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In this Bulletin:
- Child Abuse Update
- The Impact of COVID-19 on Mental Health
- COVID Reimbursement Claims
- Coronavirus: Guidance for Young Carers
- ‘Your COVID Recovery’ Service
- COVID-19 Up to Date Guidance
- Updated Shielding Guidance Changes for Children
- Supplying Face Mask Exemption Letters to Patients
- Advice and Guidance Toolkit for the NHS e-Referral Service
- New Animated Videos to Support Total Triage in General Practice
- Severe Penalties for Assaulting Emergency Workers
- First Contact Physiotherapists (FCPs)
A) Child Abuse Update
The NSPCC has released figures showing that in April, May and June there were more than 22,000 contacts to the NSPCC helpline from adults with concerns for the wellbeing of a child, an increase of 32% on the monthly average for the three months prior to lockdown. Figures show that the main concerns people have spoken to the NSPCC helpline about during this period were parental behaviour, physical and emotional abuse and neglect, and around 40% of the contacts received were referred on to local authorities or the police for further action.
The NSPCC has updated their Definitions and signs of child abuse guidance for professionals who work with children on how to recognise the signs of child abuse, including the following – physical abuse, neglect, sexual abuse, child exploitation, harmful sexual behaviour, emotional abuse, domestic abuse, bullying and cyberbullying, child trafficking, and female genital mutilation (FGM).
B) The Impact of COVID-19 on Mental Health
The British Medical Association (BMA) has published a report outlining the effects of the coronavirus outbreak on the mental health of the population in England. The report expresses concern that children and young people will be adversely affected, and gives recommendations that includes:
- The health and wellbeing support for all healthcare staff must be accessible and sustained for the long-term
- All NHS staff should have access to basic training in mental health
- National and local government and NHS bodies should take a ‘mental health in all policies’ approach to policy making, by undertaking a mental health impact assessment of all new policy proposals
C) COVID Reimbursement Claims
General practice was provided with additional funding to meet all extra costs associated during the first part of the COVID emergency and moving forward the funding will be flexible to adapt to the changes that are required. Practices should liaise with their local CCG to confirm which additional costs that might arise which are agreed to be reimbursable, if not already stipulated on the claim form. More funding for general practice will be available soon and NHS England is expected to release further information about the COVID Support Fund.
D) Coronavirus: Guidance for Young Carers
The Department of Health and Social Care (DoHSC) has published a really useful guide with pictorial and bullet point information for people under the age of 25 who are providing care for someone during the coronavirus outbreak. The guidance is designed to help young carers understand the changes they need to make and signposts the help available during the coronavirus outbreak.
E) ‘Your COVID Recovery’ Service
People who are suffering long-term effects of coronavirus will soon be offered an on-demand recovery service. Patients who have been in hospital or suffered at home with the virus, but still have problems with breathing, mental health problems or other complications, will have access to a face-to-face consultation with their local rehabilitation team, usually comprising of physiotherapists, nurses and mental health specialists. Following this initial assessment, those who need it will be offered a personalised package of online-based aftercare lasting up to 12 weeks, available later this summer.
F) COVID-19 Up to Date Guidance
For the latest COVID-19 information and advice the NHS England and NHS Improvement coronavirus website has a section for Primary Care, and further information for General Practice which includes updates and guidance, the GP SOP, information about at risk patients, and guidance for GPs and practice staff considering returning to the NHS.
The gov.uk website has the latest Government guidance and support, and you can read more about what people can and cannot do (updated 9 July 2020) including gatherings, public spaces, and activities; vulnerable groups, shielding, 70 year olds and over, and care homes; going to work/closed businesses/safer spaces; workers’ rights; public transport; schools and childcare; borders/international visitors; and devolved administration (if you live in an area that is experiencing a local COVID-19 outbreak where local lockdown measures have been imposed).
G) Updated Shielding Guidance Changes for Children
The Government shielding guidance has been slightly relaxed so that those who are shielding can meet in groups of up to 6 outdoors and to form “support bubbles”, if they wish. In addition to these changes, the guidance has been updated to reflect the Royal College of Paediatric and Child Health’s guidance on children and shielding, which the government has now endorsed. Children and young people should continue to shield until 31 July 2020.
From Saturday 1 August 2020, the guidance will then be paused so clinically extremely vulnerable people of all ages will no longer be advised to shield. Most children and young people are expected to be removed from the shielded patient list following consultations with clinicians and GPs over the summer. This group will not be advised to shield if government guidance on shielding is changed in the future.
H) Supplying Face Mask Exemption Letters to Patients
There is an increasing number of requests from patients for letters of exemption to wearing face masks. The BMA has produced guidance (updated 6 July 2020) on reducing COVID-19 transmission and PPE which includes a section on face mask exemptions.
It explains “the Government guidance suggests there is no requirement for evidence for exemption. It should be sufficient for someone to declare that they are eligible for an exemption direct with the person questioning them (e.g. bus driver). Practices are therefore not required to provide letters of support for those who fall under the list of exemptions, or to those who do not fall under the list of exemptions. Some transport providers are providing evidence of exemptions themselves”.
I) Advice and Guidance Toolkit for the NHS e-Referral Service
Advice and Guidance (A&G) services enable secure and rapid communication between primary and secondary care colleagues across a range of specialties. A&G provides one of the three main NHS e-Referral Service (e-RS) channels through which a GP may obtain a clinical opinion. By facilitating access to specialist advice prior to or instead of referral, A&G services help reduce unnecessary outpatient activity and deliver better outcomes for patients.
To help increase the uptake of A&G, the National Elective Care Transformation Programme (NECTP) has made various tools and resources available to GPs via its Community of Practice platform and practices can email [email protected] for access. Further support is also available on the Advice and Guidance toolkit for the NHS e-Referral Service webpage.
J) New Animated Videos to Support Total Triage in General Practice
As part of Health Education England’s (HEE) e-learning programme for COVID-19, a remote total triage in general practice resource has been developed by the Digital First Primary Care Team and HEE to support all GP practices in England with the rapid implementation of a ‘total triage’ model consisting of five free short videos which cover each of the key steps.
K) Severe Penalties for Assaulting Emergency Workers
The Ministry of Justice has launched a consultation on introducing more severe penalties for assaulting an emergency worker. After consulting with the public including with those who represent emergency workers, the Government will decide whether to bring forward legislation which could double the maximum sentence to two years in prison.
QCS has a Zero Tolerance Policy and Procedure to demonstrate the commitment of our clients to the safety of staff, patients and visitors whilst supporting staff to undertake training to be able to defuse anger and avert violence or aggression and report incidents effectively to ensure that appropriate action is taken.
L) First Contact Physiotherapists (FCPs)
Musculoskeletal (MSK) FCP roles are now funded under the new PCN DES and have been helping primary care services support self-management whilst delivering services virtually under the lockdown. There is an expectation that general practice will see an increase in MSK patients seeking an appointment as the lockdown eases. PCNs will want to consider including FCPs in their workforce plans and many FCPs are also prescribers.