriate and safe care for patients and the profession.

Optometry

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

Additional information

Key worker guidance and family support package
We recognise that in this current pandemic, our key worker parents and carers may be facing the additional pressure of having difficult conversations with their children and families on their role as a key worker, and how this may impact on the safety and dynamics of their family. In collaboration with clinicians at the Tavistock and Portman NHS Foundation Trust, NHS England and NHS Improvement have published some written and audio guidance for key workers that will support them in having those difficult conversations, including considering when is the best time to talk to your children about your role, and how to explain why you are still working when other parents might be at home. To listen to the podcast and read the supporting information, please visit: https://people.nhs.uk/uncategorized/communicating-with-children-about-covid-19/

Mental health support apps for NHS staff
In recognition of Mental Health Awareness Week this week, we would like to encourage all NHS staff to access the mental health and wellbeing support offers available to them.  More than 108,000 downloads of the free mental health self help apps have been made so far, showing just how important this type of support is to our NHS staff.  You can also access our free staff support line and the confidential bereavement line.  Please visit the following page for more information or to download the apps: https://people.nhs.uk/help/ 

Bereavement support for #OurNHSPeople
Recognising that it is an incredibly tough time for many of us at the moment, NHS England and NHS Improvement have put together a suite of bereavement resources that aim to help NHS staff access support during what will be a difficult time, given the restrictions and changes to normal grieving patterns and processes for staff who come from diverse backgrounds. You can find a selection of resources that will support you during a bereavement, be that practical next steps to take as a line manager or confidential bereavement support staffed by a team of specialists.  You can access the bereavement support online or call the confidential bereavement support line, operated by Hospice UK, on 0300 303 4434, free to access from 8am – 8pm, seven days a week.

Dates for your diary 

Tuesday 19 May, 5-6pm - Remote Working across primary care. Looking at remote working from different perspectives - GP, sessional GP, Nursing, CCG and more. Presenters include Dr Paul Atkinson, Helen Crowther RN, Dr Damian Williams 

Wednesday 20 May, 7-8pm - Community pharmacy webinar with Keith Ridge and Ed Waller

Thursday 21 May, 5-6pm - GP Webinar with Nikki and Ed focusing on care homes (submit your questions in advance)

Tuesday 26 May, 5-6pm - Update on Direct Booking into General Practice from NHS 111 & CCAS via GP connect. Presenters include Dr Phil Koczan, GP and Digital Clinical Champion and Michelle McDermott, GP Connect Lead

Nikki and Ed's link of the day

Coronavirus – supporting children’s mental health. Resources toolkit from Mentally Healthy Schools.