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COVID-19 UPDATE BRIEFING DDLMC – 13.05.2020

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

Summary of New Government Advice. Dr Susie Bayley pulled together a summary (Attachment A) to put into plain language the changes that came into effect today. Much has stayed the same but there has been a subtle relaxation of some of the rules. And remember that you heard the new slogan here first:

Think HANDS Think FACE Think SPACE STAY SAFE

NATIONAL UPDATES

Government advice for working safely. The suggested changes to workplace practices have been summarized and can be found here .

Care Home Testing. The Government have now opened a Care Home testing online portal where care homes can access testing for staff and residents.

Risk Reduction Framework. Following the recent emerging evidence about the differing risks to staff based on age, gender and ethnicity the NHS have produced a Risk Reduction Framework (Attachment B) which practices may find helpful in analyzing risks.

LOCAL UPDATES

Post COVID-19 Speech Problems. One of the DCHS speech and language therapists has been part of a national group that has produced an excellent document “Advice for people experiencing voice problems after COVID-19” (Attachment C).

Meds management Update. Please find below the link to the latest Derbyshire Medicines Management Bulletin 6 (11th May 2020)

Red Home Visiting. Wound care for mobile COVID-19 positive patients has been raised as possible commissioning gap. The CCG are working with DCHS and DHU to develop a solution. INR venous blood testing for patients in “Red” residential homes can be carried out by District Nursing if conversion onto DOACs is not possible, since near patient testing will not be available.

Death Certification. Following the publication of our guidance we have received a number of queries about phone consultations in the 28 days prior to death and whether these are acceptable as “having attended” the patient for the purposes of completing the MCCD. Our view is that as general practice moves towards more remote consultations then a telephone consultation should be considered as “attended” which was why we included it in our guidance. We developed this guidance in conjunction with the Derbyshire Coroner and he didn’t raise any objections. Since the GPs legal obligation is to complete the MCCD, provided they make it clear on the form then they have fulfilled that obligation. If the registrar has a problem with that, they then have the option to seek further information from the GP or indeed refer the death to the Coroner themselves.

In summary then, our advice is that if the GP has only “seen” the patient by phone, then they can still issue the MCCD (providing they give full details) and the registrar can refer if they feel it is necessary.

CCG Membership Briefing. Dr Chris Clayton provide a 30 min update at 1pm tomorrow (14th May) via Zoom. All GPs and Practice Managers are encouraged to attend.

JUCD Long Term Conditions & COVID-19 Update. The latest (11th May 2020) local updates (11 May 2020) for shielded patients, respiratory, diabetes, cardiovascular disease and gastroenterology are at Attachment E.

OTHER UPDATES

ECHO Education Session Thursday 14th May 7pm-8:15pm. Following the success of the previous Education Session on Management of COVID19 on 23/4/2020, Dr Sarah Parnacott has asked us to publicise the next event tomorrow evening focussed on PTSD.

The speakers are:

  • Dr Rachel Holt Consultant Clinical Psychologist
  • Dr Jo Hall Consultant Clinical Psychologist
  • Ms Liz Mathews Counselling Support Manager Ashgate Hospice

The session will explore:

  • What is PTSD and what is the impact of COVID19 on patients, relatives and staff.
  • Strategies for managing PTSD.
  • Specific measures introduced by Ashgate Hospice and CRH.
  • Improving resilience to minimise the development of PTSD.

Your Zoom Meeting ID is : 986 5483 0865, Password: 549839 or

https://echo.zoom.us/j/98654830865?pwd=bnZ1cTR2SngrS0xTOXJINjlBTW1TUT09

Meeting will open at 6:30pm for admission to waiting room. You will be admitted about 6:55pm where you are asked to add your full name and job role in the CHAT.

All participants need to complete a Registration and Data Agreement form (Attachment F). Please email completed forms to Joanne.reynolds@ashgatehospicecare.org.uk Any staff who have already completed a form do not need to re-do them.

Total triage and remote consultations. The NHSE Daily Primary Care Bulletin yesterday contained an update on the remarkable transformation of the delivery of GP services. Nationally, prior to COVID-19 only 5% of practices were live with video consultations. Now video consultations are available in 97% of practices and online consultations are available in 75% of practices. Dr Nikki Kanani stated “Thank you to all of you who have contributed to these efforts – these achievements would not have been possible without you. We understand that these remain challenging times, so want to reassure you that we are committed to continuing to support practices to optimise digital solutions and gain benefits for patients and for staff – contact your NHS England and NHS Improvement regional team or the NHSX Implementation Team for more information.”

We have been provided with a guide on Video Consultations (Attachment E) which may also be useful.

Airmid. TPP have produced a pack of posters and flyers for SystmOne users. number of patient-friendly videos will be available shortly. Alongside change messages, regular updates to Airmid functionality, suitable for patients will be posted on Twitter at https://twitter.com/airmidcares.

PUBLIC MESSAGES

General Practice is open. There has been an increasing amount of feedback from patients that they have not been contacting practices because they are either closed or unable to deal with anything other than urgent problems. We will continue to focus our messaging on this and would also ask practices to review your online presence and welcome messages on your phone systems to spread the message that you are open but working differently. Thank you.

Cancer Research UK. A safety netting leaflet has been produced which is aimed at GPs and other health professionals. They have also produced a short film reminding patients to see a GP should they show symptoms.

Messaging for overseas visitors. Gov.UK now has translations about entitlements, social distancing and shielding, in relation to COVID-19 for overseas visitors. including anyone living in the UK without permission.

AND FINALLY…

LMC PCN Webinar. Apologies to those of you who were unable to get onto the webinar today. We have been the victims of our own success as we never dreamt that we would ever exceed our 100-participant capacity. We are looking to upgrade our Zoom package to increase capacity and the recording of today’s webinar is on the website for those that missed it.

Guidance on how to make and wear face coverings
Following the publication of the government’s COVID-19 recovery strategy which recommends that face coverings are worn on public transport and/or when social distancing isn’t possible, you may find this useful.

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