Email from GPL team to Practice Managers 18 August 2021

Email from GPL team to Practice Managers 18 August 2021 Good morning Practice Managers The following is the information we currently have pertaining to the Level Four response. This information will be frequently changing and being refined, and we will communicate these changes with you.

To ensure your practice remains updated please nominate a communication lead and ensure that person is regularly checking emails and forwarding on information to the rest of the practice team.

If your practice hasn’t already done this, then setting up a team messaging system – e.g. through Whats App or Messenger is a really good way to ensure rapid sharing of information.

Please provide your GPL with a nominated phone number for your practice (not the reception) in case we need to call to share any urgent messaging.

And get in touch with your GPL if you have any issues or queries.

In particular, we can redeploy staff to assist practices with testing so please let us know if testing levels are becoming unmanageable. The DHB is closely monitoring testing demand.

Swabbing/PPE If swabbing in car or well-ventilated environment, then current best practice applies. Gown, mask, goggle/face shield – change gloves between patient and total change after HIS cases (read on for more information about this). Consider if examination is going to add anything to the assessment, diagnosis, and treatment plan, that a history and temp/pulse ox in the car would give.

The Primary care quick reference guide summarises most of the information – remember at Level 4 you should consider swabbing all ages if clinically indicated. https://www.health.govt.nz/system/files/documents/pages/covid19_primary_care_quick_reference_guide_august_2021.pdf If you have urgent requirements for PPE please contact your GPL, there is a DHB supply.

N95 The Ministry of Health will make an exemption to the fit testing requirements nationwide for general practice and urgent care clinics, and community-based assessment centres for access to Ministry of Health centralised supply of N95/P2 particulate respirators for the initial period of the next 14 calendar days.

A reminder as to when N95 mask use must be considered (taken from the Primary Care quick reference guide) HIS Criteria We are seeking exact details in regards to the current situation, in the meantime: •

Anyone who is symptomatic and has been at a location of interest should be considered HIS - swab and notify Toi te Ora via eReferral, and claim a Full Assessment through Halcyon as per this flowchart

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People who are asymptomatic but have been at locations of interest should self-isolate and call Healthline on 0800 358 5453 to notify them that they have been at a location of interest and follow their advice (self isolate and a swab at a time yet to be determined) Anyone else currently symptomatic should be swabbed and advised to isolate until negative result returned and symptoms resolved but not notified to TTO at this stage. This would be a simple assessment plus swab Halcyon claim as per this flowchart

Locations of interest are going to be frequently updated and your best source for this is the MOH website page: COVID-19: Contact tracing locations of interest | Ministry of Health NZ All updated guidance for Primary Care can be sourced on this MOH website: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid19-information-health-professionals/covid-19-primary-care#questions Pathlab We will confirm any new codes which need to be added to the Halcyon form, or Pathlab test requests ASAP. In the meantime please use ‘Other’ as the code and state ‘Level4’ in the Halcyon form. We are also confirming Pathlab’s testing capacity at this time and will update you.

Virtual Clinics Following is the information from the RNZCGP:

The principles of general practice at Level 4 • The target during Level 4 is for general practice to reduce face-to-face consultations by

70%.That means the majority of your consultations will be phone or video based and you will do phone triage for every patient.

• If, having done a phone triage assessment, it is clear that the patient needs to see a GP, then a normal GP consult can be arranged.

• You need to continue to reassure patients that they can get healthcare from their general practice but that they might do that differently. General practice is safe and careful and we've done this before.

• Use your PPE. • Convert your COVID vaccine clinics (if you're operating those) to car clinics or use the alternative methods you used during 2020's lockdown.

• Maintain scrupulous hand hygiene • Maintain physical distancing practices in the surgery, within reason, – at Level 4 that is two metres.

• Please check our risk matrix, which is designed to allow primary care clinicians to assess their own and their colleagues' risk within the clinical setting.

Vaccinations The Ministry of Health have instructed that for the next 48 hours vaccinations are cancelled while health services respond to this Level 4 situation.

Please stay in touch and take care as we step back up to Level 4. We are here to support you in any way we can.

Nga Mihi, GPL Team