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DAILY COVID-19 BRIEFING DDLMC – 24.04.2020

NATIONAL UPDATES

Testing. The government announced yesterday that in England all essential workers with symptoms and members of their households with symptoms of coronavirus will now be able to get tested. Employers or the employees themselves can book the tests and the full details are here . Tests will be available at regional testing sites, via home testing or at certain NHS sites. There are also plans to develop a mobile testing capability.
Test results will be sent to the individual and it will be up to them to inform their GP and/or employer. The update also contains guidance about returning to work:

  • Negative result after testing. The employee can return to work if they are:
    • Well enough to return
    • Have not had a raised temperature (above 37.8⁰C) for 2 days or more
    • Not living with another household member who has tested positive or is symptomatic
  • Positive result after testing. The employee can return to work after the isolation period (7 days if living alone or 14 days if living with a symptomatic patient) providing they are:
    • Well enough to return
    • Have not had a raised temperature (above 37.8⁰C) for 2 days or more

Demand for testing will no doubt be high, and I note that by 11:00 today the self-referral portal had closed.

May BH. NHSE announced by webinar yesterday that 0800-1830 on Friday 8th May (BH) would be designated as core hours for GPs. The CCG have already negotiated for DHU to take over from 1600. Practices therefore need to arrange the delivery of essential services to their patients between 0800-1600 on Friday 8th May. Drawing on the experience of the Easter weekend and the levels of activity, practices and PCNs are advised to make arrangements based on their local patient needs. To claim for reimbursement (based on the rates published for Easter) after 8th May you will need to:

  • Complete the return (which the CCG will provide) with actual hours worked,
  • Raise an invoice (on tradeshift or by email) to the CCG for the additional staff and other costs.

British Association of Physicians of Indian Origin Letter. BAPIO has written to the Chief Executives of NHS Trusts and CCGs to highlights its concerns about the disproportionately high mortality rates in BAME health and social care (HSCW) workers. In supporting the significant numbers of BAME staff in general practice we fully support the principles that:

  • As a priority, where this has not already happened, all staff on the frontline are risk assessed for age, sex, ethnicity, pre-existing medical conditions, and if at significant risk, they are deployed in non-COVID clinical areas or advised to work remotely. Retired and returning doctors and nurses should be given the highest priority in this assessment.
  • No employee must feel bullied or harassed for raising concerns about unsafe working conditions, rather appropriate support must be offered to allay their concerns.

PHE has also acknowledged the benefits of taking vitamin D supplements: “Consider taking 10 micrograms of vitamin D a day to keep your bones and muscles healthy. This is because you may not be getting enough vitamin D from sunlight if you’re indoors most of the day.”

LOCAL UPDATES

Local Testing Experiences. We have received some useful feedback on the local testing process (Chesterfield but applicable to all). The main thing (difficult for the men I know but) read the instructions, which are very comprehensive. A few other things:

  • Go in the car that you notified them of as they use the registration to identify you. If you haven’t used it for a few days, it might be worth checking it will start.
  • Take your mobile phone and ensure it is charged.
  • Take your NHS ID (or other photo ID). It doesn’t mention it on the instructions, but you may be asked for it.
  • Allow plenty of time for the journey, the roads are getting busier.
  • Be prepared for a wait – they are block timings and it can take 30-45 mins.
  • Follow the instructions of the staff – I imagine it’s a pretty thankless task so a huge thank you to the testers.

IT Update on remote access solutions. The CCG have reported that they are fielding a lot of queries about the NECs remote access solution (UYOD-VDI) and asked that we remind you about the system and how to apply/install in the attached documents (A-C). They are also available on the CCG Intranet (for those that have access rights).

Diabetes In Red Hubs Dr Karissa Owen has asked us to share the attached information (D-E) about diabetic patients presenting in red hubs.

OTHER UPDATES

Update on shielding. NHSE have updated the shielded patients list and a further 79k individuals have been flagged to be at highest clinical risk nationally. From today, letters and text messages are being sent to this group. Further information on the national algorithm is on NHS Digital’s website . Where they have not already done so, practices are requested to contact all the people on their shielded patient list as a follow-up to the letter. These conversations should: (a) discuss what shielding means, (b) describe any changes to their ongoing care and treatment, Including home visiting wherever this is clinically needed (c) confirm they have an arrangement in place for receiving their medications and (d) check that they are aware of the government support offer. Practices were asked (via a task in the IT system on/around 28th March) to review the original “self-declaring” extremely vulnerable patients by COP 28th April. Any future “self-declarers” should be reviewed and in your clinical opinion, where they meet the criteria, coded and added to the list.

Splenectomy patients. NHSE have now confirmed that splenectomy patients should be included in the Shielded Patient List. These patients were contacted by letter by NHSEI to recommend that they follow shielding advice. If practices have removed any patients in this category from the SPL they should contact the patient to inform them of this error. NHS Digital will provide practices with a list of these patients from rom 29th April.

QOF year-end process. Some practices will have seen their QOF year-end actual achievement data. NHSE have provided reassurances that they are currently analyzing these figures and will make an adjustment to ensure practices are paid at the higher of the 2018/19 or 2019/20 activity levels. More details will follow.

Clinical Updates. The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have published a number of COVID-19 related resources:

Further advice on neonatal:

KEY MESSAGES TO THE PUBLIC

A big thank you to Derbyshire GP and GPTF Fellow Dr Shehla Imtiaz-Umer for creating these brilliant ‘ Top Tips’ for Ramadan:

We have liaised with both Radio Derby and Radio Ikhlas to get the word out. Please feel free to share.

AND FINALLY…

Thanks to Sandra Johal (CCG Comms Manager) for providing the attached (F.) “Where are you” and I like to think I am generally in the growth zone although the amazing LMC/GPTF team do look after me when I revert to the Fear Zone by getting mad at people.

In summary of the local testing experiences (and in the true tradition of incomprehensible abbreviations. PPPPPPP and RTFI (a variation on RTFQ). And before anyone complains the 5th P is potential, and F is for factual....

Dr Gail Walton issued the challenge of including something about trees in this section. You wood not believe that I couldn’t log in to find anything. I hope you all have a restful weekend.

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