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GPs told to start ‘virtual’ weekly care home rounds from next month



GPs and community teams will be expected to carry out a ‘virtual’ weekly care home round as NHS England moves into the ‘second phase’ of its response to the Covid-19 pandemic.

In a letter to all parts of the health service, NHS England chief executive Simon Stevens said this comes as the country is ‘coming through’ the ‘peak of hospitalisations’.

In this next phase ‘we are going to see increased demand for Covid-19 aftercare and support in community health services, primary care, and mental health,’ Mr Stevens added.

The letter said this would include bringing ‘forward from October to May 2020 the national roll out of key elements of the primary and community health service-led Enhanced Health in Care Homes service’.

NHS England said that ‘further details’ would be ‘set out shortly’, but said requirements will include a weekly care home round, carried out ‘virtually’.

The letter said: ‘To further support care homes, the NHS will bring forward a package of support to care homes drawing on key components of the Enhanced Care in Care Homes service and delivered as a collaboration between community and general practice teams.

‘This should include a weekly virtual “care home round” of residents needing clinical support.’

Just before Christmas, NHS England put forward proposals for GPs to carry out fortnightly care home ‘ward rounds’ as part of its Network DES, to be brought in later this year.

However, following an outcry, it watered down these proposals as part of the 2020/21 contract agreement, allowing PCNs to decide how often ‘medical input’ is required – suggesting other clinical staff may take on the visits instead – as long as it was ‘appropriate and consistent’. 

The news comes as GPs have voiced serious concern for their care home patients as over 3,000 residents have now died.

The letter also provided some more detail on the Government’s announcement earlier in the week that non-Covid NHS services would begin to be ‘restored’.

It said regarding cancer that ‘referrals, diagnostics (including direct access diagnostics available to GPs) and treatment must be brought back to pre-pandemic levels at the earliest opportunity to minimise potential harm, and to reduce the scale of the postpandemic surge in demand’.

It said that over the next six weeks, ‘urgent action should be taken by hospitals to receive new two-week wait referrals and provide two-week wait outpatient and diagnostic appointments at pre-Covid-19 levels in Covid-19 protected hubs/environments’.

This comes as a study published today estimated that cancer deaths could rise by a fifth due to the pandemic, with urgent cancer referrals down by 76%.

It also said GPs should deliver ‘as much routine and preventative work as can be provided safely’, including screening, with the direction coming as NHS England had previously told Pulse screening programmes were under review.

The ‘second phase’ of the pandemic response

NHS England has set out the ‘key points for primary care’ as follows:

  • Ensure patients have clear information on how to access primary care services and are confident about making appointments (virtual or if appropriate, face-to-face) for current concerns.
  • Complete work on implementing digital and video consultations, so that all patients and practices can benefit.
  • Given the reduction of face-to-face visits, stratify and proactively contact their high-risk patients with ongoing care needs, to ensure appropriate ongoing care and support plans are delivered through multidisciplinary teams. In particular, proactively contact all those in the ‘shielding’ cohort of patients who are clinically extremely vulnerable to COVID-19, ensure they know how to access care, are receiving their medications, and provide safe home visiting wherever clinically necessary.
  • To further support care homes, the NHS will bring forward a package of support to care homes drawing on key components of the Enhanced Care in Care Homes service and delivered as a collaboration between community and general practice teams. This should include a weekly virtual ‘care home round’ of residents needing clinical support.
  • Make two-week wait cancer, urgent and routine referrals to secondary care as normal, using ‘advice and guidance’ options where appropriate.
  • Deliver as much routine and preventative work as can be provided safely including vaccinations immunisations, and screening.

Source: NHS England bulletin to practices on 29 April

 

 

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