Coventry & Warwickshire COVID-19 Portal

Primary Care Coronavirus briefing – Coventry and Warwickshire – 26 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

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

**NEW** Advanced Practice Payment for Covid Expenses

**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

Advanced Practice Payment for Covid Expenses

The CCGs will be making a payment in advance to each practice, to acknowledge the costs that you have already encountered as part of the COVID-19 response. This initial payment will be made to practices today. Payments will be made as follows, based on list sizes as of 1st January 2020:

• £3,000 – Small Practice less than 7,000 list size

• £5,000 – Medium Practice 7,001 -10,000 list size

• £10,000 – Large Practice 10,000+ list size

At the end of March please complete the attached pro-forma to identify the actual costs incurred to 31st March 2020. Going forward any additional costs incurred by practices will need to be submitted to the CCG via the attached proforma at the end of each subsequent month. This will need to be sent to the Finance contact detailed on the form for your appropriate CCG. The expected categories are listed on the proforma, but if there are other items please can you provide specific details.

Submission of backing invoices will not be required with the claim proforma, but the CCG asks that you retain copies of these as they will be requested at a later date.

 

Please note: IT equipment and software is excluded from this claim method. Please speak to your CCG IT lead (South Warwickshire CCG - Sue Phillips Sue.Phillips@southwarwickshireccg.nhs.uk, Coventry and Rugby CCG, North Warwickshire CCG – Roma Holland Roma.Holland@coventryrugbyccg.nhs.uk) for any requests around additional kit.

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. If we don’t know about an issue then we cannot provide support in resolving it.

Local cases (as of 25 March)

• In the Local Authority of Coventry, there are a total of 25 confirmed cases.

• In the Local Authority of Warwickshire, there are a total of 59 confirmed cases.

LATEST LOCAL UPDATE

Primary Care Support England (PCSE) update

Primary Care Support England (PCSE) continue to work with NHS England to prioritise services so that we can make sure high priority services run smoothly, avoiding disruption to front line Primary Care. These essential include:

• processing and uploading the monthly contractual payments to practices

• delivering supplies orders such as needles, syringes, prescriptions and essential NHS forms

• processing patient registrations, removals and dealing with any messaging errors on the GP links between practices and PCSE

• processing urgent medical record requests to ensure continued patient care

• ensuring that GPs are correctly registered on the Performers List and able to provide services to the NHS

• processing retirement, pension opt-out and death in service applications

Please note, as we focus on the above essential services during this time, it may take longer for us to process and resolve queries for other services.

Temporary practice closures

If a practice should need to close temporarily as a precaution against the spread of Coronavirus, PCSE can support practices. For example, we can manage the movement of patient records and postpone deliveries of supplies. In the first instance, practices should get in touch with their CCG to discuss options, and our

 

supplies team will be happy to discuss possible actions. The team can be contacted via the online form available here.

End of year pension forms

We continue to accept pension forms for 2018/19 end of year. Please be aware however that processing times might be extended as we prioritise our activity towards urgent and essential services.

Service provision

PCSE will continue to work with NHS England to do everything we can to ensure practices are supported. Updates are also available on the PCSE website.

If you have any questions please contact pcse.gpengagement@nhs.net.

Tips for telephone consultations from RCGP

The RCGP has published top 10 tips for Covid-19 telephone consultations.

Throat examination in adults and children

The following advice has been written by Dr Sanjay Patel - a consultant paediatrician at University Hospital Southampton and a specialist in infectious diseases had advised for the Royal College of Paediatrics and Child Health. (please see the tonsillar examination attachment included with this email which complements the below).

Although the COVID-19 narrative has focused firmly on adults, there is growing concern about the role played by asymptomatic children in the spread of infection.

1 Transmission from the upper airway has been raised as a particular concern by ENT specialists,

2 with viral replication shown to take place in the upper airway as well as the lower airway. This may explain why a number of paediatric and/or ENT healthcare professionals have developed disease in the absence of currently defined risk factors.

We recommend that the oropharynx of children should only be examined if essential. If the throat needs to be examined, personal protective equipment (fluid resistant surgical face mask, plastic apron and gloves) should be worn, irrespective of whether the child has symptoms consistent with COVID-19 or not.

Suspected tonsillitis in primary care or A+E

If a diagnosis of tonsillitis is suspected based on clinical history, we recommend that during the COVID-19 pandemic, the default stance becomes not examining the throat unless absolutely necessary. If using the feverpain scoring system to decide if antibiotics are indicated (validated in children 3 years and older) 3 , we suggest that a pragmatic approach is adopted, although automatically starting with a score of 2 in lieu of an examination is not entirely unreasonable. Children with a total feverpain score or 4 or 5 should be prescribed antibiotics (we suggest children with a score of 3 or less receive safety netting advice alone). Although this is likely to result in a temporary increase in antibiotic prescribing in children, we feel that this is preferable

 

to healthcare staff being unnecessary exposed to COVID-19. Antibiotics rarely confer a benefit in children under 3 years with tonsillitis and should only be prescribed in exceptional circumstances or if a diagnosis of scarlet fever is strongly considered.

References

Kam KQ, Yung CF, Cui L et al. A Well Infant with Coronavirus Disease 2019 (COVID-19) with High Viral Load. Clin Infect Dis 2020.

Lu D, Wang H, Yu R et al. Integrated infection control strategy to minimize nosocomial infection of corona virus disease 2019 among ENT healthcare workers. J Hosp Infect 2020.

Little P, Hobbs FDR, Moore M et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). 2013; 347: f5806.

State-backed clinical negligence scheme for general practice (CNSGP)

The attached letter (Letter to practices re Pharmacists CNSGP 27.02.2020) relates solely to business as usual activities. Indemnity arrangements in relation Covid-19 are covered in other specific communications.

LATEST UPDATES FOR EACH PLACE

UPDATES FOR Coventry and Rugby – 26 March 2020

New resource from the Coventry Safeguarding Adults Board

The Safeguarding Adults Board, has produced a poster regarding the exploitation of adults with care and support needs who are self-isolating in Coventry. The poster is attached and also available at this link: https://www.coventry.gov.uk/downloads/file/32368/safe_isolating_advice

UPDATES FOR South Warwickshire – 26 March 2020 GP IT Update

Attached to this email is an update on GP IT, please take a few minutes to read this and the associated attachments. Subjects include: remote working and access to EMIS; Laptop rollout; online consultations; and data sharing.

UPDATES FOR Warwickshire North – 26 March 2020 Consultant Connect and NHS 111

Consultant Connect is working on behalf of a 111 provider to bolster their 111 clinicians’ access to advice. Would you be willing to share your expertise this way by answering some calls? Even an hour or two each week would make a real difference right now.

 

How it will work

This would be organised via Consultant Connect so your number would never be shared, and you would be on a rota. This means, if you are unable to answer, the call will go to the next GP available. Calls can be taken anywhere, so even if you are at home or self-isolating, all you need is to be accessible via a mobile phone.

Offer free help or get paid

You can choose to either do this work pro-bono or receive a payment of £15 (from the 111 provider) for each answered call.

To let us know that you would like to help please email: hello@consultantconnect.org.uk - with the following details:

I would like to help with 111 calls.

• My name:

• My surgery:

• My CCG/Health Board area:

• My mobile phone number:

• I would like to do this work pro-bono: Y/N

• I wish to be paid £15 per call answered: Y/N

Your assistance is much appreciated. You can withdraw from answering calls at any time, simply let us know when you wish to stop.

LATEST NATIONAL PICTURE

• As of 9am on 25 March 2020, 97,019 people have been tested in the UK, of which 87,490 were confirmed negative and 9,529 were confirmed as positive. As of 9am on 25 March 2020, 463 patients who tested positive for COVID-19 have died. (Numbers are updated around 5.00pm each day by Public Health).

• The latest government advice on coronavirus has been updated on 23 March 2020.

• The Prime Minister carried out a briefing on 25 March, a copy of the transcript is available online.

• The government is to provide free car parking for NHS and social care staff.

COMMUNICATIONS FROM NHS ENGLAND

Shielding from coronavirus

Following the publication of measures for a group of people whose physical health conditions mean they are at the greatest risk from Coronavirus, the guidance can be found here. Some of this group will be people with a learning disability, autism or

 

both and we are asking for your help to share the easy read guidance for shielding from coronavirus with people, their families and carers, and providers of services.

NHS England Primary Care Bulletin

COVID-19: latest guidance for general practice is issued in the NHS England Primary Care Bulletin (24 March). This regular COVID-19 Primary Care Bulletin is from Nikki Kanani and Ed Waller and you are encouraged to sign up here: https://www.england.nhs.uk/email-bulletins/general-practice-bulletin/

Primary Care webinar

The next GP Preparedness webinar will be tonight (Thursday) from 5-6pm. Join via this link.

ACTIONS FOR PRIMARY CARE

Please review the claim proforma information attached to this email.

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

• Watch the GP Preparedness webinar this evening

• Ensure you promote the key public messages of stay home, save lives