We understand that working in primary care you are the first port of call for many of the patients looking for answers in the current crisis. Time is of the essence and you are fighting to do a fantastic job in very trying circumstances – just when you thought your day to day PM role couldn’t get any more challenging! We are facing a pandemic unlike anything else we have seen before and as such, we feel it is important to pool our resources and offer you as many sources of support and information as possible. The situation is changing rapidly so we will do our best to stay on top of updating news and resources for you as soon as we can.

Current guidance for healthcare professionals can be found here:

ENGLAND: https://www.england.nhs.uk/coronavirus/primary-care/

SCOTLAND: https://www.hps.scot.nhs.uk/a-to-z-of-topics/covid-19/

NORTHERN IRELAND: https://www.publichealth.hscni.net/news/covid-19-coronavirus

WALES: https://hiw.org.uk/covid-19

Guidance for Employers COVID-19 

You may find you are receiving requests from patients for a sick note. Current guidance states that up to 7 days does not require a sick note and employers are being asked to be flexible about what they require after this period.

If someone has been advised by a professional to isolate, they can obtain an isolation note online here 

Advice and Guidance on Covid-19 for Employers and Businesses

https://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19/guidance-for-employers-and-businesses-on-covid-19

In particular Point 13 explains the necessary information about sickness certification and what is required.

Advice on SSP payments for Businesses with staff affected by COVID-19 or self isolation.

Information here explains that SSP will be covered for up to 2 weeks for absence because of COVID-19 for those with up to 250 employees.

Information Governance and COVID-19

Due to the severity of the situation, we may be under pressure to share the relevant information to the right people at the right time. Use of media devices – such as our own mobiles, videoconferences via our own laptops, and colleagues working from home on their own laptops may be required under the circumstances. Whilst this would normally not be acceptable, the NHS have shared updated COVID-19 specific information on data sharing, which you can read here. Additional information on data protection during this period has been updated by the ICO.

Staff Leave

Claiming GP Sickness Locum Payments

While it may be that you aren’t able to claim sickness payments for your GPs if they aren’t off work for long enough, it is possible that they may be. Guidance about claiming reimbursement is here (there’s a 2 week waiting period). This applies to GMS practices, but PMS practices should be treated equitably.

Cancellation of Annual Leave

We’d recommend that if this is something you feel you may need to consider, you discuss it with your staff members as soon as possible. It may be that those who had annual leave planned overseas are now not able to travel and are able to reschedule their leave. Additionally, there may actually be members of staff facing large costs as they are unable to travel, so employer cancellation might actually help some out depending on their policies. What the law says is, if you’re going to cancel you need to give the same length of notice as the amount of time they had booked off.  More information can be found here.

The flip side of this is that many of us don’t have much slack in the system for holidays, and with the likely built up demand for appointments once the immediate crisis is resolved, cancelling planned leave will surely be a fine line to tread. We could find ourselves with no capacity to allow leave once it’s all over because we wouldn’t be able to continue running. Cancelling planned leave is therefore likely to be a last resort.

Medications

It might seem like a good idea to deter people from coming into surgery by issuing large amounts on scripts. This will affect your prescribing budget for this year and is not advised. If you are looking to reduce unnecessary visits to the practice, where possible, you could consider post dated scripts, repeat dispensing and online/app requests. If considering post-dated prescriptions, it is suggested that you notify local pharmacies that you are contemplating doing this, so that they are alert to the possibility of people trying to submit them early. You should consider repeat dispensing as the first and most suitable option. Ask patients, where possible, to submit requests for medication online.

Whilst not normal practice to accept telephone requests, for those who are unable to attend the practice, nor have access to the internet this may be the only option for them. As we do not want Mabel phoning to ask for her pink tablets, and then the non-clinician not understanding which pink tablet Mabel is asking for, the safest option would be for one of the clinical team to take these calls, or if you are aware that a patient may be in this situation, maybe pre-empt this and make the call?

Pandemic Planning

Our Pandemic Management Policy [PLUS] has been updated throughout with COVID-19 information.

We are obviously looking at staff now having to take time off and self isolate, even if it is because one of their family is unwell. The Pandemic Staffing Policy [PLUS] will help you manage your staffing and provides answers to those many HR questions that are being asked by each of our teams.

The NHS have also compiled a document on guidance on managing Coronavirus in practice here 

Risk assessments on your practice team are vitally important, as we must consider variables that mean some may be shielding or some already isolating. To make this easier, we have compiled all the guidance and an easy to use assessment form in a new FREE OF CHARGE risk assessment toolkit

Consider placing a poster in your reception window/main door to stop people entering your premises if you are consulting via triage/phones. We have created a Coronavirus poster which that you can download for free.

As many practices have reduced face to face and are working on a telephone triage and consultation via video, the communication policy covers managing video consultations in section 6.

For staff working from home there is a free questionnaire to support staff

Recording cases

If you have a case of COVID-19 in practice, the Practice Index toolkit allows you to record the details in once place. The government guidance lists various actions practices need to take if there is a suspected case, this toolkit covers these in a simple document. It can be found here [PLUS]

Guidance for Patients

Facebook Posts

We have compiled some draft Facebook posts for you to post to your surgery page to keep your patients informed:

• If you think you may have symptoms which include a continuous new cough, or a high temperature, advice on what you should do next can be found here: https://www.nhs.uk/conditions/coronavirus-covid-19/ You do not need to call NHS111 in order to self-isolate.
• If you have symptoms which include a new continuous cough, or fever, DO NOT COME INTO THE SURGERY. Appropriate advice about what to do can be found here: https://www.nhs.uk/conditions/coronavirus-covid-19/
• If you have symptoms of COVID-19 Coronavirus and are self-isolating as advised by the Government, you should follow the advice here: https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance
• We’d like to share a simple video on how to explain to children why it’s important to wash their hands. https://www.goodhousekeeping.com/uk/news/a31655787/tom-fletcher-coronavirus-hand-wash/
• Sometimes encouraging toddlers to wash their hands can seem a real challenge. Here’s an idea about how you can help them to see it as fun! https://www.dettolarabia.com/en/new-moms-related-articles/infant-toddler/fun-ideas-to-teach-your-child-how-to-wash-his-her-hands/
• The best way to clean your hands is good old fashioned soap and water. https://www.huffingtonpost.co.uk/entry/best-soap-hand-sanitizer-coronavirus_l_5e693977c5b6bd8156f0c11d
• We all think we know how to wash our hands, but do we really? 20 seconds is the recommended time, so about the same as singing the Happy Birthday song twice. Here’s a video that shows how to wash and not miss any spots. https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/
• Age UK has some brilliant advice about Coronavirus https://www.ageuk.org.uk/information-advice/health-wellbeing/conditions-illnesses/coronavirus/
• If you have health anxiety, or are struggling with the idea that you might need to self-isolate MIND have some fantastic advice about how to cope https://www.mind.org.uk/information-support/coronavirus-and-your-wellbeing/

Messages for patients requiring repeat medications:

• If at all possible please request these online, or using the NHS App. Please do not come into the surgery. Alternatively, please request via your local pharmacy.

Messages regarding service level:

• COVID-19 We are experiencing unprecedented levels of demand and a rapidly changing situation. We are all doing our very best to manage this, but please bear with us.
• COVID-19 In order to best serve our patients and the community, we need to keep staff well so that they can continue doing the vital work of primary care, which is essential while our hospitals are under pressure. Additionally, we don’t want to risk passing on COVID-19 to patients who are very unwell with other conditions. We know that this may feel very frustrating as you try to go about your daily lives, but we really do have everyone’s best interests at heart.
• COVID-19 In order to try and minimise the risk to staff and patients alike, we will, as always, be thoroughly cleaning our environment.
• COVID-19 We may take further steps to ensure the safety and wellbeing of patients and staff which may include: telephone or online consultations only in the first instance, suspension of face to face appointments, suspension of online booking, asking you to order repeat prescriptions through our website, or via the NHS App, suspending routine appointments such as medication reviews and smear tests.
• COVID-19 Each medical practice will carry out the steps they feel necessary in the order that best suits the needs of their patients with the staff that they have available. Please be aware that self-isolation guidance also applies to medical and practice staff and therefore we may be operating with fewer staff than we usually do.
• The NHS App: We know that access is more difficult than usual at the moment, so please consider downloading the NHS App which offers online shortcuts and avoids telephone queues for you.

Messages on travel advice:

•  If you are currently overseas, or have travel planned over the coming weeks, Government advice on travel is changing rapidly and the most up to date information can be found here: https://www.gov.uk/guidance/travel-advice-novel-coronavirus
• We appreciate that the situation for travellers feels very uncertain and many people face challenges with costs and insurance. We are unable to offer medical reports for insurance purposes unless there is a genuine and acute illness which prevents you from travelling. We are not able to certify you as unfit to travel if you are not acutely unwell.

As we all know, advice is changing by the hour, and we will do all we can to ensure you have your finger on the pulse with any resources and information that could help. Keep an eye on our blog or join the discussion on the Practice Index forum.