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COVID-19 UPDATE BRIEFING DDLMC – 24.06.2020

There have been some major changes announced over the last few days so we thought it would warrant a special update.

NATIONAL UPDATES

Clinically Extremely Vulnerable (Shielded) Patients. The government have announced changes to the guidance (Attachment A) for this group of patients:

From 6 July, they may:

  • meet in a group of up to 6 people outdoors,
  • no longer observe social distancing with other members of their household; and
  • form a ‘support bubble’ with one other household, without needing to socially distance.

All the other current shielding advice will remain unchanged at this time.

From 1 August, provided there are no significant increases in incidents they may:

  • go to work, if they can’t work from home, as long as the business is COVID-safe;
  • return to their education settings (children) if they are eligible.
  • go outside to buy food, to places of worship and for exercise.

This group should remain cautious, so the advice is to stay at home where possible and, if they do go out, follow strict social distancing.

The letter to patients (Attachment B) infers that the changes on 6th August have already been decided but there is also a caveat in an earlier paragraph: The latest scientific evidence shows that the prevalence of disease across all English regions has continued to decline. If this trend continues as we expect it to, the Government will further relax its shielding advice in two stages on 6 July and 1 August.  

Relaxation of Lockdown – England. While the government announced some relaxation in lockdown yesterday, it was made clear that each step is conditional and reversible, and they are still asking people to LIMIT SOCIAL CONTACT and ACT RESPONSIBILITY. The specific changes are:

From 4th July:

  • Social Distancing. Remains at 2m where it is possible, but can be reduced to 1m WITH MITIGATIONS e.g.avoid F2F, good ventilation, reducing number of people, screens, face coverings and the fewer contacts you have the safer you will be.
  • You can meet with another household. Inside or outside and can stay overnight but must social distance
  • You can still meet up to 6 people from mixed households outside
  • The following will be allowed to reopen - Pubs/restaurants (table service only), museums, cinemas, hotels, hairdressers, places of worship (no singing). NOT – softplay, leisure centres, gyms, swimming pools, nightclubs.

From 6th July

  • Shielding, see above.
  • For GPs/Clinicians Oxford University are producing a tool to help risk assess these individuals but details have not been published yet. We will share when we have it.

LOCAL UPDATES

2 Key Points for Derbyshire General Practice:

  • This relaxation is across the whole of England and doesn’t necessarily reflect what we are seeing in practices across the county. We know we’ve seen an increase in red/coronavirus hub activity in the past week in the CITY and so we need to be very careful and agile in our local response.
  • Previous relaxations happened while we were still at Level 4 and we haven’t yet had a chance to see the full effect this may have. We would therefore implore the general public to adhere to the advice on social distancing and ensure we don’t see any additional relaxation in our mitigations until we’ve had the time to determine what effect the changes to date have made.

Funding for Services commissioned by Derby City Council. We understand that practices have been informed that the payment of average achievement for public health activities commissioned by the City Council will cease from 1st July and revert to the contracted position of being paid for what you do. To our knowledge there has been no consultation over this change, and we are seeking urgent clarification from the City Council, but practices should be aware and plan for this eventuality. We are also seeking to confirm if the County Council position is the same.

OTHER UPDATES

Covid-19 antibody testing. We mentioned yesterday that the indemnity arrangements had been confirmed if practices take blood from their own staff who are not registered patients. We should remind everyone that this test is not compulsory and the BMA have provided an update on the potential impact that a positive test may have on an individual applying for insurance:  The BMA has been in constructive dialogue with the ABI (Association of British Insurers) and we are in agreement that healthcare workers should not suffer any additional barriers when applying for insurance policies. Although this is reassuring this is not an explicit guarantee that there will not be an effect and staff should be made aware of this.

Resumption of Optician Services. NHSE published an update on the resumption of opticians service on 17th June 2020.

Advice on Post Viral Fatigue Management. Guidance (Attachment C) has been published on how to manage post-viral fatigue after COVID-19.

PUBLIC MESSAGES

ULTIMATELY THIS DISEASE IS STILL KILLING PEOPLE

WE HAVE NO CURE, WE HAVE NO VACCINE

EVERYONE HAS A ROLE TO PLAY IN GETTING THROUGH THIS.

AND FINALLY…

THINK HANDS /  THINK FACE  / THINK SPACE AND STAY SAFE

And if you can read this you don’t need to make an appointment at the newly reopened optician.

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