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DAILY COVID-19 BRIEFING DDLMC - 06.04.2020

NATIONAL UPDATES

General Practice COVID SOP v2. Updated guidance issued on 05.04.20 (attached).

We have key concerns over conflicting information about the Home Visiting service. Currently, COVID HV is carried out by DHU. The guidance states that home visiting services should be ‘considered for shielded patients’ and then says to ensure patient review is done remotely (telephone, video, online) where possible, otherwise by home visit. The SOP does on to say that if the patient needs face-to-face assessment, they should be seen on a home visit, and not brought into general practice premises.

We recognise the guidance is hugely conflicted and we believe this is dangerous for HCW and shielded patients alike to undertake HVs as remote workers in their own cars will struggle to effectively decontaminate between visits. This will also have considerable resource implications for general practice.

We’ve pushed back to GPC and NHSE and raised this with DDCCG. Our recommendation is to NOT to carry out routine home visits to shielded patients until further clarity is sought.

LOCAL UPDATES

  • UHDB online booking system for blood tests is now live. Advanced blood test appointments can be booked by individuals and their family members/carers. If practices wish to make patient referrals online for the available Phlebotomy Clinic times register by Swiftqueue . The security code to register is sw1ft45
  • Mental Health Support Line. Now live for Derbyshire residents as a temporary service, further information for patients here . See letter (attached), this service does not replace usual MH referral pathways.
  • GP Practice HCW testing now live on limited nos and roles. Further refinement to process and prioritisation underway.

OTHER UPDATES

  • 2ww cancer referrals. The EMCA letter (attached) explains the pathway in detail.
    • We have had confirmation that UHDB, all non-emergency GI endoscopy is currently cancelled throughout the Trust in line with national BSG guidelines. The process is that these referrals are assessed by telephone by the relevant specialists and a decision will then be made about how best to process the referral. We are aware that referrals have been mistakenly rejected rather than specialist consultations been carried out. In addition, all bowel scope endoscopy and all Bowel cancer screening colonoscopy has stopped.
  • PPE – It is now explicit that in primary care PPE should include eye protection and PPE should be worn for all contacts. We have called on the Government to ensure rapid delivery of eye protection to all practices and they have committed to do this. All patients must be assumed to have COVID-19 infection and it is now recommended that they should wear a mask during any face-to-face consultations.

Action: Urgent PPE response to CCG. Please respond to ddccg.primarycarequalityteam@nhs.net with the PPE questionnaire (attached and circulated) to help the CCG to obtain the right level of PPE equipment to maintain service provision safely over this difficult time.

Face Shields – DDCCG has been contacted by a company offering to produce and supply face shields. Contact One to One Support Services / 01246 200018.

  • Indemnity. Joint letter from the DoH confirms arrangements for indemnity for current clinicians, returners and other NHS staff.
  • I.T. The CCG have received delivery of laptops. Email David.hill@nhs.net for this and support on video consultation
    • Away from my Desk. There are a number of options available when requesting remote access, one of which is the BMS remote access solution from NECS and Away from my Desk. Each have variations in functionality – for more information, see the NECS Implementation Spreadsheet and the DDCCG Away from my Desk Process (attached).
  • Meds Management COVID resources here.
  • PCN DES BMA guidance (attached). Highlights of funding arrangements and services during COVID
  • COVID calm website for GPs and Nurses on the front line for daily stress and trauma management.
  • Easter B/Hols. We have had queries as to DHU and Practice opening hours. This is currently being worked through, more to follow. Telephones will be operating to practices directly and not defaulting to 111. Staff pay and sample collection being confirmed. Pharmacies open 2pm-5pm. May bank hols are also expected to be working days, more to follow.
  • Useful resources – Remote review of LTCs and Retired GP Returning to Practice (attached)

AND FINALLY…

Who left me in charge?! The power of the final thoughts….

This is what we all feel like right now, but your friendly LMC team are here to help you navigate through the overwhelming information, guidance and resources.

Ensure you use our Derbyshire LMC website for previous COVID resources and follow us on Derbyshire LMC FB and Twitter @DerbyLMC for the latest information.

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