Covid19 Daily Briefing 27 March

**Email sent on behalf of the LMC, Clinical Directors and NHS Calderdale CCG**
Hi everyone
1.    Clinical Decision Making Support Documents to support changes in delivery of general Practice
Thanks for your hard work and support over the last few weeks. I am aware that you are being asked to work differently and to make these changes at speed. We believe this is essential in order to continue to be able to provide GP services over the coming weeks and months.
This is a massive change for all colleagues working in general practice and also our patients and therefore clinicians from the LMC, CCG and PCNs have worked to provide support documents for the patient journey - there are 7:
1.    Patient Journey Flow Chart
2.    Admin Assessment Flowchart
3.    Admin Assessment Flowchart
4.    Phone Assessment Flowchart
5.    Video Assessment Flowchart
6.    Self-Management Advice for Clinicians
7.    Face to face clinic Assessment
All of these are the first draft but will provide a start. They will all be on the LMC website and that is where you will find the updated versions. We will let you know when they have been updated through the key messages bulletin.
A comms poster and messages for your website will be with you early next week to assist.
2.    Prescribing
a)    Warfarin to DOAC considerations
National guidance has been issued to aid appropriate switching of patients on warfarin to DOACS. Please read carefully as not suitable for all patients. Prioritise considering patients who are unstable on warfarin needing frequent blood tests. CCG will liaise with anticoagulant clinic to see if they can help identify priority patients for switching.
b)    eRD
NHSBSA are sending out lists by email today to each practice of patients who they think are suitable for switching to eRD. Suggest share with your NECS pharmacist/PCN clinical pharmacist who will be supporting the work to move patients onto eRD.
c)    Inhaler Shortages
Some guidance on alternative inhalers is available to aid appropriate choice where there is a shortage.
3.    Key Messages from the PPE Webinar 27.3.2020
·         Guidance Review
o   All guidance is under constant review, particularly around PPE and recent tests have confirmed current advice is correct – in particular following more tests on face masks (FFP3s only needed for AGP’s)
o   UK suggests higher protection than WHO recommend (i.e. FFP3 over FFP2 and more AGP’s covered)
o   H&S Executive are carrying out an independent review this week and guidance will be updated accordingly
o   Academy of Medical Royal Colleges is to review all the guidance and intended updates to ensure consistent messages particularly around societies creating their own guidance and ensure these follow National Guidance
·         New e-commerce portal being established w/c 6th April 2020 for Primary Care and Community Services
o   New portal for ordering is being set up and will use royal mail for distribution
o   Aim to get multiple small deliveries out to thousands of smaller services for Primary Care
o   Aimed at GP practices, DOP’s, Care Homes, Hospices etc.
·         Between now and 6th April 2020
o   Work through mutual aid agreements and share with local services, where possible
o   Order PPE through your existing stockists
o   If unable to obtain supplies, escalate via NSDR Helpline on 0800 915 9964
·         FFP3 masks
o   Re-confirmed that FFP3 masks are only required for staff carrying out AGP’s
o   This has been reviewed and re-tested and is still the current guidance
o   Anyone wearing an FFP3 MUST be fit tested – (Guidance for infection prevention and control in healthcare settings - page 26):
o   GP settings, home visits, hospital wards etc. are predominately disposed to droplets so do not require FFP3s, which are needed for AGP’s only
4.    E-Learning resources for returning staff
·         See attached for specific S1 & EMIS resources for any returning staff to your practices.
5.    Safeguarding Advice – message from Paul Butcher
·         The current Covid "lock-down" is likely to increase the risk of abuse of all kinds.  Attached is a REALLY USEFUL guide for Practices during the current crisis.
·         It's only 3 pages and, as well as useful links, it also has some very good practical advice about questions to ask during phone/video consultations, for example.
6.    Temporary Suspension of Calderdale NHS Walk-in Centres (WIC)
·         Calderdale Clinical Commissioning Group has taken the decision to temporarily suspend NHS walk-in services at Horne Street Health Centre in Halifax and Todmorden Health Centre in Todmorden until further notice.
·         We are letting members of the public know how best to use primary care services in Calderdale through our website, social media channels and general practices.
Thanks very much.
Dr Caroline Taylor CCG, Dr Seema Nagpaul LMC, Dr Fawad Azam CD, Emma Bownas