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COVID-19 guidance round-up: Week ending 22 May

Medeconomics summarises the latest coronavirus guidance changes for general practice. This week: learning disabilities health checks, routine work, domestic abuse, COVID-19 testing and support for key worker families.

NHS England primary care medical director Dr Nikki Kanani
NHS England primary care medical director Dr Nikki Kanani

Please note: these guidance articles are based on centrally-updated guidance from NHS England, Public Health England and other national bodies. Practices will also be subject to local guidance which may have also changed.

Learning disabilities health checks

NHS England has reminded practices that they should continue to undertake health checks for patients with learning disabilities. A primary care email bulletin sent to practices this week stressed that the learning disabilities DES has not been suspended during the pandemic and practices should continue to offer this service to patients.

NHS England advised healthcare staff to discuss with the patient or carer the most suitable way to conduct the health check, adding that 'where this can be delivered safely on a face-to-face basis this should continue'. If this is not possible or if the patient has a condition that requires them to shield the review should be conducted remotely 'with as much of the physical review completed as is practicable in these circumstances'.

Resumption of routine work

Practices will have to work ‘in different ways’ to restore routine services safely over the coming weeks, NHS England has warned. During the general practice webinar on 14 May, NHS England primary care medical director Dr Nikki Kanani that practices should only restore services where this could be done safely - and they should consider remote consultations for patients with long-term conditions, and options such as group video consultations across primary care networks (PCNs).

Dr Kanani said: ‘We encourage you to [bring back routine work] but only if you can do that safely - and you might need to do that in a different way. It’s really worth thinking about different ways of delivering care but keeping safety as the priority.’

She said general practice could be in a transition phase for months to come.

Care homes

NHS England has clarified that care home clinical leads are not medically responsible and accountable for the care of care home residents. Medical responsibility for the care of individuals remains with the patient's registered GP. Residents within a care home can still be registered with different GPs, despite the new enhanced package of care that NHS England is expecting practices/PCNs to provide.

Safeguarding/domestic abuse

NHS England has published details of a range of resources for healthcare professionals and NHS managers, providing advice on managing domestic abuse during the COVID-19 pandemic. You can find this here.

Of particular use to GP teams is advice from IRISi on how to respond to domestic abuse during video or telephone conversations. IRISi is a social enterprise that works to support and train staff in GP practices to identify and respond to gender-based violence You can find this here.

COVID-19 testing

Patients who need information about testing for COVID-19 should be directed to the government website https://www.gov.uk/apply-coronavirus-test. Alternatively patients in England and Wales can call 119 for free, those in Scotland and Northern Ireland should call 0300 303 2713. The call centre is open 7am to 11pm. NHS England has said that 98% of all test results are sent to patients within four days. If they have to been received by then the call centre can help people chase results.

Elective procedures

A new operating procedure for hospital services has said that patients going into hospital for elective procedures and household members should self isolate for 14 days prior to admission. They will also need to undertake a COVID-19 test (a home test) a maximum of 72 hours before admission.

Family support for NHS workers

NHS England has worked with the Tavistock and Portman NHS Foundation Trust to produce written and audio guidance to help key workers to have difficult conversations with their children about their role and how this might impact on family life. The podcast and supporting information can be found here.

Mental health in lockdown

The RCGP has produced a new learning module that looks at the factors during lockdown that may contribute to mental health problems for patients. It also outlines ways that GPs can support patients.

Meanwhile another RCGP learning module looks at post traumatic stress distorted during and after lockdown for both patients and key workers.

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