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Primary Care during COVID-19

The COVID-19 situation is rapidly changing and we recommend that GPs ensure they are receiving updates from their local CCG.

GPs can also review the current NHS guidance for primary care.

The AHSN Network also holds useful resources and information on Patient Safety in Primary Care during COVID-19.

As well as this, we have produced a RESTORE2 Poster for GP Practices.

COVID Oximetry @home and COVID virtual wards

The West of England AHSN is supporting the continued set-up of ‘COVID Oximetry @home’ and ‘COVID virtual wards ‘in our region. Our local support offer makes use of our existing expertise, infrastructure and resources.

Click here to find key information about ‘COVID Oximetry @home’ and ‘COVID virtual wards’, including relevant resources and webinars.

NEWS and NEWS2

NEWS and the updated NEWS2 (National Early Warning Score) was developed by the Royal College of Physicians and is a structured set of observations based on a simple aggregate scoring system acting as ‘track and trigger’ and a common language across settings.

Read more about the Royal College of Physicians and NEWS 

Watch an example of a patient story from our region where NEWS has been used to assess and trigger responses across patient pathways and ultimately improved outcomes for this patient.

Evidence is accumulating, such as the Scott et al finding, that the higher the NEWS the more likely a patient is to be admitted, the longer the length of stay and the more likely they are to die.

Concern has also been expressed that many people in the community will have a high NEWS due to underlying conditions. This has not been found to be the case. Barker et al case reviewed 19,604 NEWS from 2,424 older adults in 46 care homes over 30 month period; the median NEWS was 2, 66% had a NEWS of 2 or less and 28% had NEWS of 0.

National Early Warning Scores and component physiology in COVID-19 positive hospitalised patients in the West of England

In collaboration with ARC West, we’ve examined the impact of COVID-19 on NEWS2 across four acute hospital trusts. The study concluded NEWS2 is a reasonably good predictor of short-term mortality in this population, and the respiratory components are of the most value individually. These findings support the RCP’s recommendations to use NEWS2, alongside clinical judgement, in the assessment of COVID-19 patients. Read the NEWS pre-print study here. 

NEWS2 and COVID-19

NEWS2 is recommended by the Royal College of Physicians to risk assess patients with COVID-19 or possible COVID-19 in hospital.

However, the Royal College of GPs position on COVID-19 and NEWS is that there is no validated scoring system for COVID-19. The RCGP also recommends that while recording physiological measures may be helpful in supporting decision-making it should be used alongside wider clinical assessment and not replace clinical judgement. Further research has been recommended by Prof Trish Greenhalgh and colleagues from the University of Oxford Centre for Evidence Based Medicine (CEBM).

The reasons for the caution are partly because it is not recommended that patients be seen for a face to face assessment solely for NEWS2 to be calculated. In addition, severe COVID-19 may present with unpredictable physiological change such as ‘silent hypoxia’ when someone does not appear unduly short of breath or cyanosed but may have reduced oxygen saturation.

RESTORE2, incorporates NEWS2, and was developed before COVID-19, which seems to behave in ways not yet fully understood. However, the use of RESTORE2 provides a common language of communication with carers and enables the monitoring of physiological change and it is in this way that we recommend it is used. Find out more about this and our other training resources for care providers.

Further resources:

Care home resident and employee

Support, resources and training for care providers

We offer free training and resources for care providers - whether you’re in a nursing or residential home or providing domiciliary care.

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Learning Disabilities during COVID-19

If you work in a care home or organisation for people with Learning Disabilities review our free resources and training opportunities.

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Primary Care

At the West of England AHSN we are working on a wide range of initiatives to support primary care.

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Healthcare Innovation

Proactive Care Frameworks for long term conditions

Find out more about our work, and download implementation resources, to support people with long term conditions through use of UCLPartner's Proactive Care Frameworks.

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