Covid19 Daily Briefing 20 March

**Email sent on behalf of the LMC, Clinical Directors and NHS Calderdale CCG**
Hi everyone
1.    Update from meeting held yesterday:
·         We held a virtual meeting yesterday with CCG, LMC and Clinical Directors to start and plan the next phase for general practice. Your clinical directors will be sharing and discussing plans for the changes that will be required to working in general practice to respond to the 6 key priorities outlined in the preparedness letter received 19/03/2020.
·         We are working on each PCN having:
1.    one site open for face to face
2.    other sites providing remote triage and consultations and
3.    thirdly a team for home visiting (people with confirmed or suspected Covid and others).
·         We made significant progress yesterday, however there is still more to do and we recognise this is a significant change to normal working practices required in unprecedented times and is unsettling for us all. The next meeting to continue this work is with the Clinical Directors, LMC and CCG on Monday 23rd and planning needs to continue at pace.
2.    OPEL system Agreed.
·         An email has gone out today from Marcus asking for practices to provide a baseline position.
·         Yesterday we stood down the requirement of daily reporting so practices are only required to report when their level changes – this is important to ensure consistency across Calderdale and enable the LMC and CCG to provide backing and support for practices and PCNs to make decisions re service offers.
·         See attached for the final version
·         For now, please can all practices ensure they have moved to 100% remote triage and be working to remote consultations as a first option where clinically possible.
3.    Nationally the acute hospitals have been asked to clear as many beds as possible and work to a two hour discharge time for patients who are medically able to be discharged from acute facilities.
·         There is a detailed document that has been released today with the expectations for social care, community staff and AHPs.
·         Farrukh Javid is involved from our primary care perspective and we are working hard to ensure that the correct specialist advice is available for you from secondary care to assist with keeping patients at home.
4.    PPE:
·         Many are anxious about PPE for treating suspected and confirmed cases and current advice with evidence is included within the SOP attached.
·         At present, the advice is standard PPE.
·         We have also attached the letter issued by the BMA last night (19/03/20)
5.    Practical News
·         Online sick notes for people with symptoms and those that need to self-isolate -
6.    Communications:
·         We are working with comms to get some messages out through social media to support people to understand the changes that are being made to delivery of general practice and how to access things.
·         Posters
o   NEW: Link to Gov.UK -
o   Link to NHS -
·         Latest Coronavirus Guidance in Different Languages -
·         Doctors of the World, a voluntary organisation that provides health services to people worldwide, have set up a web page website with the latest NHS Coronavirus guidance translated into 20 different languages. As national guidance is updated, the old guidance and translations are removed, then the new guidance is added with translations as they are produced. This ensures that the guidance is always up to date.
·         Patient Messages: NHS England have developed the following message for patients, to be used as needed (page 13 ‘Preparedness Letter of 19.3.2020’) :
·         To reduce your chances of catching COVID-19 and reduce pressure on your local GP practice during this busy time, appointments will be carried out over the phone or through (ADD OTHER OPTIONS AVAILABLE) unless there is a clinical need for you to come into the practice. This will help minimise risk while continuing to ensure people get the care and advice they need.
7.    IM&T Support with Changes
·         We recognise that there is much to do to be IT ready for this. A few have asked around additional lap tops.
·         We have been advised that we are looking at utilising personal kit where possible and more will follow on this in the next few days. (see pages 14/15 ‘Preparedness Letter of 19.3.2020’ around remote working.)
·         Microsoft Teams – see attached email from Ian Wightman
8.    Prescribing
·         Delivery of medicines
·         Prescribers should advise patients to contact the pharmacy directly and to ensure other options for the collection of medicines are considered e.g. collection of medicines by relatives, neighbours or other nominated individuals.
·         Further national guidance on prescription delivery services will be shared when available.
·         If the prescriber deems that a prescription needs urgent delivery they must first speak to the community pharmacy to ask if the pharmacy is able to deliver and confirm when the pharmacy is able to deliver.
·         Urgent prescriptions that require delivery must not just be sent to the pharmacy with a note NB previous serious incidents reported in relation to this.
9.    Healthy Hearts Message
*****Message on behalf of Dr Youssef Beaini ********
Dear colleagues
We have become aware of a very small number of clinicians who are concerned about an interaction between ACEi and ARBs and coronavirus. The West Yorkshire Healthy Hearts team can reassure everyone that there is no concern and no need whatsoever to change treatment. The European Society of Cardiology have also issued a very clear statement of reassurance.

10.  CQC
·         See letter attached regarding our local contact and assistance that CQC are offering at the moment.
·         Visits continue to be suspended.
Thanks very much.
Dr Caroline Taylor CCG, Dr Seema Nagpaul LMC, Dr Fawad Azam CD, Emma Bownas

Attachments are here