Primary Care Coronavirus briefing – Coventry and Warwickshire – 17 April 2020 (Issue 22)
17 April 2020
Attachments
Sent on behalf of the COVID-19 Incident Management Team for Coventry and Rugby, South Warwickshire and Warwickshire North CCGs
Primary Care Coronavirus briefing – Coventry and Warwickshire – 17 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. Staff testing is available this weekend
PLEASE NOTE STAFF TESTING IS AVAILABLE OVER THE WEEKEND. To request Staff testing (for you and your household as long as you have been symptomatic for five days or less and are over 18), please go to the Staff Testing section on the new Primary Care support website www.cwcovid.support and following the instructions.
You will be notified if your request is accepted and provided with appointment details.
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
Today’s attachments
• RCGP COVid coding flowchart.pdf (item 3)
• Covid coding prompt cards.docx (item 3)
• Cyber and COVID19 Letter and Attachment 20200416.pdf (item 4)
• 2020 04 09 Primary Care Safety Netting Letter1.pdf (item 6)
• COVID-19 bowel FAQs 20200409 FINAL.docx (item 6)
• Charity-support-lines-for-patients.pdf (item 6)
• COVID-19 - Updated Maternity Advice V1 FINAL.PDF (item 10)
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.
Coventry and Warwickshire COVID position up to 17.08.2020
• 1,291 cases now confirmed in Coventry and Warwickshire (+210 / +19.4% from yesterday, note that whilst this is a sizeable jump compared with previous days, this likely due to increased pillar 2 testing of key workers.)
• 266 of these are currently admitted (-15 / -5.3% from yesterday)
• 818 beds still available (+37 / +4.7% from yesterday)
• 22 ITU beds occupied by Covid patients (-8 / -26.7% from yesterday)
• 228 reported deaths in a hospital setting (+21 / +10.1% from yesterday)
CareHome cumulative position up to 17.08.2020
• 486 Care Home residents affected (+71 / +17.1% from yesterday)
• 109 confirmed cases (+16 / +17.2% from yesterday, 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)
o Confirmed carehome cases broken down by area (not CCG):
o Coventry: 30
o South Warwickshire: 26
o North Warwickshire and Rugby: 53
• 44 Covid related deaths (+12 / +37.5% from yesterday, note some of these deaths may have occurred outside of the home and so may be counted in the figure above)
• 90 Care Home deaths in total (+38 / +73.1% from yesterday)
LATEST LOCAL UPDATE
2. Shielding patients
Thank you all for the work you have already completed in checking the patients flagged in your clinical system as very high risk who require shielding and for identifying any additional patients that fall into this category who hadn’t already been flagged.
As you are aware, a number of people have self-identified as being at highest clinical risk themselves by registering on the government’s website prior to the 29th March 2020. You will shortly receive this list for your practice via tasks in your IT system between the 17 - 24 April 2020. Once received please could you check this list and confirm and flag the patients as high risk as appropriate, where possible please could complete your reviews 28 April so the data extraction (starting every Tuesday evening) can be completed and patients offered the support they need.
3. COVID Clinical Codes are now available
Clinical codes have been synchronised with both EMIS and TPP systems and codes are now available for reception/triage teams as well as staff responsible for clinical coding within practices. There are two attachments – a flowchart and a COVID prompt card which also links to NHS England guidance.
4. Cyber-security
Please be extra vigilant with opening emails and attachments that are unsolicited or that you don’t recognise and please be patient if attachments are held up by the IT providers while they check they are safe. COVID has not been deterred cyber criminals If you are in any doubt about an email or website please contact the IT provider. (Attachment: Cyber and COVID19 Letter and Attachment 20200416.pdf)
5. Resource on difficult conversations
An online resource has been created to provide some practical advice on how to talk about some difficult topics related to COVID-19.
6. Cancer information
National guidance issued by West Midlands Cancer Alliance has been circulated in a previous bulletin. Please find detailed below an update on a number of issues pertinent to primary care.
Primary Care Management and Safety Netting
National guidance sets out recommendations for primary care. A significant number of patients are choosing to defer their referral due to fear of Coronavirus. The following documents will provide guidance and support for primary care, ensuring patients do not slip through the net.
• West and East Midlands Cancer Alliance letter (Attachment: 2020 04 09 Primary Care Safety Netting Letter1.pdf)
• EMIS Tips 5: Creating Deferred Treatment Workflow (download here – WeTransfer link will expire on 23 April)
Vision have confirmed that a similar document will be made available over the next couple of days. As soon as this is available arrangements will be made to circulate information to practices with the Vision system.
Secondary Care Management
Local Trusts are working hard to ensure patients are reviewed in line with guidance released by the West Midlands Cancer Alliance. This includes clinical triage of referrals, establishing virtual clinics and straight to test where appropriate. Please provide as much appropriate clinical information about the referral as possible to avoid delay and to ensure nominated secondary care clinicians are able to undertake a comprehensive clinical triage of referrals. Please ensure patient demographics including the patient’s preferred contact number are included on the referral form.
Bowel Cancer Screening COVID-19 response
You will already be aware that the Bowel Screening Hub in Rugby are no longer sending screening invitations to patients and will be suspended for 12 weeks with effect from 24th March. The NHSE/I National Team has issued the following Bowel FAQs (Attachment: COVID-19 bowel FAQs 20200409 FINAL.docx) to local commissioning teams. A summary of the primary care FAQs is summarised below:
a. What is the advice for patients with a positive bowel cancer screening test result (further tests needed) who have not been offered a follow up appointment?
If the person is not symptomatic, please advise them to contact the bowel screening helpline (0800 707 6060) for advice. You may want to warn them that the helpline may be very busy and they may have to wait before their call is answered.
b. What action should I take if a patient with a positive bowel cancer screening test result (further tests needed) has symptoms but no appointment for further tests?
In the first instance you should advise the patient to speak to the screening centre for further clinical advice. If they do not know the contact number of the screening centre, they should call the screening helpline 0800 707 60 60 who will get someone to call them back. Please only refer a patient who has a positive bowel cancer screening test to the 2-week wait urgent referral pathway if the patient has specific symptoms of obstruction, such as a pain or lump in their abdomen after eating.
Macmillan Coventry and Warwickshire Benefits Advice Service
Please note that while the Coventry Citizens Advice office is currently closed the COVENTRY AND WARWICKSHIRE BENEFITS ADVICE SERVICE is OPEN, with advisers working from home. Face to face appointments are not available at this time however they are able to support cancer patients and their families via telephone, email or Zoom. Please phone 024 7625 2050 (Heather or Pat) for more information or alternatively email macmillan@coventrycab.org.uk
Charity Support Lines for patients living with Cancer
Please find further information attached (Attachment: Charity-support-lines-for-patients.pdf)
Health and Care Partnership Website
You may already be aware that a new website has been launched. We are working closely with colleagues to ensure the cancer page is developed over the coming weeks and will continue to review and add patient information where appropriate. The website link can be found here https://www.happyhealthylives.uk/our-priorities/cancer/
7. Directory of COVID-19 Community-Led Support Groups
The new-look "Covid-19 Community-led Support Group Directory" has been compiled by the Localities Team and is now live on the WCC website. The team are still building up the information in this directory. A full list of the groups contained in the directory can also be found on the WCC coronavirus pages at https://www.warwickshire.gov.uk/information-coronavirus/coronavirus-volunteering/1 . This list is updated on a regular (usually daily) basis.
8. Warwickshire CAVA Community and Voluntary Action
An update on voluntary support available within the area, including a searchable database of groups that are supporting people during the crisis is available here
LATEST UPDATES FOR EACH PLACE
UPDATES FOR Coventry and Rugby and Warwickshire North – 17 April 2020
9. SNOMED codes for identified C19 at risk pts for Vision Practices
Vision uses SNOMED CT Term 443999008 Risk of exposure to communicable disease to record this data, this displays as Read term 9d44.00 Risk of exposure to communicable disease in Vision 3. If you add this Read code manually it displays as 9d44.00 Potential infectious contact. Further information is available on the Vision website.
UPDATES FOR South Warwickshire – 17 April 2020
10. COVID-19 Updated Maternity Advice
South Warwickshire Hospital Trust have issued some very useful information on their maternity services through the pandemic. (Attachment: COVID-19 - Updated Maternity Advice V1 FINAL.PDF)
LATEST NATIONAL PICTURE
• As of 9am on 16 April 2020, 417,649 people have been tested in the UK and 103,093 were confirmed as positive. As of 5pm on 15 April 2020, of those hospitalised in the UK, 13,729 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 Foreign Secretary Dominic Raab gave the 16 April 2020 daily press briefing on the government’s response to the COVID-19 pandemic. A transcript of the briefing can be read online and viewed here.
• The press conference slides and datasets used by Sir Patrick Vallance, Chief Scientific Adviser, in the daily coronavirus press conference on 16 April 2020 can be accessed online.
COMMUNICATIONS FROM NHS ENGLAND
11. NHS England Primary Care Bulletin – new edition – 16 April
COVID-19: latest guidance for general practice is issued in the NHS England Primary Care Bulletin (16 April) and includes a request for support with shielded patients, referrals to secondary care and the GP retention scheme. 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/.
12. GP Preparedness webinar
The next primary care webinar, with Dr Nikki Kanani and Ed Waller, is on 23 April from 5pm and 6pm (via Microsoft Teams), the link to access is here.
13. 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
Staff testing is available this weekend, details above.
Review the actions around the shielded patients outlined above.
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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.
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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/
