MESSAGE FROM DR NICOLA JONES: Latest coronavirus information

Update from Dr Nicola Jones,
Chair of the South West London Primary Care Cell

15th May 2020

Dear Colleagues

As we watch case numbers and deaths from COVID-19 thankfully reduce, we can now focus on our future. Care homes – of which we have about 1500 across SW London, have been at the forefront of our minds in recent weeks. The staff who care for the residents, community services teams and GPs in the local practices have been doing their very best under difficult and often harrowing circumstances. There is a reminder in this bulletin about the national proposal, which seeks to rapidly establish regular pro-active MDT reviews in care homes. We have a range of established approaches across our 6 boroughs and in many care homes this co-ordinated care already exists. With time we hope to build on the good practice and ensure all residents have access to the care they need. The national proposal presents an opportunity to contribute to that future and your local primary care team is keen to support you in this.

Best Wishes
Dr Nicola Jones
Clinical Lead, SWL Primary Care

Support to care homes

We wrote to practices on 13th May regarding support to care homes in SWL, following the national letter – Primary care and community health support for care home residents.

Thank you to practices who have so far responded to the simple online form confirming whether your practice will sign up to the short-term service outlined in the SWL letter. For practices who have not yet done this, we would be grateful if you could respond by 5pm on 18th May.

PCN DES participation

We have e-mailed PCN Clinical Directors about re-confirming participation in the PCN DES for 2020/21, following a letter to all practices on 7th May. We have been encouraging early sign-up to support the release of 2020/21 funding but to be clear, PCNs have until 31st May to re-confirm participation in the DES as per national guidance.

Service and test updates

We have been receiving queries from GPs about the availability of diagnostic services. We will try and keep you informed in these bulletins, and will also update the SWL COVID-19 page on GP Team Net with information as we receive it. Below is some information, and there will be more to come.

St George’s referrals pathway (attached)

Key messages:

    • Use Advice and Guidance/Kinesis first if appropriate
    • eRS is OPEN to routine referrals
    • Refer TWR using TWR pathway as before
    • Where Urgent Pathways exist please refer as normal – eg TIA, First Fit etc

SWL pathology

Fully operating across all disciplines so GPs can request all of the usual investigations.

Pathology – ESH

It is business as usual and all tests are available for GPs to request. However, with some persistent staff illness the turnaround times of some specialist tests may be somewhat increased.

Staff risk assessments

In the Friday update last week, we reminded practices of the need to risk assess staff to identify those at increased risk from COVID-19, and linked to this guidance from NHS Employers which we said practices might find helpful. We also mentioned that a national tool was being worked on.

The national risk reduction framework has now been published. It is based on a consensus following discussions between experts in the field, and describes the different factors that should be considered in risk assessments. Practices may want to read this in conjunction with the NHS Employers guidance, which while in parts may seem more relevant to hospital employers, includes some potentially helpful actions for other employers at the end.

Reopening of fertility clinics & new SWL assisted conception treatment and fertility preservation policy

Please find attached a message from Dr Andrew Murray, Clinical Chair of NHS South West London CCG.

It has been announced by the government that fertility clinics are now able to apply to reopen, effective Monday 11 May 2020.  We expect South West London providers to begin reopening from next week at the earliest – GPs can now refer new patients for treatment for clinics to assess once they are open.

In addition, there is now a single policy for assisted conception treatment and fertility preservation across South West London. The attached message provides details of this.

Primary care and community respiratory resource pack

The NHS London Clinical Networks primary care and community respiratory resource pack has been reviewed and an updated version is now attached. This is the fifth version of the document that has been previously circulated to practices.  Updates for this version include:

  • Updated guidance on use of oxygen therapy
  • Updates on reuse of EOL medicines, advance care planning
  • Direction to links for verification of death guidance
  • Management of homeless patients on discharge from hospital emergency departments

End of life care

London EOLC Covid-19 primary care support document

The attached document brings together existing resources and guidance in an accessible way, to help inform clinicians during Covid-19. Topics covered include:

  • Compassionate conversations
  • Communication skills
  • Identification
  • Coordinate my care
  • Admission to hospital decisions
  • Community palliative care
  • PPE
  • Care home considerations
  • Care after death
  • Self-care

Supply of EOLC meds

The supply routes for EOLC meds for all boroughs can be found here.

Attachments

  1. SGH COVID referral management update
  2. Fertility treatment
  3. Primary and Community Care Respiratory Pack v5
  4. London EOLC CN COVID-19 Primary Care Support Document

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