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Practices should not change their repeat prescription durations or support patients trying to stockpile as these actions will put a strain on the supply chain and exacerbate any potential shortages. Practices should also consider putting all suitable patients on electronic repeat dispensing as soon as possible. The whole repeatable prescription can be valid for a year but each repeat should be for no longer than the patient has now. For example, if the patient has prescriptions for a month’s supply now then the repeat dispensing should be set up as 13 x 28 days’ supply.

Please do not advise that the pharmacy will be delivering – ask patients to check with pharmacy directly to clarify the situation with home deliveries.

It is also really important that a patient is not prescribed anything they have not had for a while (especially inhalers) unless there is a true clinical need

Anti-inflammatory medications

There has been concern about the use of non-steroidal anti-inflammatory medications (NSAIDs) in relation to COVID-19. There is currently no strong evidence that ibuprofen can make COVID-19 worse. However, in view of the current lack of clarity the Committee of Human Medicines (an advisory body of MHRA) and NICE have been asked to review the evidence. It is therefore suggested that, in the interim, for patients, who have confirmed COVID-19 or believe they have COVID-19, that they use paracetamol (which is coming back into the supply chain following a nationwide shortage) in preference to NSAIDs. Those currently on NSAIDs for other medical reasons (e.g. arthritis) should not stop them. This position will be kept under constant review.


In response to the pressures and focus on COVID-19 and to avoid any financial de-stabilisation for practices, the practices’ minimum earning in points for QOF 2019/20 is protected at the level of points earned in 2018/19. This will be paid at the value of a point in 19/20. If however a practice can evidence that they have achieved a higher number of points than they did in 2018/19 then the higher achievement will be used to calculate their QOF payment.

Extended Access

Practices will not get penalised for not providing Extended Access. Payments will continue. The CCG ask that you maintain as much capacity as you can in core and extended hours but recognise the difficulties that you have at this time. Please continue to work with your CCG leads to keep them informed of your plans so that they can help coordinate any potential impacts to the rest of the system and support you wherever they can. For those of you that provide Improved Access Services please contact your local commissioner to discuss.

COVID-19 Home Management Service

The COVID-19 Home Management Service service should be in place across Kent and Medway by week commencing 30/3/2020. However all partners agree that it is essential that the service is safe for our patients and that they are also able to maintain the safety of the team undertaking the home visits. Urgent work continues to achieve roll-out and we will keep you updated. In Medway and Swale the service is up and running with each area’s respective GP Federations running a daily monitoring service. The service will be reviewed regularly and altered to meet demand as necessary.

Branch surgeries – temporary changes

In light of the COVID-19, the CCGs anticipate that some practices may be considering closing or amending opening times at branch surgeries for business continuity purposes. Whether decisions are being made proactively or reactively as part of business continuity plans, please could practices ensure that an e-mail notification is sent to their local CCG Primary Care Team. This should detail the local circumstances informing the decision and assurance regarding communication to patients, management of vulnerable patients and where appropriate communication with any other organisations which may provide services from the branch surgery. Further discussions will take place as required linked to local circumstances.

Information governance

We will need to work in different ways from usual and the focus should be what information you share and who you share it with, rather than how you share it so new national guidance has been produced.

Data Security and Protection Toolkit 2019/20 submission

NHSX recognises that it will be difficult for many organisations to fully complete the toolkit without impacting on their COVID-19 response. NHSX has therefore taken the decision to push back the final deadline for DSPT submissions to 30 September 2020. Organisations can choose to complete DSPT before that date. If they do so, and if they fully meet the standard, those organisations will be awarded 'Standards Met' status, as in previous years. Further information is available at

Please do not hesitate to contact the data protection team for any advice or guidance on these and other Data Protection matters by emailing:

GP IT – VPN Tokens

The shortage of working VPN tokens means that many staff cannot access networks securely even with laptops so people are being prevented from working from home securely when self-isolating. The CCGs have therefore purchased 400 soft tokens from Red Centric to support mobile devices. Initially they will be distributed to ensure continuity of services where current BT VPN tokens have, or are about to, expire. This will be part of rolling programme to ensure BT VPN tokens are replaced by Red Centric VPN tokens. NELCSU is aware of the current status of tokens and are contacting practices directly to arrange activation. The CCG are working on a range of IT related support for practices as they know that current equipment and systems are under extreme pressure.

Tele- conference call facilities

The CCGs use WhyPay who provide a free system, however call charges may apply. You will need to check. From a data protection perspective this is suitable for practices to use as Why Pay has PIN access and calls are not recorded.

Online triage

eConsult (East Kent) and Doctorlink (West Kent, DGS, Swale and Medway) are being deployed to provide this service.

All surgeries across Medway, Swale, DGS and West Kent have been emailed a form to fill in, please follow instructions on email and send back to Doctorlink. The CCGs have hired four interim Practice Managers who will be contacting you to see if you need help getting ready to use DoctorLink. This will be over the phone due to current restrictions. For more information on Doctorlink please email:

The CCGs are working in East Kent to rapidly deploy eConsult to ensure that all practices in east Kent can go live as soon as possible. A 10 step deployment checklist is now available to support your practice with a rapid mobilisation of eConsult. In the first instance please direct any queries or requests for additional support to The CCG are also asking practice managers who have helped their practices go live to support you where they can.

Video consultation

AccuRx video consultation has now been installed on all devices with EMIS.

AccuRx Flemming – Web based desktop Icon is being deployed to all Vision sites – the CCG will confirm when this is live. If you wish to use this product, as well as EMIS video consultation, please ensure your desktops are turned on and for laptops, that your VPN is switched on, so that the application can activate. This product is to be approved by NHS England with national Data Protection Impact Assessment. We expect approval to be confirmed next week.

More information:

It is important to note that if any patients are not yet signed up for Patient Access through EMIS, they do not need to visit the surgery as previously advised. Ensure Online Registrations is enabled in EMIS Manager and they will be able to setup their account online and book and join one call. Find out more here about Video Consult.

iPlato text messaging

iPlato credits should only be used for day to day operations – this can include: appointment reminders, call/recall, notifications of service changes. They should not be used for bulk messaging all patients generic advice about COVID-19. This is because the amount of credits available will quickly run out if it is used for bulk messaging. The CCGs know this is not useful so they are negotiating with iPlato for an increase in credits for the next 12 months to help practices with an increase in demand and for bulk messaging.

Subject Access Requests

Unfortunately, GDPR has not been relaxed and practices have reported ongoing Subject Access Requests. We have raised this with the BMA who have advised that although the legislation has not been relaxed, practices who receive an SAR and are unable to complete it within the specified 30 days may reply to the data subject (within 30 days) to inform them that an extension of 60 days will be required due to the pandemic. This will extend the total time window to 90 days

Furlough Staff

The government expects that the scheme will not be used by many public sector organisations, as the majority of employees are continuing to provide essential public services or contribute to the response to the coronavirus outbreak. Therefore, It is our understanding that practices will not be able to apply for government support to cover furloughed staff.

    HGV Medicals

The government has announced a temporary relaxation of the requirement for bus and lorry drivers to provide a doctor’s medical report in order to renew their licence. Under the scheme, drivers will be able to receive a temporary 1-year licence, providing they do not have any medical conditions that affect their driving and their current licence expires in 2020. This will help to reduce workload for doctors whilst ensuring that drivers can still have licences renewed.


Drivers with health issues will still need to declare these, and those with health issues that prevent them from driving safely will not have their licence renewed. This temporary change will only apply to those drivers whose licences are due to expire or have expired since 1 January 2020 and not for those making their first application for a Group 2 bus or lorry licence.


Section 88 of the Road Traffic Act 1988

During COVID many drivers licences have expired and DVLA gave extensions so that they could continue to drive and work. For many drivers though this extension is coming to an end. Drivers are now being told by DVLA to ask their GP if they are “fit to drive” so that they can continue to drive under Section 88 of the Road Traffic Act 1988 (RTA 1988). DVLA has produced a leaflet which explains RTA 1988.


Most GPs are not confident to advise patients whether or not they are fit to drive, and in normal circumstances we would provide a factual report for DVLA so that their expert medical advisers can decide upon fitness. If we provide an opinion that someone is fit, and then an accident occurs, are we liable? If we say a patient is not fit, then this can adversely affect our long term relationship with that patient. For these reasons, if you have any doubt about whether a person is fit to drive, you should decline to provide this assurance, and should write to DVLA explaining that you cannot give an opinion, but offering to provide factual information about a person’s health.


Practices could have an explanatory note on their websites or noticeboards, so that patients are forewarned that this is what your policy is.


Updated on Thursday, 27 August 2020, 908 views

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