8 April 2020

All attachments can be found here

Dear colleague
 
Please find below the latest GP update regarding Covid-19.

You can also find the update with attached files on the new North West London password-protected site page. You can also review the full list of Covid-19 related service changes, to ensure you have not missed any notices.
 
Website: https://www.nwlondonccg.nhs.uk/professionals/coronavirus-clinical
Password: NWLCovid-19
 
Today’s update includes:

• Service change:

- Early Pregnancy Unit at Chelsea and Westminster Hospital

• Message from Professor Stephen Powis and Ruth May re maintaining standards and quality of care in pressurised circumstances
• Message from Liz Wise at NHSE re immunisation programmes during Covid-19
• Community-based management of illness in children
• Paediatric telephone Advice and Guidance (A&G) for primary care
• Lockdown coping guide from University College London Hospitals NHS Foundation Trust                                                                                                                    

Service change: Early Pregnancy Unit at Chelsea and Westminster Hospital

ACTION: View in full here using the password at the top of this email and implement

Due to the evolving COVID-19 situation, the referral criteria to the Early Pregnancy Unit at Chelsea and Westminster Hospital has changed. So that we can continue to provide timely, high quality care to women, we are now collaborating with reputable colleagues at this unprecedented time until further notice.  
 
Effective immediately, all patients who fit the below criteria will be seen at The Lister Fertility Clinic, The Lister Hospital, Chelsea Bridge Road, London SW1W 8RH.
Please send referrals to:
Telephone: 07841 053 294 (Mon-Fri 09:00-17:00 only)
Email: secretarygroup@lfclinic.com (Out of Hours)
 
Referral criteria:

• Early pregnancy patients, less than 12 weeks gestation (or a crown-rump length on formal written ultrasound report of less 56.0mm) with a positive pregnancy test
• Estimated blood loss of <1pad/ hour
• Mild-moderate pain score (i.e. less than 7 out of 10 pain score)
• Women do not have a fever ≥ 37.8C OR new continuous cough OR a positive COVID-19 swab result. Women must also be ≥ 18yrs old
• Please advise all women who do not meet this criteria, that we will be able to care for them at Chelsea. In an emergency requiring immediate medical care, women must continue to attend their nearest Emergency Department for review by the on-call team gynaecology. Please also note at Chelsea our evening and Saturday morning clinics are unfortunately now suspended during this pandemic.

 
Message from Professor Stephen Powis and Ruth May re maintaining standards and quality of care in pressurised circumstances

ACTION: View document here using the password at the top of this email

The NHS Constitution is clear that we should deliver care and support in a way that achieves dignity and compassion for each and every person we serve. We should be cognisant of the principle of equity of access for those who could benefit from treatment escalation, and the principle of support for autonomy for those who want to be involved in decisions. Even under pressure we strive for the delivery of personalised care and high standards of patient experience. In regard to those patients who are the most vulnerable, we should encourage them to discuss their individual wishes and concerns regarding their treatment preferences should they develop COVID-19 symptoms and record those preferences in an advance care plan.
 
The British Medical Association, Care Provider Alliance, Care Quality Commission, and the Royal College of General Practice have recently issued a statement on the role of general practitioners in this regard which provides an excellent basis for the approach required, not just in general practice but throughout the health and care system.
The key principle is that each person is an individual whose needs and preferences must be taken account of individually. By contrast blanket policies are inappropriate whether due to medical condition, disability, or age. This is particularly important in regard to ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) orders, which should only ever be made on an individual basis and in consultation with the individual or their family. 
 

Message from Liz Wise at NHSE re immunisation programmes during Covid-19

ACTION: View document here using the password at the top of this email

Many of you have been in touch enquiring about the status of London’s immunisation programmes during the COVID-19 outbreak. We are waiting on national guidance which we will share with you as soon as we receive it. In the meantime, the attached should provide some clarity.  
 

Paediatric pathway: community-based management of illness in children

ACTION: View document here using the password at the top of this email

The pathway for community-based management of paediatric care in North West London has been agreed. Follow the link and ensure you are working in accordance with this pathway. 
 

Paediatric telephone Advice and Guidance (A&G) for primary care

ACTION: View document here using the password at the top of this email

The advice lines below have been set up to provide support from local paediatricians to GPs, HVs and other primary care professionals. This information is provided in order to help maintain the quality of out of hospital care, reduce paediatric activity in our acute hospitals, share the specialist knowledge within the sector and utilise the capacity for telephone support that self-isolating and at-risk workforce can offer This document will be updated as the services evolves.
 
Every attempt will be made to maintain these telephone lines over the Easter weekend.
 

Lockdown coping guide from University College London Hospitals NHS Foundation Trust

ACTION: View document here using the password at the top of this email

Practice staff and patients alike may find the steps and tools produced by UCLH useful during lockdown. While concerns related to your physical wellbeing are a key priority during the lockdown period, there are other concerns that relate to your emotional and social wellbeing, and these are equally as valid and important to acknowledge and to consider. During this lockdown period, it is vital that you take the necessary steps to address these concerns, to continue to maintain your emotional and social wellbeing, and your physical health. It is hoped that the information in the guide will serve as a useful tool that supports you in this cause.