DAILY COVID-19 BRIEFING DDLMC – 30.04.2020
NATIONAL UPDATES
PCN DES. You will no doubt have seen in the letter from Sir Simon Stevens yesterday that NHSE have brought forward the requirements of the Enhanced Health in Care Homes as part of the PCN DES from 1st October 2020 to May 2020. We have provided a summary of the requirements in Attachment (A.) The LMC’s view is reflected in the statement from Dr Richard Vautrey, BMA GP committee chair: “Practices are doing all they can to care for their patients in care homes through this crisis, and they should be able to do so with proper support not more regulation and bureaucracy.
“We were incredibly disappointed to see in the letter from NHS England yesterday that it intends to bring forward the introduction of key elements of the care home specification without engaging with the profession, and in the full knowledge of the serious concerns many in the profession have previously expressed about this earlier this year. We have told NHSEI that this approach is unacceptable. The profession will be rightly dismayed that this element of the contract scheduled for October, which depended on an expanded workforce and additional resources, could be imposed without either being provided. It is not too late for NHSEI to change this damaging approach and instead work with us to support practices to provide the care they know their patients need.
“Of course, with the shocking impact that COVID-19 is having, we appreciate that it is imperative to do all we can to help care home residents, as well as the staff, who need all the support they can get to mitigate the impact on this vulnerable group of patients and those caring for them. This includes a ready supply of PPE, timely access to testing, the guarantee that patients will be admitted to hospital when necessary, and the necessary IT infrastructure to support effective virtual consultations with GPs, community nursing teams and hospital specialists.”
Domestic Violence and Abuse. During the COVID-19 lockdown, home may not be a safe place for those affected by Domestic Violence and Abuse. Weeks or
months of self-isolation may be a dangerous and deeply difficult time for many, as their routes to support and safety will be shut down or limited. IRIS have produced a very useful 2-page guide (Attachment B) for General Practice Teams “Responding to domestic abuse during telephone and video consultations”. Derbyshire Police have also produced the poster (Attachment C) which practices may wish to use (or upload to website) to promote the contact details for support locally.
LOCAL UPDATES
Faecal Immunochemical Testing (FIT) for high risk symptomatic patients during Covid-19 pandemic. Covid 19 has accelerated the interest in the use of FIT in a symptomatic context and JUCD have developed a pathway for the use of FIT in high risk symptomatic patients who meet the 2WW clinical criteria following national referral guidance. This is Attachment D and any queries should be directed to Christine Urquhart christine.urquhart2@nhs.net or Jo Rhodes jo.rhodes@nhs.net at the CCG.
Community Geriatrics Support from UHDB During COVID 19. Starting from Monday 4th May for four weeks, the Department of Medicine of the Elderly (DME) at UHDB will be offering telephone consultations with Consultants in Geriatric Medicine, at four fixed time slots during the afternoon. Situations where support from a geriatrician may be helpful include:
- Uncertain prognostication in older patients with frailty and COVID-19.
- Management and investigations of falls in the community during the pandemic.
- Support in managing delirium and dementia in the community.
- Issues related to polypharmacy and prognostication.
- Advice on long-term conditions management in older people with frailty.
Advice can be given on care home residents or older people with frailty living at home.
Bookings by email dhft.DME@nhs.net, or by phone on either 01332 788848 or 785347
This is a temporary service during the COVID pandemic but will be subject to review.
Scrubs. We have been approached by the iconic knitwear manufacturer John Smedley of Matlock with the very kind offer of a donation of scrubs for practices (in batches of a round 100) which they are currently manufacturing. Any practices who are interested should contact Jess Mcguire-Dudley, Marketing and Design Director at jessmcguire-dudley@johnsmedley.com
Ashgate Hospice Training Event 23rd April 2020. The event was a great success with over 80 GPs registering. It was run with support from Echo and for licensing reasons we are unable to share it freely. However, I’ve spoken to Dr Parnacott and if individual GPs would like a copy please contact her secretary Joanne and she will forward it to you. Joanne.reynolds@ashgatehospicecare.org.uk
Today’s CCG Zoom Membership Briefing. The CCG have asked us to include the following: “Almost 80 general practice colleagues attended the first weekly Zoom conference call, hosted by Dr Chris Clayton -COVID Strategic Lead for the Derbyshire Health and Social Care System and CCG Chief Executive Officer. The briefing aims to keep you up to date on the decisions and discussions about the CCG and system response to the COIVID-19 pandemic, as well as forward planning. Today’s call covered the current position, stages of epidemic as NHS see it, the Sir Simon Stevens letter, challenges and how general practice fits in. Requests to discuss staff testing and care homes next week were submitted at the end of the call. If there are any other areas you’d like covered please email: dccg.communications@nhs.net”
JUCD. Attachment E is the latest long-term conditions update.
Meds Man Bulletin Please see link to latest Meds Management update:
http://www.derbyshiremedicinesmanagement.nhs.uk/assets/Clinical-Policies/CPAG/CPAG_Bulletin/cpag_bulletin_february_2020.pdf
OTHER UPDATES
Indemnity for patients/GP stranded overseas. The question has been asked about the indemnity position for GPs providing phone or on-line advice to patients who might be stranded overseas and for GPs who have been stranded overseas but who have been able to provide remote care on-line while abroad. NHS Resolution have now confirmed that in both circumstances CNSGP will cover this activity as long as the care offered is being done through a qualifying GMS/PMS/APMS contract. (i.e. NHS work). Notwithstanding this clarification we would remind you that there is no obligation to provide advice and treatment when a patient is overseas
Shielded Patients. Dr Shaba Nabi from Avon LMC has produced a step by step guide to shielded patients which practices may find useful. We have uploaded to our website .
Video Consultations. Oxford University have produced this useful summary Video consultations – a guide for practice - click here . In addition “Compassion in Dying” has published a new resource to support GPs with advance care planning conversations over the phone or video, in the context of coronavirus.
AND FINALLY…
There is only really one thing we can say and that is “Happy Birthday Colonel Tom”. His humble, selfless demeanour is an inspiration to us all and let’s not forget that he has inspired so many people to donate the huge sum of money at a time when finances are tight and uncertain. His appointment as Honorary Colonel of the Army Foundation College, Harrogate is a hugely fitting tribute. The whole episode sums up everything that is great about the people of this country. Perhaps Boris Johnson’s words this morning best sums it up “Captain Tom you are a point of light in all our lives”.
And on this day of celebration let us not forget all those that have paid the ultimate sacrifice in the fight against this disease. The words of the Kohima Epitaph and the exhortation that is used in the Act of Remembrance are particularly fitting. The Kohima Epitaph is carved on the Memorial of the 2nd British Division in the cemetery of Kohima (North-East India) and is used to commemorate all those who died in the Burma campaign. Captain Tom served in that campaign and I’m sure he would join us in using the words to remember the doctors, nurses, and all other clinicians, carers and support staff who have died.
'When You Go Home, Tell Them Of Us And Say,
For Your Tomorrow, We Gave Our Today.'
They shall grow not old, as we that are left grow old,
Age shall not weary them, nor the years condemn.
At the going down of the sun, and in the morning,
We will remember them."