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COVID Virtual Ward Implementation
Pack
This Implementation Pack has been developed to provide you with
relevant information and documentation to help get your practice
ready to identify, assess and refer eligible patients to the COVID
Virtual
Ward.
If
you
have
any
queries
please
contact
[email protected].
If you have specific patient queries
please see provider contact details on page 13.
Contents:
1.
Managing COVID in Primary Care Flowchart
2.Newly COVID positive patient identification -
search Instructions
3.
Pulse Oximetry at Home Flow-chart
4.
Primary Care risk assessment against Virtual Ward
criteria
5.
Patient consent conversation
6.
Pulse Oximeters
7.Referral Form
8.
SNOMED Codes
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1. Managing COVID in Primary Care Flow-chart
(also on G—Care)
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2. Newly COVID positive patient identification
- search Instructions
You will be able to identify some of your newly COVID positive patients from them contacting the practice for advice/support.
For some patients who do not self-present at the practice, you will be relying on newly COVID positive test results coming from the lab. The PCCAG Team have written searches for TPP and EMIS to enable you proactively identify these patients.
Searches should be run daily and will show your past three days’ newly COVID positive patients - – although this will result in some duplication, as some results are delayed (and will be filed on ‘date of test’) this will reduce the likelihood of a patient not being picked up.
TPP Instructions
a. Portal – including automated searches and COVID Virtual Ward activity/discharge
information
You can sign up to a portal designed by GCCG to allow you receive your newly COVID positive patients via an automated email on a daily basis.
The portal will also allow you to see COVID Virtual Ward activity/discharge information for your patients - including patient status (active/discharged from the Virtual Ward) and data collected during the time they have been on the COVID Virtual Ward.
The email has been sent to your generic practice nhs.net account from [email protected]. You need to register for the service and will be sent automated emails for newly COVID positive patients/new COVID Virtual Ward activity for your patients. *If you have no newly COVID positive patients or new COVID Virtual Ward activity, you will not receive an email on that day*.
Please consider registering for the service. If you need a new invitation email to sign up to the service please contact [email protected].
You can use the portal to view COVID Virtual Ward activity/discharge information only if you would rather continue to run your in house searches separately.
b. Searches that can be run in-practice
Alternatively, the PCCAG team have developed TPP COVID positive searches.
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The search goes back over the 3 previous days so if you run on a daily basis there will inevitably be some duplication. If you need help with removing duplicated patient records PCCAG have developed a template and instructions which can be viewed here:
Patients with covid positive test - TPP.xlsx
You can continue to run this search and use the portal to view your patients COVID Virtual Ward Activity and post discharge information. The portal is currently the only way to see this information.
If you have any questions or feedback, please email the COVID Virtual Ward Project Team on [email protected]
Please find embedded instructions on how to obtain and run the search for TPP Practices:
TPP Covid positive
patients Search Report Instructions Nov 2020.pdf
You can continue to use the search above if required/preferred.
EMIS Instructions
a. Searches that can be run in-practice
The instructions below will support the practice to run a daily PCCAG written search using the clinical system to enable identification of all patients who have had a positive COVID-19 test result within the last 3 days.
Select the group ‘NHS Gloucestershire CCG ES&R’ when in population reporting. Navigate to ‘Covid19 Patientmanagement’ and run the search ‘Covid Positive Patients’. The search goes back over the 3 previous days so if you run on a daily basis there will
inevitably be some duplication. If you need help with removing duplicated patient records PCCAG have developed a template and instructions which can be viewed here:
Patients with covid positive test - EMIS.xlsx
(b) Patient activity/discharge information from the COVID Virtual Ward
You can sign up to a portal designed by GCCG to allow you receive COVID Virtual Ward activity/discharge information for your patients - including patient status
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(active/discharged from the Virtual Ward) and data collected during the time they have been on the COVID Virtual Ward.
This portal is currently the only way for you to see information on active and discharged patients from the Virtual Ward.
An invitation email has been sent to your generic practice nhs.net account from [email protected] and you need to activate the link within this email to register for the service.
You will be alerted on a daily basis via email to your generic nhs.net account if you have any new COVID Virtual Ward related activity. *If you have no patient activity on the
COVID Virtual Ward, you will not receive a report on that day*.
Vision Instructions
Please run a Vision search daily, searching for the following SNOMED codes:
o 1324601000000106 o 1240511000000106 o 1240581000000104 o 1240751000000100 o 1300721000000109 o 1300731000000106
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4. Primary Care risk assessment against Virtual
Ward criteria
(Please read in-conjunction with the flowchart on page 4)
1. Risk assessment of newly COVID positive patient should be made using the COVID Virtual Ward Referral Criteria:
Referral Criteria – At Higher Risk
50 years of age with COVID symptoms.
OR
< 50 years of age at ‘higher risk’: BAME, diabetes, known CVD, active cancer, obesity (BMI >35). Learning disabilities or Downs Syndrome.
Patients living in a care/nursing/residential home.
Patients >24 weeks pregnant or with an immunosuppression eg certilumizab
Patients who do not fall into these categories can be referred based on clinician discretion.
Exclusions
Children < 18 years of age.
Patients who are deemed as unable/unsuitable to follow a self-monitoring programme (e.g. significant cognitive impairment) and do not have a carer or family member to support them.
Patients aged 18-49 with no risk factors.
Patients not for escalation e.g. end of life where care plan is in place with GP.
2. Patients assessed as ‘at higher risk of severe COVID’ (i.e. meeting the COVID Virtual Ward criteria) will be eligible to be referred to the Gloucestershire countywide COVID Virtual Ward.
This service is being provided as a centralised model using GDoc and Baywater Telehealth LTD.
3. Patients assessed as ‘minimal risk’ (i.e. not meeting the COVID Virtual Ward criteria and sitting outside this pathway) can be safety-netted in-practice. GCCG has sourced extra pulse oximeters which have been allocated and delivered to practices. These additional pulse oximeters can be used at your discretion to help ‘minimal risk’ patients self-monitor or used for patients who do not wish to be referred to the COVID Virtual Ward.
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5. Patient consent conversation
1. Once you have identified a patient as ‘at higher risk of severe COVID’, and therefore eligible for referral onto the COVID Virtual Ward, you must seek consent to refer.
2. It is suggested that the practice contacts the patient to discuss the following:
What is the COVID Virtual Ward? (see patient information leaflet)
Why the patient meets the referral criteria for the COVID Virtual Ward.
Initial assessment as to whether the patient is able and suitable for self-monitoring.
Obtain consent to referral and sharing personal information with GDoc/Baywater as part of that process.
Ensure patients are aware that they will receive self-monitoring equipment and information within 24 hours of a referral being sent - providing the referral is sent off before 12 noon.
Patient leaflet - Covid Virtual Ward
* If you require this leaflet in a different language please contact
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6. Pulse Oximeters
It is important that your patients receive a pulse oximeter and advice/safety netting information as soon as possible, upon referral. This is to minimise the time between
symptom onset and the patient beginning to record their O2 sats and is a high clinical safety priority.
There are a number of ways a patient can quickly access a pulse oximeter:
You can provide your patient with a pulse oximeter from your practice stock (please let us know if you need your stock replenished by emailing
Patients can arrange for collection from a designated central location in their area (See table below)
A patient’s own pulse oximeter can be used if they have one available.
If none of the above options are suitable, there is a postal option available (which needs to be noted on the referral form). This is not a preferred option but we will endeavour to deliver a pulse oximeter to the patient’s home on the next working day but this timescale cannot be guaranteed.
Site Name Address Opening Times Attending Instructions
North Cotswold MIU Stow Road Moreton in Marsh Gloucestershire GL56 0DS
Tel 0300 421 8774 press option 2
8am – 7:45pm Go to first hatch on left as you enter main doors of hospital. MIIU Ring Bell
Cirencester MIU Tetbury Road Cirencester GL7 1UY
Tel 0300 421 6356 option 2
8am – 7:45pm Go through main entrance of hospital and follow signs to MIIU. Go to reception desk
Stroud MIU Trinity Road Stroud Gloucestershire GL5 2HY
Tel 0300 421 8666
8am – 7:45pm Go into hospital through MIIU entrance (signed)
Reception on left
Lydney MIU Grove Rd Lydney Gloucestershire GL15 5JE
Tel 0300 421 8720
8am – 7:45pm Go into hospital through doors marked MIIU
MIIU reception on left
Tewkesbury Community Barton Road Tewkesbury
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Hospital Gloucestershire GL20 5GJ
Tel 0300 421 6166
Reception desk on left
Gloucester Health & Care (GHAC)
Eastgate House, 121-131 Eastgate St, Gloucester GL1 1PX
8:30am – 19:30pm Please come the door of GHAC and press the video bell. Please bear with us if our receptionists cannot respond immediately; they may be dealing with other patients.
West Cheltenham Medical Hesters Way Community Resource Centre, Cassin Drive, Cheltenham, Gloucestershire, GL51 7SU Monday- Friday 8am-6:30pm Wednesday we do extended hours until 7pm
Please use the entrance in the car park and enter through the GP reception area on the left hand side.
Badham Pharmacy 118 Swindon Road Cheltenham Gloucestershire GL50 4BJ Mon-Sat 7:00am – 10:00pm Sunday 7:00am-19:00pm
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7. Referral Form
Please find a copy of the COVID Virtual Ward Referral Form attached below.
Please note, patients will be ‘inducted’ on to the COVID Virtual Ward and receive self-monitoring equipment and information within 24 hours of receipt of referral - providing the
referral is sent off before 12 noon.
Please ensure that the Referral Form is fully populated before sending off, to avoid any delays.
Please ensure that the patient’s email address and contact number is on the referral form. We will need this to enrol them onto the ward.
Primary Care
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8. SNOMED Codes
SNOMED code Description When to use
1325211000000107 Provision of pulse oximeter
(procedure).
When practices provide their own pulse oximeters to patients to allow self-monitoring.
1325251000000106 Referral to telehealth pulse
oximetry monitoring service (procedure). Synonym: Referral to remote virtual care pulse oximetry monitoring service.
When a patient is referred to the COVID Virtual Ward provided by GDoc.
1325241000000108 Telehealth pulse oximetry
monitoring declined (situation). Synonym: Remote virtual care pulse oximetry monitoring declined.
When a patient declines to be referred to the COVID Virtual Ward provided by GDoc.
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9. Contact information
Name
Role
Contact
Nature of contact
GDoc Provider of centralised COVID Virtual Ward [email protected] For: Non-urgent clinical queries
Advice & Guidance
Specific patient queries PCCAG Primary Care Clinical Audit Group Created the clinical system searches to find newly COVID positive patients [email protected] For:
Search queries for TPP or EMIS Vision queries COVID Virtual Ward Team Developed and implemented the COVID Virtual Ward service in Gloucestershire [email protected] For: Pathway queries or feedback Any help or support needed
Please do not sent
any patient
identifiable
information to this email address
