Health and Social Care Support during COVID-19: Primary Care in Care Homes

Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents 6thMay 2020 NHS England and NHS Improvement

Agenda Time Item Lead 11:00 Welcome and Introductions Adrian Hayter 11:05 Overview of Recent Communications Adrian Hayter 11:15 Health and Social Care Support to Care Homes during COVID-19 Adrian Hayter 11:30 Reporting Structure Regional Teams, CCGs Adrian Hayter 11:40 Practicalities IT, Financials, Regional Structure Adrian Hayter 11:50 A.O.B Adrian Hayter 2 | 2 | Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents

Overview of Recent Communications Second Phase of NHS Response to COVID-19 Simon Stevens 29/04/2020 Increased demand for COVID-19 aftercare and support in community health services, primary care, and mental health Bring 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 for the period of COVID-19 COVID-19 Response: Primary Care and Community Health Support Care Home Residents Dr Nikki Kananni, Matthew Winn and Ed Waller 01/05/2020 Delivery of a consistent, weekly check in , to review patients identified as a clinical priority for assessment and care Development and delivery of personalised care and support plans for care home residents Provision of pharmacy and medication support to care homes Urgent Further CCG Assistance to Local Resilience Forums in Supporting Care Homes: Training the Trainers on Infection Prevention and Control Ruth May 04/05/2020 We are asking every CCG to make a formal offer under the direction of their Local Resilience Forum (LRF), and in partnership with local authority public health / environmental health teams to provide a named contact to help train the trainers in care homes about PHE s recommended approach to infection prevention and control. Particular support should be offered to those care homes that lack the infrastructure of the bigger regional and national chains. 3 | 3 | Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents

Health and Social Care Support to Care Homes during COVID-19 Interim service for COVID-19 patients of elements of EHCH framework which includes virtual weekly check ins via development of MDT, personalised care and support plans and pharmacy and medication support Managing the deteriorating COVID-19 patient within the care home via implementation of remote monitoring in primary care via pulse oximetry Supporting implementation of published guidance on supporting the medicines re-use scheme in the care home setting Supporting care homes with implementation of advice on visiting in last days/hours of life Supporting the Implementation of verification of death guidance within care homes Guidance for symptom management and giving medicines through alternatives routes Support the implementation of guidance on discharging patients into primary and community care following ICU COVID-19 treatment 4 | 4 | Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents

Primary Care and Community Health Care Home Support Sitrep information from CCGs to be commissioned this week, to report by early next week on: a) the proportion of practices which have put the COVID-19 care home service in place for their patients b) the extent to which this is being delivered through networks, c) whether each care home has support in place, and d) whether each care home has a nominated clinical lead. A series of national webinars are in place to support the roll out of the service to care homes, and share good practice. These include: Webinar with Trust and CCG lead pharmacists on pharmacy and medication support Tuesday COVID-19 webinar for general practice Thursday (expected 3,000-4,000 participants) Clinical pharmacy in care homes webinar, hosted by PCPA Thursday COVID-19 webinar for CCGs and Primary Care Networks, hosted by NHS Confederation and NHS Clinical Commissioners Thursday Short Life Working group established, chaired by the Deputy Chief Pharmacist, to rapidly develop advice and guidance to systems on the pharmacy support to be provided to care homes. Regional support offers in development to co-ordinate and deliver the model. This includes: implementation webinars/virtual events across most regions this week and next week other bespoke regional implementation measures (including leadership support across care home provides, CCGs, LAs, general practices and community health providers). assurance frameworks to support the national sitrep process and to ensure that problems identified through the sitrep can be tackled swiftly. Daily calls in place via the Primary Care COVID-19 Cell with regional teams to identify and resolve issues. 5 | 5 | Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents

Reporting Structure Regional Teams, CCGs How can we report the progress of care homes What will be the reporting route? CCGs > NHSE/I Regions > NHSE/I National Team Could we utilise Capacity Tracker? Will Capacity Tracker system champions be an asset in this? What level of information do we need to report? Will this information be used by Local Resilience Forums? How will the data be used by NHSE/I? 6 | 6 | Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents

Practicalities IT, Financials, Regional Structure Do care homes have the IT infrastructure in place? Are care homes signed up to NHSmail allowing them access to Microsoft Teams? Are care homes linked to more than one GP surgery? Do GP surgeries have the technology in place to support care homes? How is the roll out being funded? What are the implications on Primary Care Network DES? How can we utilise the existing regional structures What role will Community Services and Ageing Well Regional Leads play in the roll out What support do care homes and primary care need? 7 | 7 | Clinical Reference Group: Primary Care and Community Health Support to Care Home Residents