Covid19 Daily Briefing 31 March

**Email sent on behalf of the LMC, Clinical Directors and NHS Calderdale CCG**
Hi everyone
** All updates and guidance are on the LMC website
·      Reminder to please submit daily into by 12 noon
2.    Vulnerable Patients  
We are aware of the conflicting guidance that was in the NHSE New GP Preparedness Letter released - 27 March 2020 and the Primary Care Bulletin from NHSE/I published on 30th March 2020.  We have raised this with NHSE along with other CCGs in West Yorkshire and no doubt nationally. We have been advised that further more detailed guidance will be issued imminently.  We will of course share this with you as soon as its available. We are also working behind the scenes to ensure that you can be supported by our Business Intelligence and Data Quality Teams to support the effective communication with patients and the coordination of support for health and care agencies.
3.    Advice and Guidance and Secondary Care Specialist Support
CHFT are establishing routes through which General Practice can communicate with colleagues in secondary care, in order to ensure better care for patients and to be confident that only those in urgent need are referred to the hospital or admitted.
a)            Advice and guidance is available through ERS but you need to select the referral priority as urgent, for both routine and urgent requests. (If routine A&G is opened then it will open all services again). The hospital will offer advice to support management in Primary Care where possible.
b)            Direct phone numbers to consultants in key specialties have been made available (see below).This provides an opportunity for immediate advice, and the opportunity to discuss alternative plans for management and avoid admission or attendance to hospital.
01422 222537
Respiratory (starting 6th April)
01422 222538
01484 342000 (switchboard, ask for the Gastroenterology consultant)
Acute Medicine Calderdale
01422  222343
Acute Medicine Huddersfield
01484 342000 (switchboard, ask for the acute medicine consultant)
Elderly Care
01484 342000 (switchboard, ask for the Diabetes consultant)
01422 222505
01484 342000 (switchboard, ask for the Haematology consultant)
01484 342000 (switchboard, ask for the Nephrology consultant)
01422 222533
01484 342000 (switchboard, ask for the Oncology consultant)
01422 222532
01422 357171 (switchboard, ask for the Stroke consultant)
General Surgery
07741 363262
07741 363257
07741 363254
Trauma and Orthopaedics
07741 363261
01422 222468
Maternity – Calderdale
01422 261364
Maternity – Huddersfield
01484 357430
01422 225330
4.    Advice on maintaining cancer treatment during the COVID-19 Response
Letter attached from the NHS England National Cancer Directors informing that NHSE are clear that we must ensure that cancer diagnosis, treatment and care continues during the response to the COVID-19 emergency.
This means:
·         Essential and urgent cancer treatments must continue. Cancer specialists   should discuss with their patients whether it is riskier for them to undergo or to delay treatment at this time.
·         Where referrals or treatment plans depart from normal practice, safety netting must be in place so that patients can be followed up.
·         Urgent consideration should be given to consolidating cancer surgery in a COVID-free hub, with centralised triage to prioritise patients based on clinical need.
See attached for full details
5.    Advice for health and justice healthcare teams on medicines and pharmacy services continuity
The attached guidance describes the changes that may be needed to provide continuity of medicines during an outbreak. Providers should already have plans for pandemic and seasonal flu outbreaks or major incidents that can be used and adapted for COVID-19 outbreaks.
The supply of medicines is a clinical priority to minimise the risks of harm from omitted and delayed medicines. Health and justice (HJ) patients have additional risks if continuity of medicines is interrupted.
Full details attached
6.    PPE
We are aware this continues to be an issue and have escalated the risk again to NHSE primary care team
7.    Important information about your year-end QOF
In light of COVID-19 NHS England and Improvement has put measures in place to support practices with their year-end activities. QOF will be automatically accepted for 20/21 for practices who participated in 19/20. Manual indicators will be automatically completed for practices yet to submit them. Payments will be automatically declared and approved. Full details are available at the QOF 19/20 year end support link in the Published Information box on the home tab.
QOF payments 2019/20

NHS England and Improvement published a letter on Thursday 19 March 2020  which confirmed that calculations for QOF 2019/2020 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 COVID19 activities.  Learn more.  
8.    Changes in Regulations for Cremation Certification
Please find attached a letter from our Dr Howard Barnes, Principal Medical Referee regarding implementation of changes in regulations for cremation certification outlining the new regulations under the Coronavirus Act 2020 which have been enacted.
·         In England and Wales, a confirmatory medical certificate (Cremation Form 5) is no longer required.  A Medical Certificate (Cremation Form 4) and an authorisation of cremation of deceased person by medical referee (Cremation Form 10) are still required.
·         A copy of the enactment regulations of 26th March 2020 can be viewed at
9.    COVID deaths notification system update  Single point of contact (SPOC), NHSE
Providers are now able to edit their un validated records. All un validated records appear on the screen plus an additional NHS Number search option to locate records quickly. Full details on how to access these records is attached.  Please advise  if this functionality is not enabled.
10.  Guidance from the coroner
The LMC in Calderdale are seeking to establish a clear position from the coroner relating to certification of death. We will update as soon as we receive a response
11.  Biobank COPI notice
Please see the attached letter and information sheet from the Secretary of State for Health and Social Care asking primary care to release data to UK Biobank for purposes related to the outbreak of COVID-19, this data will be incorporated into the main UK Biobank database for researchers to study determinants of COVID-19 infection.
12.  Loan Store Change of Telephone number
Due to an unforeseen technical issue the phone contact details for the Community Equipment service has had to be changed permanently.  The new contact number is 01422 261346 and will be active from Wednesday April 01 2020
13.  Antihypertensive medications and COVID-19
Further to our daily brief on using ACEi and ARBs and coronavirus on 20.3.2020.
A briefing has been released which states there is no evidence from clinical or epidemiological studies that treatment with ACE-I or ARBs might worsen COVID-19 infection.
14.  IT capability to support revised ways of working
There will be further communication tomorrow from Ian Wightman updating on progress in relation to additional capacity to support remote working and also an update on the situation in relation to kit and hardware.
15.  National Documents and Guidance
The following documents have been uploaded to the LMC website
Covid-19 Immunisations FAQ
Maintenance of TB Services
Newborn and Infant Physical Examination and Screening Technical Guidance of TB During Covid-19
Thanks very much
Dr Caroline Taylor CCG, Dr Seema Nagpaul LMC, Dr Fawad Azam CD, Emma Bownas