Coventry & Warwickshire COVID-19 Portal

Primary Care Coronavirus briefing – Coventry and Warwickshire – 23 March 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 (the page was last updated on: 22 March, 2020 4:06 pm)

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

LATEST LOCAL PICTURE

Remember COVID-19 communications in Coventry and Warwickshire is being issued from a single email address: warnoccg.covid19primarycarecommunications@nhs.net. By doing so we will help you to get the right information in a consistent way.

Please also send any COVID-19 related queries to this box, as it is being monitored and enquiries logged.

Please add the email address to your safe list

Keep an eye out for and give priority to emails from the email address.

Do check your junk/spam folders to make sure the emails aren’t going there by mistake:

warnoccg.covid19primarycarecommunications@nhs.net

 

Local cases (as of 22 March)

• In the Local Authority of Coventry, there are a total of 14 confirmed cases.

• In the Local Authority of Warwickshire, there are a total of 29 confirmed cases.

LATEST LOCAL UPDATE

LloydsPharmacy – temporary closures

Starting 20 March all LloydsPharmacy stores will operate behind closed doors for the first and last hour of trading to enable their teams to assemble and clinically check prescriptions. In addition all LloydsPharmacies will close between 1 and 2

pm. Posters will be displayed in store windows to communicate this information to the public.

Cytology samples

Following a number of internal discussions and in consultation with Commissioners and SQAS the Trust has had to take a decision to suspend the daily collection of cervical cytology samples ahead of a decision regarding the national HPV screening programme.

We are reluctantly forced to take this action for a number of reasons. These are:

• The sickness rate in our transport and portering department means that we need to redeploy our HPV drivers to more clinically urgent activities

• The main HPV analyser that we use is due to be converted to COVID-19 testing at the beginning of next week

• We have eight staff on sick leave or in isolation in the department.

We are also conscious that the number of samples that we are collecting has reduced significantly in the last week as we understand that GP practices are minimising non urgent/face to face appointments and/or because patients are not turning up.

We will undertake collections from all locations on Monday 23 and Tuesday 24 March. After that date collections will only be made from Colposcopy Units.

As the situation improves we will keep you updated.

We are currently trying to ascertain the situation regarding high risk patients and will issue further guidance once in a position to do so.

Thank you for your continued support in these difficult times. Cervical Screening Service

HPV Screening Programme

 

Remote access

For clarification all current logon accounts for the Healthcare Network (practices already deployed to) can have all their staff remote access from home. In other words, all Practice users who have an IT account have access.

Domestic Abuse support during the COVID-19 pandemic

At the request of the Heads of Safeguarding for Warwickshire and Coventry, we are sharing a link to all GP practices across Coventry and Warwickshire.

This information is being distributed as given the current situation, domestic violence is anticipated to escalate during the COVID-19 Pandemic. The site can be accessed via:

http://www.safelives.org.uk

Update from the Specialist Palliative Care Teams

Please consider this advice from our Specialist Palliative Care Teams regarding patients who are in likely in the last weeks/months of life and the risks around Covid- 19:

1. All those caring for nursing homes - please review how many anticipatory medicines you have. Please start prescribing anticipatory medicines for vulnerable patients now.

2. Start prescribing anticipatory medications for community patients that are vulnerable.

3. Consider proactive Advance Care Planning for all patients including completing a ReSPECT form.

4. The Association of Palliative Medicine will be sending out specific guidance in palliating COVID patients soon including breathlessness in the dying patient. Any helpful guidance for primary care will be forwarded on when it is available.

5. Access to the West Midlands Palliative Care guidelines is now free. The link is www.wmcares.org.uk/wmpcp/guide/

Update from The Myton Hospices

At The Myton Hospices we are working closely with our partners in the local hospitals, community and hospice services to ensure a coordinated approach to end of life care for Coventry and Warwickshire so that we can best support the NHS at this time.

All the staff and volunteers working at Myton are committed to do all we can under the current circumstances to support our patients and their relatives while minimising the risk to patients and the workforce at this time.

At the current time:

 

· Our Inpatient Unit services are open

· Our Myton at Home Community services are open

· Lymphoedema clinics are running

· Our Living Well Programme continues to be open for referrals with the understanding that the only contact we can provide is by telephone consultation

· We have taken the difficult decision to suspend the following services: o Respite beds at Warwick Myton Hospice

o Day Unit Services on each of our sites at Coventry, Rugby and Warwick, which includes our Fatigue and Breathlessness Programme, Therapeutic Days and Drop-in Sessions.

We are though offering existing patients the option of regular telephone support

· The only visitors we are accepting into Myton are those who are directly visiting patients in our inpatient units or are essential to the efficient/ safe running of our Hospices

With kind regards, Sarah

Dr Sarah MacLaran BM FRCP

Volunteer support for those self-isolating

Warwickshire County Council (WCC) is committed to supporting Warwickshire’s communities through the current Coronavirus pandemic. WCC has put together a list of community support groups that are currently responding to offer support to individuals who are isolating.

The directory can be accessed here, which is a link the Provision of current community led activity across Warwickshire directory - this won't be a complete picture and if there is no local group for a specific individual you should ask them to contact Warwickshire Community and Voluntary Action (WCAVA) via: https://www.wcava.org.uk/contact. Anyone that is interested in volunteering should also register with WCAVA.

LATEST UPDATES FOR EACH PLACE

UPDATES FOR Coventry and Rugby – 23 March 2020

No place specific update

UPDATES FOR South Warwickshire – 23 March 2020 Ellen Badger Hospital: First Aid Centre temporary closure

During this National Level 4 Covid-19 emergency, the decision has been made to close the First Aid Centre at Ellen Badger Hospital during this period, to protect our staff and vulnerable inpatients.

 

Please ensure you disseminate this information within your practices and with patients who potentially access service.

A decision to re-open the service will be communicated as appropriate.

Reminder of the Acute Physician phone number

If you need advice on a patient with suspected COVID-19, you can access the 24 hours a day 7 days a week on 07917 212535 (the phone will be manned by an Acute Physician 8am to 8pm and the General On call doctor from 8pm to 8am).

UPDATES FOR Warwickshire North – 23 March 2020 Remote access for Warwickshire North

Access to the remote working solution requires a user ID and password for our network and there are a large number of Warwickshire North practices who will not have these. We are gathering the necessary information and working on creating the user ID’s and these will be communicated back to practice managers between Monday and Wednesday this week. If you have not yet responded to the request for this information please do so as soon as possible.

For best performance we recommend using either Internet Explorer or Microsoft Edge to access the solution from a Windows PC. Google Chrome will work, however depending on the version being used, may display a prompt indicating that the VPN client is still installing – this can be safely ignored.

Further details are attached.

Death certificates books and ordering

In relation to practices and ordering their death certificate books for Nuneaton, and we presume all other Registry Offices, is that they would be comfortable with earlier requests supported by a brief note from the practice, their M code, the certifying GP name and GMC number signed by a member of the practice. Alternatively practices can order two when they reach the ‘order tab’ within their current book.

Update from Mary Ann Evans Hospice

At Mary Ann Evans Hospice we made the decision on Friday 13 March to refocus all of our resources into our community services. We have temporarily closed all of our hospice based services to enable us to expand our Rapid Response end of life services. This service is now available day and night across all of northern Warwickshire – 24/7 (including still offering a night service in Rugby). We are aiming to double our night rapid response provision to have two teams available to meet the growing need. We are working alongside SWFT to provide this blended service and, to enable this, we are pooling resources.

At this time of crisis the only option that was available was to do our utmost together to provide essential levels of care to all of the most vulnerable across northern Warwickshire and this is why we stepped up our joint operation immediately. We are very conscious that demands on community care will grow as the acute services

 

concentrate on caring for those with COVID-19 and we are prepared to meet this additional challenge. We are calling upon all staff to work flexibly and adopt different roles as necessary – this includes calling people back into roles they have previously held with us. We remain willing to stretch our resources as far as possible to meet the increasing need of our community. However, I assure you that safety and high quality care remains paramount.

We are continuing to offer support where necessary to people who received our other services e.g. day hospice, lymphoedema, family support – and this is taking the form of telephone support or, when the need is considered critical, a home visit. If required our cook is planning a “meals on wheels” support programme and our Family Support team remain ready to offer emergency childcare at Mary Ann to enable our front line staff to remain at work (we have cleared this concept with WCC’s Safeguarding department).

We are liaising closely with our hospice colleagues throughout Warwickshire and are looking at how we can also share resources to improve and expand our offer further.

Message of support

A message of support from Wasps Rugby:

LATEST NATIONAL PICTURE

• As of 9am on 22 March 2020, 78,340 people have been tested in the UK, of which 72,657 were confirmed negative and 5,683 were confirmed as positive. As of 9am on 22 March 2020, 281 patients who tested positive for COVID-19 have died. (Numbers are updated around 2.30pm each day by Public Health).

 

• The latest government advise on coronavirus has been updated on 22 March 2020.

• The Prime Minister’s speech from 22 March is available here: https://www.gov.uk/government/speeches/pm-statement-on-coronavirus-22- march-2020.

• The latest FCO advice is advising against all but essential international travel (updated 18 March 2020)

Public Health England COVID-19 update

The latest materials for the public information campaign have been updated with the latest advice and are available on the Campaign Resource Centre. Public Health England has also published new guidance on staying at home, for households with possible COVID-19 infection and social distancing to protect vulnerable groups.

Other existing guidance is being updated to reflect the latest advice. ACTION: Please review the material and display where appropriate.

Translated guidance – now available

Public Health England has translated the guidance for stay at home, household and vulnerable groups. This is available as PDFs alongside the current coronavirus guidance on the gov.uk website. Languages include Arabic, French, Polish and Welsh.

Also available in PDF format is translated guidance on social distancing for vulnerable groups. Languages include Arabic, French, Polish and Welsh.

Disposable eye protection

The new IPC guidance for infection prevention and control in healthcare settings advises disposable eye protection for any aerosol generating procedure. It includes a list of a number of procedures that are essentially secondary care but may be implications for primary care.

COMMUNICATIONS FROM NHS ENGLAND

COVID-19 – your support in advising the public

As the situation on COVID-19 evolves, Public Health England is liaising with Local Authorities and partners. Advice for the public is being updated regularly, the government have published the Coronavirus action plan last week, and PHE is addressing common questions through their blogs.

A UK-wide public information campaign is taking place to advise the public on how to slow the spread of coronavirus and reduce the impact on NHS services. The latest

 

COVID-19 campaign materials are attached to this email and all materials are available on the Campaign Resource Centre.

COVID-19 – PHE Guidance

Following the Prime Minister’s announcement to increase social distancing measures across the country, PHE have published guidance for everyone on social distancing, and stay at home guidance for households with a possible case of coronavirus (COVID-19).

Guidance about coronavirus (COVID-19) for the following non-clinical settings was published this week:

• Educational settings such as schools or universities

• Prisons and other prescribed places of detection

• Shipping and sea ports

• Transport hubs including airports and train stations

• Hostels or day centres for people experiencing rough sleeping

• Employers and businesses

The guidance documents provide advice for people present in these non-clinical settings regarding what to do if someone develops coronavirus (COVID-19) symptoms in their setting, use of shared spaces, cleaning and waste, and more setting-specific information.

FOR ACTION: The full suite of guidance, for both health professionals and non- clinical settings, can be accessed on this gov.uk collection page.

Key workers

The Government has published a list of key workers whose children can continue going to school. The guidance for schools, childcare providers, colleges and local authorities in England on maintaining educational provision is now available.

Amends to Messages

REMINDER: Please ensure your practices are updating their messages with the new text for telephone messages and online bookings. The additional ‘or’ word is very important.

Telephone message

If you have symptoms associated with coronavirus including a new continuous cough and or a high temperature, you are advised to stay at home for 7 days. Do not book a GP appointment or attend your GP practice. If you live with other people, they should also stay at home for at least 14 days, to avoid spreading the infection outside the home.

If your symptoms are serious, or get worse, NHS 111 has an online coronavirus service that can tell you if you need further medical help and advise you what to do. Only call 111 direct if you are advised to do so by the online service or cannot go online.

For the latest COVID-19 advice please visit www.nhs.uk/coronavirus.

Online booking

 

If you have symptoms associated with coronavirus including a new continuous cough and or a high temperature, you are advised to stay at home for 7 days. Do not book a GP appointment or attend your GP practice. If you live with other people, they should also stay at home for at least 14 days, to avoid spreading the infection outside the home.

If your symptoms are serious, or get worse, NHS 111 has an online coronavirus service that can tell you if you need further medical help and advise you what to do. Only call 111 direct if you are advised to do so by the online service or cannot go online.

For the latest COVID-19 advice please visit www.nhs.uk/coronavirus.

Launch of national online 111 isolation note for patients

Online isolation notes launched - providing proof of coronavirus absence from work

People unable to work for more than seven days because of coronavirus (COVID-

19) can obtain an isolation note through a new online service. The isolation note service can be accessed via the 111 online coronavirus

service or NHS.UK/coronavirus as well as via the NHS app.

Updates to community pharmacy regarding the emerging COVID-19 situation

The second of a series of regular updates to community pharmacy regarding the emerging COVID-19 situation has been published on 19 March and is available to download.

Novel Coronavirus (COVID-19) standard operating procedure

The standard operating procedures for Community Pharmacy (attached) have been updated on 22 March and include, amongst other things, changes to minimum opening hours for pharmacy (page 10).

ACTIONS FOR PRIMARY CARE

NHS England has produced a patient pathway and patient transfer standard operating procedure. The general advice is to:

• identify potential cases as soon as possible

• prevent potential transmission of infection to other patients and staff

• avoid direct physical contact, including physical examination, and exposures to respiratory secretions

• isolate the patient, obtain specialist advice and determine if the patient is at risk of COVID-19

Please ensure you familiarise yourself with this

information: https://www.england.nhs.uk/coronavirus/primary-care/management- suspected-covid-19/

 

MEDIA ENQUIRIES

If you are approached by the media and do not want to handle it yourself, 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 TO TAKE

• Monitoring the latest updates from Public Health England and GOV.UK

• Ensure your practice websites are updated with the latest advice

• Ensure you promote the key public messages

• Update practice telephone messages