Primary Care E-bulletin (Issue 102) - 11 December

Click here to view web browser version of this briefing.

In this issue:

• Post-acute COVID-19 assessment (long COVID) clinics open 14 Dec
• NHS COVID-19 vaccination programme update
• Mid and south Essex prescribing update for December 2020
• High Impact Pathways to prevent paediatric conditions worsening
• LD health checks: supporting some of your most vulnerable patients
• Easy Read screening information to support patients with LD and language challenges
• Passenger transport to London trusts: Clarification
• Paediatric sepsis podcasts
• Mid and South Essex Training Hub
• Think 111 First national campaign materials
• Waste collection issues with Stericycle (formerly SRCL)

Support with day to day issues and COVID care

Post-acute COVID-19 assessment clinics open Monday 14 December

From Monday 14 December, a multidisciplinary service is opening across England for patients presenting 12 weeks after suspected or confirmed COVID-19 diagnosis with complex symptoms. Generally called “long COVID clinics”, these are launching across the country on the same day.

The clinics have been established with the knowledge and resources available in December 2020 but are subject to change, with updated pathways, as our learning evolves.

There is a direct referral pathway for mid and south Essex patients into this service using an electronic referral form. However, before patients are referred it is vital that other diagnoses that may account for these symptoms, should be ruled out first. If other pathologies are not excluded the referrals may not proceed.

Equally, once alternative pathologies have been excluded, if the patient’s symptoms are non-complex, a referral should be made to the appropriate community service directly, as per the attached Directory of Services. If the patient’s symptoms are sufficiently complex as to require a multi-disciplinary assessment, a referral should be made to the Long COVID Clinic.

A diagram outlining the referral pathway is available for download below, along with the referral form (also available in SystmOne) and the COVID Directory of Services. The Single Point of Access (SPA) addresses to which practices can email the form if they are not referring via SystmOne are given on the form itself. All these resources will be on the Health and Care Partnership website from Monday for easy access.

All patients referred into the long COVID service go through a robust triage and functional screening process. Patients will be booked into a largely virtual MDT which assesses the patient online and then refers cases requiring further specialist input to an appropriate provider. Both clinicians and non-clinical support staff are working within the MDT.

A GP will always be part of the MDT to provide holistic input and avoid unnecessary tasking back to primary care. Low complexity patients in particular will have an exit route back to social prescribing Link Workers and then on to non-NHS services.

Provide CIC is the host organisation for the Mid and South Essex Health and Care Partnership long COVID clinic. As noted above, most MDT work is expected to be virtual with face-to-face assessments if required.

Discussions currently taking place with secondary care specialities regarding onward referral management but in all cases equity of care is paramount and long COVID patients referred on will not ‘leapfrog’ others on those services’ waiting lists.

Long COVID clinic referral form (also available on SystmOne) for emailing to your SPA

Pathway for MSE Long COVID clinics

MSE COVID Directory of Services (DoS)

NHS COVID-19 vaccination programme update

Primary Care Network vaccination sites
NHS England has requested that no information be shared with the public about the sites within your PCNs that are hosting COVID vaccination clinics until Monday 14 December at the earliest. The Mid and South Essex CCGs joint communications team is managing messaging to the public.

The latest information on the COVID-19 vaccination programme is online at:
www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine

and we advise checking there first if you have questions about the safety or effectiveness of COVID vaccines, or your priority to receive vaccination.

IMPORTANT: Register interest in local COVID-19 Vaccination programme

If you or someone you know would like to register interest in supporting the local COVID-19 vaccination programme, please do so via the Essex Primary Care Careers website.

If you have any questions about the Vaccination Programme yourself, please do email [email protected] so the Incident Management Team can log and respond in a coordinated way to the high number of queries coming in.

Mid and south Essex prescribing update for December 2020

This month’s update can be downloaded from the button to the right. Please ensure all prescribers in your practice are aware.

Prescribing update for MSE clinicians, December 2020

High Impact Pathways to prevent paediatric conditions worsening

During the winter months many children suffer with common conditions which can worsen if not treated correctly. Three common winter ailments that often bring parents into contact with GPs or A&E have been identified within mid and south Essex. Guidance is available from the buttons below on clinical pathways, plus information your practice can share with parents and carers, so children experiencing diarrhoea and vomiting, bronchiolitis or head injury are treated consistently.

Clinical pathway: head injury

Clinical pathway: bronchiolitis

Clinical pathway: gastroenteritis

Advice for parents/carers: Head injury

Advice for parents/carers: Bronchiolitis

Advice for parents/carers: diarrhoea and vomiting

LD health checks: supporting some of your most vulnerable patients

Despite the pressures on practices this year, a large number of you continue to run LD health checks to the usual schedule around the birthdays of your patients with learning disabilities aged 14 and up.

We do appreciate your support for your patients, but there is low take-up in some areas and the CCGs want to improve this, particularly as government figures show a mortality for LD patients from COVID that is up to six times that of patients without LD.

To support you in this, the CCGs have co-designed with our LD residents various materials that can be shared with patients and used in health checks to facilitate communication and understanding.

South West Essex practices in Basildon, Brentwood and Thurrock have a fully developed suite of materials downloadable from the Basildon and Brentwood CCG and Thurrock CCG websites, with two additonal items available from the buttons below if you do not already have them.

South East Essex practices are using a suite of materials that have recently been updated, and this update will also be delivered to id Essex practices for immediate use. These will be sent separately.

LD health check letter for Basildon / Brentwood / Thurrock practices’ use

LD health check training slides from Basildon& Brentwood / Thurrock CCGs

Easy Read screening information to support patients with LD

The NHS England and NHS Improvement Cancer lead has produced Easy Read resources around screening programmes. They may help patients with learning disabilities and possibly language or literacy challenges to understand the need for screening and so improve outcomes. You are welcome to make use of any/all of the packs linked below.

• Bowel screening: www.gov.uk/government/collections/bowel-cancer-screening-information-leaflets#easy-read-information
• Breast screening: www.gov.uk/government/collections/breast-screening-information-leaflets#easy-read-information
• Cervical screening: www.gov.uk/government/collections/cervical-screening-information-leaflets#easy-read-information
• Diabetic eye screening: www.gov.uk/government/collections/cervical-screening-information-leaflets#easy-read-information
• Abdominal Aortic Aneurysm (AAA) screening: www.gov.uk/government/collections/aaa-screening-information-leaflets#easy-read-information
• Antenatal Newborn Screening Programme: www.gov.uk/government/publications/
• screening-tests-for-you-and-your-baby-easy-guides

Passenger transport to London trusts: Clarification

The item titled “Non-emergency patient transport into London Trusts” in last Friday’s e-briefing (4 December, issue 101) stated that patients travelling to London trusts not on the accompanying list should travel on the locally commissioned patient transport service. However, the item mentioned only TASL, the current provider for mid Essex.

In the three south Essex localities, the main NEPTS provider is the East of England Ambulance Service NHS Trust (EEAST), of course. Apologies for any confusion caused.

Education and training

Paediatric sepsis podcasts

The Royal College of Paediatrics and Child Health is making podcasts on paediatric sepsis as an educational resources for healthcare professionals. The series is free to access.

The podcast explores topics such as what sepsis is, the complexities of how to recognise and manage it in children and different care for children with complex health conditions.

Free podcast offering information and CPD around paediatric sepsis – details and booking information

More information about and email address for RCPCH Education and Professional Development team

Mid and South Essex Training Hub

For the latest initiatives from the Mid and South Essex Health and Care Partnership Training Hub, please visit the Training Hub section of our website.

For information

Think 111 First national campaign materials

This national campaign from the NHS is directing people to use NHS 111 first when they have an urgent but not life-threatening medical need, rather than going straight to A&E / Emergency Departments. If the patient needs urgent care, NHS 111 can now book them in to be seen quickly and safely in a hospital ED.

We shared an interim toolkit to promote the campaign with you in a previous bulletin, pending national materials becoming available. That has now happened and if your practice has a capacity to share the messaging, perhaps through your PPG, all the national assets are available from the button below.

National Think NHS 111 campaign promotional toolkit

Waste collection issues with Stericycle (formerly SRCL)

As you may already have seen from the East of England Gateway, a number of contractors who have a clinical waste account with Stericycle (formally SRCL) are experiencing great difficulties with clinical waste building up and getting ad hoc collections or additional bins.

Your CCG is not able to liaise with Stericycle on your behalf, so to help resolve these issues as efficiently as possible, all GP contractors should email [email protected] in the first instance. Please include the nature of the clinical waste issue and your Stericycle account number.

The company has informed us that the impact of COVID-19 on their business are causing the delays and commissioners are working regionally and nationally to resolve this.

NHS England Primary Care COVID-19 Bulletin

Click here to access NHS England’s latest primary care COVID-19 bulletins. For the latest advice around coronavirus for clinicians, please visit the NHS England website.