Please find our GP weekly summary below, which include updates on Remote Consultations, the COVID-19 Temporary Privacy Notice, National flu immunisation programme 2020/21 and more. Download it now here:
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This week has seen the introduction of new measures to gradually lift some of the lockdown restrictions across England. Workplaces, such as branch sites, which have been temporarily closed during the lockdown are permitted to reopen and staff must continue to adhere to social distancing and hygiene standards.
A) Bank Holiday – Monday 25 May 2020
As announced on the NHS webinar last week, is anticipated that 25th May will be treated as a normal Bank Holiday with GP Practices not expected to be open. This is dependent and conditional on local arrangements being made as normal to provide cover.
B) Implementing and Managing Support for Care Homes
NHS England has requested that primary care and community health services continue to help, building on what practices are already doing, to support care homes. All practices are encouraged to take part, ideally delivered at Primary Care Networks (PCN) level.
The clinical service model should implement the delivery of a consistent, weekly ‘check in’, to review patients identified as a clinical priority for assessment and care. The weekly check in should:
- be delivered, primarily remotely wherever appropriate, by an MDT where practically possible, drawing on general practice and community services staff and expertise
- review patients identified as a clinical priority for assessment
- support the provision of care for those patients identified as a clinical priority
- include appropriate and consistent GP medical supervision and input
- support the introduction and use of remote monitoring of COVID-19 patients using pulse oximeters and other equipment and prescription and supply of oxygen to care homes for treatment, where clinically indicated
- include more frequent contact with the care home where further needs are identified
A process must be established to support development of personalised and individually agreed treatment escalation plans for care home residents with care home teams, including end of life care plans and preferences where appropriate.
CCGs, PCNs and practices should co-ordinate pharmacy teams to provide support to care home residents and staff to include facilitating medication supply to care homes, including end of life medication, delivering structured medication reviews – via video or telephone consultation where appropriate and supporting reviews of new residents or those recently discharged from hospital.
A named clinical lead for each CQC-registered care home in their area must be identified. This clinician will provide clinical leadership for the primary care and community health services support to the care home and take responsibility for the co-ordination of the service provision.
Additional costs for general practices and community health services providers – which cannot be met from their existing resources – may be eligible for reimbursement. Please check with the local CCG.
C) Total Triage and Remote Consultations
General practice has rapidly moved to triaging patient contacts and remote management of patients’ needs in response to COVID-19. In the last few weeks there has been an incredible level of change from carrying out most work face-to-face, to now providing most services to patients remotely.
To support total triage (remote total triage) and remote management, Practices should by now have an online and video consultation system procured and live to help protect both patients and staff by reducing footfall and ensuring general practice remains open and available to anyone who needs it.
D)COVID-19 Temporary Privacy Notice
Information sharing has happened differently over the last few weeks to support the fight against COVID-19 and to protect people compared to usual times. Doing things differently can bring uncertainty about what is and is not appropriate from a data sharing perspective; the concern may be that too much or too little information is shared. Practices must make sure that they have the balance right. The COVID-19 response has proven just how effective confidentiality safeguards are, and how quickly laws and clauses supporting the sharing of confidential patient data in a time of crisis can be activated.
NHS England is working closely with the National Data Guardian (NDG) and Information Commissioner’s Office (ICO) to ensure a high level of transparency for patients during this period. This example supplementary privacy notice can be used by organisations to inform patients about the ways information is being used because of COVID-19.
COVID-19 Information Governance advice for staff working in health and care organisations is available from the NHS including mobile messaging, video conferences, home working, using your own device, and communication between health and social care colleagues.
E) National flu immunisation programme 2020/21
There have been many questions about planning for the 2020/21 flu season to protect those at risk. Due to COVID-19 it is more important than ever that effective plans are in place to prevent ill-health and minimise further impact on the NHS and social care. NHS England has published a letter setting out which groups are eligible for the flu vaccination programme this autumn and the actions that Practices should take to prepare. Delivering the flu immunisation programme is likely to be more challenging this year because of the impact of COVID-19, but further guidance will be issued about how to manage the immunisation programme to reflect circumstances nearer the planned start of the programme in September 2020.
F) Safety Alert – Tiger Eye Protector Product
The CAS alert issued on 09-May-2020 highlighted the results of a test carried on Tiger Eye protective goggles and frames that originated from the Pandemic Influenza Preparedness Programme (PIPP) Stock purchased in 2009. The test showed the product does not meet the current requirement for splash protection required in BSN 166 (including certain testing requirements documented in BSN 168). As a result, this product should not be used in a Covid-19 setting and will removed from the supply chain.
The current Infection Prevention and Control Guidance recommends that a full-face shield or visor should be used when performing ‘aerosol generating procedures’ (APGs). Staff in your Practice may already have used the above Tiger Eye Protector product for non AGPs and the risk from using it in direct patient contact when not performing AGPs is limited.
If staff have used the product when performing AGPs or if otherwise they have been exposed to droplets or splashes you should communicate this to HSE through the RIDDOR route https://www.hse.gov.uk/news/riddor-reporting-coronavirus.htm.
G) NHS Volunteer Responders: Practical Guide for Primary Care
NHS England and NHS Improvement have published a practical guide to help understand the opportunities that the NHS Volunteer Responders scheme presents for primary care. It includes some useful mythbusters and top tips to be as proactive as possible to refer people who may benefit from the help of a volunteer.
H) Domestic Abuse and Coronavirus
Measures introduced by the Government to tackle coronavirus e.g. lockdown will mean many people have felt unsafe staying in a home with an abusive person, isolated from their support networks. In response, the Government said the coronavirus household isolation instructions did not apply if they need to leave their home to escape domestic abuse.
Although some lockdown restrictions have been gradually lifted this week some people may still not come forward if they are experiencing abuse, and since face to face consultations over the last few weeks have been extremely minimal it is important to recognise signs and take action.
Most appointments are still being carried out over the phone or via a video link, so Practices need to know how to best support people if they know or suspect that someone is experiencing abuse. Women’s Aid has put together advice and information about support that’s available – Coronavirus safety advice.
I) Updated FAQs on Coronavirus Outbreak Indemnity
NHS Resolution has produced some updated Coronavirus outbreak indemnity FAQs including:
- What indemnity arrangements cover clinical negligence for NHS services provided in relation to the response to the coronavirus outbreak?
- Do volunteers supporting the response to the coronavirus outbreak have indemnity cover?
- How will retired staff coming back to work to support the response to the coronavirus outbreak be indemnified?
- What are the indemnity arrangements for pharmacists working in general practice and secondary care, including those returning to the profession to help with the response to the coronavirus pandemic?
- What is the position in Scotland, Wales, and Northern Ireland?