13 April 2020

Children's  safeguarding - single point of contact

ACTION: Note new contact details

A new single point of contact for children’s safeguarding for NW London.
This will ensure that contacts for advice, support and escalations are managed appropriately Monday – Sunday 8am – 8pm


020 3350 4033 
nwlccgs.safeguarding@nhs.net
 
Safeguarding materials and support
All partners who work in safeguarding are also able to apply to register for the NHS England Safeguarding Workspace which contains a host of resources and information including Covid-19 and safeguarding practice.
 
https://future.nhs.uk/system/login?nextURL=%2Fconnect%2Eti%2Fsafeguarding%2Fgrouphome
  

Reminder on request from NHS E – At risk patients

ACTION: read shielding letter and ensure actions are complete by 5pm Tuesday 14 April

A CAS alert was sent on 9 April with actions for GP practices  regarding the management and shielding of patients who are at the highest risk of severe morbidity and mortality from COVID-19. 
 
This is a reminder that actions in part 1 and part 3 of the attached letter need to be completed by 14 April.



Part 1 - to identify the individuals within your practice who have been flagged as vulnerable.  This is by running a specific search and the appendix to the document sets out how to do this for the various systems.



Part 3 - to add flags on patients who you know to be vulnerable, and send them the letter with advice on shielding - this letter is embedded in the document



The other 2 actions of the letter have the following deadlines:



Part 2 - review patients identified as high risk by acute trusts - you will receive letters from the trusts identifying these patients and only need to take action if you feel this is inappropriate.  This work is ongoing as the notifications come through



Part 4 - review the patients who have self-identified as vulnerable and assess their risk - this information will be available from 17 April and you are asked to complete this review by 20th April
 
Attachment:
 
1.    Shielding letter 9 April
 

Care home infection control stepdown guidance
 

Guidance for stepdown of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings
 
COVID-19: guidance for stepdown of infection control precautions within hospitals and discharging

COVID-19 patients from hospital to home settings
 

Clinical guide learning disabilities and autism

A guide for front line staff to support the management of patients with a  learning disability, autism or both during the coronavirus pandemic – relevant to all
clinical specialities (attached)
 
Attachment:
 
1.    C0031_Specialty guide_LD and coronavirus v1_ 24 March
 
 

Data sharing update  - governance and further changes

Action: update FPNs
 

We have introduced significant COVID data sharing measures in NWL and this letter is to inform you about the information governance arrangements which need to be put in place and advise you of further changes:
 

• We have to date supported the extension of smartcard permissions within PCNs, however as the pandemic escalates we now need to extend this sharing to within CCG boundaries and these changes will shortly be reflected on your smartcards. We have engaged with CCGs, IT leads and the LMC in making these plans.
• Practices should now have access to local Respiratory Hubs and the other local facilities are in place which vary between CCGs.
• COPI legislation has been released by the secretary of state for health (as below in FPN). National shielding measures require a coded list of patients at highest clinical risk from COVID-19 (a subset of the flu jab cohort) to be extracted from GP clinical systems through GPES in the week starting 13th April. These patients will be written to by the NHS with specific advice. See update with a link to the original communication and FAQ sent on the 3rd April. Under COPI measures, aggregate data will also be used through WSIC to support planning and care provision in the NWL sector.

Clinicians and primary care staff get access to clinical systems and medical records through smartcards (or equivalent mechanisms) which authenticate their ID and role. They also need to have a Legitimate Relationship (LR) to view records.  As we necessarily extend the boundaries from GP practices to PCN Hubs, and wider to CCG or NWL levels, clinical and primary care staff will have access to a much larger number of patient records. They have all had IG training to understand their responsibilities, in particular that if they do not have a legitimate reason for accessing a record they should not open it (even though it may be possible for them to do so). Access is recorded and audited and staff who access records inappropriately may be subject to disciplinary proceedings (mentioned here by way of reassurance, rather than threat).
 
Because of these changes we are advising all practices to make further amendments or to include a paragraph in their FPNs as below:

Data Sharing Measure in relation to the COVID pandemic

1)      The secretary of state has served notice under the Health Service COPI (Control of Patient Information) Regulations 2002 to require organisations to process confidential patient information during the COVID Pandemic and these measures will remain in place until September 2020. In addition, aggregate data which supports the planning and delivery of health care during the COVID pandemic will be processed securely through the Whole Systems Integrated Care database. Any such data will be formally identified as COVID related and used only for this purpose until Sep 2020.
2)      Primary care staff across each CCG will be able to access your full medical record without consent during the COVID-19 pandemic but will only do so when this is necessary to provide you with care. They will be required to use a smartcard which confirms their identity, and which limits their access and actions to those appropriate for their role. They will all have been trained to understand their professional and legal responsibilities in providing you with care. Access to records by trained clinicians will be made available for example when patients:
a.       are asked to present to the Respiratory Hubs offering care for COVID related illness
b.       are directed to other hubs based services for routine face to face, or telephone or video consultation
c.       require community visiting services
3)      The extension to smart card permissions is currently limited to CCG wide sharing, but in the event of the pandemic escalating we have taken measures to implement NWL wide sharing and will notify patients through this Fair Processing Notice, should that need arise.
4)   The government have requested reinstatement of the “break glass” facility” previously available in TPP clinical systems so as to allow a declared access to patient records in the event of an emergency.
 
NWL Registration Authority
 
Dr Laurie Slater
Clinical IG Lead NWL Collaboration of CCGs
IT Lead Hammersmith & Fulham CCG
 
Dr. E.Norman-Williams
NWL GPs - Data Protection Officer (DPO) GDPR Certified Practitioner
 
 

National end of life care pack from NHS England

Action: for information
 

In addition to the NW London palliative resource pack circulated two weeks ago (link) NHS England have also published a series of resources.
 
Some of this information is already in our NW London resource pack but there are also useful updates contained within the resources from NHS England.
 
From NHS England please find attached guidance on symptom control using non-oral, non-parental routes of medication administration during COVID-19 and accompanying letter.
 
Also attached, an updated GP EOLC toolkit – version 2 - to include this and other guidance documents that have been published or changed.
 
In addition please also find:
    •    MCA and DoLs COVID-19 guidance
    •    Information on the NHS staff support line
    •    For family members - Caring for your dying relative at home with COVID-19
    •    The HEE e-LfH COVID-19 education programme for EOLC
    •    Online patient referral form to request a volunteer’s support and guidance document
 
We have had a number of enquiries asking whether there will be a pan-London response to bereavement. We are currently working with the GLA and bereavement stakeholders on this and will keep you updated. In the meantime, please continue to signpost to local services or use the London EOLC Clinical network’s bereavement leaflet which can be found here
 
Attachments:
1.    Cover letter_EOLC medication COVID-19
2.    Guidance on symptom control using non-oral non-parental routes of medication administration during COVID-19 V1
3.    London EOLC CN COVID-19 London Primary Care Support Document V2
 

Home delivery of medicines and appliances

This letter announces that, while patients meeting the COVID-19 shielding criteria need to stay at home and away from community pharmacy and dispensing doctor premises, they must be offered a home delivery option for their prescription items unless a family member, friend, relative or volunteer can collect the medicine for them.
 
The National Health Service (Amendments Relating to the Provision of Primacy Care Services During a pandemic etc.) Regulations 2020 came into effect on 27 March 2020 and provide for such an announcement.
 
Medicines delivery services will be commissioned from both pharmacies and dispensing doctors across England from 9 April 2020 until 1 July 2020 in the first instance but may be extended as necessary as part of the COVID-19 response.
 
Attachment:
 
1.    C0265_Pharmacy letter re delivery service_10 April
  
 

Remote working in primary care

Guidance for GP practices during COVID-19 emergency response
           
https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0112-NHS-Volunteer-Responders-Information-for-Primary-Care-Professionals_31-March-2020.pdf
 

 
NHS Volunteer Responders information for health professionals

Includes information on how to use and refer patients to NHS Volunteer responders.
https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0112-NHS-Volunteer-Responders-Information-for-Primary-Care-Professionals_31-March-2020.pdf