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DAILY COVID-19 BRIEFING DDLMC - 15.04.2020

STOP PRESS

Finance Claims for Easter BHs. Hannah Belcher has asked me to share the attached spreadsheet for practices to complete. Please complete and return to ddccg.finance@nhs.net.

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

Death Update. We met with the Coroner today and will provide a full update in tomorrow’s update.

NATIONAL UPDATES

NHSE GP Preparedness Letter. This catchily titled letter actually has a lot of useful information in it which I have summarised (please refer to actual letter for exact wording):

GMS/PMS/APMS Contract Regulation changes. This enables NHSE to suspend specific terms of the contract and to date the suspensions (subject to individual clinical judgement) are:

  • New patient reviews (including alcohol dependency)
  • Over-75 health checks
  • Annual patient reviews, including under QOF
  • Routine medication reviews
  • Clinical reviews of frailty
  • Friends and Family Test (FFT)
  • Engagement with and review of feedback from Patient Participation Groups (PPG)
  • Dispensing list cleansing

In addition, NHSE have paused FFT indefinitely, instructed PCSE to pause list reconciliation, encouraged practices to pause complaint handling initially for 3 months and stated that practices can also pause the granting of access to historic online patient records.

The regulations also enable NHSE to:

  • Temporarily (30th March – 30th June 2020) amend the definition of “core hours” so that it may include Good Friday, Easter Monday and May Bank Holidays. We have confirmed with GPC that this has not yet been formally instigated for the 2xMay BHs (sorry we misled you at the webinar) but would strongly urge practices/PCNs to start planning for this as a decision is expected soon.
  • 111 direct booking. The previous contractual requirement to make 1 appointment per 3000 patients per day available for direct NHS111 booking has been increased to 1 appointment per 500 patients per day. (see CCAS update below).

NHS immunisations. While treating and prevention of COVID-19 is a public health priority, the routine immunisation programme continues to play a critical role in preventing ill-health through other diseases. (see DCHS offer below) Where practices experience high demand on services, it is important to prioritise time sensitive vaccines:

  • All routine childhood immunisations offered to babies and infants
  • All doses of targeted hepatitis B vaccines for at-risk infants
  • Pertussis vaccination in pregnancy
  • Pneumococcal vaccination for those in risk groups from 2 to 64 years of age and those aged 65 years and over
  • Child Health Surveillance (NIPE Infant Check). The Newborn and Infant Physical Examination (NIPE) check can be delayed until 8 weeks of age to coincide with the first primary childhood immunisations so they can be done in one visit.

LOCAL UPDATES

DCHS School Age Immunisation Service. DCHS employs an award-winning School Age Immunisation Service (SAIS) who are available to support primary care with their childhood vaccination programme during the current COVID-19 crisis across Derbyshire.

They are currently available to offer support both within the practice and if necessary, may be able to undertake home visits for the hard to reach. If you would like to discuss this further or have any additional questions please contact: Amy Sims, Clinical Lead on amy.sims@nhs.net Mobile: 07717 498317 or Jan Dawson, Head of Service South on jan.dawson10@nhs.net Mobile: 07876 391763

Oxygen for Hot Hubs. Hot hubs are now able to order oxygen directly from Air Liquide. To order oxygen please complete the attached form and email it to alhomecare.hcpsupport@nhs.net .

OTHER UPDATES

Clinical Updates:

  • Dementia Complex Palliative Care Resource. Please find attached a locally produced Resource which aims to enable improved palliative care for people living with advanced dementia, with complex mental and physical health needs in care homes/supported living. The resource is focussed on ensuring the person remains at home (wherever home is) and avoiding unnecessary acute care admission.
  • Helping prevent facial skin damage beneath personal protective equipment. The attached guidance provides some useful advice on skin protection.

GP Referrals to UHDB & CRH. We have received a joint message and the attached guidance from UHDB and CRH “Where clinically appropriate, referrals into secondary care should be avoided due to the downturn in capacity. It would be of great benefit to the system and our patients if alternative options such as self-care can continue to be discussed with patients and referrals only made when clinically necessary. Patients need to continue to be made aware of the pressures hospitals and community providers are facing”. In addition, JUCD has published an update on 2ww cancer referrals (also attached). We will publish updates as the situation changes.

Emergency Dentistry. Further to the update yesterday a new pathway has been commissioned which went live last Thursday. If patients contact their dentist, they will be triaged and if needed treatment will be provided at an urgent dental centre hub. All dental queries should be directed back to their own dentist or NHS111. Please keep us informed if this continues to be an issue in practice.

CCAS/NHS111  Direct Booking. The technical instructions were sent out yesterday form the CCG and practices are advised to plan for this going live. Our understanding is that the requirement is for 1 appointment per 500 patients for both CCAS and NHS111 but they are actually separate technical pathways. While NHS111 directly books allocated slots, it looks as if CCAS will be more like an on-call list without specific time slots for practices to work through during the day. However, this is a fast-changing situation and the IT has not yet been enabled to allow this to happen. More to follow.

IT Updates.

NECS Virtual Desktop (VDI). Ged Connolly-Thompson, the new Head of Digital Development at the CCG, has provided more details on the VDI solution for remote working. The Service Spec, User agreement and application are attached.

  • To access, the practice needs to have ben migrated onto GPN domain (ongoing programme) and have Windows 10.
  • Unlike Away From My Desk (which is now being rolled out), the VDI allows secure access to NHS Spine (including prescribing) through smartcard readers.
  • If your practice has not yet migrated to GPN, you can request a NECS laptop and BMS token if you require access to NHS spine services.
  • If you do not require NHS spine services, but need access to the practice clinical system, Away From My Desk remains available.

Digital Responses to COVID-19 Webinar 16th April 2020 12:30 -13:30 - register for this event . Senior leaders from NHSX, NHS Digital and other agencies leading on digital responses to Covid-19 are hosting a webinar focussing on national work to enable all parts of NHS primary care to offer remote care through video consultations. With the background of the dramatic acceleration of the digital first primary care agenda this will update on the national procurement, outline what it aims to achieve, how it will work, the timescales and how practices and CCGs can access the solutions it will provide.

You will be able to put your questions directly through

https://discourse.digitalhealth.net/ in advance or post them live during the webinar. These questions, suggestions and responses on each session will be collated and shared.

BMA COVID-19 Survey. For individual GPs. The BMA have asked for GPs to complete a COVID-19 survey https://www.research.net/r/BMA_COVID_tracker focuses on PPE, testing, shortages of drugs and a question on burnout and stress. We would urge GPs to fill this in (only takes a couple of minutes) as to quote the BMA “The higher response rate we get then the more bite we get from the media over the results”. Thank you.

KEY MESSAGES FOR THE PUBLIC

Attached are two posters about accessing practices and repeat prescription ordering which practices might find useful.

AND FINALLY…

Apologies that today’s update is long, late and contains a lot of attachments (I think they are in the correct order?). It’s been a busy day…….

And does anyone else find it slightly ironic that NHSE published the letter about contract changes to Easter bank holiday working 2 days after Easter Monday?

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