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27 August 2020

Dear colleague

Please find below the latest GP update regarding Covid-19. If you are receiving this update as a practice manager, please make sure you do share it with your colleagues, including sessional GPs.

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, including restarts, 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:

  • Public Health England Infection Prevention and Control (IPC) guidance update (mass immunisation clinics)
ACTION: Ensure you follow the updated guidance
  • PPE stock planning for flu vaccination programme
ACTION: Practices must continue to place orders each week using the PPE portal and secure delivery of stock up to current limit set
  • Message from Penny Hever (Head of Cancer Care)
ACTION: Fill in the survey here and/or contact mohammed.isaq@nhs.net with any queries

 

Public Health England Infection Prevention and Control (IPC) guidance update

ACTION: Ensure you follow the updated guidance as below

PHE has recently updated its IPC guidance for various situations and gives the following advice for mass immunisation clinics:

In some clinical outpatient settings, such as vaccination/injection clinics, where contact with individuals is minimal, the need for single use PPE items for each encounter, for example, gloves and aprons is not necessary.

Gloves and aprons are recommended when there is (anticipated) exposure to blood/body fluids or non-intact skin. Staff administering vaccinations/injections must apply hand hygiene between patients and wear a sessional facemask.’ (p14)

Therefore, for adult flu immunisation clinics, staff members should wear a fluid resistant surgical mask and apron as sessional items, with gloves not being necessary. 

Hand decontamination remains a key IPC measure, particularly if single use gloves are not being worn.  Contact transmission has been a key part of COVID19 transmission and this needs to be remembered during the flu clinics.

  • Being bare below the elbows is essential for hand decontamination to be carried out effectively.
  • Sufficient hand gel must be used to cover all surfaces of the hands, and must be allowed to dry before continuing.
  • Hand decontamination should not be rushed.

The following situations should be considered and risk assessed accordingly:

  • The Live Attenuated Influenza Vaccine (LAIV) can produce droplets and sneezing and therefore single-patient-use gloves and sessional eye protection may be considered necessary.
  • Other childhood immunisations often lead to the child crying etc, and will involve more direct patient contact, so single-patient-use gloves and sessional eye protection may be required for these clinics too.
  • Patients should be discouraged from attending the clinic with respiratory symptoms. However, if they do present with respiratory symptoms that are not felt to be COVID19 related and are well enough to receive the vaccine, gloves and eye protection should be considered.
  • Any gloves worn would be single-patient-use. Eye protection could be kept on and worn sessionally.

 

PPE stock planning for flu vaccination programme

ACTION: Practices must continue to place orders each week using the PPE portal and secure delivery of stock up to current limit set

Practices are encouraged to forward plan the PPE stock they require to meet demand supporting the flu vaccination programme. Based on the number of vaccinations that needs to be administered and considering the IPC guidance issued to date (see above), practices should be able to estimate the PPE required by each stock item.

To support this demand, practices must continue to place orders each week using the PPE portal and secure delivery of stock up to current limit set.

Any shortfall in your PPE requirement should then be met by placing orders with your business as usual suppliers/wholesales. It may also be prudent to consider advance ordering while stock is available in the market place at reasonable price. As a reminder, please also refer to information to Government’s PPE Portal and steps involved in accessing PPE below.

Registration and use of Government’s PPE Portal

  • Member(s) of staff at each GP practice in NW London should have received an email from ppe.dedicated.supply.channel@notifications.service.gov.uk inviting practice to register for access to the Government’s PPE portal.
  • The PPE portal is a top-up system and practices are required to register and place an order each week up to the pre-authorised limit set by the national team.
  • PPE ordered via this portal is FREE and approved quantities will be delivered to practices directly.
  • If you have any issues with registration or accessing the site, please contact the PPE Dedicated Channel customer service team on 0800 876 6802 immediately.

Please see below current GP Practice order limits on the Government PPE Portal.

GPs with fewer than 8,000 patients can order (per week):

  • 100 IIR masks
  • 200 aprons
  • 400 gloves (200 pairs)
  • one bottle of hand hygiene (usually 500ml)
  • one box of visors (usually 50 per box)

GPs with 8,000 patients or more can order (per week):

  • 200 IIR masks
  • 400 aprons
  • 800 gloves (400 pairs)
  • 2 bottles of hand hygiene (usually 500ml)
  • one box of visors (usually 50 per box)

How to access PPE

In addition to practices ordering their weekly supply from the Government’s PPE Portal, current NWL process (outline below) remains in place.

  • Step 1: practices should continue using their business-as-usual and wholesaler routes to source their local PPE requirement.
  • Step 2: practices who have an urgent requirement for PPE, which they are unable to secure through their business as usual channels, should then contact the NSDR via the 24/7 helpline: 0800 915 9964
  • Step 3: request support for urgent supplies by sending an order form to NWL team: nwlccgs.covid19ppesupplies@nhs.net

If you have any further queries, please contact your LSM in the first instance.

 

Message from Penny Hever (Head of Cancer Care)

ACTION: Fill in the survey here and/or contact mohammed.isaq@nhs.net with any queries

Dear GP colleagues,

You will have seen our request for practices to complete this survey at the end of July.  Many thanks to those practices who have already completed it but we’d really appreciate it if practices who have not yet done so to complete it now.

You will probably all be aware of the NHS England directive to re-establish cervical screening services in Primary Care, and that invitation letters have been sent out from 5 June onwards. NHSE are working firstly through the call/recall patients, followed by patients who weren’t able to be screened during Covid-19, together with those who would normally be eligible for screening. So there is an expectation that we can rapidly increase our screening numbers.  

In order to fully understand Primary Care’s position with respect  to undertaking cervical screening, and the issues that you may be facing either getting started or continuing,  could you please fill in the survey via the link below so that we can get an overview of what the key issues are, and where we can help.

Every surgery is being asked to complete this survey, and we would ask you to send it back, as soon as possible.

The survey is available here.

If you require further information please contact: Mohammed Isaq – Cancer Care, Project Manager (mohammed.isaq@nhs.net)