COVID-19 Primary Care bulletin

20 April 2020

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

Dear primary care colleagues,

We hope you managed to get some rest over the weekend.

As you may be aware, there have been pressures on stocks of gowns used for staff involved in aerosol-generating procedures and other high risk areas. Public Health England have now published additional advice, in line with World Health Organisation advice, on PPE alternatives staff can use in the event of shortages within existing organisations.

Below we have included some information on resources being made available to pharmacy colleagues to support public messaging, details of upcoming webinars and information about managing locally held vaccine stock in primary care.

Nikki and Ed

Community pharmacy

Marketing and communications support for pharmacies

We wanted to give you an update on our progress with our public facing work and resources to support pharmacies during the pandemic.

1. New resources for pharmacies were added to the PHE Campaign Resource Centre on 10 April and are available for download here, these include versions optimised for printing locally on site.
2. We are mailing out a package of resources to all community pharmacies via the Royal Mail which will be delivered by the end of this week. All pharmacies will receive the following posters: ‘Do not enter if you have symptoms of coronavirus’, ‘Keep a safe distance’ - reminding people to keep 2 metres apart; and ‘We may be closed to the public during certain times’ - with white space for them to add their opening hours.
3. Our public facing messaging for relevant pages on the NHS website www.nhs.uk is being updated.
4. Digital resources for pharmacies are being developed and include a digital screen, social media assets (optimised for Facebook, Twitter and Instagram) in the national look and feel used for coronavirus public facing marketing messages. These will be available this week.
5. We will also be launching a national public facing PR shortly.

General practice

Temporary removal of routine D4 medical for renewal of HGV licences

The government has announced a temporary relaxation of the requirement for bus and lorry drivers to provide a doctor’s medical report in order to renew their licence. Under the scheme, drivers will be able to receive a temporary 1-year licence, providing they do not have any medical conditions that affect their driving and their current licence expires in 2020. This will help to reduce workload for doctors whilst ensuring that drivers can still have licences renewed.

Drivers with health issues will still need to declare these, and those with health issues that prevent them from driving safely will not have their licence renewed. This temporary change will only apply to those drivers whose licences are due to expire or have expired since 1 January 2020 and not for those making their first application for a Group 2 bus or lorry licence.

Shielding patients - guidance for GPs

We know that general practice is dealing with queries from patients who require support over and above the care and treatment they are receiving for their medical condition. Included in this slide deck on the FutureNHS portal is information, provided by the Government and the NHS, to support you in answering queries from patients in both the shielded and non-shielded groups who may require additional support 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.

Additional information

Remote prescribing guidance for health and justice sites

During the COVID-19 pandemic, it is expected that some aspects of healthcare in health and justice sites may need to be delivered by remote technology, for example, using video appointments. Prescribers should be aware of the processes for prescribing responsibly remotely. Processes have been described separately for controlled drugs (CDs) and non-CDs. Providers should have written procedures underpinning how remote prescribing is undertaken.

Managing locally held vaccine stock in primary care and the use of Patient Group Directions in Primary Care Networks

Immunisation services have not been identified as activities that can be suspended within the GP contract and it is important to ensure the continued delivery of vital NHS services. 

While there are no central supply issues of vaccine stock, it may be necessary for CCGs and/or Primary Care Networks to facilitate the transfer of locally held vaccine stock from one provider to another to ensure the continued delivery of immunisation programmes. To support this, the Medicines and Healthcare Products Regulatory Agency (MHRA) has now confirmed that it would not prevent the transfer of locally held vaccine stock from the NHS routine immunisation services during COVID-19, provided that:

• the CCG, PCN or General Practice believes the transfer of vaccine(s) is necessary to support the continued delivery of routine immunisations in primary care during the COVID-19 response and will ensure the effective use of available resource;
• the CCG, PCN or General Practice that is holding the vaccine stock has assurance that the vaccine has been stored in the correct temperature-controlled conditions;
• confirmed daily record keeping of temperature monitoring is available;
• the CCG, PCN or General Practice that requires locally held vaccine supply can verify the assurances given; and
• the vaccine(s) can be transported appropriately under the right cold chain conditions.

Regional NHSEI commissioners should be informed of any incidents including cold chain breaches during transfer of vaccines. CCGs, PCNs  and Primary Care providers should refer to Public Health England’s protocol for the ordering, storing and management of vaccines.

Community Pharmacies are already able to transfer medicines to other healthcare providers without a wholesalers licence under specific circumstances, and should refer to the relevant guidance.

The NHS Specialist Pharmacy Service has made available guidance on the use of Patient Group Directions in Primary Care Networks.

Dates for your diary 

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

• 21 April, 12.30-1pm: COVID19 Digital Nurse Network
• 23 April, 4.30-5pm: using accuRx throughout COVID19 for video consultations

Regular primary care webinars

• 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

Coaching support webinars

• 24 April, 3pm: Coaching support launch webinar

Nikki and Ed's Link of the Day

Prof Mike Holmes, GP Partner Haxby Group and Practice Nurse Louise raise awareness of behaviour that can be perceived as being discriminatory