MESSAGE FROM DR NICOLA JONES: Latest coronavirus information

Dear Colleague

General Practice has a history of doing what is needed to rise to a challenge and I know that there is an immense amount of effort going into planning and delivering safe services at the moment. It’s a very fast moving environment and we are working hard across SW London to mount a co-ordinated response to the COVID-19 pandemic, liaising with your local clinical and managerial leads on a daily basis. We are aware that there is a lot of guidance being issued, and yet it doesn’t cover every situation so people have lots of questions. I know you are all adapting rapidly as you encounter new issues and we want to ensure you are in the best position possible to care for patients, and protect your staff.

We have established groups of clinicians and managers who are working on COVID planning. This includes people from your local teams who are experts on primary care, clinical and digital/IT issues. Together we will endeavour to ensure that you receive the advice and support you need.

Thanks to everyone in primary care in South West London for all your hard work.

 Nicola Jones

Clinical Lead, SWL Primary Care

In this e-mail you will find a summary of the latest, most important information on COVID-19 for all practices. We are sending out these summaries every Friday and will continue to send information in between with  changes to the guidance or other important updates.

There is now one national site for all primary care guidance on COVID-19, which will be updated regularly – https://www.england.nhs.uk/coronavirus/primary-care/. Please ensure you check this site daily for the latest information.

Move to delay phase in response to COVID-19

The attached letter has now been circulated to practices via a CAS alert. This entails significant changes to how potential cases of COVID-19 are identified and managed. Advice is now as follows:

  • The public are being advised to stay at home (self-isolate) without any testing for COVID-19, regardless of travel history or contact with confirmed cases, if they have: a. A new continuous cough OR b. High temperature (of 37.8 degrees centigrade or higher). Individuals should self-isolate for 7 days from the onset of symptoms. If someone has serious symptoms they cannot manage at home they should use NHS 111 online here https://111.nhs.uk/covid-19. People should only call NHS111 if they cannot get online. New guidance for patients has been published here https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-people-with-confirmed-or-possible-coronavirus-covid-19-infection.
  • The geographic element of the case definition has now been removed. Travel and contact history are no longer important for diagnosis, which is on the basis of symptoms alone. If people who have travelled do not have symptoms they do not need to stay at home, regardless of their travel history.
  • Testing will not be offered routinely to individuals staying at home.
  • Patients who require overnight admission to hospital should still be tested regardless of travel history if they present with:

∙ either clinical or radiological evidence of pneumonia

or

∙ acute respiratory distress syndrome

or

∙ influenza like illness (fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset: persistent cough (with or without sputum), hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing)

We are expecting further national guidance for practices reflecting this, including on changes to patient access to practices. Please continue to check your e-mail and check back at the Primary Care website – https://www.england.nhs.uk/coronavirus/primary-care/ – for the latest information.

Use of NHS 111 

NHS 111 is experiencing very high call volumes.

As per the attached letter from Dr Nikita Kanani and Ed Waller, when directing patients to general information on coronavirus, please use this link – https://www.nhs.uk/coronavirus. For patients concerned that they may have coronavirus or may have come into contact with someone who has, the NHS 111 online service has created coronavirus pages that tell patients what they should do based on their particular circumstances.  These can be accessed at https://111.nhs.uk/covid-19.

Practices should ensure that telephone messages and websites use the above information, while directing patients to call 111 only if they need to speak to someone. The latest standard messages for public facing information are available at . The latest patient information posters to be put outside the practice and for a practice closure for cleaning are here https://campaignresources.phe.gov.uk/resources/campaigns/101-coronavirus-/resources/5015.  You need to create an account with PHE to access them. Please ensure you check back regularly so that your posters contain the correct information.

We are expecting all of these links to be updated with the latest advice, reflecting the move to the delay phase in response to COVID-19.

Reporting problems to Vocare

Where you want to report problems with how NHS 111 has dealt with individual patients you can raise these issues with Vocare, the local provider of NHS 111, at slduc.governance@nhs.net. You can send patient identifiable information to this address. Please only contact this address if you are sure that this is a genuine issue – for example, if the patient has spoken to 111 and does not meet the criteria for testing you should not contact this address.

Environmental cleaning

National guidance on environmental cleaning in primary care is available here #environmental-cleaning-following-a-possible-case">https://www.gov.uk/government/publications/wn-cov-guidance-for-primary-care/wn-cov-interim-guidance-for-primary-care#environmental-cleaning-following-a-possible-case.

IT Kit

As you may know or have been informed by your local lead or PCN lead , we are ordering additional IT kit,  such as Webcams and Headsets for deployment. Also we are requesting that you review your mobile devices and laptops that are currently in circulation. Please ensure these are still functioning and that they are all updated and charged up, ready to be used if required.  In addition to those devices we are also looking to deploy additional laptops from a pool that will be deployed as the need and user are identified.

IT Guidance / Away From My Desk Licenses

Many practices are making changes to their usual appointment system using telephone, video and online access. In order to support this we have put together some information and guidance for practices. It includes step by step guides for both VISION and EMIS practices to show how to change online appointment booking from face to face to telephone / video triage, following the advice to do this last week.  This will be sent out by e-mail from your local CCG teams very shortly – please look out for this.

You should receive an e-mail from your local CCG team about how to register for Away From My Desk licences to anyone (clinical or non-clinical) in your practice that might require them – please look out for this.

Business Continuity Planning

All boroughs have already held or have organised a planning meeting for PCN Clinical Directors. These meetings are designed to be an opportunity to do some planning together, harnessing your good ideas and collective wisdom. Some of the ideas that need to be explored are:

  • How to ensure that every single patient attending your practice has been triaged
  • When will it be necessary to stop routine work (which will require national guidance)
  • What care can and should be done remotely – clinician in the practice, patient at home
  • How to manage a patient who probably has coronavirus but needs a face to face clinical assessment
  • How to manage a nursing home
  • When should I be doing a home visit and how do I protect myself and the patient?
  • What happens if several of your staff are unable to work?
  • Could you work with another practice – what would be possible?
  • What else can we do to support staff?

These questions will also be discussed amongst SWL clinical leads in the next week and we are also expecting national guidance on some of them shortly.

 Test Results

We have received some queries from practices about how patients receive both positive and negative results. Positive results are communicated to patients via PHE. Negative results were being communicated via the acute Trust. However NHS England London has now commissioned the London Ambulance Service to contact all patients who have tested negative and are awaiting a call.

COVID-19 Home Management Service

The attached letter from Dr Nikita Kanani and Ed Waller refers to urgent measures taken to commission a COVID-19 Home Management Service in all parts of England for patients who have tested positive for COVID-19.

SELDoC Healthcare are now providing this service in South West London. It went live on Tuesday 10th March 2020. Patients will be provided with a freephone 0800 number to contact the service.

Text Messaging

Following on from the information sent in last week’s e-mail, practices may need to contact patients via text message where there is a change in the way the practice operates due to Coronavirus. Where this is the case, please contact your local CCG lead who can help you with wording and access to text credits.

Borough Clinical Leads

Borough level clinical leads have been identified to work on COVID-19 planning. These are:

Dr Phil Moore – Kingston
Dr Kate Moore – Richmond
Dr Karen Worthington – Merton
Myself at moment for Wandsworth
Dr Jeff Croucher -Sutton
Dr Angelo Fernandes – Croydon
Dr John French – Croydon

Updates to Pharmacies and Dental Practices

Updates have also been sent out from NHS England and Improvement to pharmacies and dental practices – we are including these in this e-mail so that you are aware of what has been sent to them.

SWL Primary Care team

Attachments

  1.  Delay phase letter
  2.  Preparedness letter primary care 10 March 2020

 1,784 total views,  2 views today