Coventry & Warwickshire COVID-19 Portal

 

Primary Care Coronavirus briefing – Coventry and Warwickshire – 7 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. Easter - updated

Further to yesterday’s update on Easter opening to clarify Good Friday and Easter Monday are now normal working days which means that each practice should provide the usual practice service as per usual in week service provision including usual phone lines, reception staff and GP availability. It is expected that normal planned work will not have been booked in and the usual courier services are not running. These arrangements could still change if further guidance is issued.

The EMIS support desk will be open as usual on Good Friday and Bank Holiday Monday.

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

• Operation Shield Service Information for recipients FINAL 0420.pdf; Useful info to support you in self-isolation and social distancing.docx (item 3)

• COVID 19- UHB 2WW breast criteria.docx; Cancer Services at UHB 20200330.docx (item 5)

• Ophthalmology Telephone and Photo Advice - April 2020.pdf (item 9)

• COVID-19 Safeguarding is Frontline.docx (item 6)

• FHLS offer.pdf (item 11)

 

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 (as of 6 April)

There are 624 cases now confirmed in Coventry and Warwickshire 

303 of these are currently admitted (+16 from yesterday)

650 beds still available (+99 from yesterday)

31 ITU beds still available (+1 from yesterday)

80 hospital deaths with Covid reported.

LATEST LOCAL UPDATE

2. Guidance and standard operating procedures: General practice in the context of coronavirus (COVID-19) – updated to 2.1

Version 2.1 of the SOP is now available and is available to download. All changes made between version 2 and version 2.1 have been highlighted for ease of reference. 

Two key links have been updated since the document was cascaded to the system on 5 April 2020.

• For guidance on death certification published on 31 March 2020

• NICE guidance on hospital admission and management in the community for patients with symptoms of COVID-19

3. Information around the Coventry Hub for coordination of support to people on the shielded list

There are approximately 4,800 people on the current shielding list for Coventry. Anyone on the shielded list who cannot access support from their local networks or online sources can register for additional support with food, medicines or social contact by signing up at the national web portal https://www.gov.uk/coronavirus-extremely-vulnerable. 

The Coventry Operation Shield Hub is based at the Alan Higgs Centre with support coordinated by CV Life, our local leisure provider. Hub staff are in the process of contacting people on the list to identify those that need support and assist them signing up to the national platform where relevant. Local information on sign ups to the platform is shared with the Hub by the national team on a daily basis. In addition the letters attached have been sent out to those on the shielded list as a prompt to encourage sign ups and highlight support available. Over 800 people in Coventry have already flagged themselves through the national portal as requiring our support and the Hub team are working hard to deliver support as required. 

(Attachments: Operation Shield Service Information for recipients FINAL 0420.pdf, Useful info to support you in self-isolation and social distancing.docx)

4. UHCW Ultrasound Department

After careful consideration, a clinically led review has been undertaken with consideration of the current situation with COVID-19.

The decision has been made to cancel non-urgent outpatient ultrasound scans.  

The reason for this action is to reduce the amount of patient flow and associated community infection risk for our patients and staff within the hospital environment.

It is very difficult for us to gauge how urgent your request is based on the available clinical information. If you feel that a particular scan you have requested is not routine and needs to be performed as a matter of urgency, please contact us as soon as possible on the below email address and we will re-instate the appointment as soon as we feasibly can.

We apologise for this inconvenience. However patient and staff health and safety is our primary concern during this period of COVID-19 pandemic. 

Thank you for your co-operation in this matter.

Radiology Department

UHCW Trust

uhc-tr.radiology.referrals@nhs.net 

5. Cancer services at University Hospitals Birmingham (UHB) during COVID-19 pandemic

Following the release of NHSEI Specialty guide on Cancer for patient management during the coronavirus pandemic (Clinical guide for the management of non-coronavirus patients requiring acute treatment: Cancer https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/specialty-guide-acute-treatment-cancer-23-march-2020.pdf- ) a series of changes to cancer services is taking place. 

Amid a very fluid situation, UHB is attempting to manage cancer services as optimally as possible with the redeployment of staff, loss of operating capacity and the need for surge capacity in respiratory support in order to cope with the expected number of COVID19 related patients.

Therefore:

• Two week wait services will be managed as long as possible with the caveats that as long as the benefits outweighs the risks: 

o Patient will have an initial remote assessment. 

o Some tests if clinically appropriate may be deferred.

o Prioritisation for urgent assessment and tests. 

• MDTs will be flexed according to the availability of the team members. 

• Treatment including surgery and systemic will be prioritised taking into account the six categories outlined in the guidance.

o This may include a change to the order of treatment - systemic before surgery. 

o This will involve internal patient tracking.

• Patients who choose to defer assessment following a 2WW referral will be asked to re-present to their referrer when are willing to attend secondary care.

Tertiary Referrals

For Tertiary referrals, only Children and urgent referrals are being accepted. There is currently no change to the radiotherapy pathway. Referring organisations should send the referral to the relevant MDT inbox, and there will be an automated message that states to only refer if clinically urgent or if referring a child. If the referring centre deem the patient to be urgent and cannot wait for up to 3 months, then the MDT lead should be contacted for a clinical discussion.

Cancer Surgery

For patients awaiting surgery, patients will only have surgery at present if they go through the clinical prioritisation process that has been implemented by the Trust. Any patient that is currently in the system is being kept on a PTL and reviewed by the Speciality MDT. The Trust currently only have the capacity to carry out 3-4 operations a day. Theatre capacity is severely depleted as a result of theatre teams being re-purposed to manage additional critical care capacity. 

Additional Capacity

Private sector capacity is currently being scoped to bring in additional capacity, however, there is limited availability as much of the private sector work is currently carried out by NHS surgeons and anaesthetists. The Trust have however managed to move some Breast, Skin and plastic procedures out into the private sector (around 50 cases so far).  

Specific Service Changes (as at 2.4.20)

GHH Oncology Unit

Patients currently receiving systemic chemotherapy treatments at Good Hope Hospital Chemotherapy Unit will now be asked to attend Solihull Chemotherapy Unit.

Breast 2ww Services

From Monday 6th April all Breast 2ww clinics will be centralised on the Queen Elizabeth Hospital site.

A Breast patient pathway for all primary care referrers has been communicated on 1st April 2020 and this will be in place from that date (communication enclosed).

Bowel Scope and Bowel Cancer Screening at UHB

Both services have been suspended at UHB until further notice.

Systemic Chemotherapy

C-art T Cell therapy service at QEH has suspended services until further notice.

Communication

Any patient who is already under a UHB cancer service currently and has concerns regarding delayed or suspended treatment should contact either their Clinical Nurse Specialist, or the PAL’s team at UHB (Email: PALS@uhb.nhs.uk Tel: 0121 424 0808) Their concern will be logged and passed onto a senior member of the Cancer team or MDT who will respond as soon as possible.

(Attachments: COVID 19- UHB 2WW breast criteria.docx; Cancer Services at UHB 20200330.docx)

6. Covid-19 Safeguarding is Frontline

Leads for Warwickshire and Coventry have asked for the attached document to be disseminated to all Primary Care practices within Coventry and Warwickshire 

In addition to information contained therein it has the contact numbers of available staff, as some of the GP’s usual contacts will be unavailable as they are being redeployed to the Nightingale Hospital. (Attachment: COVID-19 Safeguarding is Frontline.docx)

7. Covid - rapid NICE guidelines

NICE has published a number of new COVID-19 rapid guidelines over the weekend, of which the following are of interest to primary care:

a. COVID-19 rapid guideline: Guidance on EoL care (which includes a section on anticipatory prescribing):

https://www.nice.org.uk/guidance/ng163

b. COVID-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community:

https://www.nice.org.uk/guidance/ng165

c. COVID-19 rapid guideline: severe asthma

https://www.nice.org.uk/guidance/ng166

8. Coventry and Warwickshire LPC update

Community Pharmacy Status Update for Stakeholders is available to download and includes information on Easter opening, prescriptions, and supply chain. Please note that this information is for use inside your own organisations only.

LATEST UPDATES FOR EACH PLACE

UPDATES FOR Coventry and Rugby and Warwickshire North – 7 April 2020 

9. Ophthalmology Telephone and Photo Advice 

The Ophthalmology telephone and photo advice line has now gone live. Details are attached. (Attachments: Ophthalmology Telephone and Photo Advice - April 2020.pdf)

Coventry Mental Health Service information

The service information can be downloaded from https://www.coventry.gov.uk/info/1/council_and_democracy/3551/covid-19_coronavirus/8 

10. Warwickshire North Hot hub open for referral

The Hot Hub based at Galley Common Medical Practice is now open and ready to receive referrals.

UPDATES FOR South Warwickshire – 7 April 2020 

11. Family Health and Lifestyles Services

South Warwickshire NHS Trust would like to inform all partners of the revised Family Health and Lifestyle Services offer, due to the Covid19 Pandemic in line with current NHSE Guidance. The full update is attached. (Attachment: FHLS offer.pdf)

12. Consultant Connect Extended Hours Telephone Advice & Guidance Now Available

We are pleased to inform you that you now have access to Consultant Connect Extended Hours Telephone Advice & Guidance for Cardiology, Diabetes, Care of the Elderly and the Frailty Unit from South Warwickshire NHS Trust consultants. The service is commissioned by NHS South Warwickshire CCG, provided by Consultant Connect and is available from Monday 6th April. The newly extended hours will be:

Cardiology: 8am – 8pm Mon-Sun

Diabetes: 8am – 8pm Mon-Sun

Care of the Elderly: 8am-8pm Mon-Fri

Frailty Unit: 8am-8pm Mon-Fri

The Consultant Connect App is the quickest way to get Telephone Advice & Guidance from these extended hours specialties and all other specialties available to you. To access Phone Advice & Guidance, download the free Consultant Connect App from the App Store or Google Play. Alternatively, you can call your surgery’s unique Dial-In Number from a landline phone. 

If you do not know your Dial-Number or have any other questions, please contact Lucy Sammons at lucy.sammons@consultantconnect.org.uk. You can also find out more about the service and the app by reading this start-up guide.

LATEST NATIONAL PICTURE 

 

• As of 9am on 6 April 2020, 208,837 people have been tested in the UK and 51,608 were confirmed as positive. As of 5pm on 5 April 2020, of those hospitalised in the UK, 5,373 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's statement on coronavirus (COVID-19) delivered via a press conference on 6 April 2020, detailing the government’s response to coronavirus. The briefing transcript is available to view online.

• The press conference slides and datasets used by Professor Angela McLean, Deputy Chief Scientific Adviser in the daily coronavirus press conference on 6 April 2020 can be accessed online.

COMMUNICATIONS FROM NHS ENGLAND

13. NHS England Primary Care Bulletin – new edition – 6 April

COVID-19: latest guidance for general practice is issued in the NHS England Primary Care Bulletin (6 April) and contains the Revised Standard Operating Procedure for general practice (version 2.1), supporting NHS 111 and details of upcoming webinars. This regular COVID-19 Primary Care Bulletin is from Dr Nikki Kanani and Gabi Darby and you are encouraged to sign up here: https://www.england.nhs.uk/email-bulletins/general-practice-bulletin/

14. New PHE guidance issued

New guidance on admission and care of people in care homes has been published by PHE. It is for care homes, local health protection teams, local authorities, clinical commissioning groups (CCGs) and registered providers of accommodation for people who need personal or nursing care. It sets out how to admit and care for residents safely and how to protect care home staff.

15. Coronavirus (COVID-19) information leaflet 

Leaflet has been produced and published today on what to do to help stop the spread of coronavirus, including information on symptoms and government support.

 

16. COVID-19 assets

The following COVID-19 campaign assets are now available on the PHE Campaign Resource Centre:

Act Like You’ve Got It, Anyone Can Spread It – additional resources 

A1, A3, A4 posters of all three versions, print ready and web friendly 

Email Signature

Banner 3500 x 1350

Additional social statics 

*Still to come are print friendly posters  

Alternative Resources for Stay Home, Save Lives

BSL version of Stay at Home Prof Chris Whitty 30s Social/TV Ad (mp4)

BSL version of Stay at Home media animation social film 18s (mp4)

Stay at Home audio/radio ad 40s (mp3)

Updated Alternative Resources for Home Isolation 

Easy read poster/handout of the standard poster (pdf)

Audio version (using radio ad) 40s (mp3)

17. Media enquiries 

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 updated SOP for Primary Care in relation to coronavirus (version 2.1).