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DAILY COVID-19 BRIEFING DDLMC 01.04.2020

KEY MESSAGES FOR TODAY

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

The EOL guidance is being finalized and the Home Visiting Service is also close to completion.

NATIONAL UPDATES

National Daily PM briefings. Michael Gove reported the largest number of deaths in a single day (381) in the UK and outlined measures to source testing kits and ventilators to increase NHS capacity.

Extremely Vulnerable Patients. The Derbyshire PCN CDs consensus remains to hold off from sending any letters to Group 4 patients pending NHSE further guidance which was promised on Friday.

OTHER UPDATES

  • Testing for HCWs. Testing kits are becoming available through the national testing programme and the Derbyshire COVID Response team are working on prioritisation within general practice. The team have also investigated and discounted the option of purchasing testing kits independently. This decision was made because of concerns about the test, not due to funding which had been sourced. Practices are advised NOT to purchase any kits themselves due to questions about their efficacy
  • Easter Bank Holidays. Further to yesterday’s update the issue of payment to cover additional staff costs has been acknowledged and GPC are pursuing the amount and process with NHSE.
  • Med 3 Sick Pay Update. As the “categories” of patients has changed there has been confusion about the requirements for Med 3s and the payment of sick pay if the patient is unable to work. These can be broken down as follows:
    • Symptomatic Self-Isolating Patients. Entitled to sick pay. Self-certification via NHS111 online as evidence to employer.
    • Asymptomatic Self-Isolating Patients but living with symptomatic household member. If unable to work from home then, entitled to sick pay. Self-certification via NHS111 online as evidence to employer.
    • Extremely Vulnerable (Shielded Patients) and those Socially Isolating due to being classed as high risk. If unable to work from home but work is available, they are not entitled to sick pay as they are not sick. For employees in private sector, they can be furloughed (80% pay scheme). For practice staff, practice should consider continuing to pay them and keep a record of any associated backfill costs. The pay itself will not be reimbursable but our view is that backfill costs will be.

We appreciate the apparent discrepancy between categories b. and c. and have taken advice from a HR specialist in coming to our conclusions. I’m sure this will evolve over the next few days as things become clearer.

  • PPE. It has been pointed out that the Derbyshire GP advice “NO PPE NO SEE” is more restrictive than the current national PHE guidance. We acknowledge that difference but maintain our stance is correct until we see the updated PHE guidance which we are expecting tomorrow.
  • Finance. The principle of additional COVID-19 expenditure being reimbursable is acknowledged and the CCG and LMC are working on a system to enable practices to record these and a timely payment mechanism. The CCG have also confirmed that as an interim measure in April, they will pay both April and May global sum/PCN funding and QoF payments to help practices manage their cash flow. These payments are not additional, just bringing forward the May payments, and a reconciliation will be carried out later in the year with these and the additional payments. If any practices are going to have immediate serious cash flow problems before the April payments, please let the CCG and us know.
  • Death. In the seemingly daily changes to the current position on death verification, certification and cremation forms we have produced the attached summary which GPs might find useful.
  • IT. The CCG has deployed all available laptops and a new delivery is expected in the next 2 days. Remote working has been problematic today and to assist with bandwidth issues the preferred method is now via Checkpoint rather than BMS tokens. In conjunction with NECs the CCG are also looking at granting admin rights to a named individual within the practice and PCN CDs. Any queries to Paul Hetherington and David Hill at the CCG.
  • Pharmacy. In much the same way as general practice, community pharmacy has changed the way it works. The are open to the public 10-12am and 2-4pm (2-6pm in the case of 100hr pharmacy) and are enforcing social distancing for customers within pharmacies. We are waiting for an update on Easter opening hours. The MOL are working towards remote working solutions for their staff and more detail will follow, although this should be seamless from a patient perspective.

LOCAL ACTIONS/GUIDANCE FOR THE NEXT 24 hours

Clarity on the establishment of and funding for the Red/Green Hubs.

AND FINALLY

FAQs from today’s webinar will be published later (when I’ve written them up).

Looking after ourselves includes looking after each other. If you have members of your team displaying symptoms of COVID-19 then you should not assume that someone else has challenged them and you should ask.

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