NHS England have announced that GP practices will not be required to open, outside the normal bank holiday cover arrangements, for the upcoming Whitsun Bank Holiday (25 May).
Our colleagues at the LPC have published details of pharmacy opening in our region on the bank holiday which can be viewed here.
Relative Risks from COVID – 19 for people from Black, Asian and Ethnic Minority Backgrounds (BAME)
We have all become aware over the last few weeks of an increasing number of deaths amongst health care workers from Black, Asian and minority ethnic backgrounds. Whilst every death from COVID 19 is a tragedy it has become obvious that a larger proportion than we would have expected come from BAME backgrounds.
Statistics that have been collected nationally by Public Health England have now confirmed that there is a real issue here. No reasons for this phenomenon have yet been found although urgent research is ongoing.
This must be very worrying for our colleagues from such backgrounds and we must do all we can to reassure them and minimise any risk to which they may be exposed. People from Black, Asian and Minority Ethnic (BAME) backgrounds make up 44% of the medical workforce.
Pending more definitive guidance coming out as a greater understanding of the issues develops the LMC would recommend the following approach:
• Practices should be supported to have thorough, sensitive and comprehensive conversations with members of the practice team from a BAME background. They should identify any existing underlying health conditions that may increase the risks for them in undertaking their frontline roles, in any capacity. Most importantly, the conversations should also, on an ongoing basis, consider the feelings of BAME colleagues, particularly with regard to their safety and their mental health.
• Practices should risk-assess staff at potentially greater risk and make appropriate arrangements accordingly. Practices should consider how they can do this and take action to protect members of their team. Here are some risk assessment tools available:
• The first thing for all workers is to stay safe. The vast majority of patient interactions are now done remotely and that is likely to remain the case for some time. Any patients that are seen, will require the health care workers to wear appropriate PPE. Even when seeing patients who are asymptomatic of a potential COVID infection but need to be seen for a non COVID condition, they should still be seen in a clean environment with appropriate PPE worn by the health care worker and the patient. (usually a mask)
• As we learn more about this and can understand the true level of increased risk for our BAME colleagues, we will be communicating with all our members. Until this is possible we ask that all doctors and their staff stay safe, don’t take any risks and follow robust protocols for infection control and use of PPE.
(Our thanks to Peter Higgins at Lancs and Cumbria LMC for sharing their document)
GP opening on 8th May is not mandated by NHSE/I and will depend on local anticipated demand. NHSE/I have requested that practices agree locally with their CCGs if they need to be open. CCGs have confirmed that they will be providing specific advice on your local arrangements.
All community pharmacies in England are required to open 2-5pm with exceptions or a variation to those hours, based on the likely demand and local needs, agreed in advance with the NHSE/I regional team.
Our colleagues at Community Pharmacy Humber have shared local pharmacy bank holiday opening hours here.
The latest edition of our regular newsletter is now available with all new, updates and opportunities for general practice in the Humber area. Included in this month's issue:
- News on our mentoring service for GPs, including a new rapid access service that can be accessed online in the current restrictions
- Information for on temporary registration for GPs returning to work to respond to the pandemic
- More resilience services available to GPs and other practice staff
LMC Newsletter April 2020 (pdf).
The LMC shares practices’ concerns about the shielded patients project run by NHSE which has resulted in large amounts of work for primary care, an inconsistent approach from secondary care, and confusion for many patients.
We advise all practices to focus on ensuring any lists they are asked to review or generate are correct, rather than rushing to achieve a specific deadline.
The LMC has expressed this view to CCG colleagues, and will support practices who encounter any difficulties.
We have just produced a shielded patients update which summarises the latest guidance on shielding patients in higher risk groups, and provides information for practices to work from.
As part of regulatory changes to General Practice, Good Friday and Bank Holidays are designated as “core hours”. The LMC are working with CCGs to clarify the level of delivery required across these periods. Whilst not all CCGs have confirmed their plans, the LMC is recommending:
• Good Friday and Easter Monday – All patients to have access to a total triage service 0800 to 1830 by contacting their own practice number as normal, with the service delivered at PCN level, by phone diversion, as determined by PCN practices. For ERY practices the OOH service will commence at 18:00 as usual and for Hull at 18:30.
• Easter Saturday and Sunday – Some PCNs and localities have established “Hot clinics” which it is recommended are open on these days. Some CCGs have confirmed that Easter Saturday and Sunday will be covered by the GP Out of Hours service as usual.
• Where Out of Hours cover is available through practices or other contractors this can be used to support across the weekend, provided the use of this does not impact on available resources.
• Funding for staff who will be required in addition to normal staff to provide this cover should be funded through COVID-19 contingency CCG support.
• Pharmacies will also provide increased opening hours across the bank holiday to support general practice although their opening hours will not match practice opening hours.
• The LMC secretariat will be providing support services across the Easter bank holiday. Please contact us in the normal ways.
NHSE have released an update on reimbursement for additional staffing on these days:
Good Friday and Easter Monday reimbursement rates
Where it is determined that a practice must open on Good Friday or Easter Monday, practices can seek reimbursement for additional staffing costs incurred on these days, in line with the respective rates as set out below. That includes:
• Sessional GPs: up to a maximum of £250 a session or £500 per day;
• Overtime for salaried GPs in line with the individual’s contractual arrangements;
• Additional capacity from GP Partners to recognise up to two additional sessions on each of Good Friday and Easter Monday at a rate of £289 per session plus applicable employer National Insurance and pension costs;
• Overtime for non-GP practice staff in line with the individual’s contractual arrangements.
NHSE's advice is that practices should discuss with their local commissioner the level of service required on bank holidays and agree in advance what additional staffing costs will be reimbursed.
Details of the General Practice COVID support fund will soon be shared, and additional expenses will be considered within this.
As we find ourselves facing incredibly difficult times, please remember that the LMC is here to support you. Please visit our resilience page for information about support and resources.
If you are a qualified GP, please use the following contact details to access our mentoring service or contact Humberside LMCs for more information:
www.gp-s.org - complete the online contact form
We are working with GP-S and our mentors with a view to providing shorter, virtual sessions so that as many GPs as possible may benefit from the service over the coming months.
Mentoring can help by providing general support or specific support including the following areas:
- Emotional support
- Working through stressful situations
- Support development
- Move forward with personal and career goals
- Create a greater work life balance
- Advance professional development
- Build self confidence
- Enhance abilities outside and inside work
- Achieve aspirations
- Enhance leadership skills and build resilience.
Lighten the Load:
We are planning to hold this one day event in November, date to be confirmed, instead of 18th June as previously announced.
You will learn how to ‘lighten the load’ by skilling up with some of the must-know, fundamental and empowering coaching skills and techniques, along with the theories that underpin them. By the end of the day, you will feel lighter and be even better equipped to have some great conversations that will change things for the better going forwards, for you, your staff and patients.
The programme is free and aimed at medical practitioners and practice managers in the Humber area, provided through our GP resilience programme. Lunch will be provided. Online booking details to follow.