30 July 2020
Documents can be found here
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:
- New Clinical Protocol for clinically extremely vulnerable (shielded) children – update and actions for primary care
- Respiratory support line hours have changed
- UPDATED: Primary Care and Community Respiratory Resource Pack for use during Covid-19
- Risk of 10 times overdose with alfentanil preparations
- Primary Care Workforce Update
New Clinical Protocol for clinically extremely vulnerable (shielded) children – update and actions for primary care
ACTIONS: Read actions below and view full information here
Please review the protocol actions for primary care, which start from page 9.
GPs are asked to use the WSIC Shielded Radar to review any children on the list who have no specialist input and are only cared for within primary care, and take appropriate action before the start of the new school term in September 2020. In line with RCPCH guidelines, if children are cared for only within primary care, they are highly unlikely to remain on the shielded patient list.
If children are cared for by an acute provider, they will be reviewed by this team and no action is required from primary care.
Advice and Guidance is available to GPs from local paediatricians if required.
Over the next week or so, we will follow up directly with numbers of children requiring review per PCN, and can provide further support with using the WSIC radar. WSIC support materials in the form of a user guide and training videos are available on the Healthier North West London website - https://www.healthiernorthwestlondon.nhs.uk/news-resources/information-sharing/covid-0
Respiratory support line hours have changed
ACTION: Note the change in hours
In view of the decrease in calls the consultant hot hub and respiratory support line will alter its hours to cover 12 – 2, Monday – Friday, from the start of August. This arrangement will be kept under review and capacity will be increased if required.
UPDATED: Primary Care and Community Respiratory Resource Pack for use during Covid-19
ACTION: Review version control section here to see updates
This guidance has been co-authored at pace (contributors list under section 9). It is anticipated that it will change as knowledge about Covid-19 increases and as the system changes in response over the coming weeks and months. The document will be reviewed and updated as necessary on a weekly basis.
Risk of 10 times overdose with alfentanil preparations
ACTION: Please ensure that your organisation has considered and appropriately mitigated the risk over inadvertent overdose that has been identified.
The NHS England and NHS Improvement Controlled Drugs Accountable Officers (“the CDAOs”) have been advised recently of two administration errors where a 10 times overdose of alfentanil has been administered to patients. This resulted in severe harm and/or death being reported as the outcome. On further review there have been at least 38 patient related errors reported to the CDAOs between June 2018 and June 2020 involving alfentanil.
In view of this information could you please ensure that your organisation has considered and appropriately mitigated the risk over inadvertent overdose that has been identified. You may wish to ensure that your organisation’s Medication Safety Officer (MSO) is aware of this in formation and included in your risk mitigation process(es).
Concerns relating to the safe use of alfentanil injection were highlighted in 2017 by the London Opioid Safety & Improvement Group (LOSIG) and safe practice points were included in the Care Quality Commission’s Controlled Drugs National Group Sub-Groups Newsletter Number 1. Since this was published there have been at least 10 incidents reported in London, which have included administration, prescribing and dispensing errors in acute hospitals, general practice, community pharmacies and patients’ homes.
Primary Care Workforce Update
ACTION: To discuss workforce in more detail, contact Maggie Neale: maggie.neale@nhs.net
In North West London we are currently working hard to ensure the primary care workforce is kept high up on the NW London Integrated Care System workforce agenda. To facilitate this there is now a primary care workforce group, chaired by Dr Andrew Steeden which reports into the NW London Workforce Workforce Board and a Task and Finish Group co-chaired by Sue Jeffers and Richard Ellis, whose purpose is to support the completion of the the PCN workforce templates.
These PCN workforce plans will inform our baseline data to develop primary care workforce capacity, and utilisation of the new roles laid out in the PCN DES Additional Roles Reimbursement Scheme (ARRS).
The aim of the group within the short timescale available to develop a suite of support guides, templates and recorded webinars all stored in a purpose built Workforce Repository. An initial PCN workforce submission letter was sent to PCN Clinical Directors from Dr Neville Purssell, Dr Genevieve Small and Dr Andrew Steeden on 24 July 2020 to outline the developments. If you would like more information, you have suggestions of additional support needed or you would simply like to discuss the workforce agenda please contact Maggie Neale NW London Primary Care Workforce at: maggie.neale@nhs.net.
