MESSAGE FROM DR NICOLA JONES: SWL Primary Care Cell COVID-19 update

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

17th April 2020

Dear colleagues

It has been another week in which an abundance of guidance and documentation has come our way. I’m always impressed at the speed that practices take on board new information and requirements and make changes to their systems and clinical practice. This email tries to help by flagging the important issues and is open about where there is a lack of clarity. Our GP Teamnet portal will hopefully help you keep track of all the documentation and enable you to share it with your practice team. If you have suggestions about how we can support you in other ways then please get in touch.

Best Wishes
Dr Nicola Jones
Clinical Lead, SWL Primary Care

Managing childhood illness

During the pandemic there has been a reduction in paediatric patients presenting both to general practice and to urgent care services.  Please consider putting information on your practice website to ensure parents are aware that they can seek advice about their unwell child and that general practice services are available.

There is some suggested wording for websites below which you can amend as appropriate, along with a link to an information poster for parents and carers which can go on your website. 

Suggested website wording:

For Parents/Carers:

If your child is unwell and you need advice from the practice then please contact us as you usually would.  Please do not delay contacting your practice and seeking advice if you and your child need it. During the COVID19 pandemic, don’t come to the practice – contact us first.

https://www.rcpch.ac.uk/sites/default/files/2020-04/covid19_advice_for_parents_when_child_unwell_or_injured_poster.pdf

111 direct booking

The latest national GP preparedness letter stated that “from the date of this letter until 30 June 2020, all practices in England must make available a minimum of 1 appointment per 500 patients for direct booking from 111”. We are aware that this has caused some concern. However, it is our understanding that these appointments do not need to be ring-fenced at this time and that practices can still use these appointments for bookings through all other routes. The aim seems to be to ensure that practices have capacity to see any patients that are directed to them from 111. Practices will want to carry out a second remote triage before deciding where and how the patient should be managed. We are expecting further clarification on this early next week and will pass on any information as we get it.

Patient registration

South West London CCG has been asked to help support and ease the pressures on ED during the COVID-19 pandemic particularly in relation to a number of patients presenting at ED who are not registered with a GP.  Please find attached the guidance on registration from the national preparedness letter of 27th March, which you should follow.

EDs will be advising these patients to register at their local GP practice by visiting the GP practice website. Please ensure that your website includes a copy of GMS1 form which can be printed off and/or completed online (if online, with a supporting signed letter from the patient, posted or emailed to the practice to complete the registration). Please ensure that you follow your usual registration processes as closely as possible but consider providing some flexibility to reflect the current circumstances. Patients should avoid attending in person to sign forms.  We request that you aim to speed up your registration process where people need access to health care.  We would look to support reasonable adjustments to the usual processes during the Covid-19 pandemic to ensure timely patient care and registration.

May Bank Holidays

Thank you again for the fantastic work that you did over Easter to open on the Bank Holiday Friday and Monday.

As per the latest national GP preparedness letter the definition of core hours has been temporarily amended in the GP contract regulations so that it may include bank holidays if this is agreed between NHSE/I and the Secretary of State. This definition includes the May Bank Holidays and we understand that, like the Easter Bank Holidays, these will be classed as working days in general practice. However the national team have not yet clarified exactly what level of service will be expected on these days. We will provide further guidance on this as soon as we can.

Death certification

You may have heard about some NHS England London guidance that detailed alternatives to the usual process of confirming a death, proposing how this this could be done remotely, in place of a visit in person.

We had not yet circulated this guidance across SW London, as we wanted to check its implications and make sure it was handled with the utmost sensitivity before we issued it.

We have heard today that NHS England are now reviewing this guidance due to some expected new national guidance, and also to reflect some subsequent discussions with London Coroners.

If you have received this guidance from another source,  please do not change your current practice, and please do not circulate it further, as it may now be changed.

Video and online consultations

Please see the extract below from Wednesday’s national primary care bulletin. Practices are reminded that the use of a video consultation system such as AccuRx does not constitute online consultations, so does not fulfil the online consultation part of the requirement.

Practices using DoctorLink for Online Consultations are reminded to continue to check their nominated practice mailbox for DoctorLink Alerts. This is particularly important if you are a connected practice and you are no longer making appointments available to book via DoctorLink. The DoctorLink team will issue a communication to all users to this effect shortly so please look out for that for further information.

From national primary care bulletin:

Practices are reminded that as per our letter of 27 March, all practices should be remotely triaging all patient contacts. To support this, all practices must have an online consultation system in place that supports total triage. While total triage can be done over the phone, this is less efficient and risks patients being unable to contact the practice if phone lines are busy. Commissioners and practices are asked to ensure all practices have an online consultation system in place by the end of April 2020 at the latest. It is also essential that all practices have a video consultation system in place to support remote management of patients. This should be in place by 17 April 2020.

GP Team Net

A reminder that you will have received an e-mail on Wednesday (15th) from this address about the launch of a SWL GP Team Net portal where you can find, in one place, the latest COVID-19 guidance and information as well as these updates – please look out for the e-mail. Existing GP Team Net users will be able to access the portal using their existing logins. If your practice has never used GP Team Net then your practice manager will have received a separate email with details of how to get set up and how to access staff training.

Pan-London acute and GP data sharing

We included some information in our last update about SWL fast tracking a number of data sharing initiatives via the OneLondon (Cerner) hub.

The sharing of the GP data across London through the OneLondon HIE hub was due to go live yesterday. However, due to some identified technical issues and IG concerns this has been delayed slightly. The OneLondon programme along with the SWL Connecting Your Care programme are working towards resolving these issues as soon as possible.  We will clarify the new go-live date as soon as possible.

Raising concerns about quality of services

The SWL CCG’s quality team continues to manage concerns about the quality of provider services via the Make A Difference system for Kingston, Merton, Richmond, Sutton and Wansdworth and via DXS for Croydon. Please continue to report concerns as they arise. The Make a Difference form for reporting concerns is available on the former CCG websites even though these sites are no longer being updated.

Diabetes key information

 A series of guidance notes have been published to provide key information on diabetes and COVID-19. Please also find attached an at-a-glance factsheet on COVID-19 and diabetes from the Primary Care Diabetes Society.

Attachments

  1. Patient Registration
  2. Glance Factsheet COVID19 and Diabetes DPC

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