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16 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, to ensure you have not missed any notices.

Website: https://www.nwlondonccg.nhs.uk/professionals/coronavirus-clinical

Password: NWLCovid-19
 
Today’s update includes:

  • Thank you from NW London CCG Chairs and AO
  • Service changes: Royal Free London NHS Foundation Trust

-       diversion of children and young people’s emergency department at Barnet Hospital

-       ambulatory care and paediatric jaundice services

  • Message from NHSEI: Total triage and remote consultation
  • Updated Children and Young People Telephone Advice and Guidance (A&G)
  • Cleaning and disinfection of reusable equipment (including thermometers)
  • For information: NHSE update on dental care
  • For information: Update re acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of COVID-19 (RPS2001)
  • For information: NHSEI page created for all updates and information about accessing supplies of Personal Protective Equipment (PPE)
  • For information: Wellbeing support for #OurNHSpeople
  • For information: Ramadan

 
Thank you from NW London CCG Chairs and AO

ACTION: Read the letter in full here or attached

You will have received a letter this afternoon from all NHS North West London CCG Chairs. It is attached, and also available online via the link above.

 
Service changes: Royal Free London NHS Foundation Trust   

ACTION: Note these service changes
Temporary diversion of children and young people’s emergency department at Barnet Hospital

The children and young people’s emergency department at Barnet Hospital has temporarily closed and been diverted to:

  • North Middlesex University Hospital for London residents
  • Watford General Hospital for Hertfordshire residents

Walk-in patients will continue to be triaged at Barnet Hospital, and if well enough they will be advised to go to the relevant hospitals.
 
In north central London, children and young people’s emergency services will continue to be available at:

  • Royal Free Hospital
  • Whittington Health NHS Trust

Anyone aged under 18 needing care for an accident or an emergency should go to the emergency departments at the above hospitals.
 
Please refer patients to these hospitals.
 
In-patients are being cared for at Great Ormond Street Hospital (GOSH). Children attending a Royal Free London (RFL) hospital site who need to be admitted will be transferred to GOSH, which the RFL will arrange.
 
Further information can be found on the Trust’s website.

Ambulatory care and paediatric jaundice services

The ambulatory care and paediatric jaundice services have been relocated to Edgware Community Hospital. Both will be carried out in the children’s out-patient department, with the jaundice walk-in clinic running every Monday and Wednesday.

 
Message from NHSEI: Total triage and remote consultation

ACTION: Reminder - commissioners and practices are asked to ensure all practices have an online consultation system in place by the end of April 2020 at the latest. It is also essential that all practices have a video consultation system in place to support remote management of patients. This should be in place by 17 April 2020.

We’re grateful to everyone across general practice who has been making great progress in moving towards a total triage approach using online consultations, and also enabling video consultation to support remote management of patients. The latest data shows there has been an impressive uptake in response to COVID-19 with 84% of practices now offering video consultations (with a further 15% in the process of implementing or procuring a video solution) and 49% of practices offering online consultations (with a further 45% in the process of implementing or procuring a solution). These measures are helping to reduce avoidable footfall in practices, protect both patients and staff from the risks of infection, and enable practices to manage work more efficiently.

Practices are reminded that as per our letter of 27 March, all practices should be remotely triaging all patient contacts. To support this, all practices must have an online consultation system in place that supports total triage. While total triage can be done over the phone, this is less efficient and risks patients being unable to contact the practice if phone lines are busy. Commissioners and practices are asked to ensure all practices have an online consultation system in place by the end of April 2020 at the latest. It is also essential that all practices have a video consultation system in place to support remote management of patients. This should be in place by 17 April 2020.

 
Updated Children and Young People Telephone Advice and Guidance (A&G)

ACTION: View latest telephone advice lines here or attached

The advice lines in this document 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. 

 
Cleaning and disinfection of reusable equipment (including thermometers)

ACTION: Ensure you are following the guidance (available full here)

As per the North West London IPC guidance, you must clean and disinfect all reusable equipment systematically from the top or furthest away point.
Clean and disinfect any reusable non-invasive care equipment in the room prior to their removal such as:

  • Blood pressure monitors
  • Digital thermometers
  • Glucometers.

Best practice is to clean the equipment with a chlorine-based solution each time. If any equipment will not take the solution it can be cleaned with combined detergent or disinfectant wipes between patients, with a final clean with chlorine-based solution at the end of each day.

 
For information: NHSE update on dental care

The latest dental letter from Sara Hurley, Chief Dental Officer has been published today alongside the standard operating procedure. 

 
For information: Update re acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of COVID-19 (RPS2001)

In response to the public health emergency posed by Covid-19, NHSEI has established a rapid policy development process to aid clinicians in offering best care and advice to patients with or at risk of Covid-19. This document sets out the clinical policy for the acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of Covid-19. The chronic use of NSAIDs is outside of the scope of this policy with a separate review to take place. NICE has also produced a rapid evidence summary.

 
For information: NHSEI page created for all updates and information about accessing supplies of Personal Protective Equipment (PPE)

All information can be found here, including a dedicated primary care section. 

 
For information: Wellbeing support for #OurNHSpeople

Our NHS people are doing extraordinary things in the face of an extraordinary challenge. The NHS has developed a range of wellbeing support to care for our NHS people, whether at the front line or in supporting services. The new support package includes:

  • a free wellbeing support helpline 0300 131 7000, available from 7.00 am – 11.00 pm daily, providing emotional support from trained volunteers and onward signposting to specialist financial advice, bereavement care and coaching
  • a 24/7 text alternative to the above helpline - simply text FRONTLINE to 85258
  • online peer to peer, team and personal resilience support, including through Silver Cloud, and free mindfulness apps including Unmind,  Headspace Sleepio and Daylight.

 
For information: Ramadan

The Chief People’s Officer launched a staff health and wellbeing package last week that included guidance on COVID-19 and Ramadan. This was produced by the NHS Islamic Network in collaboration with the British Islamic Medical Association, that represents over 3,000 Muslim clinicians across the UK. It can be accessed here: https://people.nhs.uk/guides/covid-19-and-ramadan/