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DAILY COVID-19 BRIEFING DDLMC 30.3.2020

KEY MESSAGES FOR TODAY

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

We are fully aware that it is becoming increasingly difficult to stay on top of all of the comms. FROM WEDNESDAY, the CCG and the Derbyshire COVID-19 Task Force have agreed that we will be publishing one daily update which will contain all of the critical information that general practice will require. This will be a short summary of the latest updates (with links where appropriate) backed up by a library of source documents on our website .

If you only read one document today, then please make it the updated DERBYSHIRE GENERAL PRACTICE – COVID-19 RESPONSE (see attached) which has been updated over the weekend (thanks to Dr Duncan Gooch and the team). It contains a consolidation of the current national guidance and further detail of the emerging Derbyshire Plan in an easy to read format. Two headlines:

  • Updated PPE guidance and the promise of further deliveries but remember:
    • NO PPE - NO SEE
  • Risk assessments for staff. Minimise face to face contacts and clarification of Red (high temp/cough), Green (NO high temp/cough) and Blue (Remote Consultations) and the staff groups that can undertake these consultations.

Staff Wellbeing. There have been some minor updates to the leaflets and these have been uploaded to our website.

NATIONAL UPDATES

  • National Daily PM briefings.
    • These emphasized the need to continue to follow the guidelines to stay at home.
    • Current restrictions could remain in force (or be tightened) for 3-6 months.
    • Testing for NHS workers has started and one priority for today will be to clarify how this will work for staff in general practice in Derbyshire.
    • PPE deliveries promised. National Supply Disruption Response (NSDR) telephone helpline: 0800 915 9964.
  • PPE. The updated national guidance was published on Friday see attached but poster in the Derbyshire General Practice – Covid-19 Response document is a very useful one-page summary.

OTHER UPDATES

  • Extremely Vulnerable Patients.
    • Update. Letters to Groups 1-3 have gone out centrally. Practices were originally asked to send Letters to Group 4 but have now been told to pause while national searches are developed. These are expected this week and if patients ask the message is wait for letter and/or access bespoke support through the new portal G et coronavirus support as a clinically extremely vulnerable person
    • Can shielded patients come into the practice? The advice in the letter to patients about planned GP practice appointments is clear. “Wherever possible, we will provide care by phone, email or online. But if we decide you need to be seen in person, we will contact you to arrange your visit to the surgery or a visit in your home.” We read this as it being the clinicians decision to determine the most appropriate place to assess/ perform required procedures. If a patient has any queries about hospital appointments, they should contact the hospital.
  • Returning retired GPs. The MDOs have waived their fees for retired doctors returning to work – read more on their websites: Medical Protection ; Medical Defence Union ; MDDUS
  • Easter Bank Holidays. Good Friday and Easter Monday (08:00-18:30) are now included as core hours in GMS/PMS contracts and practices will need to provide essential services during these hours. Practices should consider planning for a “normal” service or an “extended access hub model” and we will clarify which is required once we know. GPC have informed us they are urgently seeking clarification on expectations and attached funding.
  • GP Support and Training. There have been a number of updates to help GPs locally and nationally:
    • Psychotropic medication and COVID-19 in Primary Care. DHcFT have produced an update for the ongoing monitoring of this patient cohort.
  • EOL. The COVID-19 Task Force are producing a Derbyshire specific EOL guide which we hope to share tomorrow. The emerging plan is for 2 Hubs, plus OOH and home service run by DHU.
  • Death. More detailed guidance will be in the Derbyshire EOL paper but in summary:
    • Verification. Does not need to be done by GP – can be done by anyone. We advise against GPs verifying in person the death of patients who may be infected with coronavirus.
    • Certification. Can be done by any doctor who has seen patient in last 28 days (inc by video) and able to give cause of death to the best pf their knowledge.
    • Cremation. NO requirement for Form 5. Viewing the body via videolink not permitted by national guidance but seeking urgent local clarification. We would strongly advise against GPs examining the body of a deceased patient infected with coronavirus and if completing form 4 simply state no to Question 9 ‘have you seen and examined the body’.
  • IT. Remote Working. “Away from my desk” is imminent and VDI (for EMIS) pilot has been favourable and should be rolled out later this week.

LOCAL ACTIONS/GUIDANCE FOR THE NEXT 24 hours

Clarity on funding and cash flow for practices.

Reminder: Next LMC Webinar is 1st April 2020 at 11:00. Dial in details to follow.

KEY MESSAGES FOR THE PUBLIC

The media messaging will focus on preparing the wider population to be ready for loved ones falling ill or dying and their own preparedness. This applies equally to our staff.

The public facing team will be expanded to increase exposure and the demographic of our team and any volunteers for media roles should be passed to Susie Bayley.

AND FINALLY

You will no doubt have seen the first reported deaths of HCWs from COVID-19 in the UK, A GP in Essex and a local ENT consultant from UHDB. Naturally our condolences go out to the families and colleagues of these dedicated individuals who have paid the ultimate sacrifice.

This Canticle for Lazarus is a very poignant and timely reminder for everyone:

  • Your lives are all precious
  • Your efforts are vital but
  • There is no emergency in a pandemic
  • So above all NO PPE – NO SEE

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