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DAILY COVID-19 BRIEFING DDLMC 24.03.2020

KEY MESSAGES FOR TODAY

You will have all seen the Prime Ministers update yesterday with the “Stay at Home” message. “The single most important action we can all take, in fighting coronavirus, is to stay at home in order to protect the NHS and save lives.”

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

The COVID TASK FORCE has been working hard on a coordinated support package for practices. In addition to resources sent yesterday (the COVID-19 practice plan, wellbeing guide, EOL Guide, template letter and death certification guidance) we have progressed the following:

  • The COVID-19 Derby Medical Chambers. We have responded to the need for a simple way for practices to access locum support and for any GP who wants to respond to the crisis by offering sessions (including recent retirees) by opening up Derbyshire Medical Chambers to all GPs at no cost to individuals. The attached letter provides the detail.
  • Interim Remote Working Contingency. While the IT infrastructure catches up with the huge increase in the need for remote working, we have produced the attached protocol which is a pragmatic interim work around.
  • EOL Palliative Care. Further to the guide published yesterday we are working on the system wide delivery of palliative care at scale.

NATIONAL UPDATES

  • National Daily PM briefings. “STAY AT HOME” The 3 measures announced/reinforced yesterday are:
    • Stay at home, except for very limited purposes.
    • Shopping for basic necessities, (food and medicine)
    • One form of exercise a day, alone or with members of your household.
    • Any medical need, or to provide care/help to a vulnerable person
    • Travelling to and from work, where absolutely necessary
    • Closing non-essential shops and community spaces.
    • Stopping all gatherings of more than two people in public
  • Extremely Vulnerable Patients – The Role of General Practice during COVID1: The details of the cohort of 1.5m extremely vulnerable patients has now started emerging and the RCGP and BMA published guidance yesterday. The majority of patients (Category B Groups 1-3) will be contacted centrally by NHSE but there will be a smaller number of patients (Category C Group 4) who practices will need to contact. We are urgently seeking clarification.
  • The RCGP Guidance on Workload Prioritization. Following on from the Derbyshire General Practice COVID-19 Response document that we shared yesterday the RCGP have now produced some more detailed guidance on workload prioritization which you might find useful.
  • PPE – There has been no response yet from the Prime Minister to the BMA letter sent yesterday but this remains one of the most critical issues and there is a Department of Health meeting today. We hope to have an update from that meeting in time for tomorrow’s update.

OTHER UPDATES

  • Pharmacy Preparedness for EOL patients. There is a locally commissioned palliative care service in Derbyshire, commissioned by NHSE/I. Attached is the list of the pharmacies who hold EOL stocks. NHSE have confirmed good supplies at the moment. Diamorphine remains out of stock but morphine is available.
  • While the national guidance catches up, we advise practices NOT to issue Med 3s for shielding patients but follow the process for self-isolating patients for the first 2 weeks and await further detail i.e. they can self-declare and get a certificate on nhs.uk. We would also suggest that practices might want to adopt the same process for staff in this group as it is not yet clear what the expectation is going forward.
  • Inhalers and Asthma/Respiratory Conditions “Rescue Packs”. There is some inaccurate information circulating (especially on social media) regarding inhalers and rescue packs. We have produced the attached which practices may wish to use in their practice comms.
  • Easter Opening. While no decision has yet been made the emergency legislation going through parliament does allow for the NHS to mandate GP practices to be open over the Easter Bank Holiday period. We would therefore urge practices and PCNs to start planning for this eventuality. We have no further details as to whether this might be just the bank holidays or the whole weekend and we will of course provide further detail as and when we receive it.
  • Doors Open. There has been some confusion over the message from NHSE that practices need to ensure they keep their doors open during core contractual hours. We have clarified with the CCG, who understand completely that patients will not have full unfettered physical access to practices during this period and that practices will be using various triage processes to minimise the risk of infection to their staff.
  • Financial Issues. The issues of cash flow and the locum reimbursement qualifying period are being progressed by the CCG and we hope to have an update soon.

LOCAL ACTIONS/GUIDANCE FOR THE NEXT 24 hours

  • Thank you to everyone who filled in the survey yesterday and work is ongoing to finesse the survey to minimize the work for practices and maximize the usefulness of the data.
  • In conjunction with survey data we are working to provide an agile way to plug the inevitable workforce gaps.

KEY MESSAGES FOR THE PUBLIC

We are working on a series of short videos to share on social media to get the important messages out to patients in an easy to understand format. Please keep an eye out over the next few days.

AND FINALLY

Apologies that we didn’t manage to get the webinar up and running for today, but we are definitely hosting another one tomorrow mid-morning (Wednesday) with both clinical and operational inputs. Dial in details will be sent out later.