Coventry & Warwickshire COVID-19 Portal

 

Primary Care Coronavirus briefing – Coventry and Warwickshire – 15 April 2020 

 

**Please find below the latest daily primary care coronavirus briefing.**

 

Information provided by NHS Coventry and Rugby CCG, NHS South Warwickshire CCG and NHS Warwickshire North CCG in line with Public Health England guidance.

 

This information may change rapidly as the situation develops. For the latest information for primary care, visit: https://www.england.nhs.uk/coronavirus/primary-care

1. Preparedness letter for general practice

The latest guidance letter for general practice was published yesterday and contains updates on changes to the GP Contract Regulations, NHS immunisations and child health surveillance as well as details on other guidance that has recently been published.

Contracting updates: 

Update on changes to the GP Contract Regulations 

 

The GMS & PMS Regulations, and APMS Directions, have been amended to formalise the arrangements announced in the letter dated 19 March 2020 to free up capacity in general practice. The changes to the Regulations:

• enable NHS England and NHS Improvement to suspend specific terms of the GP contracts during a pandemic with the agreement of the Secretary of State

• temporarily amend the definition of “core hours” so that it may include Good Friday and Easter Monday and bank holidays.

• increase the minimum number of appointments that practices must make available for 111 direct booking: From the date of the 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. The letter dated 27 March has further details.  

Network Contract DES  

 

Recognising the impact of COVID-19 on practices, and following the letter of 19 March 2020 setting out changes to the Network Contract Directed Enhanced Service (DES), they have published the Network Contract DES for 2020/21 alongside a cover note and associated guidance.

NHS immunisations  

While preventing the spread of COVID-19 and caring for those infected is a public health priority, it is very important to maintain good vaccine uptake and coverage of immunisations. The routine immunisation programme will continue to play a critical role in preventing ill-health through diseases other than COVID-19.

Child Health Surveillance (NIPE Infant Check) 

 

The Newborn and Infant Physical Examination (NIPE) infant check can be delayed until 8 weeks of age to coincide with the first primary childhood immunisations so they can be done in one visit

Today’s topics – use the links to jump to each section

 

**Latest local picture**

**Local updates** 

**Latest updates for each PLACE (Coventry and Rugby, South Warwickshire, Warwickshire North)**

 

Latest national picture

Communications from NHS England

Actions for Primary Care

Practice Nurse Communications - new

 

Today’s attachments

• Coventry and Warwickshire changes to local hospital services due to Covid-19 v02 8th April 2020.pdf (item 3)

• Safeguarding Newsletter No.2 - April 2020.pdf (item 5)

• EMIS Tips 5 Creating Deferred Treatment.pdf (item 6)

 

LATEST LOCAL PICTURE

 

Please remember: we are issuing daily (Monday to Friday) communications via: warnoccg.covid19primarycarecommunications@nhs.net. We would also ask that if you have questions or concerns relating to the current situation around coronavirus and COVID-19 you use the same address: warnoccg.covid19primarycarecommunications@nhs.net. Please keep us updated with any issues that you may be having so we can try to address them.

 

Local picture up to 15 April

• 1048 cases now confirmed in Coventry and Warwickshire (+29 / +2.8% from yesterday)

• 288 of these are currently admitted (-14 / -4.6% from yesterday)

• 741 beds still available (-62 / -7.7% from yesterday)

• 29 ITU beds occupied by Covid patients (-1 / -3.3% from yesterday)

• 197 reported deaths in a hospital setting (+8 / +4.2% from yesterday)

Care Home Cumulative Position up to 15 April

• 415 Care Home residents affected

• 93 confirmed cases note this number will always be lower than residents affected as once a care home has 2 cases confirmed testing stops and residents with symptoms are assumed positive and reported in the number of residents affected

• 32 Covid related deaths note these are in addition to the hospital deaths detailed above

• 52 Care Home deaths in total

 

LATEST LOCAL UPDATE

2. GP Connect

Information for EMIS sites: All sites should now be able to activate GP Connect HTML and Appointments in Organisation Configuration.

All practices are asked to not tick the structured capability as this capability has not yet received FRA and will not work. 

A useful guide for practices to follow is available online.

Any individual issues please report via EMIS now so that they can be investigated further. 

Vision practices are not able to use GP Connect as the development work has not been completed, if we hear of the situation changing we will update.

3. Changes to local hospital services due to Covid-19 

Current version: v03, Correct as of 15th April 2020. Please disregard previous versions. 

Your local NHS is working hard to tackle the ongoing COVID-19 situation. However, in order to ensure we are doing everything we can to protect our population, our staff and our NHS, and ensure we have enough staff where they’re needed most, we have had to make some difficult decisions about our non-urgent services, including cancelling appointments or temporarily closing services. 

Please note: all providers are committed to contacting patients affected by these temporary service changes and you do not need to contact the hospital booking officers unless it is urgent. (Attachment: Coventry and Warwickshire changes to local hospital services due to Covi....pdf)

4. Update on QOF aspiration payments in April 2020 

We have received some queries from commissioners about the timing of QOF aspiration payments in April 2020. We would like to reassure you that all practices will have received a QOF aspiration payment by the end of April 2020. The value of this payment will be the same as the March 2020 payment, as previously communicated. The timing of this payment will vary between practices based upon the date of their usual contractual payment.

For practices who receive their usual contractual payment on or before the 15th April, we will be making an ad-hoc separate payment for their QOF aspiration before the end of April.

For practices who receive their usual contractual payment on or after the 16th April, this will include their QOF aspiration payment.

5. Safeguarding newsletter 

The Safeguarding Newsletter is for General Practices to provide you with current safeguarding guidance and information. Supporting you to protect children, young people and adults. Issue 2 is attached. (Attachment: Safeguarding Newsletter No.2 - April 2020.pdf)

6. Safety netting templates – reissued from yesterday as some systems blocked the attachment

The COVID-19 pandemic means that GPs and patients may decide that a test or referral is not warranted at this time and would benefit from a delay until the worst of the pandemic has passed. This safety netting template is an excellent way to keep track of those patients. It is accompanied by an easy search which can be run at intervals to find those patients who can then be reviewed and a decision made about when to refer/investigate at a date chosen by the clinician and the patient together.  

If you do decide to still make a test request or referral, please put as much clinical detail as possible in each referral to enable clinicians at the acute trusts to triage these if required. As you know the 2ww pathway is still very much active and should be used when required. However, if a patient cannot be referred on this or another pathway for any reason such as patient choice, this template can be used to keep track of them.

 

This attached documents are useful templates to manage these delayed treatments safely in EMIS. (Attachment: EMIS Tips 5 Creating Deferred Treatment.pdf)

7. Warwickshire CAVA update – issue 8

The latest issue of the Warwickshire CAVA update is now available to view online.

 

LATEST UPDATES FOR EACH PLACE

UPDATES FOR Coventry and Rugby and Warwickshire North – 15 April 2020 

No updates this issue.

UPDATES FOR South Warwickshire – 15 April 2020 

8. SWFT – cancer diagnostic service

We remain committed to providing as efficient a cancer diagnostic service to the local population as possible. To support this, 2ww referrals will be added to the waiting list in line with standard process and managed in line with the clinical decision made following triage / assessment. However, we currently have very limited access to diagnostic endoscopy given the risk aerosol generating procedures (AGPs) pose to both patients and healthcare professionals. Access restrictions are in a keeping with national and international best practice and guidelines. We therefore will not able to offer diagnostic gastroscopy (OGD) or lower GI endoscopy to symptomatic patients for a number of months. We will update you when timescales for resuming endoscopy become clearer. 

We kindly ask you to remind referring doctors to be aware of this practical challenge when making any referral to our gastrointestinal services. 

Patients who choose to defer assessment, will be asked to re-present to their referrer (GP) when they are willing to attend at the hospital. The responsibility to return to their referrer will remain with the patient. If the referral does not meet the 2WW criteria, the GP will be consulted to discuss downgrade / discharge in line with the standard cancer waiting time rules.

If there are any particular queries or challenges regarding out-patient referrals during this time please contact Dr Jeremy Shearman, clinical director of endoscopy (jeremy.shearman@swft.nhs.uk) or the relevant cancer lead (upper GI - Bernhard Usselmann, lower GI – Sean Ramcharan). 

For any patient who may need an emergency assessment please continue to contact the on-call general surgeon for lower GI or the on-call gastroenterologist for upper GI concerns – available via switchboard.

9. DESMOND courses

For all patients with type 2 diabetes who have had a group session (DESMOND) cancelled and those that have been referred since the sessions have been cancelled, SWFT is offering the option of: 

• 1:1 video or telephone call with an educator

• access to MyDESMOND e-learning 

• access to Pocket Medic Video’s 

UPDATES FOR Warwickshire North – 15 April 2020 

No updates this issue.

LATEST NATIONAL PICTURE 

 

• As of 9am on 14 April 2020, 382,650 people have been tested in the UK and 93,873 were confirmed as positive. As of 5pm on 13 April 2020, of those hospitalised in the UK, 12,107 have died. (Please note: the figures for test results and for deaths are compiled from different sources. This is why the figures for deaths are reported from an earlier point in time than the figures for test results.)  

• The most up to date government advice on coronavirus is available online.

• The Chancellor Rishi Sunak spoke at a press conference with Steve Powis, Medical Director of the NHS and Yvonne Doyle, Medical Director at Public Health England. The briefing is available to view online and a transcript can be read here.

• The press conference slides and datasets used by Professor Stephen Powis, Medical Director of the NHS, in the daily coronavirus press conference on 14 April 2020 can be accessed online.

• Government to offer testing for “everyone who needs one” in social care settings. All care home residents and social care staff with coronavirus (COVID-19) symptoms will be tested as capacity is built up, the government is announcing today Details.

COMMUNICATIONS FROM NHS ENGLAND

10. NHS England Primary Care Bulletin – new edition – 14 April

COVID-19: latest guidance for general practice is issued in the NHS England Primary Care Bulletin (14 April) and includes the latest preparedness letter for general practice and the importance of maintaining the routine immunisation programme as part of the Child Health Information Services (CHIS). This regular COVID-19 Primary Care Bulletin is from Dr Nikki Kanani and Ed Waller and you are encouraged to sign up here: https://www.england.nhs.uk/email-bulletins/general-practice-bulletin/.

11. Primary care webinar

The next primary care webinar, with Dr Nikki Kanani and Ed Waller, will be tomorrow, Thursday 16 April between 5pm and 6pm (via Microsoft Teams), the link to access is here. Do note that webinars will now take place weekly.

 

12. Media enquiries 

Our communications team is here to support you if needed. If you are approached by the media, please forward on to your local communications team: agem.communications@nhs.net. Outside of working hours the communications team can be reached via 01522 537887.   

 

ACTIONS FOR PRIMARY CARE

Review the details in the latest preparedness letter.

Make a note in your diaries for tomorrow’s primary care webinar.

PRACTICE NURSE COMMUNICATIONS

Information below and included in this Communication relates to our General Practice Nurses and the services they provide.

This initial communication collates all the information to date, and further GPN Communications will be included in a sub-section of the daily Covid-19 Comms sent to Primary care, your Nurse Leads will be able to share these with you in the first instance.

Should you have any specific information requests, or wish to include information, please can this be directed to your Nurse Lead in the first instance.

In this edition:

• BSH B12 Supplement advice

• Compression Therapy information for patients

• Diabetes Newsletter

• FSRH Pregnancy Planning during Covid 19

• FSRH Provision of Contraception during Covid 19

• FSRH Recommendation on extension of impant during Covid 19

• RCGP Workload Guidance

• Remote Contraceptive advice – for telephone consultations

• PPE Information and links to current guidance

• Additional information – containing links to Gov.co.uk information pages

• Information relating to Questionnaire regarding support to other areas during Covid-19

The above files available to download via the following WeTransfer link. The link will expire on 22 April 2020.

Immunisation and Vaccination

The current guidance is that these must continue as part of our routine work, please do discuss with parents and alleviate any concerns they may have, and identify the importance of the programme at this current time. Advise them that only one parent should accompany the child for their appointment to reduce infection risk.

Cervical Screening 

The current programme is awaiting further guidance from PHE and NHSE, The Royal Wolverhampton service stopped the collections of cervical screening samples from primary care due to the required laboratory response for processing of Covid-19 samples. Please be reassured that we are continually requesting guidance for the follow up and treatment of our high risk ladies, and will communicate this as soon as possible.

----------------------------------------------------------------------------------------------------------------------------

 

Please note: This is the designated inbox for all Primary Care enquiries for practices across Coventry and Warwickshire, set up to help support practices and provide a single point of contact to send and receive information about the rapidly developing COVID-19 situation. Please be aware that guidance is changing regularly and we are endeavouring to keep you as up to date as possible.

 

Please note: the CCG has made the decision to use every email distribution list at its disposal in order to ensure as many people as possible receive these important updates. If you no longer wish to receive these updates, please reply to this email and we will remove you from the distribution list.

 

The inbox is monitored regularly, and we will respond to you as soon as we can. 

 

In the meantime, the latest guidance for primary care can be found here: https://www.england.nhs.uk/coronavirus/primary-care/ 

. This email has been scanned for viruses; however we are unable to accept responsibility for any damage caused by the contents. The opinions expressed in this email represent the views of the sender, not South Warwickshire GP Federation unless explicitly stated. If you have received this email in error please notify the sender. The information contained in this email may be subject to public disclosure under the NHS Code of Openness or the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed.