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COVID-19 UPDATE BRIEFING DDLMC – 11.06.2020

A short update today as there are a few pressing issues that we thought we should share with you before the planned update tomorrow.

** STOP PRESS **

Press Statement Following agreement from the Primary Care Leadership Group the following statement has been sent to local press (Full Statement - Attachment A):

“From today all patients attending GP surgeries across Derbyshire will be asked to wear face coverings. From next week (15 June), it will be compulsory to wear face coverings on public transport and in hospitals in England. To protect patients and NHS staff, Derbyshire GP practices are to follow suit by urging patients to provide, and wear their own face coverings in surgeries, as well as continuing to follow hand-washing and social distancing guidelines. As per government guidance, exemptions apply to very young children, disabled patients and those with breathing difficulties.

We know many of you have already contacted patients by Text Message. If you have not and wish to do so, suggested wording of these messages is ‘In light of recent government guidance, all patients will be required to wear their own face-covering when attending an appointment at the surgery. Thank you for your continued support’

Further information will be shared via our social media channels Facebook  and Twitter

NATIONAL UPDATES

Face Masks. It has been widely reported that the wearing of face masks will become mandatory in GP premises from Monday 15th June. However, the actual letter states: “As announced by the Secretary of State for Health and Social Care, from the 15 June, the recommendation will be that all staff in hospital wear a surgical face mask when not in PPE or in a part of the facility that is COVID-secure in line with the workplace definition set by the government. The guidance will also apply to other NHS healthcare settings, including primary care, and will be published this week by Public Health England. We therefore ask that you make the necessary changes to implement that advice and help reduce any further risks of transmission, by 15 June at the latest.”

Which in contrast to the reports is not mandatory, it is guidance and I fail to see how you can make the necessary changes to implement advice which hasn’t been published yet. In the absence of a reliable supplier of crystal balls, the PCN CD video conference meeting tomorrow lunchtime is going to decide on a Derbyshire wide policy, and we will publish that tomorrow. I appreciate the very short timescales, but I reiterate that this is guidance, not mandatory and you will all have extant procedures in place as a result of your risk assessments. In addition, the press release about face masks for patients will hopefully ensure a reduced risk to practice staff if everyone coming into the practice heeds this advice.

The WHO have also produced some very useful and practical guidance on the use of face masks and surgical face masks.

LOCAL UPDATES

Joined Up Careers Derbyshire. We have been notified that there a small number of clinicians who have not been redeployed and may be available to be employed within general practice within the following specialism: Registered General Nurse, Physiotherapist, Osteopath, Mental Health Nurse, Pharmacy Technician, Learning Disability Nurse, Health Visitor, Primary Care Nurse

If you are interested, please contact Susan Spray Programme Lead immediately (the deadline was yesterday!)

e: susan.spray@nhs.net | t: 07880885306 | w: joinedupcareers.co.uk.

Shared care Pathology Pathways. We’ve been asked to share an update for all pathology requesters:

“We've updated some of the Shared Care Pathology guidelines: Neutropenia, Thrombocytopenia, B12/folate, Diagnosis of DM in under 16s​.

No big changes, but as always, please get in touch with any one of us below if you have any questions or queries”

Penny Blackwell ( penelopeblackwell@nhs.net ) GP Lead for Shared Care Pathology

Helen Seddon ( helen.seddon1@nhs.net ) Lead Clinical Scientist for Shared Care Pathology

Julia Forsyth ( Julia.Forsyth1@nhs.net ) Consultant Clinical Scientist Chesterfield and Derby and Associate Clinical Director for Pathology

Supply of non VKA Anticoagulants. Meds Management have asked us to share the updated guidance .

OTHER UPDATES

Tetanus-Prone Wounds. As the incidence of tetanus-prone wounds is increasing, DCHS have asked us to share the guidance (Attachment B) they have circulated to their staff as practices may find if helpful.

Online Access to Records. We have received a number of queries about granting online access to retrospective records which was a contractual obligation from 1st April 2020, subject to redaction availability. This guidance has not yet been published due to COVID and we have therefore sought clarification from GPC who responded:

“So for this COVID period the following applies:

We recognise that practices are unlikely to have capacity to grant access to patients’ full historic records during the outbreak – and wanted to clarify that there are already provisions under the Regulations for practices to delay providing the facility to a patient for a specified period if the contractor considers that it would have an adverse impact on the provision of essential services

Patients retain their right to full retrospective records if they request it, but practices are not required to promote it. Full retrospective access can be delayed during COVID period

In terms of the redaction facility we are working with system providers and NHSD to work up the guidance.”

Self-Isolation for 14 Days before Elective Admission. Practices have been receiving requests from patients for Med 3s or letters for their employers, when the patient has been notified that they (or a member of the household) need to self-isolate for 14 days prior to elective admission to hospital. This is actually nothing to do with GPs and unless the patient is ill a MED 3 should not be issued. We do recognise that these requests are coming in and we therefore advise:

  • The admission letter from the hospital should be sufficient evidence for an employer.
  • If the patient is insistent, they should be directed to NHS 111 to self-declare and apply for a self-isolation note. They should answer yes to the question: “Have you been told to self-isolate by an NHS service or a healthcare professional?” and if they then tick the box that says “I have been told to self-isolate by a test and trace service” they will be able to get a self-isolation note sent to them.
  • Accepting that it is not a GP responsibility, but hoping it might reduce your workload, we have also produced a template letter (Attachment C/D) that you might want to upload to your website. You can then direct patients to it and they can print off a copy for their employers.

AND FINALLY…

Without wishing in any way to undermine the seriousness of the tetanus guidance, what happens if you get injured while standing up………?

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