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DAILY COVID-19 BRIEFING DDLMC 02.04.2020

KEY MESSAGES FOR TODAY

STOP PRESS

PPE Updated Guidance. This has just been published and Table 2 is the best place to start for a summary which reinforces the Derbyshire NO PPE NO SEE policy. PPE should be used for all patient contacts in primary care and this now includes eye protection.

Patients should also wear masks. More details are here :

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

The Team have now produced the Interim Guidance on End of Life Care for Patients with confirmed or presumed COVID-19 . This is an amalgamation of national guidance and local best practice and thanks to Dr Pauline Love and the team for pulling this together.

The Home Visiting Service is going through final governance checks at the CCG and subject to approval will be “soft-launched” tomorrow and rolled out fully on Monday. There will be a simple flow chart for practices to follow for referrals, but it should be noted that shielded but mobile patients will be out of scope and for any treatment deemed necessary the patient should be invited into the practice. District Nurse capacity is under strain and they will be unable to visit this cohort.

NATIONAL UPDATES

PCN DES. The headlines from the PCN DES Specification which was published on 31st March 2020 are as follows:

  • Funding. £1.45 Extended Access (raw) and £1.50 Core PCN Funding (raw) paid to PCNs. £1.76 PCN Participation (weighted) paid to Practices (No change)
  • PCN Support Payment. Additional 27p per weighted patient to support practices through COVID-19. The proposed Investment and Impact Fund has been delayed until October and this payment if 50% of the funding allocated for IIF.
  • Service Specifications.
    • Structured Medication Review delayed until 1st October.
    • Early Cancer Diagnosis delayed until 1st October but PCNs asked to continue work of this where COVID-19 capacity allows.
    • Enhanced Health in Care Homes remains a requirement and practices and PCNs will already be working on caring for this cohort of patients in response to the COVID-19 outbreak.
    • Additional Roles Reimbursement Scheme continues at 100% but requirement to submit workforce plans delayed until 31st August.
  • PCN Clinical Directors. It is acknowledged that PCN CDs will be focussed on support constituent practices in dealing with COVID-19. delivering

The BMA have produced a very useful 2 page summary (attached) and the Full Specifications for the PCN DES are here.

Extremely Vulnerable Patients. No Change. The Derbyshire PCN CDs consensus remains to hold off from sending any letters to Group 4 patients. NHSE have shared that this week, NHS Digital will update the original cohort and identify some additional patients based on GP data. Any additional patients identified will be flagged in GP systems in the same way as the original cohort and practices will have an updated report in their system. After this next update we would like practices to review the list for accuracy and identify any additional patients who meet the CMO’s original criteria but are not included amongst those identified. We will provide further details of how this should be done via GP system suppliers.

OTHER UPDATES

  • Community Sexual Health Services Update: Please see the attached update on temporary changes to DCHS Sexual Health services and note they will no longer be accepting “walk-in” patients.
  • Returning GPs. Returning GPs who wished to re-register were initially directed to take their identification documents to their practice. After discussion with the Home Office, this can now be done virtually with the doctors concerned using a video link to show any required documents and there is no need for the GP to go into their practice.
  • PPE. A parallel supply chain for PPE is being established through a company called Clipper Logistics. This service will start operating from 6th April and practices will be contacted individually to register as there is a phased roll out. The attached letter and presentation provides the background information from NHS Supply Chain. In the meantime if you have any emergency requirements please contact the CCG ddccg.primarycarequalityteam@nhs.net. They can also be contacted for advice about PHE interpretation of guidance about the requirements following an unexpected case in a practice.
  • Managing Long-term Conditions during COVID-19 outbreak. JUCD have produced an update for GPs relating to patients with Respiratory, Diabetes, Cardiovascular Disease and Gastroenterology conditions. We have also uploaded revised referral pathways for paediatrics at Burton Hospital.
  • Empty cylinders should be returned through the usual route and any queries about refills/empty cylinders should be through the Air Liquide Patient Support Team Helpline on 0808 143 9993 who will advise on additional COVID related precautions for deliveries/returns. Clinical queries should be directed to Home Oxygen Assessment & Review Service (HOSAR): North: 01246 516128. South 01332 788225 (Option 1 or 4) Out of Hours (For new patients): The referrer should complete a Part A HOOF (referral) on www.airliquidehomehealth.co.uk/hcp/ Any queries please contact ddccg.conditionsspecific@nhs.net
  • Finance. The updated financial procedures mentioned yesterday are being signed off by the CCG and we hope to publish details tomorrow. In the meantime please keep a note of any additional expenditure and if you have any serious cash flow problems please contact clive.newman3@nhs.net until Hannah Belchers return on Monday.
  • IT. NECs have produced a separate update with details of the deployment of additional laptops – see attached.
  • Pharmacy. We are expecting an update on warfarin/NOACs and Vitamin B12 tomorrow following sign off. The use of multi-compartment compliance aids (MCA) is subject to review by pharmacies and if their discontinuation is causing any problems please contact kateneedham@nhs.net at the CCG.

LOCAL ACTIONS/GUIDANCE FOR THE NEXT 24 hours

Clarity on the changing referral pathways at CRH and UHDB.

Reviewing preparedness for peak COVID-19 activity.

KEY MESSAGES FOR THE PUBLIC

There is expected to be a high level of interest in the launch of the Red Hubs (particularly the tented one at Derby University) and a press release has gone out.

We will be discussing this on BBC Radio tomorrow.

AND FINALLY

FAQs from yesterday’s webinar are attached and the webinar will now be weekly on Wednesday at 11:00.

And don’t forget Clap for Our Carers Tonight at 8 pm.

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