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Knowledge @lert for Monday 27th April

April 27, 2020 CCG Daily News

Latest rapid guidelines from NICE

  • Critical care in adults [NG159], NICE (updated 24 April 2020)
    The purpose of this guideline is to maximise the safety of patients who need critical care during the COVID-19 pandemic, while protecting staff from infection. It will also enable services to make the best use of NHS resources. On 24 April 2020, we clarified the role of specialists in our recommendation on frailty assessment.
  • COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders [NG167] NICE (updated 24 April 2020)
    The purpose of this guideline is to maximise the safety of children and adults with rheumatological autoimmune, inflammatory and metabolic bone disorders during the COVID-19 pandemic, while protecting staff from infection. It also enables services to make the best use of NHS resources.

Administration of end-of-life drugs by family caregivers during covid-19 pandemic, BMJ
This editorial discusses the administration of end of life drugs by family caregivers, including risk and issues around drug supply. It notes that it is vital to plan and provide suitable support now if changes in practice in the community are going to be safe and appropriate.


COVID-19: guidance for sampling and for diagnostic laboratories, PHE (updated 25th April 2020)
This documentdescribes the samples required for establishing a diagnosis of COVID-19 acute respiratory disease and the tests that will be performed in England.


Exclusive: National alert as ‘coronavirus-related condition may be emerging in children’ – Health Service Journal
A serious coronavirus-related syndrome may be emerging in the UK, according to an “urgent alert” issued to doctors, following a rise in cases in the last two to three weeks, HSJ has learned.


COVID-19: paediatric surveillance, PHE  
This guidance carries a description and contact details of PHE paediatric surveillance programmes for COVID-19.


Managing anxiety about loss – King’s Fund Blog
What have you lost since the arrival of Covid-19? What are you afraid of losing as the pandemic unfolds? “I have lost my usual routines; which help life hang together. I’ve lost the in-the-flesh laughs with colleagues that carry us through the more difficult conversations; I’ve lost meaningful work projects that I’d invested time and labour in; and I’ve lost watching the joy my mother takes from holding my children on her knee.” Jo Maybin.


Coronavirus (Covid-19): guidance for care staff supporting adults with learning disabilities and autistic adults – Department of Health and Social Care
This guidance is for care workers and personal assistants who support adults with learning disabilities and autistic adults. The guidance will help care staff to: keep people with learning disabilities and autistic people safe; support them to understand the changes they need to make during the Covid-19 outbreak; and protect their own wellbeing.


View from the frontline of anaesthesia during Covid-19: April 2020 survey results – Royal College of Anaesthetists
Over a 24-hour period from 15–16 April 2020, the Royal College of Anaesthetists (the  College) conducted a survey to develop a snapshot ‘view from the frontline’ of anaesthesia during Covid-19. Sixteen per cent of all hospital consultants are anaesthetists, making anaesthesia the single largest hospital specialty in the UK. Anaesthetists of all grades play a critical role in the care of two-thirds of hospital patients. 2,174 members completed the survey. This briefing presents the findings and a detailed picture of the issues faced by anaesthetists across the UK.


Care fit for carers: ensuring the safety and welfare of NHS and care workers during and after Covid-19 – Institute for Public Policy Research 
This reportprovides new evidence on the experience of the healthcare workforce during Covid-19 to date – from the Institute for Public Policy Research (IPPR)/YouGov polling of healthcare workers and the general public, an IPPR consultation and a literature review. It shows that without further bold action in the days, weeks and months to come by the UK government and NHS England (and the NHS in the rest of the UK), the country’s health care workforce will face significant health, mental health and welfare challenges.


Clinical trial approved to help the NHS treat COVID-19 patients using plasma – Department of Health and Social Care
If effective, a national programme will deliver up to 10,000 units of plasma a week to the NHS to help treat coronavirus (COVID-19) patients.

  • A clinical trial has been given approval to determine if plasma donated by patients who have recovered from COVID-19 can help those battling the illness
  • If effective, a scaled-up national programme will deliver up to 10,000 units of convalescent plasma per week to the NHS
  • This would provide enough convalescent plasma to treat 5,000 patients each week

Ovarian cancer: recognition and initial management [CG122], NICE (Published 27th April)
This guidelinecovers detecting, diagnosing and treating women (18 years and older) who have, or are suspected of having, epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer or borderline ovarian cancer. It aims to enable earlier detection of ovarian cancer and improve initial treatment.


Update on the introduction of T Levels – NHS Employers 
The government has confirmed both T Levels and the T Level transition programme will still go ahead in 2020 and 2021.


Updates from HSJ 

  • Trust treating all BAME staff as ‘vulnerable and at risk’ A hospital trust is treating all its black, Asian and minority ethnic staff as “vulnerable and at risk” of coronavirus and is prioritising them for fitting of masks.
  • Trusts told it is ‘paramout’ to free up stroke beds for covid patients Stroke victims could be admitted to district general hospitals which do not normally provide such care if specialist units do not have the beds or staff as a result of the coronavirus pandemic.
  • Coronavirus deaths mapped: London recovering twice as fast as the Midlands HSJ’s unique analysis shows the spread of hospital deaths confirmed as coronavirus cases to date, by trust and area, as well as the regional growth trends.
  • Fears over vulnerable children after 50pc drop in referrals Vulnerable children have become “invisible” amid the coronavirus pandemic, leading clinicians have warned, following a dramatic reduction in referrals to child sexual assault services.
  • Network of army-operated mobile testing units launched The government has launched a “network” of mobile coronavirus testing units to boost access to testing for essential workers and the most vulnerable in society.
  • Coronavirus deaths mapped: North of England seeing most fatalities HSJ’s unique analysis shows the spread of hospital deaths confirmed as coronavirus cases to date, by trust and area, as well as the regional growth trends.
  • ‘Systematic reviews’ to discover true cause of outbreak deaths There should be detailed investigations to establish the different causes of deaths during the covid-19 pandemic, possibly in the autumn, pathologists have said.
  • ‘Unprecedented’ number of DNR orders for learning disabilities patients A learning disability care provider said it has received an “unprecedented” number of do not resuscitate forms from doctors that it believes to be illegal.
  • NHS England gearing up to restart routine care NHS England will next week set out a plan for “releasing and redeploying some of the treatment capacity” created to deal with coronavirus, now the healthcare impact of the peak of the virus has passed.
  • Widespread service suspensions will have ‘lasting impact’ The NHS has been warned of the “lasting impact” and worse outcomes likely to result from delaying cancer screening programmes amid the coronavirus pandemic.
  • Coronavirus deaths mapped: South east joins capital in steady decline HSJ’s unique analysis shows the spread of hospital deaths confirmed as coronavirus cases to date, by trust and area, as well as the regional growth trends.
  • NHS England gearing up to release coronavirus surge capacity NHS England will next week set out a plan for “releasing and redeploying some of the treatment capacity” created to deal with coronavirus, now the healthcare impact of the peak of the virus has passed.
  • NHS warned of ‘lasting impact’ of cancer test suspensions The NHS has been warned of the “lasting impact” and worse outcomes likely to result from delaying cancer screening programmes amid the coronavirus pandemic.
  • Exclusive: Hospital chiefs keen to restart operations as covid peak passes Several acute trust chief executives have told HSJ they are keen to resume more planned operations, as the peak of new coronavirus cases has passed and many hospital beds remain empty.
  • Radical relaxation of GP records and booking rules All NHS GPs will be able to access records of patients registered at other practices during the coronavirus pandemic, following a significant dropping of normal restrictions.

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