Here’s a round up of key information that came out this week relevant to general practice #covid19
Great resources published by @trishagreenhalgh and team on remote consulting. Despite there being a lot of noise about the Roth score, it turned out it wasn’t always easy to use in practice, especially when English is not a 1st language 
See this list of pragmatic questions that can be used to help assess breathlessness remotely:
This is from a very useful paper in @bmj_latest on how to conduct a ‘query covid’ consultation remotely. The importance of safety netting is highlighted: bmj.com/content/bmj/36…
Hot hubs are being fiercely debated. General consensus is that most consultations can be closed remotely, but a minority will need clinical examination of some form. Jury is still out on whether hot hubs will help w/ staff attrition and reduce the risk of HCPs acting as a vector.
@NHS_England @Nikki_KF letter broadly supports creation of hot hubs for suspected covid-19 pts, especially as 111 will now be redirecting pts to us who may need F2F assx. england.nhs.uk/coronavirus/wp…
Letter also talks about ‘green sites’ to see all other patients without covid symptoms. And confirms GP surgeries will remain open over Easter bank holiday weekend.
The govt clarified groups who need to practise ‘shielding’ (12 weeks self-isolation) due to being at a higher risk of serious illness. gov.uk/government/pub…
Everyone else not on this list, (those who would qualify for a flu vaccine) need to practise social distancing. Its unclear how this is applied to keyworkers. Should GPs be writing letters for employers- hopefully @BMA_GP will take a position on this.
@asthmauk have published helpful guidance on what constitutes severe asthma and @RheumatologyUK have done similar for people on immunosuppressants asthma.org.uk/advice/trigger…
rheumatology.org.uk/Portals/0/Docu…
rheumatology.org.uk/Portals/0/Docu…
HMG have asked us to identify ‘ at very high risk groups’ using a systematic search of our primary care databases. We will need to make contact with these groups, review or create care plans, ensure they have sufficient meds and check their social care needs are being met
Much of this work will be done with support from our social prescribing link workers and community pharmacy teams. It is also possible to refer someone for volunteer support through the @GoodSamApp – e.g. for delivery of shopping or meds
Rules around death certification have been relaxed. Any medical practitioner can now certify death, as long as they can (to the best of their knowledge) identify the cause of death. And they only need to have seen the deceased in the 28 days prior to death (video link acceptable)
Thank you to all my amazing GP colleagues working so hard to make this all happen. @PrimaryCareIT have done a great job collating all this info and much more - primarycarepathways.co.uk/covid19
