Mword Issue 51 - Dr Michelle Drage's latest update for GPs and practice teams on covid-19

Covid19heading
Mword Heading - Issue 51

30 March 2020


Dear Colleague

In response to the rapidly developing covid-19 situation I would like to:
  1. remind you of the need to practice safely, and
  2. provide a much needed update on death certification following the enactment of measures in last week’s Coronavirus Act.
As ever, this information is as current as possible and may be subject to change. If that should happen, my team and I will update you as soon as possible.

1. Practising Safely

Practising safely protects patients, staff and colleagues and minimises the risk of covid-19 transmission in practices in the absence of widespread covid-19 testing, and with data from Italy and China suggesting that ‘cold’ patients and health care workers are significant vectors for spreading disease.

Practising safely involves:
  • operating a remote screening system;
  • carrying out consultations remotely through video or phone wherever possible;
  • only seeing patients face to face (in the surgery or through home visits) if initial assessment deems it essential;
  • screening people prior to entry;
  • miniminising the time a person spends in practice;
  • minimising the number of people the patient encounters;
  • wearing PPE for all face-to-face consultations and making sure all staff adopt correct donning and doffing techniques.
This advice will be updated as more evidence becomes available from agencies such as PHE and NHSEI, such as the letter emailed out from NHSEI Primary Care Director Dr Nikki Kanani which crossed with my own on Friday evening.

2. Changes to Death Certification

Coroners offices have confirmed that there is no need for the doctor to see the patient after death as long as any doctor saw them in the 28 days before death (including for verification of death). The doctor should write 'N/A' on the Cremation Form 4 where it asks about what examination was made of the body. Ideally they should say who did see the patient when alive.

Any doctor can now complete the MCCD as long as a doctor saw them in the 28 days before death. They do not have to have seen the patient alive and they can also complete Cremation Form 4, with some caveats: Section 8 of the form should be completed as NA; the doctor completing the form should indicate (if possible) which doctor saw the patient in the 28 days prior to death, and; if no doctor saw the deceased within the 28 days before death, the body should be seen after death to avoid referral to the Coroner - this is the only circumstance in which the body needs to be seen after death.

Video/telemedicine counts for 'attending' a patient during life but not after death – please refer to the information at the following link: Advice from the General Register Office.

As ever I welcome your feedback at mword@lmc.org.uk, and know that my team of experts and leaders here at Londonwide LMCs will always be by your side.

Keep well. Stay safe.

With best wishes

Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs

 

Last updated : 13 Dec 2021
 

M word - Issue 12 - Measles - MMR catch up scheme UPDATE (26 Apr 2013)

Dear Colleague Measles - MMR catch up scheme UPDATE   Here is an update based on current information and your...
Read more »

M word - Issue 11 - Measles - MMR Catch up Campaign (25 Apr 2013)

Dear Colleague Measles - MMR Catch up Campaign As you cannot have missed, The Chief Medical Officer (CMO) has announced a national MMR catch up campaign, centred...
Read more »

The M Word - Issue 10 - Dr Michelle Drage's latest personal briefing for practices on NHS reforms (03 Apr 2013)

Dear Colleague  Another April, Another New NHS  But this time it’s huge, so please see below for some sanity which I have drawn up from the perspective of practices as...
Read more »

The M Word - Issue 9 (20 Dec 2012)

Dear Colleague, Just before the second year of NHS ‘transition‘ draws to a close we are beginning to see how it will all fit together in London. There...
Read more »

The M Word Issue 8 - Dr Michelle Drage's latest personal briefing for practices on NHS reforms (05 Jul 2012)

I know in General Practice we’re all supposed to be the best at tolerating uncertainty when it comes to our patients health, but I’m not so sure we’re able to...
Read more »

The M Word Issue 7 - Dr Michelle Drage's latest personal briefing for practices on NHS reforms (01 Mar 2012)

  Through the fog    I felt it timely to send a beam of light out into the fog and try to illumine the way ahead for general practice.   ...
Read more »

The M Word issue 6 - Dr Michelle Drage's latest personal briefing for practices on NHS reforms (16 Dec 2011)

I have 3 updates for you:   The Health and Social Care Bill, 1 year on GP Primary Medical...
Read more »

The M Word issue 5 - Dr Michelle Drage's latest personal briefing for practices on NHS reforms (10 Oct 2011)

  Here's the latest update on what has and what has not been going on over the last few weeks, and what is likely to happen over the Autumn. I...
Read more »

The M Word issue 4 - Dr Drage's briefing on the NHS reforms (15 Jun 2011)

The Day After...   The Politics The Real World Michelle’s 3 step guide (definitely not a toolkit) to QIPP and GRIP   Dr Michelle Drage FRCGPCEO Londonwide...
Read more »

The M Word issue 3 - Dr Michelle Drage's briefing on NHS reforms (07 Jun 2011)

I thought I’d share three of my more serious thoughts to do with Providing General Practice and NOT commissioning (mostly!)   The new transitional management landscape in London Our...
Read more »
Next Page »
« Previous Page