Coventry & Warwickshire COVID-19 Portal

Primary Care Coronavirus briefing – Coventry and Warwickshire – 27 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

Thank you

Before we jump into the main briefing, can we take a moment to say to each and every one of you, thank you for hard work you undertake in what can only be described an unprecedented scenario. Last year no one had heard of COVID-19 and now it is the thing that consumes our lives. Yesterday evening you cannot have failed to hear around the city and county, hundreds on the street cheering and clapping in a show of support and appreciation for our NHS and for all you are doing. In this situation it can be easy to concentrate on what is going on around us each day and lose sight of our wellbeing, there is advice and guidance from NHS Employers to make sure we all stay physically and mentally well at this time.

Please continue to do what you are doing, keep healthy and safe through these challenging days, with the work and support that is already going on we will all get through this together.

Thank you.

Dr Sarah Raistrick, Dr David Spraggett, Dr Imogen Staveley PPE message

Dear All

We understand you are all very concerned regarding the allocation of use of PPE equipment.

The attached presentation provides information regarding the Covid-19 virus and the principles for the control of this infection including the requirements for the use of PPE.

To confirm Covid-19 transmission is NOT airborne but is transmitted via droplets and this determines the PPE required.

 

National advice from Professor Keith Willett, Director for Acute Care to NHS England today has confirmed the following:-

FRSM fluid repellent surgical masks, aprons and gloves are adequate when managing patients suspected of having Covid-19.

Due to supply issues, please ensure you only use this equipment for the appropriate patients. At this moment in time, as based on the latest information, we are anticipating the surge of cases are likely to come in the next 10 to 15 days.

We clearly do not want you or your teams to be at risk due to limited supplies at this time.

Instructions regarding the donning and doffing of this equipment are included in the presentation. (Attachment: Coronavirus (COVID-19).pptx)

To confirm FFP3, long sleeved gowns are only to used when using aerosol generating procedures likened to those performed in ITUs so are currently not required for general practice.

We do understand your concerns regarding the levels of PPE and we can assure you we continue to escalate supply issues.

Finally on the Primary Care call last night (26.03.20) if you require additional PPE supplies please call 0800 915 9964. Delivery time lines are 72 hours and may NOT be Monday to Friday 9am to 5pm.

We will of course update you should anything change Kindest Regards

Dr Sarah Raistrick, Dr David Spraggett, Dr Imogen Staveley Vulnerable patients

If you have not received your list of shielding patients, you can escalate your concerns to england.covid-highestrisk@nhs.net. A template letter which was previously circulated to GP practices regarding vulnerable patients has been resent yesterday. Again, if you continue to have any concerns, please email england.covid- highestrisk@nhs.net.

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

• Coronavirus (COVID-19).pptx (see opening paragraphs)

• QOF year end 19-20 payments update (see item 11)

• Safeguarding newsletter (see item 6)

• 2020-03-26-covid19-occupational-health.pdf (see item 5)

• Safe Haven Service – Change of provider (see item 10)

• LPC External Update 27th March 2020.pdf (see item 7)

LATEST LOCAL PICTURE

Hot hubs

We are working with each place to finalise the operations of each hot hubs and further information will be shared in Monday’s briefing including information about sites, manning and opening times.

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.

Update on provider services

We are working with our local providers to gather a list of service changes resulting from COVID-19 situation, such as elective surgery, outpatients and within emergency departments. We are planning to send this out to practices today once we have confirmed the current status.

Local cases (as of 26 March)

• In the Local Authority of Coventry, there are a total of 35 confirmed cases.

• In the Local Authority of Warwickshire, there are a total of 74 confirmed cases.

LATEST LOCAL UPDATE

1. Death certificate update

You may be aware that within the Coronavirus Bill, currently making its passage through Parliament, there is legislation which will allow the electronic transfer of the MCCDs (medical certificate of cause of death) to the registration service, as face to face appointments will be suspended and informants will give details for the registration over the telephone. The form required for the burial or cremation will then be emailed directly to the chosen funeral director.

In readiness for this would you please email all future MCCDs to:

 

nuneatonro@warwickshire.gov.uk, for Nuneaton and North Warwickshire, rugbyro@warwickshire.gov.uk for Rugby area

warwickrbd@warwickshire.gov.uk for deaths in Warwick, Leamington, Stratford, South Warwickshire.

Please ensure that both sides of the MCCD are scanned as we require the full document. To ensure that we can match both sides would you please print the MCCD number on the reverse in the top right hand corner.

If possible, please include details of the next of kin and a telephone number in case we don't hear from them. Bookings can still be made using the link on our

website www.warwickshire.gov.uk/registrations or by calling 0300 555 0255.

The office will still require the original MCCD as this will have to be forwarded to the General Register Office as normal. Please keep them securely and we will be in touch to arrange collection of these later.

2. Registration with CQC and changes to statements of purpose during COVID- 19

We want to support health and social care providers as they look to increase capacity as part of the ongoing effort to respond to COVID-19. To help ensure that registration does not act as a barrier to these different ways of working, we have developed a special COVID-19 registration framework, which covers both new registrations and change to service that can be made by submitting a notification online.

Read the full update, which explains what constitutes a COVID-19 registration and what this means for providers.

3. Category 4 patient searches - IT System update

We have received a number of questions relating to the searches for Category 4 High Risk patients, yesterday both EMIS and Vision have communicated about their input and are looking at a resolution for practices having to run these searches.

Please see EMIS advice below as circulated to practices yesterday, Vision will also be making an update announcement.

IMPORTANT: Caring for people at highest risk during COVID-19 pandemic

EMIS Health is aware of challenges related to the letter sent to patients last week and the guidance sent to GP practices by NHS England / BMA / RCGP at the weekend around identifying high-risk patients.

We have been in discussion with NHS Digital to seek clarification on a number of points:

• Enabling clinicians to understand what clinical conditions have led to patients being marked as high-risk.

 

• Understanding why some GP Patients are not included in the high-risk group and the process GP’s need to take to include those patients.

• What responsibilities GP’s have with respect to contacting patients who they believe should be included.

We are awaiting guidance from NHS Digital and we advise practices NOT TO UNDERTAKE any activity until further guidance is forthcoming.

4. RCGP safeguarding resource

The RCGP has created a resource on COVID-19 and safeguarding. This is available online.

5. Updated Occupational Guidance in Pregnancy

The Royal College of Obstetricians and Gynaecologists has produced occupational health advice for employers and pregnant women during the COVID-19 pandemic (attachment: 2020-03-26-covid19-occupational-health.pdf)

6. Safeguarding Newsletter – March 2020

The latest version is attached and includes Government guidance on COVID-19 in relation to vulnerable children, young people and adults will guide you on specific safeguarding risks. (attachment Safeguarding Newsletter – March 2020.pdf)

7. Community Pharmacy Status Update for Stakeholders

Attached: LPC External Update 27th March 2020.pdf

8. Easter Bank Holiday

We are expecting a national letter to general practice setting out expectations regarding Easter bank holiday business hours in light of the COVID-19 situation and projections for peaks in infections over the Easter period. We are aware that some practices have already started planning to be open over Easter, and we strongly advise that all practices consider making similar plans.

9. Extended Hours

A number of queries are still being received in respect to Extended Hours. The position of all three CCG’s on Extended Hours and work load associated with DES’s and LES’s is that:

During the COVID outbreak period where it is necessary to suspend, reconfigure, redirect or repurpose capacity and workforce to support resilience in general practice to deliver vital priority services to patients and or redirect capacity and effort towards COVID related activities to maintain public health; Extended Hours can be suspended without penalty.

Decisions on when to redirect or repurpose capacity to other essential and necessary general practice or COVID related activities will be at the discretion of

 

general practice / PCN’s and will depend on capacity, demand and escalation of COVID virus experienced locally.

LATEST UPDATES FOR EACH PLACE

UPDATES FOR Coventry and Rugby – 27 March 2020

No updates in this edition

UPDATES FOR South Warwickshire – 27 March 2020

No updates in this edition

UPDATES FOR Warwickshire North – 27 March 2020

No updates in this edition

10. Warwickshire Safe Haven Service

Change are taking place to the Safe Haven provision in Warwickshire. The Safe Haven aims to support people who are feeling distressed and overwhelmed and is available during the evenings (including weekends) when other forms of support are often closed.

The current Safe Haven service, delivered by Mental Health Matters in Warwickshire, will end on 31st March 2020. (Please note they will continue to operate a site 7 days a week in Coventry).

For Warwickshire, a new Safe Haven service will be delivered by Coventry and Warwickshire Mind which can be accessed from 2nd April 2020 via phone or email: 02477 714554 or safehaven@cwmind.org.uk. (Complete details are attached: Safe Haven Service - Change of Provider.docx)

LATEST NATIONAL PICTURE

• As of 9am on 26 March 2020, 104,866 people have been tested in the UK, of which 93,208 were confirmed negative and 11,658 were confirmed as positive. As of 9am on 26 March 2020, 578 patients who tested positive for COVID-19 have died. (Numbers are updated around 5.00pm each day by Public Health).

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

• The Chancellor, Rishi Sunak, carried out a briefing on 26 March, outlining new coronavirus support measures for the self-employed, 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

 

11. QOF year end 19/20 payment update

NHS England and Improvement published a letter on Thursday 19 March 2020 (https://www.england.nhs.uk/coronavirus/wp- content/uploads/sites/52/2020/03/preparedness-letter-primary-care-19-march- 2020.pdf) which confirmed that calculations for QOF 2019/20 will be made as

usual. This data submission will be followed by a piece of analysis to understand the impact of Covid-19 and a one-off financial adjustment for practices who earned less in 2019/20 than 2018/19 as a result of Covid-19 activities. Full details are included in the attached document (QOF year end 19/20 payment update.doc)

12. NHS England Primary Care Bulletin – new edition

COVID-19: latest guidance for general practice is issued in the NHS England Primary Care Bulletin (26 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/

13. Primary Care webinar

The next GP Preparedness webinar will be on Thursday 2 April from 5-6pm. We will share the link when it is released.

ACTIONS FOR PRIMARY CARE

Please note the changes to MCCD (medical certificate of cause of death) included in today’s briefing.

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