From 1 April 2022 this website will not be updated.

  For the latest North West London health and care information, visit www.nwlondonics.nhs.uk.

Read more...

30 April 2020

All documents can be found here

Dear colleague

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

You can view the North West London password-protected GP extranet homepage using the details below. As always, you are advised to review the full list of Covid-19 related service changes on a regular basis, to ensure you have not missed any notices.

Website: https://www.nwlondonccg.nhs.uk/professionals/coronavirus-clinical
Password: NWLCovid-19
 
Today’s update includes:

  • Apology: ChelWest endometriosis guide
  • Dental pathway and information revised
  • Letter from NHSEI’s Simon Stevens and Amanda Pritchard re Covid-19 response second phase
  • Reuse of medicines in care homes and hospices
  • Message from NHSEI re Direct booking from NHS 111 to support the Covid-19 response and Covid-19 Clinical Assessment Service (CCAS)

 

Apology: ChelWest endometriosis guide

ACTION: View the guidance in full from ChelWest here

Apology: We understand there was an issue accessing the ChelWest endometriosis guidance documents yesterday. The link to the full documents is above. The original message read as follows:

ChelWest consultants would like to share with GPs and their patients during the current Covid-19 pandemic information regarding the endometriosis service at Chelwest. We understand there has been disruption to the service and the information in the link above will offer guidance to GPs managing patients during this time.

If you would like to discuss individual queries on a case-by-case basis, please email endometriosis@chelwest.nhs.uk with the subject line ‘GP ADVICE’ where this will be picked up by a member of the team. If you have acute concerns regarding gynaecological emergencies or need immediate advise, please contact the gynaecology registrar on call via 020 3315 8000 (bleep 8742) and refer to the emergency department as appropriate.


Dental care pathway and supporting information updated

ACTION: View the pathway and information here

Note that the dental care pathway and supporting information has been revised as per the two documents available via the link above.

 
Letter from NHSEI’s Simon Stevens and Amanda Pritchard re Covid-19 response second phase

ACTION: Read the letter on phase two here

Simon Stevens, NHS Chief Executive and Amanda Pritchard, NHS Chief Operating Officer have published a letter today outlining the second phase of the NHS response to Covid-19. Please do take time to read this letter.

The key points for primary care are:

  • Ensure patients have clear information on how to access primary care services and are confident about making appointments (virtual or if appropriate, face-to-face) for current concerns.
  • Complete work on implementing digital and video consultations, so that all patients and practices can benefit.
  • Given the reduction of face-to-face visits, stratify and proactively contact their high-risk patients with ongoing care needs, to ensure appropriate ongoing care and support plans are delivered through multidisciplinary teams. In particular, proactively contact all those in the ‘shielding’ cohort of patients who are clinically extremely vulnerable to COVID-19, ensure they know how to access care, are receiving their medications, and provide safe home visiting wherever clinically necessary.
  • To further support care homes, the NHS will bring forward a package of support to care homes drawing on key components of the Enhanced Care in Care Homes service and delivered as a collaboration between community and general practice teams. This should include a weekly virtual ‘care home round’ of residents needing clinical support.
  • Make two-week wait cancer, urgent and routine referrals to secondary care as normal, using ‘advice and guidance’ options where appropriate.
  • Deliver as much routine and preventative work as can be provided safely including vaccinations immunisations, and screening.

 
Reuse of medicines in care homes and hospices

ACTION: Ensure you are working in accordance with the DHSC SOP available here

For the purpose of addressing urgent stock shortages during the pandemic,  legislation has now been changed to allow for reuse of medicines (which are no longer required for the original patient) in a care home or hospice setting.

There are, however, strict guidelines which must be adhered to ensure:

  • Medicines are suitable for re-use (this has to be authorised by a health-care professional)
  • The usual process for obtaining the medicine urgently is attempted before resorting to re-use of a medicine
  • Appropriate consent, record keeping and storage is adhered to

The Standard Operating Procedure (SOP) linked above details the responsibilities of care home staff, prescribers and community pharmacists.

A localised version of the SOP for issue to Care Homes is in development. For further information or advice please contact your CCG Care Homes Pharmacist or CCG Medicines Management/Optimisation team.

Colleagues should also continue to refer to the clinical guidance for the management of palliative care in hospital during the coronavirus pandemic.

 

Message from NHSEI re Direct booking from NHS 111 to support the Covid-19 response and Covid-19 Clinical Assessment Service (CCAS) 

ACTION: Read and implement the message below


During the current pandemic we need to expand booking capacity from NHS 111 into general practice to meet the needs of Covid-19 symptomatic patients alongside patients with non-Covid-19 conditions. This is why we have amended regulations (GMS/PMS) to set out that practices in England need to make one appointment per 500 registered patients per day available for direct booking. This supersedes the previous requirement to make one appointment per 3,000 registered patients per day available for direct booking.

During the pandemic we expect the operation of direct bookings to change and further guidance will follow shortly. Ahead of this, we wanted to be clear that people directly booked into appointments at their GP practice by, for example, CCAS will not be told a specific appointment time and instead to expect to be contacted by their practice. Practices should prioritise patients on this list based on the clinical assessment and arrange ongoing management based on the degree of urgency.

This prioritisation could result in a number of different outcomes for the patient including remote management by phone or video, the person being added to a follow up list to be reviewed at a future date or, where necessary, a face-to-face assessment which may be at the practice, local hub or locally commissioned service. To facilitate direct booking into GP practices, GP Connect has been centrally enabled for all EMIS and TPP Practices, namely GP Connect Appointment Management and Access Record: HTML. Practices will still need to configure their appointments to be shared with NHS 111 and CCAS. Guidance to support GP Connect configuration in GP practice clinical systems is available here.

We recognise that whilst the demand for these appointments may initially be low, this could increase. It is important that this functionality exists to help systems deal with any potential surges in demand. We need to work together across the system to support this work and ensure that patient flows between services are as smooth as possible and take account of demand and system capacity. We will continue to monitor this with you.