Coronavirus latest

 


The COVID-19 outbreak is arguably one of the greatest public health challenges of our time – not least for general practice, where over 1 million patients are already treated every day.North East London have set up a dedicated GP coronavirus site at:http://coronavirus.wel.nhs.sitekit.net/Please check this site daily for updates.

Click here to see the latest Redbridge Coronavirus Case numbers

Important update for primary care on national PPE eCommerce Portal

Following our last update on the latest PPE ordering process for primary care, we have an update on the national PPE eCommerce Portal.

This service, initiated and managed by the Department of Health and Social Care, is now available as an emergency top-up route for:

  • GPs
  • Small residential social care providers (24 beds or fewer)
  • Domiciliary social care providers (99 clients or fewer).

Please continue to use your current methods of ordering PPE (please see download area) before turning to the PPE Portal. The PPE Portal, which is free of charge, is an emergency top-up route only as per Government instruction.

How do you access the PPE eCommerce Portal?

Your invitation to register with the portal has been sent from the PPE Dedicated Supply Channel team to your email account which is registered with the Care Quality Commission (CQC) or the Medicines and Healthcare products Regulatory Agency (MHRA).

If you have not received an email, please contact the PPE Dedicated Supply Channel team on 0800 876 6802.

What can you order?

GPs can order one single box per week (50 IIRs, 200 aprons and 400 gloves) or individual items up to this limit.

Order limits are being reviewed with a view to increasing the amount of PPE available per customer on the portal, subject to stock and demand levels.

A DHSC Guidance page about the PPE Portal has also been launched for more information.

What if I need emergency stock and I’m unable to order via the portal?

As we move out of the Covid-19 crisis and into recovery phase, the NEL hub will continue to operate to ensure that organisations have access to the emergency PPE they need to keep staff safe.

Please refer to the latest PPE ordering process for primary care please see download area) to ensure you are clear about the ways to access PPE

Agreed East London PPE ordering process.

NHS Workforce Race Equality Standard (WRES) team on the experience of BAME staff

Outpatients at Barts Health

Dear colleague,

Thank you for your support over recent months. It’s been a uniquely challenging period and we are incredible grateful for the way you have managed a large number of patients in the community.

As we begin to restore outpatient services that were put on hold at the height of the pandemic, we wanted to provide you with an update on our plans – including how we are transforming our activity to a ‘virtual by default’ approach. We have produced a dedicated video and a flowchart that provides further details around the changes we are making, the referral pathway for outpatients, and how you can access further advice and support for your patients.

We are aware of examples whereby our consultants are incorrectly asking GPs to request tests and prescribe medications. Please be assured, we have provided guidance to our teams to ensure that procedures are correctly followed and we would like to apologise for any disruption this may have caused you.

Please continue to refer patients where you need to. Further details can be found in the attached

We are listening to your views and going forward we are setting up a GPs insights group across WEL to better understand your perspectives and to enable us to work closely together to give patients the best possible care.

Thank you once again.

Dr Neil Ashman

Chair, Barts Health coronavirus outpatients group (COVOG)

update on how to order PPE

As we move out of the Covid-19 crisis and into recovery phase, the NEL hub will continue to operate to ensure that organisations have access to the emergency PPE they need to keep staff safe. Please refer to the latest PPE ordering process for primary care to ensure you are clear about the ways to access PPE. Use of PPE As a reminder, you can find all the latest national information on the use of PPE and we have also created a summary of guidance on how to use PPE which has links to training videos and further resources. Please also remember to refer to your local Infection Prevention Control advice, along with national Public Health England guidance.

Home COVID testing

This option is available to NEL Health and Social Care Staff only

This guidance is aimed at both employers and staff. It will tell you:

Who is eligible for testing

How to access a home test

How the service works

Booking information.

RCPCH published new advice

advice leaflet

NHS Workforce Race Equality Standard (WRES) team on the experience of BAME staff

  • Due to the COVID-19 response, there have been a number of changes to blood testing services to ensure that the public, patients and staff are protected. A number of services have been closed or opening hours have changed. See the attached document for service locations and opening hours

    There has been an update from NHS Property Services – CEO Martin Steele. Please see link for more information

    NHSE have taken urgent measures to commission a COVID-19 Home Management Service (CHMS) in all parts of England, to be available 24 hours a day, seven days a week. CHMS will provide urgent primary care services to patients diagnosed with COVID-19 who are self-isolating in the community. This will include care for symptoms related to COVID-19 as well as care for other conditions. Please see document attached for more guidance.

    Please see attached, an update on COVID-19 from Amanda Pritchard NHS England and NHS Improvement’s Chief Operating Officer and NHS Improvement’s Chief Executive. This can also be found on the NEL website.

    The attached document provides information of services that are provided within BHR for Older people as part of the COVID-19 response.

    BHR CCGs have now purchased the extended accuRx package, including unlimited Pathways and lifestyle surveys. For more information please click on the link.

    Here are some Frequently asked questions on EMIS for BHR GP Practices. This documentcan also be found on the NEL website.

    The Government has published Guidance for people most at risk of severe illness requiring hospitalisation if they catch coronavirus. People with certain cancers and those who have received or are receiving certain treatments are among those who are most at risk and will receive information about shielding. Please see link for more information

    BHR CCGs have now purchased the extended accuRx package, including unlimited Pathways and lifestyle surveys. Please see attacheddocument for more information

    All GP practices, whose IT systems are supplied by TPP or EMIS, to instruct them to release the relevant primary care data to UK Biobank for purposes related to the outbreak of COVID-19. Please see link for further information

    Most practices are already doing their best to continue to provide services to their patients who present with problems not necessarily related to Covid-19. The RCGP and BMA have together published guidance on workload prioritisation during the Covid-19. Please see link

    This pack is intended to provide guidance to assist staff from primary care and the community with the organisation of services during COVID-19. Providing advice on triage and pathways for monitoring and signposting patients as well as suggesting treatment and palliative care. Please download document here

    Please click thelink for Londonwide LMCs guide for London’s GP practices

    BMJ has provided some guiding principles on how to choose between telephone and video appointments, how to conduct a “query covid” consultation remotely, and considerations when arranging follow-up and next steps in the following article. Please click on the linkfor more information.

    During the COVID emergency, the current patient transport eligibility criteria have been suspended with immediate effect. Please click on the linkfor further information

    Redbridge Coronavirus Hub
    London Borough of Redbridge have set up a website with all local information, including details of the wellbeing service that is providing support to local residents. You can access the site here

    Please click on the link to read the BHR Planned Care Joint Update

    GP Practices are expected to open on Good Friday and Easter Monday: find out more in this letter

    NICE have issued new COVID 19 specific guidance for the management of severe or complex asthma cases. As you will see, this is very much aimed at the more severe and complex patients within the acute system. Please see link

    Message from CCG Chairs – Shielded Patients:  Action by close of play Tuesday 14 April 2020

    The national expectation of practices is that they check the appropriateness of the names on the shielded list and add any other names that practices feel should be on the list by 5pm Tuesday 14th April. Previous correspondence asked GPs to add lots more patients – that can now be disregarded as the letter of 3rd April and the letter today supersedes that guidance.  Practices can still add individual patients to the list who meet the criteria, based on their own clinical judgement.  The expectation is that it will be a low number of patients that need to be added.  Details of how to undertake this work are described in the attached letter.  Review of the care plans and other checks that you undertake into the welfare of these patients is an on-going process and therefore these elements of the work do not have to be completed by the 14th.   Along with the letter are some FAQs developed nationally, as well as a simplified summary document .  Please contact CCG Chair Dr Anil Mehta or the CCG primary care team (bhrccgs.primarycare@nhs.net) with any queries.

    End Of Life Care – Training from Palliative Care Consultant

    Dr Corinna Midgeley, Consultant in Palliative Medicine at St Francis Hospice, delivers a session on preparing for covid-19 and the strain it will put on end of life services.  You can access the recording here. In the session Dr Midgeley covers treatment and care planning, managing symptoms of Covid-19, and giving support at an impossible time.

    End of Life Symptom Control

    The current crisis poses particular challenges to the administration of medication for symptom control for those with advanced life-threatening illness, including in the last days of life, and to those with COVID-19.  This guidance attached is designed to summarise the recommended medications for management of common symptoms via standard and alternative routes of administration

    National GP Update

    NHS England published a letter for all GPs yesterday attached which included contractual updates for practices in relation to activity that should be maintained, activity that can be delayed or temporarily suspended, and new requirements on GP practices – in particular for practices to increase the number of appointments for direct booking from 111 to a minimum of 1 appointment per 500 patients by 30 June 2020.

    Covid-19 Testing – Update to Process

    The CCG has published changes to the testing of primary care workers across NEL.  Staff must be tested no later than 5 days after the onset of symptoms, practices should submit a list of eligible staff by 12pm each day (scheduled day per CCG now discontinued), the data capture form has been revised, and practices will no longer be required to input the time/date slot and email the invitation with instructions to the key worker.  Full details can be found here.

    Update on NELFT Services

    The NELFT CEO has written a letter outlining the changes in service provision NELFT has put in place in Redbridge in response to coronavirus. 

    Newbury Park Care Centre

    The Newbury Park Care Centre has been set up at the Holiday Inn Hotel in Newbury Park to provide additional care capacity to patients who are being discharged from hospital and would normally be able to return to their own homes with a suitable care package.  It has 126 rooms which could be made available as demand increases.  The Centre has been set up by the local authority  and will be registered with the CQC as a domiciliary care provider.  It is anticipated that occupation of the centre will increase gradually over the coming weeks.  It will have a registered manager and deputies on site, with support provided by experienced care staff.   

     HBD has been asked to provide primary medical care to the facility.  To ensure local practices are not placed under additional pressure at this difficult time, we have agreed a model whereby residents at NPCC will remain registered with their own practice but day to day management will be overseen by an experienced HBD GP, led by Dr Ann O’Brien.  A ‘virtual’ ward round will be carried out daily to enable proactive management of any issues with an on-call arrangement to manage any acute issues arising outside of the virtual ward round between the hours of 08 00- 18 30.  The established out of hours arrangements with PELC will be maintained. Practices will be approached individually to seek permission for any Redbridge patients admitted to NPCC to have their day to day care delegated to this HBD service.  Britannia Pharmacy (Horns Road) has agreed to work with us to provide pharmacy support to the centre.  Practices will be informed when patients are discharged from the centre and details of any ongoing care package will be provided.

    Latest from the CCG

    NEL has published its latest newsletter which you can find here.  It includes the final guidance on management of expected and unexpected deaths during Covid-19 which has been agreed by all CCG Chairs in NEL, and a message on monitoring repeat prescription quantities from medicines management.

  • We understand that the current outbreak is worrying, and we want to take a moment to share the ways we can all help keep the workplace safe, as well as the steps we’ll take as an organisation if and when necessary. Please see the Policy attached.

    Many clinicians are looking for support with how to execute telephone and video consultations. The tips attached. should help you get started with telephone consultations.

    For more information about the programme, which is free for the health and care workforce to access without the need to register, visit www.e-lfh.org.uk/coronavirus.www.e-lfh.org.uk/coronavirus.

    In the document attached,are Three simple steps to configuring GP Connect on your EMIS Web system. There is also further guidance available within the document itself

    GPs and practice staff can access free, confidential mental health support from the NHS Practitioner Health Service and the BMA. Details can be found within theattached,document

    National remote working guidance

    Remote working guidance to support practice staff to continue working from home or other care settings during the COVID-19 crisis has been published nationally.  It includes information on NHS issued IT kits, using your own device, SMART card readers, VPN tokens and more.  Please use the guidance to check you remote working solutions are in line with the national regulations – any queries can be sent to pcdt@nhsx.nhs.uk

    Covid 19 Staff Absence Tracker

    A national staff absence tracker service has launched and all GPs and practice staff should use it to report their COVID-19 related absence from work and subsequent return to work. It can be accessed from any computer or mobile device, and is very easy to use.  Staff should register using their NHS email address and if they provide the details of their practice manager or rota manager, they will be automatically informed of the absence. The tracker can be completed by either the member of staff themselves, their line manager, or others such as relatives as a ‘guest’. Reporting on the tracker should commence immediately. 

    Redbridge COVID template

    To help GP practices access the appropriate COVID response services that have been established across Redbridge, a standardised Redbridge COVID-19 template has been created. This standardised template has been sent to each practice by email today, and the template is called covid triage template 10.1.xml.zip.

    Please note – this will need to be downloaded into your clinical system. This template will only work for EMIS practices, we are currently exploring options on how to roll this template out to non-EMIS practices. The template may be developed further as an increasing number of COVID response services become operational. Future updates to the template will be communicated and shared with all GP practices.

    To access the appropriate COVID response services in Redbridge, GP Practices need to e-mail a completed copy of this template to the enhanced assessment centre (based at The Vintry). The email address for the enhanced assessment centre team is: redbridgeccg.loxfordwalkincentre@nhs.net. The Covid enhanced assessment team telephone number is 02037701888.

    Details of how to attach a copy of the completed standardised Redbridge COVID-19 template to the email are as follows:

    • Complete the Redbridge COVID triage template within your system
    • Save the triage template
    • Save the consultation
    • Go to the consultation tab in EMIS
    • Click on the consultation
    • In the top tool bar click on print
    • Then click selected items
    • Press Ctrl+A then Ctrl+C, paste this in to an email

    Send this to : redbridgeccg.loxfordwalkincentre@nhs.net

    Redbridge COVID visiting service goes live tomorrow

    With effect from 17th April 2020, the acute home visiting arm of the COVID-19 assessment service will become operational.  This means that when a suspected COVID-19 referral is made to the enhanced assessment centre, the triage process will include the ability for this cohort of patients to be visited at home.

    From 27th April 2020 – the COVID-19 acute home visiting service will operate from 08 00-18 30 Monday – Friday. Initial operating hours are as follows:

    • Friday 17th April and Monday 20th April: 11am – 5pm
    • Tuesday 21st April to Friday 24th April: 10am-6pm   

    Where possible the home assessment will involve self-observations which will then be fed back to the GP to determine future management.  We are therefore asking practices to gather a small amount of additional information that will help the COVID-19 visiting GP to determine whether this is appropriate.

    PPE for Practices

    An email has been sent out to each practice regarding additional face masks and hand sanitiser that is available for each practice if it is needed.  Please confirm as soon as possible with Irene / Aruna on irene.skapoullis@nhs.net / aruna@healthbridgedirect.co.uk  how much your practice requires (up to the full amount) and we will arrange distribution over the next few days.

    Worsening advice and resource pack

    Kate Adams with the LAS/111 clinicians has produced this document which provides practical tips and pitfalls for the management of covid based on their experience.

    Telephone Triage and Consultations – Top Tips Podcast

    A podcast with Osman Bhatti and Phil Bennett-Richards with tips for telephone consultations can be found here

    Redbridge COVID template

    To help GP practices access the appropriate COVID response services that have been established across Redbridge, a standardised Redbridge COVID-19 template has been created (note this is currently only available to EMIS practices, we are working on non-EMIS versions).   Thank you to all practices who fed back their experience of using the Redbridge COVID triage template version 10.1. Feedback has been taken on board and we have developed version 11 attached in response. We do not anticipate any further changes being needed to this template.

    As a reminder – To access the appropriate COVID response services in Redbridge, GP Practices need to e-mail a completed copy of this template to the enhanced assessment centre (based at The Vintry). The email address for the enhanced assessment centre team is: redbridgeccg.loxfordwalkincentre@nhs.net. The Covid enhanced assessment team telephone number is 02037701888. Details of how to attach a copy of the completed standardised Redbridge COVID-19 template to the email are as follows:

    • Complete the Redbridge COVID triage template within your system
    • Save the triage template
    • Save the consultation
    • Go to the consultation tab in EMIS
    • Click on the consultation
    • In the top tool bar click on print
    • Then click selected items
    • Press Ctrl+A then Ctrl+C, paste this in to an email
    • Send this to : redbridgeccg.loxfordwalkincentre@nhs.net

    CMC Care Plans

    At this time it is even more important that appropriate patients have an up to date CMC care plan.  Here are some resources to help: Link to CMC training; 5min video on how to create a CMC care plan; Link for CMC log in; and a short video on creating a CMC alert for existing patients

    Integration of eConsult into the NHSApp

    The NHSApp is now integrated with eConsult.  You can find out more by clicking here. eConsult are offering to contact all practices (who have mobilised) to make them aware of this change.

    Integration of eConsult into the NHSApp The NHSApp is now integrated with eConsult. You can find out more by clicking here. eConsult are offering to contact all practices (who have mobilised) to make them aware of this change.

  • CBPilates – Chair Exercises

    Please click here to access a short video with some simple pilates exercises to help you unwind at the end of a long day.  You can even do the exercises seated in your chair!

    Stay Calm and Healthy

    It is important to keep calm and healthy. Please consider this app for some healthy exercise you can do during this stressful time https://www.downdogapp.com/healthcare.  It is free with some ID verification until 1st July – you will need your nhs.net or similar account.

    Managing Your Stress

    It is a difficult time for all of us. This podcast video with Dr Caroline Walker is called “COVID-19 Supporting Doctors: How to manage our stress and anxiety through the crisis”.  Click here to watch/listen.

    Good Thinking – NHS approved wellbeing service

    Good Thinking – NHS Approved wellbeing service There are a number of free tools for any Londoners feeling anxious, having sleep problems, suffering from stress, or feeling low.  These can be accessed here on the Good Thinking website.

    Free Physio Classes for NHS Staff

    LDN Physio are offering free online classes to NHS workers. The NHS booking links for our current classes, simply click and go through the booking process to register on the date you wish. Simply use your NHS email address to book the classes, or send a message directly if you have any problems. You can book on as many classes as you like, and share them with your colleagues. The classes available are:

    Ruth’s Carpark Shapes, Monday 6:30pm. Ruth is here to push you into feeling your best whilst helping to increase your strength, motivation & energy in your everyday life. Live from her Workout Carpark, expect good music, quickfire rounds for upper & lower body and an unwavering smile. You’ll leave feeling fit, and a little sweaty!

    Anna’s Vinyasa Flow, Tuesday 6:30pm. Anna will teach you how to use yoga at home to bring some calm and ease into your day. This session is great for beginners – the perfect balance between easy flow and a bit of challenge, with the intention of opening up your body and bringing some presence into your days.

    Marshall’s HIIT it Home, Wednesday 6:30pm. Don’t think Marshall’s baby face and chilled out nature will give you an easy ride! Toning strength exercises with high-energy floor work will have you burn extra calories for hours after the session. Expect upper & lower body work mixed in with cardio for a real metabolic approach.

    Sau’s Core Crusher, Thursday 6:30pm. Get your heart rate up with Sau’s core workout centered around abdominal exercises. This ultimate floor class is a great way to tone up and work on developing a strong core. The exercises also work on your back, allowing you to improve your posture, balance and develop your stability.