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DAILY COVID-19 BRIEFING DDLMC 31.3.2020

KEY MESSAGES FOR TODAY

JOINT DDLMC/ GPA / GPTF / DCHS COVID RESPONSE TEAM

The EOL guidance is being finalized for publication tomorrow and the Home Visiting Service is also close to completion.

NATIONAL UPDATES

National Daily PM briefings. The briefing yesterday focused on repatriating UK citizens. Sir Patrick Vallance (Chief Scientific Adviser) also stated that social distancing measures are "making a difference". Transmission of coronavirus in the community is thought to be decreasing, which could mean fewer infections.

Extremely Vulnerable Patients. Derbyshire consensus is to hold off from sending any letters to Group 4 patients pending NHSE further guidance which was promised on Friday. If NHSE guidance is not forthcoming by tomorrow this will be reviewed and a local solution promulgated.

OTHER UPDATES

  • Testing for HCWs. Testing kits are becoming available for HCWs and the roll out programme is being implemented. The timescale and process for general practice is not yet clear but the Derbyshire COVID Response team are working with the CCG on an interim solution if these are delayed. Practices are advised NOT to purchase any kits themselves due to questions about their efficacy. To quote the Chief Medical Officer “there is only one thing worse than no test and that is a bad test
  • Patient complaints. NHSE have sanctioned practices taking a “pause” on dealing with patients’ complaints. Practices can choose to either pause (initially suggested for 3 months) or continue as normal. From 26 March 2020, the Parliamentary and Health Service Ombudsman has stopped accepting new NHS complaints and has stopped work on open cases.
  • Easter Bank Holidays. As previously stated, Good Friday and Easter Monday (08:00-18:30) are now included as core hours in GMS/PMS contracts. In consultation with the CCG (and the absence of national guidance) it has been agreed that essential services during these hours can be provided either at individual practices or in a “hub” arrangement, according to local demand/resources (and suitable telephone access being available).
  • Med 3 Update. Patients should be advised to go to NHS 111 online to get the isolation note as evidence for their employer. GPs are not required to issue Med 3 for any COVID-19 situations. Guidance is emerging about those who are shielding, self-isolating and social distancing and I will provide a more detailed update tomorrow.
  • Death. Some people have asked for clarification on cremation forms and our guidance has been amended: 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 or suspected coronavirus and if completing Form 4 having not examined the deceased simply state in the box after Q8 that you have not seen the body and the reason for this e.g. risk of infection. It is then up to the medical referee to decide whether to accept or reject it. We are collating guidance from the Chief Coroner, the General Registrar’s Office and the local coroner to provide a comprehensive (but short) local summary tomorrow.
  • IT. Remote Working. “Away from my desk” has now been cleared for use and the roll out should begin this week. NECs have produced a short guide (with pictures) attached for TPP Airmid video consultations.

LOCAL ACTIONS/GUIDANCE FOR THE NEXT 24 hours

Clarity on HCW Testing.

LMC Webinar is tomorrow at 11:00. Dial in details: Join Zoom Meeting

https://zoom.us/j/371035146?pwd=M3kwbWYyM3FQRkxjSzdEakpKZ0lJQT09

Meeting ID: 371 035 146 Password: 623581

KEY MESSAGES FOR THE PUBLIC

Red hub working will continue to be explained to the public and how this may look at different sites

Continued messaging on EoL decisions

AND FINALLY

See you tomorrow for the LMC/GPTF Webinar 11:00 1st April 2020, when we will wish Happy Birthday to the Royal Air Force. And the snow plough driver takes it home the night before and reverses it onto the drive.

I’ll finish with a thought from the American theologian Reinhold Niebuhr which appeared in 1944 in A Book of Prayers and Services for the Armed Forces, which is fitting as this feels like a time of war. While this was published in a religious context it is a very fitting thought for all of us in trying to protect our mental wellbeing. Every one of us only has a finite capacity so let’s focus on what we can do to make a difference and accept that others are also doing their bit.

Grant me the serenity to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference
.

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