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14 April 2020

All attachments can be found here

Dear colleague

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

You will find this update with links to the files on the new North West London password-protected site page.

You can also review the full list of Covid-19 related service changes here, to ensure you have not missed any notices. You are advised to check this page regularly.
 
To access our GP page:
Website: https://www.nwlondonccg.nhs.uk/professionals/coronavirus-clinical
Password: NWLCovid-19
 
Today’s update includes:  

  • Service changes

- St Charles Centre

- Pembridge Palliative Care Unit

- Reduced opening hours at Western Eye Hospital A&E

  • Standard Operating Procedures (SOPs) for Escalated Care Clinics and In Hours Home Visiting
  • Message from NHSEI following the national guidance on dentistry
  • NHS Digital First webinars available
  • For information: Guidance published on redeploying the optometry workforce

 
Service changes

ACTION: Note these three service changes. As always you can review the full list of service changes here.
St Charles Urgent Care Centre

Due to the rapid development of Covid-19, the NHS in North West London and Central London Community Healthcare Trust took the decision to temporarily suspend the St Charles Urgent Care Centre service from Tuesday 14 April. The number of people attending the centre has reduced dramatically over recent weeks. Staff will be redeployed to support the Covid-19 response, providing clinical support and care for our most vulnerable patients.

Signage will be placed on the door of the St Charles Urgent Care Centre informing people of the closure and alternative services available, and a poster has been created (which you can view here). NHS 111 will be informed that the centre is not currently available and patients should be directed to their GP Practice or referred to alternative services.

GPs will be instructed to text patients informing them of the temporary closure, and if they need medical help to visit 111.nhs.uk, call their GP practice or 111. Further information can be found on the CCG and local GP practice websites.


Pembridge Palliative Care Unit

The inpatient beds at Pembridge are being temporarily re-designated for the care of patients with Covid-19. This is part of a system response to support patients who no longer require a hospital bed but cannot return to their usual place of residence until they are confirmed as non-contagious. It’s important to note no decision has been taken about the future of the Pembridge in-patient unit. The timelines and next steps of the palliative care review are currently under review.

 
Reduced opening hours at Western Eye Hospital A&E

Imperial College Healthcare NHS Trust’s A&E department is operating on reduced opening hours from 08:00 to 20:30 with effect from Friday 10 April 2020. This temporary change to opening hours is part of the response to the coronavirus outbreak which is affecting NHS services. Any patients who feel their condition requires urgent treatment outside of these times is advised to attend the A&E departments at St Mary’s Hospital or Charing Cross Hospital.

 
Standard Operating Procedures (SOPs) for Escalated Care Clinics and In Hours Home Visiting

ACTION: Read and implement the SOPs via this link using the password at the top of the email

Please follow the link above to find the latest iteration of the Escalated Care Clinic and In Hours Home Visiting SOPs, and accompanying documents.

The In Hours Home Visiting SOP has been updated in various places (outlined in the version control table on page one) and has a new guidance document ‘Personal Protective Equipment for Covid-19 in a Community, Primary, Mental Health and Social Care Home Visit’.

The Escalated Care Clinic SOP has been updated in various places (outlined in the version control table on page one) and is accompanied by several guidance documents, some of which are new:

  • IPC guidance – updated version
  • Covid-19 Personal Protective Equipment (PPE) SOP (updated version)
  • Community Based Management of Children (new)
  • Paediatric Telephone Advice and Guidance for GPs and Primary Care during the CoVid period (new)
  • Minimum competencies and training plan for Escalated Care Clinics guidance (new)
  • Oxygen safety training leaflets AL1878 and AL1879 (new)

These will also be sent directly to hub leads, sent out in the primary care bulletin to practices, and saved on our GP Extranet pages. The details, as given above, are:  

www.nwlondonccgs.nhs.uk/professionals/coronavirus-clinical

The password is: NWLCovid-19.

 
Message from NHSEI following the national guidance on dentistry

ACTION: Read the guidance below. Click here to view letter sent out from NHSEI to dentists and the pathway document

Following the national guidance published on 25 March 2020 (published here) the AAA protocol should be the first level of support for patients with urgent dental needs. That is initially telephone triage by the practice. All dental practices should establish (independently or by collaboration with others) a remote urgent care service, providing telephone triage for their patients with urgent needs during usual working hours, and whenever possible treating with AAA:

  • Advice
  • Analgesia
  • Antimicrobial means where appropriate

In line with the guidance, NHS England (London Region) has set up Urgent Care Hubs for those patients whose condition cannot be managed by the above means so that patients can be referred accordingly. These practices will be supplied with the appropriate PPE to treat patients.

Any patient that falls in the above category should be informed that they will be referred to the Dental Triage Service via 111, this will mean a second layer of triage. Once the Dental Triage Service has assessed the patient, if they do need an onward referral this will be made to one of the Urgent Dental Care Hubs (dependent on the service available at the time of call). In a number of cases the patient will then once again be assessed by the clinician before they are booked in. This is to ensure they have all the information about the patient as well as any Covid-19 concerns

Finally it is also important to note that in line with https://www.nhs.uk/common-health-questions/dental-health/how-can-i-access-an-nhs-dentist-in-an-emergency-or-out-of-hours/ patients should only go to hospital (A&E) in serious circumstances, such as: severe pain heavy bleeding injuries to the face, mouth, or teeth.

 
NHS Digital First webinars available

A range of Digital First webinars are available for primary care to support remote triaging and other aspects of the Covid-19 pandemic.

New sessions are added regularly. Remember to check the latest details via this link: www.events.england.nhs.uk 

 
For information: Guidance published on redeploying the optometry workforce

New guidance has been published on deploying the clinical and non-clinical optical workforce to support the NHS clinical delivery plan for Covid-19. The optical workforce has a wide range of skills and experience that can be utilised to undertake activities that will help clinical colleagues and the wider workforce during Covid-19. The document sets out the principles of safe redeployment and healthcare delivery as critical care units prepare and deliver increased activity during surge and super-surge in the coronavirus pandemic.