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DAILY COVID-19 BRIEFING DDLMC 03.04.2020

KEY MESSAGES FOR TODAY

STOP PRESS The Deputy Chief Medical Officer for England Medical Director for Primary Care have just sent out the attached letter which we will digest and comment on next week.

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

The Home Visiting Service has now been signed off and will launch on Monday. The CCG Primary Care team will circulate the details later today.

NATIONAL UPDATES

Testing, Testing, Testing. Now the SoS is back at work following his self-isolation due to a confirmed case of COVID-19, the impetus behind testing for NHS workers and the wider public appears to have been reignited. A local roll out is being worked on now and we hope to get this out on Monday. The letters from the NHSEI team are here.

CQC. We are urgently trying to clarify any additional registration requirements for red/green hubs from CQC and produce a simple guide to support practices and minimise the impact on practices.

Extremely Vulnerable Patients. We are still waiting for the national update on the centrally produced letters for Group 4 patients. NHSE have produced a series of FAQs which may help practices deal with some of the requests from patients.

In the meantime, Dr Kath Checkland from Eyam Surgery has shared the attached template letter which practices may wish to embed within their clinical system and use for these patients asking for proof for their employers. While we acknowledge this is not work that GPs should be doing, it is sometimes easier to just produce the letter than have the 38-minute* discussion with the patient. (*based on a real experience from a practice in Derbyshire!). The extremely vulnerable people guidance has also been translated into additional languages.

OTHER UPDATES

  • DCHS Update.
    • Update to provision of MSK, FCP and Physiotherapy services in DCHS DCHS is continuing to provide MSK and physiotherapy services for patients with the following conditions: Emergency and urgent MSK conditions (who may need referral to secondary care), recent elective surgery, recent fracture, acute and/or complex needs, (including people with carer responsibilities). All other rehabilitation work is postponed. Further details in the attached update.
    • Call for Nurses and HCAs. As mentioned yesterday, the DCHS community nursing service is under severe strain as staffing levels are depleted, and most of their face to face visits are still required. This situation is likely to worsen as the need for community-based end of life care escalates. Any nurses or HCAs in General Practice willing to offer some time, please contact chst.peopleresourceteam@nhs.net (DN experience desirable but not essential as you will only be asked to work within your competencies).
    • Shielded Patients. We also update yesterday that otherwise well shielded patients would not be covered by the home visiting service being commissioned by the CCG and patients should be encouraged to consider using volunteer drivers if they have no other way of getting to practices for their appointments.
  • PPE. Marie Scouse at the CCG is responding to the urgent ministerial request for an update on PPE stocks and if Marie and her team contact you we would urge you to please respond. The new supply chain will be phased in for general practice next week. We know that supplies in some areas are running low and if you need emergency supplies there are 2 routes:
    • Contact the CCG ddccg.primarycarequalityteam@nhs.net They are coordinating supplies in Derbyshire and may be able to temporarily source PPE from elsewhere in Derbyshire.
    • Providers who have an urgent requirement for PPE, which they are unable to secure through their business as usual channels, should contact the NSDR via the 24/7 helpline: 0800 915 9964.
  • Clinical Guides and Updates. NHSE have produced:
    • An easy to read guide for patients with a learning disability or autism
    • A guide for the management of anticoagulant services management of anticoagulant services during the COVID-19 outbreak.
    • The NHS Cervical Screening Programme – Colposcopy, Initial Guidance during the coronavirus (Covid-19) pandemic. (Attached)
  • Cremation Form 4. We have worked with The Medical Referee at Markeaton Crematorium, Dr Ian Ferrer to produce the attached one page guide on the completion of Cremation Form 4.
  • Online Booking Blood Tests. UHDB have launched an online booking system for blood tests which can be booked by individuals, their family members/carers or by their GP practice. The booking system is live and accepting bookings from Monday 6 April. For more information and to book, go to: https://www.uhdb.nhs.uk/service-phlebotomy-blood-tests. Please encourage all patients to book in advance as it will reduce their waiting time and will support social distancing.
  • Finance. Update on Financial procedures has been sent separately by Donna Allen from the CCG.
  • IT. General Update.
    • Away from my desk roll out has started today.
    • Away from my desk, Google Chrome, and Skype for Business can be downloaded (without admin rights – see below) from the NECs self-service portal.
    • There has been a large delivery of laptops so NECs and the CCG will be getting these out as soon as possible.
    • If there are any practices that want to be able to use video-consultation but are having problems or need advice, please contact Paul Hetherington/David Hill at the CCG and they can support you.
  • IT - Remote access. The huge increase in demand for bandwidth (both on NHS networks and more widely) has caused some perhaps not unexpected problems for remote and practice-based working. NECs have already upgraded the capacity of the network and accelerated the planned phased roll out of Checkpoint. Those using BMS tokens should continue to do so and NECs will notify practices when they will be switched over (unless there are exceptional individual circumstances, in which case contact them direct). As users are transferred to Checkpoint this should improve accessibility for BMS token users as the load is then shared between the two systems.
  • IT – Admin Rights. Please excuse the “admin rights for dummies” approach but I know this is currently a thorny issue. No offence is intended in what I am about to write – I am simply explaining both sides of the polar opposites of this discussion. Some facts:
    • General Practice is undergoing a radical change in the way it works which is far more reliant on technology.
    • There is a need for practices to be able to react to new IT requirements quickly.
    • There is an increased cyber security threat at this time. The removal of admin rights from practices has caused a great deal of consternation and we are working with the CCG and NECs to find a solution which balances the need for responsiveness with an acceptable level of threat. This is a delicate balance as practices are frustrated by the time it now takes to get things done but the attacks are becoming more sophisticated and allowing “open” admin rights increases the risk of someone inadvertently allowing a cyber-attack to happen – as happened with Wannacry. No practice would knowingly allow this to happen but we have now become even more reliant on IT systems to be able to deliver any form of service. Bear with us – we know the problem and will work tirelessly to provide a solution.

KEY MESSAGES FOR THE PUBLIC

The press release (with a photo) about the opening of the tented red hub at the University is now on the CCG Comms Page.

AND FINALLY

I know I will get a stream of people saying it doesn’t happen in my practice, but NECs have reported a significantly reduced spike of network activity this morning when they blocked the use of the feed to the Joe Wicks workout. A gentle reminder to all your staff including home workers that such activity does use valuable bandwidth and slows things down for those using the systems for clinical work (and probably contradicts your IT usage policy?). You can tell from looking at me that I am definitely not guilty.

I hope you all have a reasonably restful weekend AT HOME and that you get some time to think about something else. The Muppets Movie is on BBC 2 on Saturday afternoon…

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