8 April 2021

Coronavirus for commissioners

Government coronavirus (COVID-19) information -  

Cabinet Office 11 May 2020

COVID-19 contain framework: a guide for local decision-makers, DHSC Updated 18 March 2021
This framework sets out how national, regional and local partners should continue work with each other, the public, businesses, institutions (including schools, prisons, hospitals, care homes and homelessness settings) and other local system partners in their communities

Local authority powers to impose restrictions under coronavirus regulations
Supports the Health Protection (Coronavirus, Restrictions) (England) (No.3) Regulations 2020 that come into force on 18 July 2020n (see above)

Directions given to the National Health Service Commissioning Board, DHSC 23 March 2020 Updated 21 December 2020
  • These directions enable NHS England to exercise functions of CCGs, including commissioning healthcare from independent sector providers, to support the provision of services by the NHS to address the coronavirus (COVID-19) emergency. This power will last until 31 December 2020- extended to 31 March 2021.
Statutory guidance The Exercise of Commissioning Functions by the NHS Commissioning Board (Coronavirus) (No 2) Directions 2020 [18 August 2020]
  • These directions replace those published on 20 April and set out the exercise of functions for NHSE England to support the provision of services by the NHS to address the coronavirus (COVID-19) emergency. The power will last until 31 March 2021.
  • Direction given to the National Health Service and/or public health body. These directions enable the support and maintenance of cyber security of network and information systems held by or on behalf of the NHS or a public health body during the coronavirus (COVID-19) emergency. This power will last until 31 December 2020.
An announcement from the Secretary of State  will permit the following for NHS services:
  • The supply of schedule 2 and 3 CDs under a Serious Shortage Protocol (HMR Regulation 226A).
  • The emergency supply of Schedule 2 and 3 CDs during a pandemic (HMR Regulation 226).
  • The ability of a pharmacist to change the interval on an instalment prescription in consultation with the prescriber (HMR Regulation 15).
  • See Update on new legislation relating to controlled drugs during the COVID-19 pandemic, GPC 29 April 2020

Coronavirus Act reports
Two-monthly and yearly reports on which powers in the Coronavirus Act 2020 are currently active.

Coronavirus: Local authorities’ adult social care duties (the Care Act easements), House of Commons Library Briefing 6 May 2020. 

  • An overview of changes to local authority duties around the provision of adult social care during the coronavirus outbreak.
Coronavirus: health and social care key issues and sources, House of Commons Library Briefing paper updated 30 June 2020
  • An overview of key issues facing the NHS and social care services during the coronavirus (Covid-19) outbreak, and links to official UK and international guidance and data. It also lists other reliable sources of information in the health and social care sector, including comment from organisations representing patients, staff and service providers.

Contents:

  • Data
    • Sociodemographic differences in COVID-19 data
  • Legislation
  • Guidance/SOP for clinicians and NHS managers from NHSE/I
  • Information Governance/Corporate Governance Advice
  • Information for employers
  • Key Guidelines
  • Ethics and decision making
  • The Evidence
  • Digital Technology incl contact tracing
  • Testing
  • Recovery see here

Data

Coronavirus (COVID-19): notification to organisations to share information, DHSC updated 10 February 2021. Notification to healthcare organisations, GPs, local authorities and arm's length bodies that they should share information to support efforts against coronavirus (COVID-19). These notices have been extended 31 March 2021 to 30 September 2021.

Regular updates;

International data

Ad hoc reports:
Sociodemographic differences in COVID-19 impact

Coronavirus legislation

Guidance: Draft options for regional or local coronavirus interventions
DHSC 24 July 2020
Draft legislation options to show how government could respond to a local or regional coronavirus (COVID-19) outbreak without returning to a national lockdown.
Coronavirus Act 2020, Institute for Government
The Coronavirus Act 2020 received Royal Assent on 25 March 2020. 
The Act has three main aims:
  • to give further powers to the government to slow the spread of the virus
  • to reduce the resourcing and administrative burden on public bodies
  • to limit the impact of potential staffing shortages on the delivery of public services.
Bill documents — Coronavirus Act 2020
Care Act easements: guidance for local authorities, Guidance from DHSC (31 March 2020 updated 1 September 2020) which sets out how local authorities can use the new Care Act provisions, created under the Coronavirus Act 2020, to prioritise care and support for those who need it most. To be read alongside the COVID-19 Hospital Discharge Service Requirements.

Two-monthly reports on which powers in the Coronavirus Act 2020 are currently active.

Guidance: Coronavirus Act 2020: status table, DHSC 7 May 2020     
This table sets out the status of relaxation of provisions involving the healthcare sector during the coronavirus outbreak laid out in the Coronavirus Act 2020.. It covers the part of the act (Part 1) that facilitates legislative and regulatory changes that support the UK’s response to the COVID-19 outbreak and indicates 

Commentaries/guidance on the impact of the legislation: 

Guidance/SOP/Policy 

COVID-19 rapid guideline: managing COVID-19 [NG191], NICE: 23 March 2021. This guideline covers the management of COVID-19 for children, young people and adults in all care settings. It brings together existing recommendations on managing COVID-19 so that healthcare staff and those planning and delivering services can find and use them more easily. 

Guidance for Primary Care, Secondary care and Community care.
  • Guidance for Primary care includes prevention, infection control, diagnosis, management, discharge, isolation, travel advice, advice for general practice, community pharmacy, dental practice, optical settings and letters.

Second phase of NHS response to COVID-19 29 April 2020
Next steps on NHS response to COVID-19 17 March 2020 updated 7 July 2020

Coronavirus (COVID-19) advice for social care, SCIE
A collection of resources, including webinars, infection control guides, safeguarding guidance, MCA and COVID-19, autism and learning disabilities guides.

See also

NHS England will be holding a webinar every Thursday 5-6pm with up to date information on COVID-19 for GPs. Sign up to the GP and practice team bulletin to ensure you get the details. https://buff.ly/2ITQ76R

Information Governance/Corporate Governance Advice

Information for employers

Key Guidelines

Database of public health guidance on COVID-19 from across the world compiled by Health Information and Quality Authority. 

NICE have developed a series of guidelines and rapid reviews around COVID-19 . Some are listed below.
See the list of resources from Royal Colleges and other professional bodies on COVID-19 - compiled by the HEE Knowledge Management Team. Ongoing updates.

Ethics and decision making

The Evidence

Pregnancy and COVID-19: a systematic review of maternal, obstetric and neonatal outcomes, The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2020.1781809

Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID‐19 disease, Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD013665. DOI: 10.1002/14651858.CD013665. 7 July 2020
Covid-19: understanding inequalities in mental health during the pandemic,. Centre for Mental Health 18 June 2020. "the virus and the lockdown are putting greater pressure on groups and communities whose mental health was already poorer and more precarious"

 A Systematic Scoping Review of COVID-19 During Pregnancy and Childbirth Int J Gynaecol Obstet 24 Apr 2020  doi: 10.1002/ijgo.13182. COVID-19 infection during pregnancy probably has a clinical presentation and severity resembling that in non-pregnant adults. It is probably not associated with poor maternal or perinatal outcomes.

COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study [Preprint version 1; peer review: awaiting peer review]
Wellcome Open Res 2020, 5:75, 23 April 2020, An estimate Years of Life Lost (YLL) attributable to COVID-19, before and after adjustment for number/type of LTCs.

What conditions could we prioritise in the primary care setting to reduce non-COVID-related admissions to hospital? Oxford COVID-19 Evidence Service, 22 April 2020. This rapid review has established that targeted interventions for influenza, COPD, CHF, diabetes, UTI and cellulitis should be identified to support increased management in primary care settings.
Is ethnicity linked to incidence or outcomes of covid-19? Preliminary signals must be explored urgently [Editorial] BMJ 20 April 2020

COVID-19 in Nursing Homes
QJM: An International Journal of Medicine, hcaa136, 20 April 2020 
The problems of managing COVID-19 in nursing homes

COVID-19: background information DHSC updated 6 April 2020
Information on COVID-19 including epidemiology, virology and clinical features.

Coronavirus: the science explained by UK Research and Innovation
Coronavirus: the science explained lays out the evidence and the facts about the virus, the disease, the epidemic, and its control. This website will be regularly updated with the latest science information behind the coronavirus outbreak.

Scientific Advisory Group for Emergencies (SAGE)
Scientific and technical advice to support government decision makers during emergencies. 

Modelling the impact of Covid-19 on the NHS [live blog]
Edge Health (regular updates)
Includes Growth of Covid-19 cases, Potential impact on the NHS, Mitigating the growth and Protecting the vulnerable.

Finding the evidence: Coronavirus, PHE
The PHE Knowledge and Library Services Team has produced a page to help those, working on the current coronavirus outbreak, embed evidence-informed decision-making in their daily practice. Most of the resources are freely accessible but some may ask for an OpenAthens sign-in

The Evidence Relevant journal articles and resources available for free by various publishers and organisations.

Oxford COVID-19 Evidence Service, Centre for Evidence Based Medicine, Oxford
A series of research reviews on all areas of managing the COVID-19 pandemic, eg the evidence for hand disinfectant, use of NSAIDs, inhalers. New reviews being added all the time.

Cochrane Library:
LSHTM Viral - A global health podcast focusing on the science behind outbreaks and how we respond to them.

COVID-19 and triage/prognostic scoring systems for resource allocation: Rapid evidence review by Royal Marsden NHS Foundation Trust

Digital Technology (incl contact tracing)

NHS COVID-19 app: early adopter phase reports, DHSC 8 April 2021
The NHS COVID-19 app was trialled in the London Borough of Newham, the Isle of Wight (IoW) and among NHS Volunteer Responders. This trial period is referred to as the early adopter phase.

Dedicated app for social care workers launched, DHSC 6 May 2020.A new dedicated app for the adult social care workforce in England has been launched to support staff through the coronavirus (COVID-19) pandemic.

Digital exclusion GP map of England, Citizens Online 29 April 2020, The map shows GP surgeries with higher numbers of people aged 65 and older on their registers and GP surgeries with the lowest levels of digital engagement.

UK snubs Apple-Google coronavirus app API, insists on British control of data, promises to protect privacy, The Register [US] 28 April 2020

Digital contact tracing: protecting the NHS and saving lives, blogpost by Matthew Gould,  NHS X 24 April 2020 describing work on contact racing and security to be put in place.

Covid-19 and early intervention: Evidence, challenges and risks relating to virtual and digital delivery Early Intervention Foundation (EiF) April 2020. A rapid review of the evidence relating to the virtual and digital delivery of interventions for children and young people.

NHSX and NHS Digital launch GP Connect service  UK Authority, 24 April 2020. NHS Digital and NHSX have introduced a service named GP Connect for GPs to securely share patient records with each other during the Covid-19 pandemic.

Coronavirus: Apps to help the elderly, ORCHA. Tested apps that can offer support specifically for the elderly and vulnerable, including apps for managing COPD, medication reminders, mental wellness and general wellbeing.

Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science eabb6936 DOI: 10.1126/science.abb6936 (31 March 2020)
  • A team at Oxford University describe the mathematical modelling behind the mobile contact app tracer.
  • “A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people.”

Testing

Adherence to the test, trace and isolate system: results from a time series of 21 nationally representative surveys in the UK (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] study). medRxiv 18 September 2020.09.15.20191957; doi: https://doi.org/10.1101/2020.09.15.20191957
  • Only 48.9% of participants (95% CI 48.2% to 49.7%) surveyed March - August 2020 identified key symptoms of COVID-19.
  • Self-reported adherence to test, trace and isolate behaviours was low (self-isolation 18.2%, 95% CI 16.4% to 19.9%;
  • Non-adherence was associated with: men, younger age groups, having a dependent child in the household, lower socio-economic grade, greater hardship during the pandemic, and working in a key sector.
  • [This article is a preprint and has not been peer-reviewed. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.]
Coronavirus: Testing for Covid-19, House of Commons Library Research Briefing 14 October 2020. An overview of testing for Covid-19 in England. It covers the different types of test that are in use and in development, as well as testing capacity, the criteria for being tested, and the presentation of testing data..

NHS COVID-19 test and trace app launched 24 September 2020

NHS Test and Trace: the journey so far, Health Foundation 28 September 2020. What is NHSTT, the challenges, and what’s next.

Policy paper: Allocation of COVID-19 swab tests in England, DHSC 21 September 2020

Coronavirus (COVID-19): testing guidance for employers, DHSC 10 September 2020. Guidance for employers and third-party healthcare providers on the regulations and legal obligations of running testing programmes.

The policy sets out those who “we intend to test, as well as how and why we will test them.” Includes patients, care homes, NHS staff (“We therefore test NHS staff with symptoms as a priority, and test asymptomatically in outbreaks and in areas of higher prevalence.”)  

Guidance: Testing and contact tracing in the UK: summary of data, 13 August 2020. A summary of the data available on testing and contract tracing in the UK.
Guidance: NHS Test and Trace statistics (England): methodology updated 13 August

Coronavirus: Testing for Covid-19, House of Commons Research Briefing 5 August 2020
Coronavirus (COVID-19): getting tested. Guidance on coronavirus testing, including who is eligible for a test and how to get tested.

Guidance: Types and uses of coronavirus (COVID-19) tests, DHSC 14 July.
Information on:

  • the different types of coronavirus test
  • which type of test to use and when
  • what you should do when you receive a test result
  • testing in the future
Guidance: How tests and testing kits for coronavirus (COVID-19) work, MHRA 13 May 2020 with udpates.
  • Information for members of the public, patients, professionals and industry about COVID-19 tests and testing kits, including how they work, the different types of tests and the specifications manufacturers need to follow.  At 13 May 2020 there are no testing kits available in the UK for home use and it is illegal to supply tests for use by members of the public in the UK, though this may change.

Collection: MHRA guidance on coronavirus (COVID-19) MHRA 19 March 2020 with updates to include links to new guidance on how tests and testing kits for coronavirus (COVID-19) work. Collection includes all guidance related to medicines or devices and COVID-19 including official news releases around fake news.



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