Covid Daily Briefing 30 March

**Email sent on behalf of the LMC, Clinical Directors and NHS Calderdale CCG**
Hi everyone
General Update
As you are aware, new guidance was published by NHS England over the weekend and this is currently being reviewed:
a)    Preparedness Letter – 27th March 2020
b)    Advice on how to establish a remote ‘total triage’ model in general practice using online consultations
c)    PPE (see below for more information under item 5)
d)    NHS England Primary Care Bulletins
e)    At Risk Patient Letters – email today
·         We are exploring this further with Data Quality and working through the queries raised
·         Please submit daily into by 12 noon
2.    Clinical Decision Making Support Documents to support changes in delivery of general Practice
·         Further information was issued this morning around the patient journey flow.
3.    Patient Message on new ways of working
·         The CCG website has been updated with the following message for patients:
·         This message has also been shared with Councillors, MPs, Healthwatch & CHFT Comms
·         You may link your practice website to this message if you wish
·         The CCG Comms Team are currently preparing some posters for your practice front doors
4.    Prescribing
a)    Testosterone injection to gel considerations
·         Consider switching patients on testosterone injection to testosterone gel when this is next due to reduce need for patients to attend. CHFT endocrinologists have provided some advice about this – see attached Please check with Leeds before switching gender transfer patients
·         See attached for more information
5.    PPE
a)    PPE Letter dated 28th March 2020
b)    Extracts from the Preparedness Letter of 28th March 2020 confirms that PPE will be provided free of cost and pre-packed kits are now available within 72 hours:
·         Page 2: ‘For immediate short-term issues National Supply Disruption Response (NSDR) are able to issue ‘pre-packed kits’ with a minimum of 100 Type IIR facemasks, 100 aprons and 100 pairs of gloves within 72 hours.  NSDR 24/7 telephone helpline: 0800 915 9964
·         Page 12: ‘Funding to cover expenses incurred: Items such as PPE and IT equipment will be provided free of cost.’
c)    Summary from NHS Supply Chain following the webinar 27.3.2020:
·         NHSSC have created a dedicated PPE supply channel to handle core Covid-19 PPE products in accordance with PHE guidelines. This will support PPE distribution to all types of healthcare providers supported by Clipper Logistics providing Covid-19 logistics and delivery solutions.
·         For Community Healthcare partners, we are creating an ‘eCommerce’ solution to ship core PPE items to community partners. Partners will be able to register for an account on a portal. Delivery from the PPE warehouse will then be undertaken by Royal Mail and if necessary other parcel carriers. This solution is anticipated to start delivering w/c 6th April. Until that point, there are solutions in place to support Community partners that can be accessed through the NSDR.
o    National Supply Disruption Service (NSDR). This is a government service that NHSSC has no influence over. They decide based on need what PPE would be sent and when.
o    Please contact them 24/7 on: supply disruption helpline on 0800 915 9964

·         There will also be a new dedicated Customer Services team for delivery specific PPE queries. This will operate 24/7 and address delivery queries such as discrepancies in deliveries or to query deliver timescales. Customers will be provided with a new PPE specific contact number.

·         In the meantime all escalations for PPE stock availability should continue to be channelled through NSDR

·         The live daily NHS Supply Chain webinar link is:

6.    Infection Prevention and Control IPC)
·         Head of Quality has pulled together the attached information
7.    West Yorkshire Policy approach to Covid-19
·         West Yorkshire Police have provided details of their four point approach to enforcing the government’s legislation on social distancing during the coronavirus pandemic.
·         The details can be found in the attached document with a summary of the four points below:
1.    Engage    
We police by consent. Our initial police response will be to encourage voluntary compliance.
2.    Explain    
We will stress that this is a national public health emergency. Explaining that they are putting their own and other people’s lives at risk, and that they are contributing to placing the NHS under more pressure.
3.    Encourage          
We will ask them politely to comply with our requests, informing them of the potential consequences should they fail to do so.
4.    Enforce   
We may use our powers under the new legislation. This includes the ability to issue fines, use reasonable force to remove someone to their home address, or to make an arrest.
8.    Fraud and NHS ID Badges
·         Message from Anti-Crime Specialists at Audit Yorkshire ‘there is likely to be an influx of people using the current COVID19 emergency to their advantage.
·         Please see the attached alert which gives details of NHS ID badge issues.
·         Can I please stress the importance of ensuring ID badges are checked prior to anyone being let onto NHS property. I know most sites are either fully shut down/partially shut down at the moment but we cannot let this check slip.
9.    Registering Deaths
The registry office have advised that they are now:
·         Registering deaths via the telephone only.
·         Please scan a copy of the front and back of the signed MCCD to
a)    If the doctor who attended the person before death is unavailable, another doctor can sign the MCCD for all natural deaths including Covid-19
b)    There is no need for the certifying doctor to have attended the deceased during their last illness.
c)    The time period for the deceased to have been seen by a doctor, prior to death, is extended from 14 to 28 days.
·         See attached for more information
10.  Migrant Information Hub
·         Migration Yorkshire have just launched the new Migrant Information Hub -
·         The Migrant Information Hub aims to offer useful information and resources to help migrants, and those supporting them, to stay safe, connected and informed, and to reduce the harmful impacts of coronavirus (Covid-19) on our region and on people’s lives.
·         It includes new multi-lingual resources, national guidance, local services and support, plus news and updates on specific migrant issues.
11.  GP Connect and Direct Booking
·         A reminder that your direct booking appointments should be set up for telephone only, so that 111 can book directly into your telephone triage
12.  FAQ’s for Covid-19
·         The Primary Care Team are receiving a large volume of enquiries from practices and to support you around responding with answers back to all practices, we are setting up an FAQ process to support the daily key messages
·         The FAQ will log all enquiries/queries and we will publish a response once we have one
·         Please submit any enquiries into under the heading FAQ Covid-19, so that we can easily filter these and ensure we get you an update as quickly as possible.
Thanks very much.
Dr Caroline Taylor CCG, Dr Seema Nagpaul LMC, Dr Fawad Azam CD, Emma Bownas