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March 2020

Coronavirus round-up



Practices told to triage online bookings

Practices have been told to triage online bookings and change face-to-face appointments booked online to phone or video consultations to mimimise the risk of potentially infected patients attending the practice when they should be advised to self-isolate or be tested for coronavirus.

In the first of a series of regular updates to general practice on COVID-19, Dr Nikita Kanani, medical director for primary care at NHS England and NHS Improvement acknowledged that the virus was placing a ‘new and increasing challenge on already busy practices.’

The update has promised new arrangements to prioritise work to help manage the increased pressure on the general practice workforce, models to care for vulnerable and self-isolating members of the public and staff, and measures to temporarily increase workforce capacity. Further details will be announced ‘as required.’

Practices have also been told not to change repeat prescription durations or support patients trying to stockpile their medications, which could put a strain on the supply chain and exacerbate any potential shortages.

Practices should also consider putting all suitable patients on electronic repeat dispensing as soon as possible – the prescription can be valid for a year, but each repeat should be for no longer than the patient currently has.

Initial stocks of personal protective equipment, including aprons, examination gloves and fluid repellent face masks were due to be distributed as Practice Nurse went to press.

NMC statement on regulation during outbreak

The NMC together with other healthcare professional regulators have issued a joint statement on how they will regulate their registrants during the current ‘challenging circumstances’.

The NMC states: ‘We understand that as health and care professionals you may be feeling anxious about novel coronavirus… and recognise that should the virus spread further [you] are likely to face an increased burden in helping the UK through the outbreak. It’s important that during this time everyone follows national public health advice and guidance.

‘We also recognise that health and care professionals may have understandable concerns about decisions they may need to take... and may need to depart from established procedures.’

The statement assures registrants that their regulatory standards are designed to be flexible but provide a framework for decision-making in a wide range of circumstances.

Key principles that should be followed include ‘the need to work cooperatively with colleagues to keep people safe, to practise in line with the best available evidence, to recognise and work within the limits of their competence, and to have appropriate indemnity arrangements.’

In the event that a complaint is made, the regulators say it will ‘always be considered on the specific facts of the case, taking into account the factors relevant to the environment in which the professional is working. We would also take account of any relevant information about resource, guidelines or protocols in place at the time.’

Diabetes UK cancels professional conference

Diabetes UK has announced that ‘after very careful consideration’ its professional conference, due to take place in Glasgow this week, has been cancelled.

The team at DUK has been ‘closely and continuously’ monitoring the COVID-19 situation as it has developed both globally and in the UK, and said: ‘This is not a decision we have come to lightly. Our decision making has been informed by detailed risk assessment, but we sought to balance our commitment to delivering a conference that we know provides real value and impact, with our deep and genuine concern for the health and wellbeing of all our conference attendees.

‘Hospitals are currently operating at the highest possible national incident response level, to enable them to be as prepared as possible for the impact of the COVID-19 outbreak. On that basis, we do not believe it would be right or responsible to proceed with holding the conference when the NHS is in such need of its expert workforce. Equally we are mindful of our responsibility to support efforts to delay the spread of COVID19 across the UK.’

DUK recognises that people who had planned to attend will have practical and logistical questions, and has pledged to answer as soon as it can.

Ensure respiratory patients know how to protect themselves – PCRS

As the number of coronavirus cases rises, the Primary Care Respiratory Society (PCRS) is advising primary care teams to ensure that at-risk respiratory patients are aware of everything they can do to protect themselves.

In particular healthcare professionals should also ensure that patients’ self-management plans are up to date so that they know what to do if they have an exacerbation.

It is also a good opportunity to encourage people to quit smoking as this reduces the risk of complications from COVID-19. There is advice on instigating a quit attempt in the PCRS Tobacco Dependency Guide.

Carol Stonham, PCRS Executive Chair said: ‘As we move towards what will be a time of increased activity we need not only to be looking out for vulnerable patients but taking some time to look after ourselves and our teams too. When we are working flat out covering for colleagues who are unwell the thing that slips is self care and team morale. We know what we should do and make sure our patients are doing. Be sure to take your own good advice.’

Holiday cancellation advice

The RCGP has heard reports of insurers and travel companies requesting GP letters in order for people to cancel holidays due to Covid-19. RCGP chair Professor Martin Marshall said: ‘Insurers and travel companies should be basing their decisions to offer refunds on advice from the Foreign and Commonwealth Office and Public Health England, not letters from GPs. It is not a good use of GPs’ time to be writing letters for patients who are not ill but have plans to travel - and GPs will always base their decisions on official advice.

‘Patients will undoubtedly have good and sensible reasons for not wanting to travel to certain places because of COVID-19, but this is not the same as being unable to travel due to existing illness, and it should not become the GP’s responsibility to give patients advice about where not to travel.’

Further information and daily updates

Public Health England – https://www.gov.uk/government/collections/wuhan-novel-coronavirus

Health Protection Scotland – https://www.hps.scot.nhs.uk/a-to-z-of-topics/wuhan-novel-coronavirus/

Public Health Wales – https://phw.nhs.wales/topics/novel-coronavirus/

HSC Public Health Agency – https://www.publichealth.hscni.net/publications/advice-covid-19-coronavirus

Our travel health correspondent Jane Chiodini’s resource page – https://www.janechiodini.co.uk/help/covid-19/