Edition 3 - 10 June 2020

Dear colleagues,

Welcome to the third edition of our update which I hope you are finding useful. We will continue to share with you the latest information on COVID-19 work across community health services, hospital discharge and social care, so please do share this update with those who you think may benefit from it.

Thank you for the extraordinary steps which have taken place across all of England to care for those affected by COVID-19.  In times of adversity also comes great innovation, and that is certainly what we are seeing from you all; we are hearing many positive stories of new relationships built, new ways of working implemented and technology being introduced at pace.

To help share the learning and preserve this good practice, we are looking at ways that we can evidence the impact that has been felt on services, the workforce and patient outcomes. We are keen to hear of examples of good practice as well as exploring where things haven't worked quite so well in meeting the unprecedented challenge we have faced together. Please do tune into the regular webinars over the coming weeks where we share your experiences and I would also encourage you to join our FutureNHS collaboration platform where you can discuss key issues and share learning with peers. 

As the system begins to look at 'next steps' I ask that you also continue to implement the remarkable work being undertaken around the Discharge to Assess model, maintaining a discipline around key elements of this approach such as in use of the clinical criteria and maintenance of live hospital lists. We are working with government to determine successor arrangements for continuing this ethos and approach. 

We have continued to receive a substantial number of attendees to our regular webinars, highlighting your enthusiasm and willingness to share your experiences and maintain momentum - Thank you.

Kind regards,    

News and Updates

COVID-19 aftercare needs of inpatients recovering from COVID-19 

Guidance has been published regarding the after-care 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.

Restoring Community Health Services for children and young people

Following the letter from Sir Simon Stephens and Amanda Pritchard regarding the second phase of the NHS response to COVID-19, community health services for children and young people should now review and restore their services in line with local capacity and need. To assist with this, the 'Restoration of Community Health Services Guidance - Children and Young People' is now available (an update to the prioritisation guidance). Guidance on restoring adult services will follow shortly.

Minimising nosocomial infections in the NHS

A letter was published by NHS England and NHS Improvement on 9 June from Amanda Pritchard, Ruth May and Professor Stephen Powis. This letter helps to clarify the steps which organisations should be taking to minimise nosocomial infections, protect staff and ensure the timely reporting and management of outbreaks and staff absence in the NHS.

Coronavirus (COVID-19): provision of home care​

The Department of Health and Social Care published new guidance on 22 May for the Home Care sector in England. The guidance is in direct response to calls from the sector to provide more detail and clarity around best practice in caring for people in their own homes and in supported living settings. This guidance is in addition to existing guidance on the provision of care in care homes and is also complemented by guidance on the use of PPE in home care settings which was published at the end of April.

Pharmacy and medicines support to care homes: System-wide delivery model

A new operational model was published on 19 May to help pharmacy and medicines teams implement the NHS England and NHS Improvement Primary Care and Community Health Support for Care Homes guidance. It describes the medicines and pharmacy contribution to the work and sets out how teams should collaborate across the NHS system. It also provides practical advice and resources and a model of service to help local systems reduce the risk of harm during the COVID-19 period by ensuring that consistent medicines and pharmacy services meet the needs of care home residents and staff. It includes an implementation plan to activate the model of service at local level. The work is being led and coordinated in each area by a clinical lead appointed by each CCG and has the backing of the regional and national NHS England and NHS Improvement pharmacy and primary care teams. The model outlines that support for care homes will require collaborative, clinical and professional leadership from across all pharmacy sectors.

Joint statement on personalised approaches to care and treatment

As part of an ongoing programme of work to support colleagues across health and social care to maintain and champion personalised approaches to care and treatment, NHS England and NHS Improvement came together with a range of leading thinkers from the disabled rights movement, voluntary sector organisations, and specialist clinical directors. The current pandemic has brought into sharp focus the need for everyone, regardless of background or circumstance, to have the opportunity for their needs, wishes and preferences to be considered. This meeting was co-chaired by Baroness Jane Campbell and James Sanderson, Director of Personalised Care for the NHS, who issued this summary statement on 20 May.

CQC: Sharing insight, asking questions, encouraging collaboration: CQC publishes first insight document on COVID-19 pressures 

On 20 May, the CQC have published the first of a series of insight documents intended to highlight COVID-19 related pressures on the sectors that CQC regulates.  The document draws on information gathered through direct feedback from staff and people receiving care, their new regular data collection from services who provide care for people in their own homes, and insight from their regular conversations with providers and partners.  The information from these sources is being used to understand the wider impact of COVID-19, to share regular updates and to highlight any emerging trends and issues.  This first insight document focuses on adult social care: reviewing data on outbreaks, deaths and availability of PPE, and highlighting the impact of COVID-19 on staff wellbeing and the financial viability of adult social care services. 

Safe working for all NHS staff through COVID-19 - Impact on BAME staff in the NHS

With emerging evidence of the impact of COVID-19 on BAME communities, on 15 April, NHS England CEO Simon Stevens convened a meeting of leaders in healthcare and representative bodies such as the British Medical Association and Royal College of Nursing to agree a plan of action to support staff. All employers are recommended to risk-assess staff at potentially greater risk and make appropriate arrangements accordingly. With our support, on 30 April, NHS Employers published risk assessment guidance signposted to NHS leaders, and since updated on 28 May. A summary of the actions the NHS have taken to address the disproportionate impact of COVID-19 on NHS staff has been produced. Read more on safe working here.

Independent healthcare providers – Indicative set of provision offers

Nationally, independent care providers are working with CCGs and Trusts to support COVID-19 activity, enabling them to manage pressures in their local systems. This includes re-purposing staff and facilities to support COVID-19, providing virtual and remote care for primary care and outpatients, re-purposing patient referral centres to 111, providing home care for early discharge patients, and offering clean sites for urgent care. As we transition into the second phase, an indicative set of offers of provision has been complied which may be of interest to CCGs and Trusts, and we would suggest that you consider this when planning in respect to discharging COVID-19 patients and options to restart non-COVID-19 urgent services and non-urgent elective care. The offers can be found on the IHPN website, the representative body for independent sector healthcare providers.

Verification of death in a period of emergency

This guidance is designed to clarify existing practice for the verification of death outside of hospitals and to provide a framework for safe verification of death in this coronavirus emergency period. It is to be applied in all cases outside hospital when verification of death may be completed by people who have been trained to do so in line with their employer's policies.

Minimum bridging competencies for General Practice nurses transitioning to Community Nursing

The Queen’s Nursing Institute has published a new document, Minimum Bridging Competencies for General Practice Nurses Transitioning to Community Nursing. The Competencies will support nurses who are taking up new roles at short notice during the COVID-19 pandemic. The development of the new document has been funded by NHS England and NHS Improvement.

NHS expands offer of help to people with diabetes during the coronavirus outbreak

People living with diabetes face a significantly higher risk of dying with COVID-19 with a third of deaths in England associated with the condition, according to new NHS research. The health service in England has called on people with diabetes to access help available to them, including a new dedicated helpline and online tools to help manage the condition during the outbreak. Due to be published this week, the world-leading studies reveal that people living with type 1 diabetes are at three and a half times the risk, and people living with type 2 are at double the risk of dying in hospital with the virus, compared to people without diabetes. 

NHS Volunteer Responders ready to help health and care frontline staff

Health and care staff working in frontline services can now get help with essential tasks such as shopping and collecting prescriptions from NHS Volunteer Responders. Access to this service will help staff working at the forefront of the COVID-19 pandemic so that they can continue to support those most in need at this time. Anyone working in frontline services can ask for help from NHS Volunteer Responders by calling 0808 196 3646. This includes people working in hospital or community settings, including residential settings and domiciliary care. When requesting support, staff will need to provide an email address, which should ideally be their work email address.  It’s quick and easy to request support. Call 0808 196 3646 (8am to 8pm) to be put in touch with a volunteer nearby.

COVID-19 Stories From The System

Caring for people most vulnerable to COVID-19 in Thanet, NHS Kent and Medway

Health and Care services in Thanet, East Kent have extended their Acute Reponse Team (ART) service to help care homes and those caring for patients in their own homes to better cope with extra demands. They have extended the ART hours and adapted the shift pattern for GPs. The team provides face-to-face assessments and responds to patients’ needs. They are in touch daily with care homes and provide overall guidance on all aspects of medical care including isolation. 

Derbyshire takes action to protect BAME staff 

Against the backdrop of COVID-19 disproportionately impacting Black, Asian and minority ethnic (BAME) people, Derbyshire Community Health Services NHS Foundation Trust needed to take urgent action to protect its BAME staff who represent 4.7% of its workforce. Find out more about the challenges faced and what Derbyshire put in place to help protect and support staff.

Workforce Resources and Useful Links

Supporting local systems in developing COVID-19 care home support plans

The Better Care Support Team (BCST) has hosted the COVID-19 Care Home Support webinars in support of the Government’s care home support plans. Local Authorities were asked to submit plans by 29 May using data provided by care providers in the capacity tracker and through wider engagement with care homes in their area. Over 900 people registered for the webinars, which clarified what is being asked of local systems to enable Government to build a national picture of support to care homes in responding to the coronavirus outbreak. The slides, event recordings and an FAQ document are available on the Better Care Exchange where you can also find further COVID-19 discharge and social care related content, alongside registration details for webinars and virtual clinics. Register for access by emailing us.