Guidance: Investigating and managing individuals with a possible or confirmed Covid-19 variant (From NHS Primary Care Bulletin 23rd February)
In response to the emergence and spread of new SARS-CoV-2 variants of concern (VOC) and variants under investigation (VUI) in different countries and regions, specific precautions and actions are required in relation to the management of patients who have recently returned from areas where these VOC or VUI are known or are believed to be circulating, as well as their contacts.
This guidance is for healthcare staff in primary and secondary care and provides advice on the investigation and management of patients who may be infected with a new SARS-CoV-2 VOC or VUI.
UPDATED NICE Guidelines on managing Covid-19 (Update 23rd March 2021) has been published including updates on assessment, management and therapeutics.
Consultant Connect NEW LINE: Covid Advice Line (1st February 2021)
A new service has been set up on Consultant Connect – the Covid Advice line. This service is available for each hospital site and is staffed 8am-8pm 7 days a week, by Consultants from acute medicine, elderly care and respiratory medicine. The line is designed to help GPs and community teams who are managing patients outside of hospital and require specialist advice.
- Greenwich: Managing patients in general practice during Covid (pathway)
- Greenwich: Managing patients in general practice during Covid (summary)
- Greenwich: In Hours Home Visiting Service [Greenbrook]
- Lewisham: patient pathway including COVID-19 detailing pathways through available clinical services
- Lewisham Primary Care Guide for suspected COVID-19 detailing how to remotely assess and manage suspected covid patients
- Lewisham COVID-19 hot site clinical flow detailing the clinical flow of patients assessed face-to-face at hot hub
- Southwark: Covid pathways and guidance including home oximetry monitoring guidance
- IHL Guide to Seeing patients with suspected COVID-19 in general practice: lessons learnt and important considerations
- Film describing the South Southwark (IHL) COVID-19 Community clinic, including donning and doffing of PPE
SEL-wide guidance on pulse oximetry
- SEL Printable Patient guide: how to use your pulse oximeter leaflet and diary for patients (Updated December 2020 to align with NHSE guide below). Instructions for how set up to print can be found here.
- NHS England Patient Guide and Diary including red flags for deterioration and when to seek help
- Remote monitoring Covid-19 Diary Video for Patients from Health Education England
- Information for primary care about the Pulse oximeter distribution scheme (May 2020)
NHS England has produced a Standard Operating Procedure for Pulse Oximetry @home services.
The PRINCIPLE trial is the only national Urgent Public Health priority clinical trial evaluating potential therapeutics for COVID-19 in the primary care setting. Anyone aged 65+, or 50+ with comorbidity, and who has COVID-19 symptoms that started within the last 14 days is eligible and it is vital that every patient eligible for the PRINCIPLE trial is offered the chance to contribute to this study.
You can support enrolment by: identifying eligible patients; signposting patients to self-register for the trial at www.principletrial.org or by phoning 0800 138 0880; or where possible, enrolling patients directly into the trial (further information on how to do this is available here). Please also respond as soon as possible to requests from the trial team to provide a limited medical summary for patients who have registered to take part in the trial, so that the trial team can confirm eligibility.
Pan-London Primary and Community Care Respiratory Resource Pack during COVID-19
Version 8 has now been approved and published on 3rd March 2021.
- Revised guidance on self-isolation states that patients who meet the case definition for Covid-19 should stay at home/isolate for 10 days or until a negative swab result.
- Guidance and Standard Operating Procedures (SOP) for general practice in the context of coronavirus (COVID-19) can be found here (updated 3rd March 2021)
- Remote assessment in primary care : BMJ paper from March 2020 about assessing shortness of breath using a series of narrative questions remains sound.
Practices should ensure they notify the CCG where any staff members test positive for Covid-19. This is vital to help reduce the spread of the virus and ensure practices are properly supported.
Practices should inform the London Coronavirus Response Cell (LCRC) at firstname.lastname@example.org and/or 0300 303 4500 , the SELCCG Incident Coordination Centre via email@example.com and your borough-specific primary care lead.
A new self-isolation hub has also been launched by NHS Test and Trace (and supported by the LCRC) to help employers and employees through the process. Practices are encouraged to contact the hub on 020 3743 6715 as soon as a positive case has been identified. The hub require details of the test and trace reference number.
Implementation support for COVID-19 remote pulse oximetry services
In November 2020, clinical commissioning groups (CCGs) were recommended to put in place a ‘COVID Oximetry @home’ model as rapidly as possible, further to guidance on the use of pulse oximetry first published in June 2020. The standard operating procedure has been updated (1 March 2021) which sets out a base standard for patient self-monitoring. It should not supplant existing arrangements where these are already established and working.
The AHSN network have a support page: COVID oximetry and virtual wards | AHSN Network
All CCGs can continue to request oximeters for local use by emailing firstname.lastname@example.org in batches of 100. Allocation will take account of local infection rates and previous requests.
Once the order is agreed, delivery to the requesting CCG should be made within three working days. When requesting oximeters it is important to include the population numbers covered and where the service is sited.