Novel Coronavirus: Advice for the NHS in England – NHS England and NHS Improvement

Dear colleague letter from National Medical Director NHS England, Chief Medical Officer for England and Director – National Infection Service Public Health England. This letter updates the advice sent on 7th February 2020. Changes from the previous version are highlighted in blue font. The key changes are to the geographic component of the case definition. Advice for NHS organisations is as follows:

  • It is essential that an accurate travel history is obtained from all patients with acute respiratory infections, using any one of the following: cough or fever or shortness of breath to help identify potential cases.
  • If you have returned from these specific areas since February 19th, you should call NHS111 and self-isolate even if you do not have symptoms:
    • Iran
    • Specific lockdown areas in Northern Italy as designated by the Government of Italy
    • Special care zones in South Korea as designated by the Government of the Republic of South Korea
    • Hubei province (as previously noted)
  • If you have returned from these areas since February 19th and develop symptoms, however mild, you should self-isolate at home immediately and call NHS111. You do not need to self-isolate if you have no symptoms.
    • Northern Italy (defined by a line above, and not including, Pisa, Florence and Rimini),
    • Vietnam
    • Cambodia
    • Laos
    • Myanmar
  • Those who have returned from previously identified geographic areas within the past 14 days and develop symptoms, however mild, should self-isolate at home immediately and call NHS111.
  • Local pathways are being established, working with NHS 111 to assess returning travellers from these areas and develop community pathways for individuals who are clinically stable and meet the clinical and
    geographic components of the case definition.
  • Recommends that travellers with fever returning from these countries should still have a clinical assessment in order to assess for other important diseases, using appropriate PPE if carrying out a face-to-face consultation.

Novel Coronavirus: Advice for the NHS in England
Novel Coronavirus: Advice for the NHS in England
coronavirus-tripartite-letter-7-feb.pdf
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Novel Coronavirus: Advice for the NHS in England – NHS England and NHS Improvement

Dear colleague letter from National Medical Director NHS England, Chief Medical Officer for England and Director – National Infection Service Public Health England. This letter updates the advice sent on 31st January 2020. Changes from the previous version are highlighted in blue font. The key changes are to the case definition. These include the expansion of geography for clinical case definition from mainland China to mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia and Macau; and the modification of the clinical case definition so that fever without any other symptoms is sufficient criteria for testing (if the patient has also travelled from or transited through the previously named countries in the previous 14 days). Alternative clinical diagnosis for fever in a returning traveller should be considered and tests performed at local NHS laboratories, according to published PHE guidance.

Novel Coronavirus: Advice for the NHS in England
Novel Coronavirus: Advice for the NHS in England
coronavirus-tripartite-letter-7-feb.pdf
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Wuhan Novel Coronavirus: Advice for the NHS in England – NHS England and NHS Improvement

Dear colleague letter from National Medical Director NHS England, Chief Medical Officer for England and Director – National Infection Service Public Health England. It gives the following advice for NHS organisations:

  • It is essential that an accurate travel history is obtained from all patients with acute respiratory infections to help identify potential cases.
  • Primary care practices are asked to identify possible cases, isolate them immediately, and seek specialist advice from a microbiologist, virologist or infectious disease physician at your local trust. They are not expected to undertake any clinical assessment or sampling. Guidance for primary care can be found here.
  • All acute trusts are expected to assess possible cases of Wuhan novel coronavirus using appropriate isolation facilities. They should review the Public Health England (PHE) guidance and ensure that they have considered how to operationalise this.
  • Acute trusts should be prepared to undertake sampling and transport samples to PHE for testing as well as making arrangements for such patients to be identified immediately and isolated according to the PHE guidance, or in discussion with PHE, in home isolation if appropriate.
  • If the novel coronavirus is detected, the patient will be transferred to an Airborne High Consequences Infectious Diseases centre. PHE will undertake contact tracing and advise on management as more is known about this infection. Guidance will be updated.

Wuhan Novel Coronavirus: Advice for the NHS in England
Wuhan Novel Coronavirus: Advice for the NHS in England
coronavirus-tripartite-letter-24-jan-1.pdf
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Guidance on the submission of general and acute Friends and Family Test data – NHS England and NHS Improvement

This guidance sets out the arrangements for the submission of monthly NHS Friends and Family Test (FFT) data to NHS England.  It includes the process of submitting FFT data for:

  • Inpatients (including daycases);
  • Accident and Emergency (including walk-in-centres and minor-injury-units);
  • Maternity; and
  • Outpatients.
Guidance on the submission of general and acute Friends and Family Test data
Guidance on the submission of general and acute Friends and Family Test data
fft-revised-submission-guidance-general-acute.pdf
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Guidance on the submission of NHS dental service Friends and Family Test data – NHS England and NHS Improvement

This guidance sets out the arrangements for dental practice staff submitting monthly NHS Friends and Family Test (FFT) data to NHS England.

Guidance on the submission of NHS dental service Friends and Family Test data
Guidance on the submission of NHS dental service Friends and Family Test data
fft-revised-submission-guidance-dental-service.pdf
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Guidance on the submission of GP practice Friends and Family Test data – NHS England and NHS Improvement

This guidance sets out the arrangements for GP practice staff submitting monthly NHS Friends and Family Test (FFT) data to NHS England.

Guidance on the submission of GP practice Friends and Family Test data
Guidance on the submission of GP practice Friends and Family Test data
fft-revised-submission-guidance-gp-practice.pdf
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Guidance on the submission of patient transport services Friends and Family Test data – NHS England and NHS Improvement

This guidance sets out the arrangements for NHS patient transport services staff submitting monthly NHS Friends and Family Test (FFT) data to NHS England.

Guidance on the submission of patient transport services Friends and Family Test data
Guidance on the submission of patient transport services Friends and Family Test data
fft-revised-submission-guidance-patient-transport-services.pdf
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Guidance on the submission of community and mental health Friends and Family Test data – NHS England and NHS Improvement

This guidance sets out the arrangements for the submission of monthly NHS Friends and Family Test (FFT) data to NHS England.  It includes the process of submitting FFT data for:

  • Community
  • Mental health
Guidance on the submission of community and mental health Friends and Family Test data
Guidance on the submission of community and mental health Friends and Family Test data
fft-revised-submission-guidance-community-mental-health.pdf
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Medicines Optimisation Clinical Reference Group: Terms of reference – NHS England and NHS Improvement

The purpose of the Medicines Optimisation Clinical Reference Group (MO CRG) is to provide advice to optimise the use of high cost medicines. The overall objective is  to improve patient outcomes of care through the principles of medicines optimisation; this is evidenced through measurement including patient experience.

Medicines Optimisation Clinical Reference Group: Terms of reference
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Screening KPI data summary factsheets February 2020: Issue 10 – Public Health England

Key performance indicator (KPI) data reports for NHS population screening programmes for financial year 2019 to 2020.    The key performance indicators (KPIs) are used to measure how the NHS screening programmes are performing and aim to give a high-level overview of programme quality. The files published each quarter are:

  • the antenatal and newborn (ANNBKPI data tables
  • the young person and adult (YPAKPI data tables
  • an accompanying data report
Screening KPI SummaryFactsheets Feb2020 Issue10
Screening KPI SummaryFactsheets Feb2020 Issue10
Screening_KPI_SummaryFactsheets_Feb2020_Issue10.pdf
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Screening KPI data summary factsheets: November 2019: Issue 9 – Public Health England

Key performance indicator (KPI) data reports for NHS population screening programmes for financial year 2019 to 2020.    The key performance indicators (KPIs) are used to measure how the NHS screening programmes are performing and aim to give a high-level overview of programme quality. The files published each quarter are:

  • the antenatal and newborn (ANNBKPI data tables
  • the young person and adult (YPAKPI data tables
  • an accompanying data report
Screening KPI data summary factsheets: November 2019: Issue 9
Screening KPI data summary factsheets: November 2019: Issue 9
Screening_KPI_Summary_Factsheets_Nov2019_Issue9.pdf
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Allegations of child sexual abuse linked to Westminster: Investigation Report – Independent Inquiry into Child Sexual Abuse

This investigation concerns institutional responses to allegations of child sexual abuse and exploitation involving persons of public prominence who were associated with Westminster. Westminster is defined in this report as the centre of the United Kingdom’s government, government ministers and officials, as well as Parliament, its members and the political parties represented there. Seven topics were covered in evidence. These were:

  1. police misconduct,
  2. political parties,
  3. whips’ offices,
  4. the Paedophile Information Exchange,
  5. prosecutorial decisions,
  6. the honours system, and
  7. current safeguarding policies in government, Parliament and the political parties.
Allegations of child sexual abuse linked to Westminster: Investigation Report
Allegations of child sexual abuse linked to Westminster: Investigation Report
allegations-child-sexual-abuse-westminster-investigation-report-25-february-2020.pdf
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M (Declaration of Death of Child) [2020] EWCA Civ 164 (14 February 2020) – England and Wales Court of Appeal (Civil Division)

From England and Wales Court of Appeal (Civil Division) Decisions. This application for permission to appeal concerns the tragic consequences that have followed the difficult birth of a baby boy on 18 September 2019. Following a normal, full-term pregnancy the child’s mother went into labour on the way to hospital. There was, unfortunately, a prolapse of the umbilical cord, meaning that the cord dropped into the birth channel ahead of the baby and became trapped against the baby’s body. The significant force of the process of birth impeded the functioning of the cord which was, prior to birth, supplying oxygen to the unborn child. As a result the flow of oxygen to the baby’s brain was cut off for a significant period. At birth he had an undetectable heart rate and no respiratory output. His heart was restarted, but he was immediately placed on a ventilator in the neonatal intensive care unit (NICU). In accordance with established medical procedure, and following two “death by neurological criteria” (“DNC”) assessments, the treating doctors concluded that by 20:01 on 1 October 2019 irreversible brain stem death had occurred and the child was, therefore, clinically dead. Despite the apparent finality of that conclusion, the child’s body has remained connected to the NICU ventilator, his heart has continued to beat, and he has been fed. He has gained weight. From time to time some movement of his limbs is detected. In consequence the child’s parents do not accept that their baby is dead. They therefore oppose the plan of the Manchester University NHS Foundation Trust (“the Trust”), who are responsible for the hospital, and who seek permission to turn the ventilator off and disconnect it.

In consequence of the dispute between the parents and the Trust, the Trust issued an application in the Family Division of the High Court on 26 November 2019 seeking a declaration in the following terms:

  1. “Midrar Namiq has no capacity to consent to, to refuse, or to make decisions about the medical treatment he should receive, namely the administration of mechanical ventilation.
  2. It is lawful for Manchester University Hospital NHS Foundation Trust to make arrangements for his mechanical ventilation treatment to be withdrawn to allow him a kind and dignified death.”

Permission in this case to appeal is refused.

M (Declaration of Death of Child) [2020] EWCA Civ 164 (14 February 2020)
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Health equity in England: The Marmot review 10 years on – University College London Institute of Health Equity

Since 2010 life expectancy in England has stalled; this has not happened since at least 1900. If health has stopped improving it is a sign that society has stopped improving. When a society is flourishing health tends to flourish. Life expectancy follows the social gradient – the more deprived the area the shorter the life expectancy. This gradient has become steeper; inequalities in life  expectancy have increased. Among women in the most deprived 10 percent of areas, life expectancy fell between 2010-12 and 2016-18. There are marked regional differences in life expectancy, particularly among people living in more deprived areas. Differences both within and between regions have tended to increase. For both men and women, the largest decreases in life expectancy were seen in the most deprived 10 percent of neighbourhoods in the North East and the largest increases in the least deprived 10 percent of neighbourhoods in London.

Finds the national government has not prioritised health inequalities, despite the concerning trends and there has been no national health inequalities strategy since 2010. This as an essential first step in leading the necessary national endeavour to reduce health inequalities.

Health equity in England: The Marmot review 10 years on
Health equity in England: The Marmot review 10 years on
marmot-review-10-years-on-full-report.pdf
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Health equity in England: The Marmot review 10 years on: Executive Summary
Health equity in England: The Marmot review 10 years on: Executive Summary
marmot-review-10-years-on-executive-summary.pdf
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Mr K Farrell v Liverpool University Hospitals NHS Foundation Trust: 2411202/2019 – HM Courts & Tribunals Service

Employment Tribunal decision. The judgment of the Tribunal is that the claimant’s complaints in respect of a breach of his contract and of an unauthorised deduction from his wages are well founded and that the respondent is ordered to restore to him the value of the 13 days’ contractual annual leave carried over by him from the 2018/19 leave year, which was withheld from him in his final salary payment upon retirement.
Mr K Farrell v Liverpool University Hospitals NHS Foundation Trust: 2411202/2019
Mr K Farrell v Liverpool University Hospitals NHS Foundation Trust: 2411202/2019
Mr_K_Farrell_v_Liverpool_University_Hospitals_NHS_Foundation_Trust_-_2411202_2019.pdf
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Dr J Macanovic v Portsmouth Hospital NHS Trust 1400232/2018 – HM Courts & Tribunals Service

Employment Tribunal decision. The judgment of the tribunal is that disclosures 1 to 5 and 10 are protected disclosures that qualify for protection pursuant to sections 43B and 43C of the Employment Rights Act 1996 and that disclosures 6 and 7 are protected disclosures that qualify for protection pursuant to sections 43B and 43F of the Employment Rights Act 1996.
Alleged disclosure 9 is not a protected disclosure.
The amendment application to include alleged disclosure 11 is refused.
Dr J Macanovic v Portsmouth Hospital NHS Trust 1400232/2018
Dr J Macanovic v Portsmouth Hospital NHS Trust 1400232/2018
Dr_J_Macanovic_v_Portsmouth_Hospital_NHS_Trust_1400232.18.pdf
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Doubell v Kings College Hospital NHS Trust [2020] EWHC 359 (QB) (21 February 2020) – England and Wales High Court (Queens Bench)

From England and Wales High Court (Queen’s Bench Division) Decisions. This is an appeal from a decision of Her Honour Judge Baucher sitting at the Central London County Court on 5-6 August 2019. Judgment was handed down on 30 August 2019, dismissing the claimant’s claim for personal injury arising out of an accident which occurred on 15 June 2013 at Kings College Hospital (“the Hospital”) where she was an inpatient. The claimant was aged 65 at the date of the accident. She had been admitted to the Hospital on 5 June 2013 and she fell out of bed in the small hours of 15 June 2013 and landed on her knees. There were no obvious injuries but her knees were observed to be red. Quantum was agreed in the sum of £7500 and the only issue at trial was therefore liability. The appeal is dismissed.

Doubell v Kings College Hospital NHS Trust [2020] EWHC 359 (QB) (21 February 2020)
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Coronavirus (Covid-19) Home Diagnostic Sampling Guidance – NHS England and NHS Improvement

Guidance providing details on the procedures and equipment required for home diagnostic sampling in those persons who have been identified via NHS 111 as suitable for sampling for Coronavirus (Covid-19) in a community setting.

Coronavirus-home-diagnostic-sampling-guidance
Coronavirus-home-diagnostic-sampling-guidance
coronavirus-home-diagnostic-sampling-guidance.pdf
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Coronavirus (Covid-19) Home Diagnostic Sampling Guidance – NHS England and NHS Improvement

Dear colleague letter providing details on the procedures and equipment required for home diagnostic sampling in those persons who have been identified via NHS 111 as suitable for sampling for Coronavirus (Covid-19) in a community setting.

Coronavirus (Covid-19) Home Diagnostic Sampling Guidance
Coronavirus (Covid-19) Home Diagnostic Sampling Guidance
coronavirus-home-diagnostic-sampling-cover-letter-1.pdf
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Briefing: Primary care providers and the coronavirus (COVID-19) – NHS England and NHS Improvement

This document is a briefing note for primary care providers about the coronavirus (COVID-19).

Briefing: Primary care providers and the coronavirus (COVID-19)
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