MESSAGE FROM DR NICOLA JONES: Latest coronavirus information

Update from Dr Nicola Jones,

Chair of the South West London Primary Care Cell

Dear colleagues,

In recent days, many of you will have been dealing with patients at the front line using remote consultations and managing clinical situations in a way that feels very new and different. GPs in their practices and PCNs across SW London are considering how best to manage patients with symptoms that could be COVID19, as well as patients who have other conditions. The concept of a respiratory pathway and hot and cold sites is being evolved.

I would encourage you to think about how to phase your plans. Phase 1 is where practices have zoned areas within the same building for assessment of suspected or possible COVID19. This is working in most practices now, however a phase 2 will inevitably be needed. This would be triggered when practices find the demand increases or staffing levels fall so that a buddying arrangement or a whole PCN solution is needed. Beyond that, we should plan for consolidation of hot sites according to local circumstances. A borough may have 2 or 3 hot sites, according to local need. Some areas are choosing to go straight into this kind of arrangement but some have it as a plan that may or may not need to be implemented in the coming weeks. Attached to this bulletin is a “How to” guide which will help you to think about your local arrangements.

General practice is always fleet of foot and has an extraordinary ability to flex and change. Never has this been needed more than it is now.

Thanks everyone. Please contact me or your local clinical leaders if you have questions or need support.

Best wishes,
Dr Nicola Jones
Clinical Lead, SWL Primary Care

PPE

Please find attached a SWL position on PPE from our COVID-19 clinical cell.  We know there have been staff and media concerns about the recent change in recommendations for protective wear for staff treating COVID-19 patients.  The clinical cell has looked closely at the issue and the attached position aims to bring some system-wide clarity on this.

SWL COVID-19 respiratory symptoms clinic set up guide

This attached document provides a summary of the information that should be considered when setting up “respiratory symptoms” clinics for the purpose of face to face assessments of patients with suspected COVID-19. These are patients who cannot be safely assessed and managed by telephone and/or video consultation alone.

IT service update

Remote Access

Your local borough lead will very shortly send you a link to guides to assist with establishing remote access options, so please look out for this. The files were too big to send to you in this update.

We are aware we have been sharing a lot of separate user guides for the different remote working solutions and video consultation options over the last few weeks, so we have compiled a SWL ‘rough guide’ to remote working that includes a summary of each of the different solutions.

Further summary updates around remote working solutions are set out below.

Egton tokens

The roll out of 2007 Egton remote access tokens is now underway. It is not yet known how long it will take for all 2007 emails to arrive in individual mail boxes but they should all have been delivered by COP today 27/03/2020.

The first test users have set up connectivity successfully with Emis Web, Docman, Accurx all working so far.

The initial issues around smart card compatibility with the Egton soft tokens has now been resolved

The email will arrive…

From:   noreply@safenetid.com​  SafeNet Authentication Server

Subject: Egton N3 Connect Account Self-enrolment

Please also read the related VPN instructions from the link below:

https://www.emisnow.com/csm?id=kb_article&sys_id=5f63f5c11bfbc4506281fcc1cd4bcba0

AwayFromMyDesk (AFMD)

Those that have these licences can continue to use or reactivate their accounts.

RealVNC

Those that have this access working can continue to utilise it.

Some practices have some proxy setting issues which the SWL Service desk team are troubleshooting at the moment.

 Smart card readers

We are sourcing smartcard readers for remote working so that users of Egton tokens have access to the full range of smartcard functions including electronic prescriptions. There is a national shortage and a solution to this is being discussed by NHSD. We will update with any communication as and when it becomes available.

Guide to setting up quick codes and text in EMIS

This attached quick guide is to help practices set up codes to insert standard text into consultations, speeding up the process.

Coroner guidance

 Please find attached advice from HM senior coroner, South London, on COVID-19 and death certification. This includes information on new emergency legislation on COVID-19 and the impact on death certification.

Digital isolation notes

Please see below for noting from the NHS bulletin from Dr Nikki Kanani and Ed Waller:

To reduce the burden on GP practices a new online system, created by the NHS and the Department for Work and Pensions, is now live for patients to be emailed a digital isolation note. Isolation notes provide patients with evidence for their employers that they have been advised to self-isolate due to coronavirus, either because they have symptoms or they live with someone who has symptoms, and so cannot work. As isolation notes can be obtained without contacting a doctor, this will reduce the pressure on GP surgeries and prevent people needing to leave their homes. The notes can be accessed through the NHS website and NHS 111 online. After answering a few questions, an isolation note will be emailed to the user. If they don’t have an email address, they can have the note sent to a trusted family member or friend, or directly to their employer. The service can also be used to generate an isolation note on behalf of someone else.

As a reminder, these national bulletins are being produced on a daily basis and include lots of valuable information including details on weekly primary care webinars which are taking place every Thursday from 5-6pm. You can find the bulletins at the link below but please also ensure that you sign up to receive them in your inbox. We are passing on important national information to you through the SWL team as it arrives with us but this ensures you receive it directly.

https://www.england.nhs.uk/coronavirus/primary-care/other-resources/primary-care-bulletin/

Attachments

  1.  SWL PPE
  2.  SWL Resp Clinic Guidance
  3.  Quick Guide to setting up Quick Codes and Text in EMIS
  4.  COVID coroner

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