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DAILY COVID BRIEFING DDLMC 18.3.2020

KEY MESSAGES FOR TODAY

Yesterday Boris Johnson and the Chancellor made a joint announcement. There were no fundamental changes to the self-isolation / social distancing measures. Key take homes were:

  • Further public measures are anticipated over the next few days - details to follow
  • Health care worker testing is a priority
  • Efforts concentrated on better data and vaccines
  • Large package of financial support for businesses and individuals which will hopefully encourage those who need to self-isolate to do so

The, perhaps, more relevant update was the letter from Simon Stevens which we circulated yesterday. This set out the key priorities for NHS organisations:

  • Free-up the maximum possible inpatient and critical care capacity.
  • Prepare for, and respond to, the anticipated large numbers of COVID-19 patients who will need respiratory support.
  • Support staff and maximise their availability.
  • ‘Enhanced support’ from GP practices for patients in the highest risk group.

From a general practice perspective there is more detail due today or tomorrow which we hope will provide more clarity on:

  • The urgent need to test Healthcare workers
  • Provision of appropriate and adequate PPE
  • The ongoing impact on the general practice workforce
  • The impact (amount and severity) of increased community-based morbidity with discharges and delayed procedures
  • Further removal of non-urgent or essential burdens e.g. appraisal, all enhanced services, QoF.
  • What health and wellbeing provision will look like for Derbyshire HCW

KEY MESSAGES FOR THE PUBLIC

We will continue to publicise the following messages to the general public:

General practice will be functioning completely differently.

We need their support and adherence to recommendations:

  • DO think before ringing any services
  • DO NOT use services unless absolutely necessary
  • DO NOT request Med3s / reports / Holiday Cancellation Letters for COVID-19
  • DO follow self-isolation/social distancing guidance
  • DO use Electronic Prescribing Service to order NORMAL QUANTITIES of repeat medications
  • DO be patient with all staff – everyone is doing their bit and working flat out

LOCAL ACTIONS/GUIDANCE FOR THE NEXT 24 hours

  • GPs are now in control of what they can and can’t deliver and approval has been given by the CCG to do what is clinically necessary with the available resources. In essence, ask for forgiveness rather than seeking permission and if you need to change/stop, for example, extended access, care home provision (template letter attached) and work on QoF then do so.
  • Practices can continue to refer 2ww in the normal way. However, following national direction, we have received the following from RDH (and which should apply to all hospital referrals). “Routine activity is largely being stood down as directed nationally. We would ask that routine referrals are not made at present. We will always try to give advice - consultant connect is still live! For Existing appointments, we are trying to convert to telephone consultations wherever possible, and we will be contacting the patients directly ourselves so that should not impact on GP workload.”
  • A solution to the issue of self-isolating patients who meet the case definition of Covid-19 is still being urgently worked up by the CCG, LMC, DCHS and DHU. Through necessity, this will be a system wide approach and is likely to involve “Covid-19 positive hubs” for mobile patients and a suitably equipped home visiting service for the housebound.
  • We have been in touch with the RO Ken Deacon, who has indicated that appraisal and revalidation is going to be suspended in the next few days. The newsletter that was sent to all GPs yesterday was a routine communication that had been complied previously but has now been overtaken by events.
  • PPE. Current PHE guidance and the general practice SOP. We are working on a local temporary solution while the national system catches up.
  • IT. 45 laptops are being configured and will be prioritized for delivery over the next few days, on the basis of clinical need for self-isolating GPs and clinical staff. Some of the next batch of 200 laptops have already been delivered and will be dispatched to practices in the next week. The provision for new remote working users has improved but there are still some issues with turnaround times for faults for existing users and the CCG are monitoring NECs closely. Any requests for additional hardware or capability should be addressed to either David Hill or Claire Hilton at the CCG. The CCG update will provide further detail on remote working and video consultation solutions.

FAQs

In order to prevent a delay in publishing this update we will place the FAQs onto the LMC website and will provide a link.

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